CAM for Psoriasis: Evidence-Based Approaches for Clinicians
Complementary and alternative medicine (CAM) approaches are commonly used by patients with psoriasis, but are they safe and effective? A review in the American Journal of Clinical Dermatology looks at data from clinical trials on psoriasis and CAM, including traditional Chinese medicine (TCM), herbal therapies, dietary supplements, climatotherapy, and mind/body interventions.
Use of TCM with traditional therapies is supported by mounting evidence from controlled trials that this combination can be more effective for treating psoriasis than traditional therapy alone. The CAM strategies with the greatest evidence of efficacy include Mahonia aquifolium and indigo naturalis, while aloe vera, neem, and extracts of sweet whey have less supporting evidence of their efficacy. There has also been consistent evidence of the efficacy of fish oil supplements, but not for zinc. Limited but conflicting results have been published on vitamin D, vitamin B12, and selenium supplementation. Climatotherapy at the Dead Sea, while not feasible for most patients, has much support as an effective treatment for psoriasis. Lastly, mindfulness-based stress reduction can assist as as adjuvant treatment.
Potential risks with CAM include contamination of TCM products with heavy metals or corticosteroids, systemic toxicity or contact dermatitis from herbal supplements, and ultraviolet light-induced carcinomas from climatotherapy. Clinicians should consider the risks and benefits of CAM as an adjuvant treatment to traditional therapy and discuss this with their patients.