Psoriasis
Introduction
Psoriasis is a chronic inflammatory disease in which the skin has been particularly affected. Characteristic are sharply limited red spots that are often covered with silvery or white flakes. The symptoms can be quiet for a long time and then flare up again. Itching, burning or painful sensation, gaps and visible skin defects can affect sleep, choice of clothing, social activities and quality of life.
Psoriasis can take various forms. Plaque psoriasis is the most common, but psoriasis can also occur in skin folds, scalp, nails or joints. In psoriatic arthritis, joint complaints occur as well as skin problems.
Acupuncture and Chinese herbal medicine are tailored to the form and phase of psoriasis within Chinese medicine as well as to the underlying TCM pattern.
Common symptoms
The grievance image differs by form and phase of psoriasis. Common features are:
- red, clearly bound areas on the skin;
- white or silvery scaling;
- dry or cracked skin;
- itching, irritation or burning sensation;
- thickening of the skin in long-term areas;
- nail defects;
- periods in which the skin is relatively quiet, alternated with flares.
In psoriatic arthritis, painful, stiff or swollen joints may also occur.
Possible causes
From Western medicine, psoriasis is considered an immune-mediated inflammatory disease in which genetic predisposition plays an important role. Several factors can provoke or exacerbate a flare. Examples include infections, skin damage or irritation, certain medicines and psychological stress.
In Chinese medicine, such as constitutional predisposition, emotional stress, nutrition and external disease factors are described. According to the TCM, these can contribute to the emergence of Wind, Heat, Dampness, Dryness, and Blood disturbances. Whatever mechanism is in the foreground may change during the course of psoriasis.
How can acupuncture help with psoriasis?
Acupuncture treatment is not only tailored to the visible skin defects. It also looks at itching, warmth or dryness of the skin, the location of psoriasis, the course of flares and other physical symptoms.
Depending on your symptoms, treatment may be directed at:
- reduce redness, heat and irritation of the skin;
- help to reduce itching;
- support dry and scaly skin;
- help to calm the skin during flares;
- treat any joint complaints in psoriasis;
- factors such as stress, sleep or indigestion include when these are part of the overall symptoms picture.
Which points are used depends on the TCM pattern and may change when the psoriasis comes into another phase.
How can Chinese herbal medicine help with psoriasis?
Chinese herbs play an important role in the treatment of skin diseases within the TCM. Also, no standard formula for psoriasis is used. For example, a red, rapidly expanding psoriasis is treated differently from long-term psoriasis with thick, dry and highly scaly spots.
Depending on the complaint image, Chinese herbal medicine can be used to:
- reduce active redness and warmth of the skin;
- reduce itching and irritation;
- support dry and highly scaly skin;
- treat persistent, thickened skin abnormalities;
- treat moist skin defects in skin folds;
- adjust treatment when the character of psoriasis changes.
Herbs can be used daily between treatments. The composition can be adapted to changes in the skin during the course of treatment and the overall symptoms.
TCM vision for psoriasis
In Chinese medicine, psoriasis is not considered as one uniform disease. Two people may have the same Western diagnosis psoriasis, while the skin looks different and other symptoms are present.
In particular Blood plays an important role in the TCM description of psoriasis. Blood within the TCM is a broader concept than only blood as anatomically referred to. It relates, among other things, to the feeding and moistening of tissues and skin.
In active psoriasis, Heat in the Blood may be at the forefront. In long-term psoriasis, the skin can become insufficiently nourished and moisturized, creating Blood Dryness. In very persistent psoriasis, Qi and Blood's circulation may become increasingly impaired and Blood stasis develops.
Wind, Dampness and Heat can also play a role. Whatever combination is present, is assessed by the colour, thickness, humidity and scaling of the spots, itching, speed at which new spots occur and other physical symptoms.
What is a TCM organ system?
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are the most common patterns discussed first. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns
Wind-Heat
Brief explanation
Wind-Heat is mainly described in an early or active phase of psoriasis. Wind refers, among other things, to complaints that develop, change or expand relatively quickly within the TCM. Heat is reflected in the redness and inflammatory characteristics of the skin.
Common symptoms
- relatively recent psoriasis;
- red spots that can spread quickly;
- many new minor skin abnormalities;
- itching;
- redness and warmth of skin;
- sometimes general heat phenomena.
Blood-Heat
Brief explanation
Blood Heat has a clearly active and red skin in the foreground. According to the TCM, the Heat is deeper than with a superficial Wind-Hitte image and affects the Blood and thus the skin.
Common symptoms
- clear to deep-prode psoriasis spots;
- continuous emergence of new places;
- rapid expansion of existing sites;
- clear redness;
- itching;
- a warm feeling;
- possible thirst, restlessness or other heat symptoms.
Blood-Dryness
Brief explanation
Blood Dryness is mainly seen when psoriasis exists longer and is less active. According to the TCM, the skin is not sufficiently nourished and moisturized. As a result, dryness and flaking become more prominent.
Common symptoms
- dry psoriasis spots;
- Many white or silvery flakes;
- paler red or pink spots;
- relatively few new skin abnormalities;
- dry skin;
- itching associated with dryness;
- a chronic or relatively stable course.
Blood stasis
Brief explanation
In the case of long-term psoriasis, according to the TCM, free circulation of Qi and Blood can become increasingly impaired. Blood stasis is created. This pattern is especially suitable for old, persistent spots that remain in the same place for a long time.
Common symptoms
- long-term psoriasis;
- thick and infiltrated plaques;
- dark red, dull red or purple-like discoloration;
- places that are difficult to disappear;
- clear limitation;
- thickening of skin;
- sometimes pain or a stabbing nature of additional symptoms.
Damp-Heat
Brief explanation
Dampness-Heat gives a different skin image than the typical dry and highly scaly plaque psoriasis. Dampness has a relationship with humidity and a slightly heavier or stickier character within the TCM, while Heat causes redness and irritation.
Common symptoms
- red psoriasis spots;
- relatively humid skin defects;
- less pronounced flaking;
- itching or irritation;
- spots particularly in skin folds;
- possible other signs of Dampness and Heat.
Less common and specific TCM patterns
In certain forms, phases or circumstances other TCM patterns may occur. Some are less general or are particularly described in a specific form of psoriasis.
Disharmony of Chong Mai and Ren Mai
Brief explanation
Chong Mai and Ren Mai are two particular meridians closely associated with reproduction, menstrual periods and hormonal stages of life within the TCM. This pattern is described when psoriasis is clearly changing under the influence of hormonal conditions.
Common symptoms
- psoriasis worsening around menstruation;
- change in psoriasis during pregnancy;
- flare or change after birth;
- In addition, menstrual or other gynaecological symptoms may be present.
Blood-Dryness due to damage of Yin
Brief explanation
In the case of long-term psoriasis, both Blood and Yin can become inadequate. Yin has a nourishing, moisturizing and cooling function among other things. In addition to very dry skin, an image of internal Dryness and relative Heat can be created.
Common symptoms
- long-term dry psoriasis;
- high scaling;
- skin that easily cracks or forms gaps;
- dry mouth or throat;
- thirst;
- dry stools or constipation;
- warmth, especially later in the day or at night.
Wind-Dampness obstructing the collaterals
Brief explanation
This pattern is particularly relevant when psoriasis is associated with joint complaints. Wind and Dampness, according to the TCM, hinder circulation through the meridians and smaller network vessels around the joints.
Common symptoms
- psoriasis with painful joints;
- swelling;
- stiffness;
- movement limitation;
- complaints that may change location or intensity;
- skin abnormalities in addition to joint complaints.
Liver- and Kidney-deficiency
Brief explanation
This is mainly a more chronic emptiness. Within the TCM, Liver and Kidneys feed tendons, bones and joints. In case of long-term illness these functions may weaken according to the TCM.
Common symptoms
- prolonged or frequently recurrent psoriasis;
- chronic joint pain and stiffness;
- increasing restriction of movement;
- weakness or lower back and knee pain;
- in the event of a more severe movement, deformation of affected joints;
- other signs of chronic emptiness.
Toxic Heat with Dampness(-Heat)
Brief explanation
This is not a typical pattern of ordinary plaque psoriasis, but a severe Hitte image that is mainly described in pustular psoriasis. The skin reaction is much more intense and may be associated with general illness symptoms.
Common symptoms
- very red, inflamed skin
- rapidly expanding skin abnormalities;
- many small pustules;
- burning or pain;
- fever;
- thirsty;
- restlessness or irritability;
- sometimes painful and swollen joints.
Outlook
Psoriasis usually has a chronic and varying course. How the symptoms react depends, among other things, on the form of psoriasis, its duration and severity, the extent of skin abnormalities, possible triggering factors and the underlying TCM pattern.
An active red phase requires a different approach within the TCM than long-term, dry and thickened plaques. Also, the pattern may change during a treatment pathway. In chronic and persistent psoriasis, a longer treatment pathway is usually required than in relatively recent or limited complaints.
As a guideline, acupuncture can be treated once a week in the initial phase. In case of pronounced active complaints, a higher treatment frequency may temporarily be appropriate. If the skin becomes more stable, the frequency can be reduced. Chinese herbs can be used daily between treatments when appropriate.
Medical safety
Psoriasis may include more than just the skin. New persistent pain, swelling or stiffness of joints deserves medical assessment because this can fit in with psoriatic arthritis. Early recognition is important to avoid joint damage as much as possible.
Contact a doctor quickly if there is a sudden strong spread of psoriasis over large areas of the body, extensive redness, lots of pustules, fever or feeling clearly ill. Severe pustular or erythrodermic psoriasis may require emergency medical care.
If you are taking medicines for psoriasis, do not change or stop them on your own. Discuss changes with your treating doctor.
Contact
Do you have psoriasis and want to know if acupuncture and/or Chinese herbal medicine can fit your symptoms? During a first consultation we discuss among others the course of psoriasis, the shape and location of skin abnormalities, itching and flaking, possible trigger factors, possible joint complaints and other relevant symptoms.
On the basis of the overall complaint picture, it is considered which TCM pattern is likely to be at the forefront and which treatment fits in with it.