Psoriasis

An overview of this inflammatory skin condition & its homeopathic treatment by Dr Andrea Wiessner

Psoriasis is an inflammatory skin con­dition that affects two to three  per cent of the population. It can appear at any age, but mostly between  the ages of 11 and 60. Psoriasis is an autoimmune disease, belonging to  a group of condi­tions where the immune system is over­active and  attacks its own cells and tissues. Normally skin cells are formed at the  bottom of the outer layer of our skin. The cells go through a cycle of  change, moving upwards through the layers to the surface of the skin  where they die and are shed within a period of three to four weeks. In  psoriasis this process is speeded up and cells can go through this cycle  within three to four days. This causes thickening of the skin and its  characteristic scaly appearance. Psoriasis affects mainly the skin and  nails, but in six per cent of cases it is accompanied by inflammation of  joints, affecting mainly fingers, toes and the spine and is called  psoriatic arthritis.

The word psoriasis is derived from the Greek word psora, meaning  itch, although in most cases the affected skin is not particularly  itchy. But some patients do experience a lot of itching and sometimes  the eruptions can be sore and painful, in particular when there are  cracks present. Psoriasis can affect the whole body, including the  scalp, but the face is often spared. There are different types  ­psoriasis vulgaris, plaque psoriasis, appears in big patches of  thickened skin usually with white/silvery scales on the elbows and  knees, but also other parts of the body. When one finds lots of small  scaly spots and patches the condition is called psoriasis guttate. This  form often affects children and is frequently triggered by streptococcal  throat infections and often disappears by itself within a few weeks or  months. Psoriasis pustulosa, usually presents with little yellow  pustules and affects the palms of the hands and soles of feet.

In up to 50 per cent of psoriasis patients, nails can also be  affected. One can see small indentures in the nails or circular  discolorations under the nails. In more severe cases the nails can  thicken and separate from the underlying nail bed.

The causes of psoriasis are still not entirely clear, although in 30  per cent of patients there is a family history of the condition. Certain  factors can trig­ger the onset of the skin eruptions including  streptococcal throat infections, particular medicines and injury to the  skin, and emotional factors, such as stress or situations of trauma,  shock and bereavement. Those trigger factors can be important for the  homeopathic practitioner as it might indicate which remedy might be  appropriate for that particular person.

Due to its appearance, psoriasis can profoundly affect an individual,  as people unfamiliar with the condition might think it is contagious.  The suffer­er may also have to endure adverse comments from others about  their appearance, which can affect his or her quality of life  immensely.

Conventional treatment

There is a selection of conventional treatments on offer, starting  with topical treatments, then phototherapy (light treatment) and then  stronger, oral treat­ments. Topical treatments vary from simple  emollients to moisturise the skin and alleviate itching, to salicylic  acid­based creams, topical steroid creams of varying strength and tar  preparations. Treatment with various forms of ultra­violet light is also  used, sometimes in combination with a medicine called Psoralen.

Many patients themselves notice the beneficial effect on their skin  of ultra­violet light when their psoriasis improves with exposure to  sunlight in the summer months. For severe psoriasis, oral medic­ation  can be used, often in addition to topical treatment. However, they can  have side­effects. Also, most oral treatments are contraindicated during  pregnancy.

Homeopathic treatment

Many patients I see have already tried one or more forms of  conventional treat­ment. Those have mostly been helpful and often  cleared the skin eruptions. However, the effect has usually been only  temporary and at some stage the psoriasis has come back. Some patients  are, therefore, looking for a more permanent “cure” for their condition,  while others would simply like to reduce their use of steroid creams or  other con­ventional treatments.

From the homeopathic point of view we can approach treatment in  different ways. We can treat the person as a whole and try to find a  constitutional remedy with the aim of strengthening the organ­ism  generally. This means looking at not only the patient’s psoriasis  symptoms, but also his or her general health and way of reacting to the  environment, as well as what drives him or her on an emotional level.  But homeopaths can also treat symptomatically, meaning treating the  psoriasis symptoms specifically. I usually aim for constitutional  treatment but sometimes combine the two approaches, giving a more  symptomatic skin remedy for flare­ups, while treating the person as a  whole with a constitutional remedy.

Overall we often have good results with the treatment of psoriasis.  However, I have seen in some of my patients that their general health as  well as emotional well­being has improved but not the appearance of  their psoriasis. Occasion­ally, I also see that the itch or soreness  improves considerably but not so much the appearance. Or that the  appearance is only slightly better but that the psoriasis does not  affect them as much anymore, making it possible to get on with life.  Although not the desired out­come, this obviously can have quite a  positive impact on one’s life.

Choice of homeopathic medicine

In choosing which homeopathic remedy to use, we consider various  factors. It can be extremely helpful to know if something might have  triggered the onset of symptoms. If the psoriasis has been triggered by  bereavement, for instance, this might guide us to particular grief  remedies, although a variety of other factors or symptoms need to be  present too to give such a remedy. It is also important for a  homeopathic practitioner to understand what was the exact reaction to  such an event, as everyone has their own particular way of experiencing  and dealing with such traumas. If the patient still seems to be in deep  grief and their reaction is to try to deal with their pain by  themselves, withdrawing from others, we might think of Natrum  muriaticum. This could be confirmed if the psoriasis eruptions are  located on the scalp at the margin of the hair, and if the eruptions are  worse in the sun, which is not typical for psoriasis and, therefore, is  an individual symptom of the patient.

The location of the patches can be useful for the choice of medicine.  As mentioned before if eruptions are at the margin of the hair one  might think of Natrum muriaticum. If the eruptions are behind the ears  and in the folds of skin and possibly around the genitals, one might  consider Graphites. In pustular psoriasis, affecting the palms and soles  of feet, Phosphorus can be a good remedy, or Arsenicum album or  Arsen­icum iodatum. The latter two might also be useful if the eruptions  cause a lot of itching, or a burning sensation.

Factors that aggravate or ameliorate a sufferer’s condition are  important to know, especially if they are atypical for the condition, as  this indicates an indi­vidual mode of expression particular to the  affected person.

Debbi's story

55 year old Debbi was referred to me for treatment of her psoriasis. It was the third outbreak in her life. Initially it appeared  at the age of 29 when she was in the middle of her divorce. She  had tar treatment at the time as well as PUVA (light treatment). This  settled things. Her psoriasis came back after the death of her 4 year­old son. He was hit by a car and his death left Debbi in a  state of shock. Her psoriasis had never cleared up completely since.

This recent outbreak started after an argument with  her 16 year­ old daughter who had been diagnosed with a psychotic episode  and an eating disorder. She had been treated at a rehab clinic and had  just been dis­charged. Debbi wanted to find out what her daughter’s  plans were, when her daughter became very angry. As Debbi felt she  wanted to connect with her she tried to stand her ground. Her daugh­ter  started to throw furniture and objects at her and Debbi backed down and left the room.

She was terrified and shocked. She felt astonished that her daughter  was so violent. It left her feeling numb, confused and disempowered. The  following day her psoriasis broke out, mainly on her back and legs. She  had some Chinese medicine which improved things temporarily. But then  it returned and when I saw her she had spots all over which were very  itchy and, there­fore, interrupting her sleep. Her inner thighs felt  very sore. She was using aqueous cream as an emollient and a herb,  mahonia aquifolium.

In general Debbi’s health is good. She had an episode of depression  after the death of her parents who died within a year of each other.  Otherwise she has been well and there was no family history of  psoriasis. One of the main issues that came out during the consult­ation  was that she felt she had been cheated constantly in her life. She said  that she allows people to cheat her then gets angry but turns it in on  herself and sits on it. She also couldn’t understand that her daughter  would run off, drink and take drugs when Debbi’s parents died when they  could have grieved together. “Why would she do this after I had looked  after her and supported her?”

As there was a history of shock and deep­seated grief in her story, I  did consider homeopathic remedies for shock and grief. Debbi’s sense of  injustice about how her daughter behaved, her sense of indignation and  her way of letting others cheat her and suppressing her anger made me  consider the remedy Staphysagria. Interestingly her daughter threw  objects and furniture in her anger which is a typical Staphysagria  symptom. Staphysagria is also a good remedy when emotional suppression,  or grief, result in a persistent psoriasis.

However, as the state of shock she was in after the death of her son  preceded everything and there were still elements of shock tangible in  the way she experienced events, I started with Aconite. This is one of  our big shock remedies and Debbi noticed that her pso­riasis improved  after that. We soon started with Staphysagria in an LM potency on a  daily base and when I saw her after three months her psoriasis was much  better. There had been a slow but gradual improvement, her skin was the  best it had been since the first outbreak of her psoriasis. The itching  pretty much stopped although she noticed that it came back when she  missed her daily dose of Staphysagria.

She told me that when she started the treatment a lot of emotions  came up. She realised that she had often been a victim in the past. She  slept reason­ably well but occasionally woke up at 6am in a rage. The  theme of being a victim and having to make choices not to give away  power came up in her dreams, too. As things had been going well we  continued with Staphysagria LM 6.

When I saw her again three months later things were still going well.  Although she had been under a lot of stress – not only with her  daughter but also having lost her job – her psoriasis was 80 per cent  better than the year before, even though it was winter time. She also  told me at that stage that she had been dreaming about people who had  treated her badly in the past. They were lovely to her, offering her  cups of tea. She felt herself that this indicated a process of letting  go and felt this might be healing.

When she came back three months later, she was having lots of  problems with her daughter again. Her daughter had stopped her therapy,  was taking drugs again and had taken an overdose of paracetamol and was  back in rehab. Debbi felt numb and in a state of shock again and had  developed panic attacks. Her skin had been variable but overall quite  stable. As the shock was in the foreground again and because of the  panic attacks, I gave another dose of Aconite 200c followed, after three  weeks, by Staphisagria LM 12 daily.

She has been doing extremely well since. Her skin has improved and  the panic attacks have become less frequent. Even though there is still a  lot of stress with her daughter, she is able to deal with it and feels  pleased with her overall progress. Speaking to her during the heat wave  at the beginning of June 2009, she was happy to be wearing dresses for  the first time in years!

Interestingly, both Aconite and Staphisagria belong to the same  botanic family, ranunculaceae. Common issues of this family are great  sensitivity, ailments from grief or shock, irritability as well as  stitching and stabbing sensations. Aconite might be more appropriate  where there are acute reactions and symptoms and a state of shock or  panic, and Staphisagria where suppression and control are the main  coping mechanisms.

Georgia's story

Four year old Georgia was referred to my children’s clinic. She had developed small spots of psoriasis on her chest when she  was three years old. Later she developed crusty eruptions on her scalp  and more spots on her arms, in particular the elbows, as well as her  knees and back. If she fell and broke the skin, new spots would develop.  She had had a bad throat and ear infection a few months before the  onset and had also started nursery one month prior to the outbreak.  However, she had settled in well at nursery. She also had a history of  glue ear and one nose bleed.

When I saw her Georgia had thick, yellow crusty patches of psoriasis  on her scalp and disseminated small psoriasis spots on her chest,  abdomen, arms and the extensors of her knees. She was a bright and  delightful little girl, easy to get in contact with. In view of her  general symptoms, such as her thirst for cold water, her love for fish  and salty food, the history of a nose bleed and her imaginative,  enthusiastic and sociable nature as well as her fears, I prescribed  Phosphorus 200c in a single dose. She developed a few more spots on her  lower back initially but then her psoriasis gradually cleared up.

She had one episode of tonsillitis and chest infection which required  antibiotic treatment but was overall doing fine until she developed itchy eruptions on her body and also  started grinding her teeth. She had had two episodes of head lice and an  episode of vaginal thrush and was a bit more stroppy. Phosphorus had no  effect at that stage.

Over the next six months she had two doses of Medorrhinum which kept  her psoriasis at bay. The symptoms returned folllowing a tonsillectomy. One dose of  Tuberculinum 200c cleared every­thing. Tuberculinum is a  remedy that is related to Phosphorus. Both remedies often complement  each other in their action.

Georgia was re­referred to me again at the age of eight, after  her psoriasis came back on her scalp. She also had molluscum  contagiosum on her arms and legs and a few nose bleeds. Follow­ing  another dose of Tuberculinum her scalp cleared but the molluscum  persisted until I saw her last. She had also had a few  more nose bleeds, so I prescribed Phosphorus again which I think is her  constitutional remedy. I would expect that this will clear the molluscum  and would keep her well.

In my view homeopathy definitely has something to offer in the  treatment of psoriasis. We can often help with the appearance as well as  the experience of psoriasis. And in some instances we can see healing  and transformation on a deep level which comprises improvement of the  psoriasis as well as healing on an emotional and more general level. If  this happens I never fail to marvel at nature’s ability to bring about  healing as well as our patients’ courage to embrace it.

Andrea Wiessner MD MFHom RCST trained as a GP but now practises homeopathy full­time.