Which Alternative Therapies are Effective for Psoriasis?
A recent review on complementary and alternative medicine interventions for psoriasis found strong evidence supporting the use of topical indigo naturalis and curcumin, among others, for improving psoriasis symptoms.
“Complementary and alternative medicine treatments are gaining popularity, and this review will serve as a comprehensive resource for practitioners treating patients with psoriasis,” the researchers said. While approximately 51% of patients with psoriasis have reported the use of complementary and alternative medicine as a part of their treatment regimen, it is unclear which therapies effectively improve symptoms.
In the review, the researchers identified all articles on complementary and alternative medicine interventions for psoriasis on PubMed, EMbase and ClinicalTrials.gov. They excluded therapies that did not have more than 1 randomized control trial or showed consistent lack of efficacy. The review included a total of 44 randomized controlled trials, 10 uncontrolled trials, 2 open-label nonrandomized controlled trials, 1 prospective controlled trial, and 3 meta-analyses.
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Five randomized controlled trials, which included 215 participants, demonstrated that topical indigo naturalis significantly improved psoriasis compared with placebo. Curcumin also showed statistically and clinically significant improvements in psoriasis plaques in 3 randomized controlled trials (N=118), 1 nonrandomized controlled study, and 1 uncontrolled study.
However, the efficacy of fish oil remains unclear. Twenty studies evaluated fish oil, 12 randomized controlled trials, 1 open-label nonrandomized controlled trial, and 7 uncontrolled studies. While most of the uncontrolled studies showed beneficial effects of fish oil when used daily, the majority of randomized controlled trials did not show significant improvements in psoriasis.
In addition, meditation and guided imagery therapies, assessed in 3 single-blind randomized controlled trials (N=112), showed modest efficacy. Acupuncture was associated with significant improvements in psoriasis compared with placebo in 1 meta-analysis of 13 randomized controlled trials.
“The [complementary and alternative medicine] therapies with the most robust evidence of efficacy for treatment of psoriasis are indigo naturalis, curcumin, dietary modification, fish oil, meditation, and acupuncture,” the researchers concluded.
Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ. Complementary and alternative medicine therapies for psoriasis: a systematic review [published online September 5, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.2972