Psoriasis: a wholistic approach to recovery

Psoriasis is a quite common but complex chronic, relapsing skin condition linked to increased inflammation and overactive immune system. Some say it’s one of the most difficult conditions to improve either from conventional or naturopathic viewpoints.

I find that to make a significant difference and achieve good clinical results, psoriasis must always be addressed on many levels, including emotional and nervous system support. It always gives me such great satisfaction to be able to help clients to achieve a long-term remission or a complete resolution of symptoms. As well as witnessing the many positive changes in their lives such as the renewed confidence, self-assurance facing the world and generally getting their mojo back!

Therefore, I’d like to share my clinical insights and hope you’ll find them helpful to learn about my therapeutic approach when working with clients affected by psoriasis. I have also included a clinical case study outlining specific steps and therapies applied.

Psoriasis: symptoms and types

It’s estimated that between 1% and 5% of the world population are affected by psoriasis. In Australia over 1.6 million people live with this condition. Psoriasis can occur at any age; however, the disorder tends to occur around adolescence (16-22 years, usually more severe type linked to genetics) and later in life (57-60 years, less severe type).

Psoriasis is quite a common, multi-system, inflammatory disease that primarily affects the skin but also have metabolic, cardiovascular and immune manifestations. The disease causes speeding up the life cycle of skin cells and causes them to build up rapidly on the surface of the skin. This pile up of skin cells that replicated too rapidly (up to 1000 times more than normal) gets too large and can’t shed at the same rate, causing the silvery scales to accumulate.

The extra skin cells form scales and red patches that are itchy and sometimes painful. The areas most commonly affected are the scalp, elbows and knees, but psoriasis can occur anywhere on the body.

Psoriasis signs and symptoms are different for everyone; however, common signs and symptoms include:

• Red patches of skin covered with thick, silvery scales
• Dry, cracked skin that may bleed
• Itching, burning or soreness
• Small scaling spots (commonly seen in children)
• Thickened, pitted or ridged nails
• Swollen and stiff joints

Psoriasis has many subtypes and each manifests with specific signs and symptoms. Most types of psoriasis go through cycles: flair-ups for a few weeks or months, then subsiding for a time or even going into complete remission. So, it’s a chronic disease that often comes and goes.

There are several types of psoriasis:

• Plaque psoriasis – the most common form, plaque psoriasis causes dry, raised, red skin lesions (plaques) covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on the body.
• Nail psoriasis – psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth, poor quality nails and discolouration. The nails might loosen and separate from the nail bed.
• Guttate psoriasis – this type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It manifests as small, water-drop-shaped, scaling lesions on the trunk, arms, legs and scalp. The lesions are covered by a fine scale and aren’t as thick as typical plaques are. There may be a single outbreak that goes away on its own, or repeated episodes.
• Inverse psoriasis – this type mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis manifests as smooth patches of red, inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
• Pustular psoriasis – this uncommon form of psoriasis can occur in widespread patches or in smaller areas on the hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after the skin becomes red and tender. The blisters may come and go frequently. Generalised pustular psoriasis can also cause fever, chills, severe itching and diarrhoea.
• Erythrodermic psoriasis – the least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It’s a dermatological emergency presenting as malaise, extensive and severe erythema (redness of the skin), exfoliation and reduced skin function.
• Psoriatic arthritis – in addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or, at times, only nail changes are seen. Symptoms range from mild to severe and psoriatic arthritis can affect any joint. Although the disease usually isn’t as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.

Causes of psoriasis

The causes of psoriasis remain uncertain and can be different for each person. However, it’s generally regarded as having metabolic and/or immune system imbalances affecting the entire body, not just skin.

Nowadays, many researchers consider psoriasis as an autoimmune condition where the overactive immune system launches a strong inflammatory response towards the skin (own tissue), in the same way as when dealing with infections caused by foreign organisms such as bacteria or virus.

Although causes of psoriasis can be unclear, there definitely are known contributing factors including:

• A genetic predisposition – a number of genes are associated with different types of psoriasis, and it often runs in families.
• Defects in cellular proliferation with cellular defects that increase the skin’s susceptibility to chronic plaque formation. The rate at which cell division occurs is controlled by a balance between two compounds: cAMP (enhanced cell maturation) and cyclic guanosine monophosphate (cGMP) (cell proliferation). In psoriasis, cAMP is decreased and cGMP is increased, causing excessive cell proliferation and inflammation.
• Digestive factors such as:
  • Impaired gut detox especially of endotoxins produced by harmful bacteria in the gut, yeast compounds (Candida) and immune complexes ^[1]present in the blood. These compounds significantly contribute to increasing the rate of skin cells proliferation. Clinical severity and therapeutic response have been shown to correlate with the level of circulating endotoxins, indicating that gut-derived toxins play a key role in the pathophysiology of psoriasis. Therefore, every effort should be made to promote effective binding and elimination of these toxins (more on this below).
  • Incomplete protein digestion and/or absorption – if protein breakdown in the gut is impaired, proteins are metabolised by bowel bacteria into toxic compounds called polyamines, and their levels have been shown to be increased in individuals with psoriasis. They contribute to speeding up of cell proliferation. The best way to prevent the excessive formation of polyamines is to improve overall digestive function and correct leaky gut (increased gut permeability) ^[2]. Severe psoriasis can lead to nutrient depletion especially of protein, folate, iron and omega 3 fats.
  • Microbiome imbalances – these need to be investigated and corrected using nutrition, probiotics and prebiotics. Eating organic foods is very important as they don’t contain the pesticide Roundup which has detrimental impact on the gut (causing leaky gut), the kidneys, it can also cross the blood/brain barrier. Read about natural methods of removing Roundup from the bod y in my post. ^[3]
  • Abnormal liver function – correcting abnormal liver function is of key importance in the treatment of psoriasis. When the liver is overwhelmed by excessive levels of toxins coming from the gut or if there is a decrease in the liver’s detox capacity, the toxin level in the blood increase and the psoriasis gets worse.
• Nutrient deficiencies – such as selenium, vitamin A ^[4] and E, vitamin D ^[5], omega 3 fatty acids (among others), have been found in psoriasis patients, indicating poor free radical scavenging, which potentiate the inflammatory aspects of the condition.
• Alcohol, smoking, coffee ^[6] – can also make certain types of psoriasis worse. Alcohol consumption is known to significantly worsen psoriasis. It significantly impairs liver function and increases the absorption of toxins from the gut. All types of alcohol must be eliminated by individuals who suffer from psoriasis.
• Sunburn and skin injury – accidents or operations where the skin is damaged can create an opening to getting a skin infection, which then can initiate an initial psoriasis occurrence or flare-up.
• Gluten and dairy consumption – identification and elimination of food triggers is key. Removing gluten and diary is important, even if food intolerance tests are negative. Gluten is inflammatory to the gut and can exacerbate leaky gut thus triggering the immune system, resulting in autoimmune attack towards the skin.
• Viral and/or bacterial infections – such as strep throat, Staphylococcal, other bacterial infections result in bacteria releasing toxins to the blood that circulate systemically and activate the immune system causing considerable flare-ups.
• Certain medications – some drugs can either drive the disease or initiate first-time flair-up. For example, mood-stabilising drug like lithium can initiate a flare-up. Blood pressure medications are also known to cause flair-ups, especially beta blockers. Also, nonsteroidal anti-inflammatory drugs (NSAIDs) taken for joint pain and swelling can be implicated.
• Emotional stress – is an exacerbating factor as having such a visible skin condition can be very stressful. Also, acute stress can initiate the first-time flare of psoriasis. Chronic stress ^[7] on the other hand flares it up or exacerbates the condition.

My holistic therapeutic approach

A holistic therapeutic approach includes taking into account both the physical and emotional aspects of the condition throughout treatment. This approach differs significantly from conventional psoriasis treatment which primarily relies on short-term symptom relief using drugs and topicals that, at best, only mask symptoms.

The focus here is on identifying and resolving the cause(s) or triggers, where possible (genetic factors can’t be changed but they can be minimised in many cases); or to reduce the frequency and/or severity of flair-ups, as well as help with prevention.

Skin inflammation and changes are symptoms not causes of psoriasis. Therefore any therapies and remedies must focus on supporting the whole body, and in particular all the detox organs i.e. the gut, the liver, lymphatic system, the kidneys, the lungs, aiming to cleanse and support them as treatment progresses.

Needless to say, any therapeutic intervention needs to be personalised depending on presentation, client’s circumstances and the environment. For example, if a person has plaque psoriasis which is dry and flaky, it needs to be addressed in a different way than pustular psoriasis which is weepy and wet. It’s simply not possible to get good results with the same, generic topical cream or lotion for psoriasis, prescribed regardless of presentation. No wonder this often doesn’t work.

Although there is no known 100% cure for psoriasis and the condition is characterised by chronic systemic inflammation, impaired gut and immune functions; some people can recover if the cause of their psoriasis is established and can be corrected. This is the key to any permanent recovery.

Therefore, targeted testing is of significant importance to pin point any nutritional deficiencies, immune system triggers and gut/liver abnormalities. Generally, when starting a wholistic psoriasis therapy, I recommend a combination of the following lab tests:

• GI Map ^[8] stool test to identify gut imbalances, microbiome status, any parasites, harmful bacteria or Candida, check digestive markers
• Food Compatibility Analysis ^[9] – to identify foods that a person is intolerant to that trigger the immune system
• Blood tests, as needed – to identify nutrient deficiencies, electrolyte imbalances, inflammation markers etc
• Hair Tissue Mineral Analysis ^[10] – to gauge heavy metals levels that can interfere with many body functions

It’s important to note that chronic conditions like psoriasis involving multiple body systems take time to show significant therapeutic results. A mutual client and therapist long-term vision of health and wellbeing will provide the best possible outcomes.

Natural wholistic remedies and solutions for psoriasis

Despite the complexity of this condition my wholistic therapeutic approach is fairly straightforward and comprises the following steps:

1. First of all, identifying the cause(s) of the symptoms by taking a detailed health history that includes physical, dietary, lifestyle and stress management aspects
2. Performing targeted testing tailored for each individual to establish the levels and depth of imbalances present
3. Doing detailed nutrition analysis of the current eating patterns and developing a personalised eating plan that is simple and enjoyable to implement
4. Deciding on appropriate, tailored supplementation – to quickly provide needed nutrients in sufficient amounts to correct any nutritional deficiencies linked to symptoms
5. Correcting lifestyle, sleep, sun exposure and stress management aspects which are key to successfully improving psoriasis short- and long-term

Herbs are absolutely brilliant for addressing psoriasis! In one bottle I can combine 4-5 herbs to facilitate improvements in a number of systems or organs. From improving gut function and digestion, the liver function, blood cleansing to remove circulating yeast, bacteria or harmful immune complexes, decrease inflammation and lift a mood, among others.

Over the years helping clients with psoriasis, I tested and developed my own special herbal mixes combined with minerals and flower essences. These work very well by significantly speeding up progress and client results. Of course, each person responds to natural therapies uniquely and individual modifications are usually required as we go.

In my clinical experience, to heal or improve psoriasis the cause(s) must be investigated and found. Psoriasis can’t be healed by external applications alone such as creams, lotions or medications without looking for and removing the cause. As stated above, the real causes are internal involving the immune system dysfunction and inflammatory states.

Therefore, seeing a conventional dermatologist who focuses on dealing with skin symptoms only (often using steroid medications in the process) is unlikely to permanently improve or clear psoriasis. Plus the side effects can be significant.

All triggers and exacerbating factors need to be identified and corrected to increase your chances to either resolve or significantly improve your psoriasis. It’s a complex process and doing it alone rarely works, therefore I highly recommend working with a skin expert familiar with this condition.

Furthermore, I find that psoriasis is one of those conditions where treatment should be persisted with over a long period of time, sometimes years. So, getting proper support is highly beneficial to persevere and keep going.

I’ve been helping clients with psoriasis for a number of years now. I find it a fascinating condition to grasp and deal with. It’s so satisfying to be able to assist clients with reversing the troublesome skin changes and transforming their lives.

They go from being depressed, stressed, feeling helpless and frustrated with their bodies, to feeling confident in their own skin, enjoying social interactions or wearing short-sleeved tops or shorts without being self-conscious about their skin!

You can do it, too.

Would you like help with improving psoriasis?

If you’d like assistance with psoriasis using natural therapies and remedies, feel free to get in touch with me. I’m an online naturopath and nutritionist in Sydney ^[11] and I also conduct online Zoom consultations Australia-wide. Virtual consultations are very popular and convenient without compromising the quality of care.

Book a Zoom consultation with me HERE ^[12].

I also offer a free 25-minute initial discussion to talk about your circumstances and how I can help.

Please note that I can consult with Australia-based clients only at present.

Psoriasis case study

As stated above, wholistic natural approach to psoriasis is highly personalised and needs to be designed separately for each client. There is so much conflicting and unsubstantiated information on the internet about supplements, remedies and diets suitable for psoriasis.

It makes it virtually impossible to know what can possibly work in your circumstances, food intolerances ^[13] you may have, and environmental triggers you respond to, among others.

Therefore, I’m not going to mention any particular herb combinations or specific supplements as this information wouldn’t help YOU. Instead, I’m presenting here a case study of one of my clients with psoriasis to illustrate the comprehensive and personalised approach needed.

Case history

Sarah (not her real name), 25 years old female presented with diagnosed plaque psoriasis that had been present for the past five years, although short periods of remission occurred frequently.

She reported that her mother also has the disease. For the past 3 years she was seeing a dermatologist who prescribed a topical steroid cream which gave her moderate relief of symptoms but she was reluctant to continue using it because of its skin-thinning effect and dependency.

On examination, thickened plaques covered with silvery scales were present on the lower torso, both elbows and knees. The lesions were moderately itchy and often worsened when she was emotionally stressed.

Her other symptoms included:

• Bloating, flatulence and cramps around the belly button shortly after eating, especially after consuming fats
• Multiple food intolerances (‘reacting to everything’)
• Low energy, brain fog and poor memory
• Severe PMS and mood imbalances especially around her period
• Anxiety and depression and feeling stressed in social situations related to her visible skin lesions
• Interrupted sleep leaving her tired and irritable (she was waking up a few times during the night)

She also mentioned she has had 2-3 colds per year in the past 3 years that lingered for a long time draining her energy for weeks. Her skin was dry (she also worked all day in an airconditioned office, she rarely went out for lunch), often having a quick sandwich at her desk.

To relax, she visited a pub after work 1-2 times per week with her work colleagues drinking 2-3+ glasses of alcohol each time.

Her diet was mainly take-away foods during the week, she did some limited cooking at home on the weekends. She was drinking 1-2 soft drinks daily and disliked drinking plain water – she added sugary lime cordial to make it more palatable. On average she consumed 3-4 glasses of cordial water per day, mostly with meals.

Sarah’s overall aim was to be able to manage her condition with natural medicines and nutrition as much as possible, and she wanted to achieve 50% of symptoms relief in 3 months. She was determined to modify her diet and lifestyle as needed, and marked her commitment to following the treatment steps as 10/10.

Testing

At the first consultation we agreed she’ll do the following tests to further investigate the causes of her symptoms:

• Blood tests including full blood count, biochemistry, liver function, thyroid function, cholesterol panel, iron, zinc, copper, vitamin B12 and folate, vitamin D and selenium
• GI Map stool test to gauge her microbiome status, exclude any parasites or harmful bacteria, check digestive markers such as inflammation, pH, sIgA, pancreatic function and others
• Food Compatibility Analysis to identify which foods trigger her immune system and which ones are OK for her to eat.

Test results showed the following imbalances (normal rangers in brackets):

• Low vitamin D = 20 (50-150)
• Low Zinc = 10 (10-18)
• High copper = 23 (12-22)
• Low vitamin B12 = 210 (150-650)
• Higher CRP (systemic inflammation marker)
• Elevated liver enzymes indicating a struggling liver
• Low sIgA ^[14] – indicating inadequate immune system response in the gut
• Imbalances in the normal gut flora: low Bifidobacteria and Lactobacillus, high E.coli
• Imbalances in the main groups of the microbiome indicating gut dysbiosis and digestive imbalances
• Leaky gut linked to food intolerances
• Increased gut inflammation markers
• Inadequate digestion of fats and proteins likely due to low digestive enzymes, low stomach acid and/or gut flora imbalances
• A large number of incompatible foods identified (32) as well as sensitivity to nickel (present in her jewellery), feathers (doonas and pillows) and cigarette smoke.

Therapeutic steps

Due to a large number of imbalances identified covering different body systems, we agreed to initially prioritise the diet, supplements and lifestyle changes focussing on the most important ones for the next 3 months. These were:

Nutrition modifications

• Remove – processed sugar, sweets and pastries, gluten containing grains (wheat, rye, barley), all dairy, saturated and hydrogenated fats present in processed foods (e.g. canola oil, margarines); all alcohol; all processed foods (anything in a package or can)
• Minimise – red meat (small portion once every two weeks, if desired). Meat is high in saturated fat which can trigger symptoms in psoriasis. We know that in the skin of individuals who have psoriasis, the production of inflammatory compounds known as leukotrienes is many times greater than normal causing skin changes. These toxic compounds are produced from arachidonic acid, a fat sound solely in meat, dairy and other animal food sources.
• Consume – mainly vegetarian, high fibre diet but also include white fish, chicken (organic where possible), eggs (if tolerated), plenty of leafy greens, brightly coloured vegetables and low sugar fruits; moderate intake of non-gluten grains such as rice or quinoa (2-3 times per week); flaxseed oil and ground flaxseeds mixed into smoothies, olive oil, nuts and seeds, bone broths (to heal the gut) and vegetable broths with mushrooms to stimulate the immune system; plus other foods marked OK in the Food Compatibility Analysis results. Focus on foods that are easy to digest such as soups, stews, casseroles, steamed vegetables, some raw salads a few times per week. Chewing well and eating slowly as much as possible.
• Increase water intake – to 8-10 glasses of filtered water per day between meals to minimise stomach acid dilution which negatively affects digestion. Water can be flavoured ^[15] with lemon juice, fresh herbs and fruit pieces, taken with a pinch of Himalayan salt for trace minerals and electrolytes. Green juices with carrots and green apples are beneficial. Herbal teas: chamomile, licorice, rosehip, dandelion and nettle.
• Digestive support – 1 tablespoon of organic apple cider vinegar in a half glass of warm water 15 minutes before each meal (3 meals per day with one snack, only if needed).

Supplements – I always start with correcting nutritional deficiencies identified in tests as these are key to address ASAP for the treatment to succeed:

• Vitamin D3 (high dose) plus vitamin K2 MK7 for better absorption and utilisation of vitamin D. Vit D is very important for the well-functioning immune system and absolutely vital for skin health
• Herbal mix to comprehensively support the skin, the immune system, liver, the gut, energy and mood (one of the herbs, holy basil ^[16] for energy, sleep, anxiety and depression was particularly relevant here)
• Gut repair powder containing glutamine, curcumin (anti-inflammatory), prebiotics, probiotics and soluble fibre to support elimination and increase the good bacteria
• High potency multivitamin (to reduce a number of supplements and cover the nutritional deficiencies identified via testing) with zinc, vitamin C, magnesium, activated B-vitamins, vitamin A (super important for skin health), among others

Lifestyle modifications

• Sleep – finish all mind and physical activities and switch off all screens by 8 pm. Relax and wind down for an hour or so and be in bed by 10pm the latest
• Regular sun exposure to large body surfaces such as legs, arms, torso at least 5 days per week for 10-20 minutes per day, making sure there is no burning or skin damage. This can be done in a few short time periods i.e. 3x5min. Swimming in the sea on the weekends and during the week after work where possible (fortunately she lives near the beach)
• Stress relief – going for a walk at lunch time to the nearby park, walking or sitting on the grass and relaxing being in nature. Outdoor activities on the weekend

Sarah was excited about her therapeutic plan and was keen to start on the program straight away. I provided her with the ‘tools’ such as meal suggestions and menus, recipes, stress relief app recommensations and emotional support to keep going, as needed. We agreed to meet every 4 weeks for the next 3 months to monitor her progress and remove any roadblocks as they appeared.

The results

On average, she adhered to the plan around 80%-90% of the time and struggled at times with significantly decreasing take-away foods she was used to. Fortunately, she found a few healthier food options near her work which made a huge difference to her progress.

After 3 months she achieved results that were well beyond the 50% improvement she aimed for at the start. Her skin lesions healed with only slight red marks remaining (which were still improving). Her digestion and gut symptoms improved by around 80% and she felt much less anxious or worried about her appearance.

She started to enjoy drinking plain water with Himalayan salt or lemon, and correlated her increased water intake with the feelings of clarity, having better memory and her sense of humour coming back! Her family were very supportive and overjoyed with such positive changes.

Switching off all screens at 8pm was particularly challenging for her but she aimed to be in bed by 10pm most nights.

We continued the regimen beyond the 3 months, working on the imbalances that needed to be addressed for another 8 months, taking the whole treatment time to 12 months. By then, her condition stabilised and she was mostly symptoms free, except when she overindulged with the ‘wrong’ foods or became stressed or overwhelmed at work.

Overall, she was very pleased with the outcome and I also felt fortunate to work with a client who was committed to get better and do the work required from the start. She was also willing to experiment and educate herself about what worked for her and how to manage her condition herself, most of the time.

This truly is my ultimate aim for all of my clients – to teach them to understand their bodies and their condition, and not be afraid of it, to know how the body works and what support it needs to stay as healthy as possible for as long as possible!

Please note that, like all clinical guidelines, this information is to be used as a sample only and not a strict protocol. Every case requires an individualised approach to ensure desirable outcomes. Always consult your health practitioner before starting any dietary modifications, supplements or lifestyle changes.

Do you need help?

I have special interest and clinical experience in providing natural therapies for chronic skin conditions such psoriasis or eczema.

Book an online consultation with me HERE. ^[11]

inI also offer a free initial discussion to talk about your circumstances and how I can help.

Please note that I can consult with Australia-based clients only.

Thank you for reading and I look forward to connecting with you and to helping you to feel healthier and happier soon!

Good health and blessings

Joanna Sochan
Wholistic Health and Lifestyle Therapist
Natural and Lifestyle Therapies for Abundant Health and Wellbeing

Additional resources

• Eczema gut health and food sensitivities – a case study ^[18]
• Histamine intolerance: causes and treatment ^[19]
• Dandelion: the key herb for liver health, better digestion and beautiful skin ^[20]
• Parsley tea: a secret to health, glowing and blemish free skin ^[21]
• Online naturopathic consultations Australia ^[11]

Disclaimer: The above material is for informational and/or educational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical advice, diagnosis, treatment, prescription or recommendation. All viewers of this content, especially those taking prescription or over-the-counter medications, should not make any changes in their health regimen or diet before first consulting a doctor or other qualified health provider with any questions they may have regarding a medical condition or their particular circumstances.

Joanna Sochan is a Natural Therapist and founder of Naturimedica Holistic Health & Wellness. She has a passion for helping clients transform their lives by becoming healthy and well naturally. Joanna has 10+ years experience in clinical practice and has special interest in solving complex cases, functional medicine testing, gut health, sleep, fatigue and chronic pain. She guides clients through her tailored programs and eCourses as well as helping them individually (mostly online) Australia-wide. View full bio ^[22].