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Psoriasis - which alternative therapies work and which don't

Professor of complementary medicine Edzard Ernst and colleagues continue Pulse's series on which alternative therapies work and which don’t

Professor of complementary medicine Edzard Ernst and colleagues continue Pulse's series on which alternative therapies work and which don't

Psoriasis is a chronic inflammatory skin disease characterised by well demarcated erythematous scaly plaques on the extensor surfaces of the body and scalp.

Chronic plaque psoriasis affects 1–3% of the general population. It may also affect joints in about 10% and nails in up to one-third of the cases.

The condition affects both sexes equally and may appear at any age, although it is more likely between the ages of 11 and 45. About a third of psoriasis patients have a family history of the disease but the exact cause is not known.

Clinical bottom line

Likely to be beneficial

• Capsaicin: seems to reduce itching, scaling, and erythema.

• Omega-3 fatty acids: may reduce severity when administered as infusions.

Unknown effectiveness

• Aloe vera (Aloe barbadensis): few and conflicting data.

• Avocado oil: not enough data available.

• Homeopathy: independent replication for a Mahonia aquifolium product required.

• Hypnotherapy: not enough data available.

Unlikely to be beneficial

• Acupuncture: not superior to placebo.

• Balneotherapy: no beneficial effects of saline water.

• Efamol (omega-3 fish oil and omega-6 evening primrose oil).

• Kukui nut oil: no different from placebo.

Conclusions

• Capsaicin and omega-3 fatty acids are likely to be beneficial but the evidence is not entirely convincing.

• Omega-3 fatty acids may cause adverse events such as allergic reactions and vitamin D hypervitaminosis.

• The risk–benefit balance for capsaicin and fish oil is likely to be positive

• Compared with conventional options, complementary and alternative treatments have only a little to offer.

Psoriasis

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