Psoriasis – Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Introduction

Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. These patches normally appear on elbows, knees, scalp and lower back, but can appear anywhere in the body.  Most people are only affected with small patches. In some cases, the patches can be itchy or sore. Psoriasis affects around 2% of people in the UK. It can start at any age, but most often develops in adults under 35 years old, and affects men and women equally. The severity of psoriasis varies greatly from person to person. For some it’s just a minor irritation, but for others it can majorly affect their quality of life. Psoriasis is a long-lasting (chronic) disease that usually involves periods when you have no symptoms or mild symptoms, followed by periods when symptoms are more severe. It is considered as an auto-immune disease by a majority of experts.

Signs and symptoms

Chronic erythematous scaly rashes on skin

Sudden onset of many small areas of scaly redness

Pain (especially in erythrodermic psoriasis and in some cases of traumatized plaques or in the joints affected by psoriatic arthritis)

Pruritus (especially in eruptive, guttate psoriasis)

Afebrile (except in pustular or erythrodermic psoriasis, in which the patient may have high fever)

Dystrophic nails, which may resemble onychomycosis

Long-term, steroid-responsive rash with recent presentation of joint pain

Joint pain (psoriatic arthritis) without any visible skin findings

Conjunctivitis or blepharitis

Causes

Psoriasis involves hyperproliferation of the keratinocytes in the epidermis, with an increase in the epidermal cell turnover rate. The cause of the loss of control of keratinocyte turnover is unknown. However, environmental, genetic, and immunologic factors appear to play a role.

  • Environmental factors – Many factors besides stress have also been observed to trigger exacerbations, including cold, trauma, infections (eg, streptococcal, staphylococcal, human immunodeficiency virus), alcohol, and drugs (eg, iodides, steroid withdrawal, aspirin, lithium, beta-blockers, botulinum A, antimalarials).
  • Genetic factors – Patients with psoriasis have a genetic predisposition for the disease. The gene locus is determined. Psoriasis is associated with certain human leukocyte antigen (HLA) alleles.
  • Immunologic factors – Evidence suggests that psoriasis is an autoimmune disease. Studies show high levels of dermal and circulating TNF-α.

Pathophysiology

People with psoriasis have an increased production of skin cells. Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days. The resulting build-up of skin cells is what creates the patches associated with psoriasis. Although the process is not fully understood, it’s thought to be related to a problem with the immune system. The immune system is body’s defence against disease and infection, but it attacks healthy skin cells by mistake in people with psoriasis. Psoriasis can run in families, although the exact role genetics plays in causing psoriasis is unclear. Many people’s psoriasis symptoms start or become worse because of a certain event, known as a trigger. Possible triggers of psoriasis include an injury to skin, throat infections and using certain medicines.

Diagnosis

Clinical examination

Skin biopsy

Routine blood tests

X-Rays

Treatments

Topical treatment, such as vitamin D analogues or topical corticosteroids in the form of creams and ointments.

If these are not effective, or condition is more severe, a treatment called phototherapy may be used. Phototherapy involves exposing skin to certain types of ultraviolet light.

In severe cases, where the above treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body.

Prognosis

There’s no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of skin patches.

Complications

  • Secondary infections
  • Possible increased risk of lymphoma
  • Possible increased risk of cardiovascular and ischemic heart disease
  • Psoriatic arthritis
  • Mitral valve prolapse
  • Possibly inflammatory bowel disease

Disease & Ayurveda

Ekakushtha/ ekakushtha

Nidana

Unwholesome diet with opposite potency

Improper routine and behaviour

Teasing and humiliating other good people

Theft

Bad deeds which cause emotional stress factors like repentance/fear/anxiety

Kapha- Vaatadoshakopanidana          – causes for vitiation of the kapha dosha and Vaatadosha

Purvaaroopa

Absence of sweating

Loss of tactile sensation

Samprapti

Due to the causative factors, vitiated doshas (mainly kapha) vitiate rasadhatu and reaches skin and develop into scaly rashes.

Lakshana

Absence of sweating

Big lesions resembling scales of fish

Lesions are scattered all over the body or head

Skin resembles the skin of elephant

Itching may be present

Divisions

Not mentioned

Prognosis

Yaapya in most cases

 Asaadhya in chronic & complicated cases

Chikithsa

Treatment of eka/charmakushtha is alleviating the vitiated Kapha and Vaata doshas. It should be done accordingly in each case. If the lesions are wet/oily and swelling is present, kaphadoshahara treatment should be done. If the lesions are dry & flaky, with dark discolouration, Vaatadoshahara treatment should be administered. Other factors like body constitution, age, physical and mental strength of patient, digestion, season etc. also should be considered while treating the kushtha.

Samana

kshalana – washing with kashayas like aragwadhadikwatha or triphalakwatha

lepana – applying external medicines like kasamardalepa, chakramardadi lepa, aragwadhadi lepa etc.

Sodhana

Vamana with madanaphalakwatha

Virechana with erandatailam, or avipathi choornam

Kashayavasti

Snehavasti

(Vasti is especially beneficial in psoriatic arthritis)

Commonly used medicines

        Aragwadhadi kwatham

Amrutavrishapatoladi kwatham

Mahathikthakam ghrutham

Avipathi choornam

Nimbamruthadi erandam

Vajrakam Kashayam

Manjishtadi Kashayam

Gandhak Rasayan

Rasasindhooram

Rasagandhi Mezhu

Arogyavardhini Vati

Brands available

AVS Kottakal

SNA Oushadhasala

Vaidyaratnam oushadhasala

AVP Coimbatore

Home remedies

No home remedy is there to completely cure psoriasis. But herbs that can help the discomforts of the disease includes the following:

Turmeric

Aloe vera

Neem

Apple cider vinegar

Baking soda

Tea tree oil

Epsom salt

Oatmeal

Diet

Pathya

Light meals and easily digestible foods

Green gram, soups, buttermilk boiled with ginger, turmeric, curry leaves etc.

Freshly cooked and warm food processed with cumin seeds, ginger, ajwain etc

Apathya

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products other than buttermilk- Cause indigestion, increase Kaphadosha, can lead to obstruction in channels and respiratory problems.

Curd – causes vidaaha and thereby many other diseases

Red chilli and other pungent, hot and spicy food items.

Vihaara

Better to avoid exposure to excessive sunlight wind rain or dust.

Avoid stress.

Maintain a regular food and sleep schedule.

Avoid sedentary lifestyle as it is one of the main causes of many diseases.

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Yoga

Psoriasis, like many of skin diseases, gets worse with stress & lack of proper circulation. A regular exercise routine and yoga therapy is recommended in psoriasis cases for proper destressing & improved circulation.

Salabhasana

vajrasana

Nadisudhi pranayama

Bhujangasana

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles

  • PMID: 30508547

Psoriasis increases the risk of cardiovascular (CV) disease. Secukinumab, a fully human monoclonal antibody against IL-17A, shows significant efficacy in psoriasis, but effects on CV markers are unknown. CARIMA (Evaluation of Cardiovascular Risk Markers in Psoriasis Patients Treated with Secukinumab) was a 52-week, randomized, double-blind, placebo-controlled, exploratory trial in patients with moderate to severe plaque psoriasis without clinical CV disease. Patients were randomly assigned to receive 300 mg or 150 mg secukinumab until week 52 or to receive placebo until week 12 and then 300 mg or 150 mg secukinumab until week 52. The primary outcome was endothelial function measured by flow-mediated dilation (FMD). Baseline FMD was significantly lower in psoriasis patients than healthy volunteers (4.4 ± 3.9% vs. 6.1 ± 3.3%, P = 0.01). At week 12, baseline-adjusted mean FMD was numerically higher in patients receiving secukinumab versus those receiving placebo, but this difference (300-mg group, +1.2%; 150-mg group, +0.76%; P = 0.223 and P = 0.403 by analysis of covariance) did not reach significance. At week 52, FMD increased across groups. FMD was significantly higher than baseline in patients receiving the label dose of 300 mg secukinumab for 52 weeks (+2.1%, 95% confidence interval = 0.8-3.3; P = 0.0022). Other relevant CV markers were unchanged. CARIMA indicates that secukinumab might have a beneficial effect on CV risk by improving the endothelial function of patients with plaque psoriasis.

  • PMID: 31453631

The aim of this 12-week randomized, double-blind, placebo-controlled trial was to determine the efficacy and safety of a probiotic mixture in the reduction of psoriasis severity. Ninety 18-70-year-old adults with plaque psoriasis were randomized into probiotic and placebo groups. At 12-week follow-up, 66.7% of patients in the probiotic group and 41.9% in the placebo group showed a reduction in Psoriasis Area and Severity Index of up to 75% (p < 0.05). A clinically relevant difference was observed in Physician Global Assessment index: 48.9% in the probiotic group achieved a score of 0 or 1, compared with 30.2% in the placebo group. The results of follow-up 6 months after the end of the study showed a lower risk of relapse after the intake of the probiotic mixture. Analysis of gut microbiota confirmed the efficacy of the probiotic in modulation of the microbiota composition.

These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

Dr. Rajesh Nair, CEO, Ayurvedaforall

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

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