Ayurvedic vs. Modern Treatments for Psoriasis: Which Works Best?

Introduction

Psoriasis is an autoimmune, complex, multifactorial, and non-infectious chronic inflammatory skin disease. It is marked by the appearance of red plaques covered in silvery scales. The prevalence of psoriasis varies globally, ranging from 0.09% to 11.4% of the population. The World Health Organization estimates that over 100 million people are affected by psoriasis worldwide, significantly impacting their quality of life. This condition significantly impacts life quality, as it can lead to persistent itching, pain, and self-consciousness. Psoriasis can also affect mental health, contributing to anxiety and depression due to its visible nature and chronic nature.

In modern medicine, psoriasis treatment typically involves a combination of topical ointments, phototherapy, and oral or injectable medications to manage inflammation and regulate skin cell turnover. While these methods can be effective, they often come with side effects and may not target the condition’s underlying causes.

Conversely, Ayurveda adopts a holistic perspective, viewing psoriasis primarily as an imbalance in the doshas, particularly Vata and Kapha. Ayurvedic treatments focus on detoxifying the body, restoring balance to the doshas, and addressing dietary and lifestyle factors. Common therapies include Panchakarma (a detoxification process), herbal remedies, and dietary guidelines, which some patients find helpful in alleviating symptoms and reducing their frequency.

Understanding Psoriasis – A Holistic View

Psoriasis is a long-lasting autoimmune condition that causes inflammation and scaly, discoloured patches on the skin called plaques. It’s a chronic skin issue, meaning it can flare up unexpectedly, and there is currently no cure.

Causes of Psoriasis

Scientists aren’t completely sure why psoriasis happens, but they know that your immune system and genes are important factors. Psoriasis can run in families, but you can still get it even if no one in your family has it. Sometimes, certain things can trigger changes in your immune system that lead to psoriasis symptoms. Common triggers include stress, certain illnesses (like strep throat), skin injuries, and some medications.

Triggers of Psoriasis

Triggers can be different for each person, meaning what makes one person’s symptoms worse may not affect someone else. Here are some common triggers

• Stress: Stress is a common cause of psoriasis flare-ups. Meanwhile, a flare-up can also make you feel more stressed, which can be a tough cycle. Finding ways to relax can help reduce stress and prevent your psoriasis from getting worse.
• Skin Injury: Psoriasis can show up on skin that has been injured. This is known as the Koebner phenomenon. Injuries like scratches, sunburns, bug bites, or even getting vaccinated can cause psoriasis to develop in those areas.

There are different types of psoriasis, each with unique characteristics:

• Plaque psoriasis is the most common, affecting 80-90% of people with psoriasis and causing thick, scaly patches.
• Inverse psoriasis appears in skin folds and results in thinner, smooth plaques without scales.
• Guttate psoriasis often follows a strep throat infection, causing small, red, drop-like scaly spots, mostly in children and young adults.
• Pustular psoriasis shows up as pus-filled bumps on top of plaques.
• Erythrodermic psoriasis is a severe form, covering most of the skin with widespread discolouration and shedding.

Common Symptoms Of Psoriasis

• Patchy Rash: This can look different from person to person, ranging from dandruff-like spots to significant eruptions over much of the body.
• Dry, Cracked Skin: The affected skin may be dry, and cracked, and sometimes it can bleed.
• Itching, Burning, or Soreness: People with psoriasis often experience discomfort such as itching, burning, or soreness.
• Cyclic Rashes: The rashes may come and go, flaring up for a few weeks or months and then subsiding.
• Variety in Rash Color: The rash can have different colours depending on the skin tone. It might appear shades of purple with greyscale on brown or black skin and pink or red with silver scales on white skin.
• Limited Joint Movements: Psoriasis can affect joints, leading to stiffness and limited movement.
• Pain and Inflammation: The affected areas can be painful and inflamed.

In Ayurveda, the imbalance of the Vata and Kapha doshas due to changes in diet and lifestyle is a key factor in causing chronic psoriasis. Other important influences include Ama (toxins), various external stressors, and genetic or environmental factors. These imbalances, whether or not they involve Ama, negatively affect the skin and blood. Therefore, in psoriasis, the imbalances of Vata, Kapha, and Pitta/Rakta are major factors that contribute to its development. When Vata is not balanced, it can cause dryness and flaking skin, which is common in psoriasis. Kapha can lead to itching and a quick increase in skin cell production. Pitta may cause the inflammation and redness found in psoriasis patches. This overall view helps Ayurvedic practitioners treat psoriasis more ultimately, focusing on the root causes linked to lifestyle and diet that upset the balance of the body’s doshas.

According to Ayurveda, the causes of Psoriasis include:

•  Eating incompatible foods, such as fish and milk.
•  Consuming heavy and oily beverages.
•  Suppressing natural urges, including those for vomiting, sleep, and thirst.
•  Exercising excessively in hot weather or after a heavy meal.
•  Drinking cold water immediately after being in the hot sun.
•  Consuming raw or poorly digested foods.
•  Eating before the previous meal has been fully digested.
• Overindulging in certain foods like fresh grains, curd, fish, salt, and pungent-tasting items.
•  Excessive consumption of pastries, milk, and jaggery.
•  Engaging in sexual activity when digestion is compromised.
•  Taking naps during the day.

Modern Medical Treatments for Psoriasis

Treatments for Psoriasis aim to slow down skin cell growth and reduce scales. The options include topical therapies, light therapy, and systemic medications. The choice of treatment depends on how severe the psoriasis is and how well previous treatments worked. Finding the right approach often takes some trial and error.

• Topical Therapies: These are creams or ointments applied directly to the skin. Common types include corticosteroids, vitamin D analogues, retinoids, calcineurin inhibitors, salicylic acid, coal tar, and anthralin. Each has different effects and possible side effects, especially if used for a long time.
• Light Therapy: This involves using UV light to treat affected areas. Types include UVB light (both broadband and narrowband), PUVA, and excimer laser. These treatments require regular visits, and while effective, they can increase the risk of skin cancer.
• Systemic Medications: For more serious cases, doctors may prescribe oral steroids, retinoids, biologics (like adalimumab), methotrexate, and cyclosporine. These drugs are powerful but can have serious side effects, including suppressing the immune system, so they need careful monitoring.

Common side effects include skin thinning from corticosteroids, skin irritation from retinoids, and immune suppression from biologics. Long-term risks include liver damage from methotrexate, kidney issues with cyclosporine, and increased skin cancer risk from prolonged phototherapy.

Ayurvedic Treatments for Psoriasis

In Ayurvedic management of psoriasis, a combination of Samana (Pacifying treatment) and Shodhana (Purification treatment) is often employed.

Samana Karma (Pacifying Treatment):

This involves the use of internal medications to balance and pacify the doshas (Vata, Pitta, and Kapha) that are believed to be imbalanced in psoriasis.

Internal medications may include herbal formulations, dietary recommendations, and lifestyle changes aimed at reducing symptoms and promoting overall health.

Shodhana Karma (Purification Treatment):

Psoriasis is seen in Ayurveda as a condition where imbalanced doshas (Vata, Pitta, Kapha) mix with the seven elements of the body (Rasa, Rakta, Mamsa, Lasika), leading to symptoms. To address this, purification therapy (shodhana) is considered crucial in treatment.

This approach involves Panchakarma therapies, which are a set of purification procedures designed to eliminate toxins from the body and restore balance.

Panchakarma procedures may include therapeutic vomiting (Vamana), purgation (Virechana), enemas (Basti), and nasal administration of medications (Nasya).

Diet and Lifestyle Changes for Psoriasis Ayurvedic Treatment

Things You Can Include (Pathya):

• Foods: wheat, barley, green gram, pomegranate, bitter gourd, garlic, nutmeg
• Others: Nimba, Haridra, black pepper, old clarified butter, honey
• Regimens: bathing, light exercise, proper sleep

Things You Should Avoid (Apathya):

• Foods: Newly harvested cereals, incompatible foods, heavy, cold, and oily foods, foods causing a burning sensation, and those blocking channels, curd, sesame seeds, fish, sour substances, jaggery, milk
• Regimens: Daytime naps, holding back natural urges, mental stress, excessive exercise.

Comparing Ayurvedic and Modern Treatments

When comparing Ayurvedic and modern treatments for psoriasis, effectiveness varies significantly. Modern treatments, like topical therapies and biologics, can quickly control symptoms, especially in severe cases, but often lead to relapses. Ayurveda, on the other hand, promotes a holistic approach focused on balancing the body’s energies (doshas) and enhancing lifestyle choices, which may be more beneficial for mild to moderate cases over time. While modern therapies offer fast relief, they can have serious side effects, such as skin thinning or liver issues, and require ongoing use. Ayurvedic treatments, generally safer, emphasize long-term health improvements through herbal remedies and detox processes, although these may take longer to show effects.

In terms of cost and access, modern treatments can be expensive and less available in rural areas. Ayurvedic treatments are often more affordable and accessible, especially in places like India, but finding qualified practitioners can still be a challenge. Additionally, modern treatments are easier for patients to incorporate into their lives, while Ayurveda requires more commitment to lifestyle changes. Lastly, the environmental impact of modern medications is significant, due to their manufacturing processes, whereas Ayurveda typically has a lower ecological footprint, though responsible sourcing of herbal ingredients is essential to avoid sustainability issues.

Integrating Ayurveda with Modern Treatments

Integrating Ayurveda with modern treatments is becoming more popular for managing chronic conditions like psoriasis. This approach combines Ayurveda’s holistic methods with the targeted therapies of contemporary medicine, offering patients both quick relief from symptoms and long-term management strategies. When deciding between Ayurveda, modern medicine, or a mix of both, it depends on the severity of psoriasis and the patient’s goals. For severe flare-ups, modern treatments like corticosteroids can provide fast relief, while Ayurveda can help with stress management and prevention. For milder cases, Ayurveda alone, with its herbal treatments and lifestyle changes, might be enough. For ongoing care, using both methods together can be effective, with modern medications being adjusted as Ayurvedic practices support long-term health and stress reduction. This integration can lead to better overall wellness and may decrease the need for medications over time, offering patients a more personalized and sustainable approach to managing their condition.

Conclusion

For managing psoriasis, a personalized approach combining Ayurveda and modern medicine may provide the best outcomes. Modern treatments offer quick relief for severe symptoms, while Ayurveda supports long-term health and stress reduction. Integrating both systems can balance immediate symptom management with lifestyle-based prevention, offering a comprehensive, sustainable solution tailored to individual needs.