An overview of this inflammatory skin condition and its homeopathic treatment 

 Psoriasis is an inflammatory skin con­dition that affects two to three per cent of the population. It can appear at any age, but mostly between the ages of 11 and 60. Psoriasis is an autoimmune disease, belonging to a group of condi­tions where the immune system is over­active and attacks its own cells and tissues. Normally skin cells are formed at the bottom of the outer layer of our skin. The cells go through a cycle of change, moving upwards through the layers to the surface of the skin where they die and are shed within a period of three to four weeks. In psoriasis this process is speeded up and cells can go through this cycle within three to four days. This causes thickening of the skin and its characteristic scaly appearance. Psoriasis affects mainly the skin and nails, but in six per cent of cases it is accompanied by inflammation of joints, affecting mainly fingers, toes and the spine and is called psoriatic arthritis. 

The word psoriasis is derived from the Greek word psora, meaning itch, although in most cases the affected skin is not particularly itchy. But some patients do experience a lot of itching and sometimes the eruptions can be sore and painful, in particular when there are cracks present. Psoriasis can affect the whole body, including the scalp, but the face is often spared. There are different types ­psoriasis vulgaris, plaque psoriasis, appears in big patches of thickened skin usually with white/silvery scales on the elbows and knees, but also other parts of the body. When one finds lots of small scaly spots and patches the condition is called psoriasis guttate. This form often affects children and is frequently triggered by streptococcal throat infections and often disappears by itself within a few weeks or months. Psoriasis pustulosa, usually presents with little yellow pustules and affects the palms of the hands and soles of feet. 

In up to 50 per cent of psoriasis patients, nails can also be affected. One can see small indentures in the nails or circular discolorations under the nails. In more severe cases the nails can thicken and separate from the underlying nail bed. 

The causes of psoriasis are still not entirely clear, although in 30 per cent of patients there is a family history of the condition. Certain factors can trig­ger the onset of the skin eruptions including streptococcal throat infections, particular medicines and injury to the skin, and emotional factors, such as stress or situations of trauma, shock and bereavement. Those trigger factors can be important for the homeopathic practitioner as it might indicate which remedy might be appropriate for that particular person. 

Due to its appearance, psoriasis can profoundly affect an individual, as people unfamiliar with the condition might think it is contagious. The suffer­er may also have to endure adverse comments from others about their appearance, which can affect his or her quality of life immensely. 

Conventional treatment There is a selection of conventional treatments on offer, starting with topical treatments, then phototherapy (light treatment) and then stronger, oral treat­ments. Topical treatments vary from simple emollients to moisturise the skin and alleviate itching, to salicylic acid­based creams, topical steroid creams of varying strength and tar preparations. Treatment with various forms of ultra­violet light is also used, sometimes in combination with a medicine called Psoralen. 

Many patients themselves notice the beneficial effect on their skin of ultra­violet light when their psoriasis improves with exposure to sunlight in the summer months. For severe psoriasis, oral medic­ation can be used, often in addition to topical treatment. However, they can have side­effects. Also, most oral treatments are contraindicated during pregnancy.

Homeopathic treatment Many patients I see have already tried one or more forms of conventional treat­ment. Those have mostly been helpful and often cleared the skin eruptions. However, the effect has usually been only temporary and at some stage the psoriasis has come back. Some patients are, therefore, looking for a more permanent “cure” for their condition, while others would simply like to reduce their use of steroid creams or other con­ventional treatments. 

From the homeopathic point of view we can approach treatment in different ways. We can treat the person as a whole and try to find a constitutional remedy with the aim of strengthening the organ­ism generally. This means looking at not only the patient’s psoriasis symptoms, but also his or her general health and way of reacting to the environment, as well as what drives him or her on an emotional level. But homeopaths can also treat symptomatically, meaning treating the psoriasis symptoms specifically. I usually aim for constitutional treatment but sometimes combine the two approaches, giving a more symptomatic skin remedy for flare­ups, while treating the person as a whole with a constitutional remedy. 

Choice of homeopathic medicine In choosing which homeopathic remedy to use, we consider various factors. It can be extremely helpful to know if something might have triggered the onset of symptoms. If the psoriasis has been triggered by bereavement, for instance, this might guide us to particular grief remedies, although a variety of other factors or symptoms need to be present too to give such a remedy. It is also important for a homeopathic practitioner to understand what was the exact reaction to such an event, as everyone has their own particular way of experiencing and dealing with such traumas. If the patient still seems to be in deep grief and their reaction is to try to deal with their pain by themselves, withdrawing from others, we might think of Natrum muriaticum. This could be confirmed if the psoriasis eruptions are located on the scalp at the margin of the hair, and if the eruptions are worse in the sun, which is not typical for psoriasis and, therefore, is an individual symptom of the patient. 

The location of the patches can be useful for the choice of medicine. As mentioned before if eruptions are at the margin of the hair one might think of Natrum muriaticum. If the eruptions are behind the ears and in the folds of skin and possibly around the genitals, one might consider Graphites. In pustular psoriasis, affecting the palms and soles of feet, Phosphorus can be a good remedy, or Arsenicum album or Arsen­icum iodatum. The latter two might also be useful if the eruptions cause a lot of itching, or a burning sensation. 

Factors that aggravate or ameliorate a sufferer’s condition are important to know, especially if they are atypical for the condition, as this indicates an indi­vidual mode of expression particular to the affected person.