Subscribe for updates and to learn more:
Psoriasis - To be or not to be?
Skin conditions are not uncommon problems seen in clinic. After all, they are a very difficult, or more often than not, untreatable, condition for modern medicine. As far as I've seen, if steroids aren't used, either because they're not warranted or because they don't work, then the patient is left there helpless. This is the sad but real truth for skin conditions, (where viral or bacterial causes are ruled out), and psoriasis is just one of many types that fall under this category.
The funny thing is, psoriasis is not as specific as people believe it to be. It presents in many diverse forms, and depending on which part of the world one comes from, it may be called differently. There's no surprise here, because many skin conditions more or less all look the same. I sometimes even wonder if this is just a catch-all phrase for doctors when they can't decide what's in front of them(just like many other diseases). To Chinese Medicine the name of the disease doesn't really matter---Chinese Medicine is concerned with treating problems, not classifying and naming them---that's the job of modern science. So the question begs to be answered---is psoriasis treatable? Yes it is treatable, just like many skin conditions.
I have a patient who at the time of writing just finished a 2 months course of herbal treatment for his skin condition. He didn't go to the MD, but came straight to me in the beginning. He asked me what was the skin condition that he had. I told him, I don't know and it doesn't matter to me even I do know. But for clarity sakes it would likely be diagnosed as psoriasis if you went to the appropriate medical professionals; of course psoriasis or no psoriasis, it doesn't matter to me. Not to mention, giving formal medical diagnoses to patients is outside of my professional boundary anyways---I'm only concerned with treatment. This patient had read the Q&A section of my website before coming for his appointment and said he didn't understand why I stress skin conditions are really systemic conditions where the skin manifestation is only a marker for whole-body imbalance. He said he didn't have any problems outside his skin condition. I told him this could be simply your imagination.
First of all, his skin condition was localized in two areas. One on his face, and another on his legs. The face region was scattered with red scaly dry and slightly elevated patches. These were dry and felt constantly warm. Other areas of his face unoccupied with the red patches were dry and unmoisturized. Overall his face looked red, which gets worse in the evening, when his face also gets itchy. On his legs, there were no patches, but like his face, were dry and constantly itchy. Multiple scratch marks and scabs were seen.
The reason why he didn't seek his family physician was because his problem had been there for quite a while, yet came and go. It was recently that it seemed to have become much more constant. Of course, other than this, there were other problems. He was constantly cold. His waist felt sore almost 24/7. He urinates frequently, especially at night. All this combined together rendered his sleep poor and further exacerbated his skin condition.
I told him, how can you say you're perfectly fine(other than your skin issue) when you have all these other chronic issues? As this is a chronic case and given that skin takes time to heal, so I suggested him to at least take Chinese Medicine for 1 month in order to properly, both for him and I, assess the validity of treatment for his condition.In Chinese Medicine's understanding, the skin problem is only a part of his overall imbalance. It could just as well present itself in another way for another patient. Such "pattern" we call "upper heat, lower cold". The medicine prescribed was meant to correct this imbalance by re-aligning the water and fire of the body. After the medicine, the most immediate effect seen was the receding of redness and itchiness in the first week.
Subsequently thereafter the patches started to disappear. The skin gradually became more moisturized. He also reported his face wasn't so red in the evening anymore. His leg didn't itch either. The waist soreness and urination problem improve as well. Even though his condition essentially stabilized after the first month, I decided to continue treatment for another month to consolidate his progress and prevent any relapse in the near future. Right now being 2 months later, he has temporarily stopped treatment but has not seen his problem return.
The patient revisited recently because his facial condition seems to have flared back. In the initial visit the face was riddled with red rash patches throughout with papular elevations else where. He told me ever since the previous treatment couple of months ago, the facial problem was generally fine, save for some dryness of skin during the morning. Lately the dryness has gotten worse, and he notices plaquing and more exfoliation occurring. They were also itchy. So after one particular day where he tried to clean away the plaquing and exfoliation, perhaps using too much force in the process, the face became overly irritated. The irritation caused his face to develop rash-like red elevated patches and papular rashes as well. It did not go away despite being many days already.
From a little distance the face is simply just red throughout, resembling essentially the first time when I treated him. I asked a little bit about his history and events leading up to this. It seems he has been taking some Chinese Medicine "tonics" lately because he believed he needed it. When I discovered what he was taking, I concluded this is was the reason why the problem came back. I told him, it's not wrong to take "tonics" to booth his stamina and increase his overall energy.
But there are nuances in the art of Chinese Medicine prescription that will determine if certain herbs that are taken will suit him. Without a properly licensed Doctor of Traditional Chinese Medicine, this will likely not be the case. And therefore this is the result. Interestingly, after the inspection, I determined that his current state of health is different from when I previously treated him. It seems the Chinese Medicine he took on his own has some involvement in this.
After flipping through his file to see what was prescribed previously, it was determined a new prescription for his current presentation was needed, even though the facial rashes and redness seemed almost identical. He made hints that he wanted the medicine that I prescribed in the past. But that's not what I did, for I dispensed something completely different. I told him, I'm not really treating your face; I'm treating your pattern, which is not the same this occasion.
After a week, he came back, and the effect was quite pronounced. The redness had receded almost 100%; there was virtually no more itching, and the plaques and exfoliation stopped. He also remarked that his face felt much more moisturized, which was better than the past prescription. As he finds the medicine this time tastes even better than before, he's choosing to continue to take it for a while. Because he came to me quite immediately since the inception of the condition, so his recovery was also fast. Interestingly, his leg itchiness was not an issue this time around.