We tend to think of skin conditions as stand-alone issues that don’t have much to do with the rest of the body; however, the exact opposite is true. Not only is the skin our largest organ—it can act like the ‘canary in the coalmine,’ providing insight into what is really going on within the body. Healing from within is an important part of the process of addressing chronic skin problems. As you will learn, there are naturopathic therapies for psoriasis and other autoimmune conditions.
To learn more about how naturopathic doctors approach psoriasis, we sat down with Dr. Julie Greenberg, ND, RH(AHG), MBA, and Dr. Trevor Cates, ND, who focus on getting to the root causes of skin conditions.
All forms of psoriasis involve patches of thick, scaly skin that may be itchy, dry, and painful. The most common form is plaque psoriasis, where patches covered with silvery scales appear on the torso, scalp, and the outside of the elbows and knees. “Skin can crack, bleed, and may get infected,” notes Cates. Dr. Greenberg also points to guttate psoriasis (tear-shaped spots often seen on the back, arms, and legs) and inverse psoriasis (often seen in the armpits and groin).
As Dr. Greenberg points out, the symptoms depend on the skin tone. On Caucasian skin, areas affected by plaque psoriasis are red. “On skin of color, it is less likely to be red,” explains Greenberg. “It’s more likely the skin looks darker or lighter.”
Conventional therapies for psoriasis
According to conventional medicine, psoriasis has no cure. Conventional treatments thus focus on clearing up thick patches of skin and calming itching and pain. Steroid creams applied to the skin are often the first treatment prescribed, and phototherapy (applying UV light to the skin) may be an option. If these aren’t effective, the next step is often oral or injectable medications, with adalimumab (Humira) among the most commonly prescribed.
However, these therapies only address the surface issues, mainly by suppressing the immune system. “These medications are powerful immunosuppressives, and many people’s skin will clear while on these drugs,” notes Greenberg. “But they have to stay on these drugs to continue suppressing the immune system.”
“If someone has a lot of redness, itching, and irritation, things like topical steroids may calm inflammation temporarily,” notes Cates. “But they don’t address the root cause. Part of the reason they work is that they slow down the immune cells in the skin. We don’t want to suppress the immune system, especially with things like COVID going around.”
Naturopathic Therapies for Psoriasis
In contrast to the conventional view of psoriasis, which aims to control symptoms, the naturopathic approach goes much deeper. Both conventional and naturopathic views agree that body-wide inflammation is a key factor in psoriasis. They differ in how to reduce that inflammation long-term for psoriasis relief.
“The big question is, what is driving this increased inflammation?” asks Greenberg. “The standard medical view is ‘we don’t know,’ which leads to medications that just suppress the immune system.”
Dr. Greenberg has a different approach. “The majority of my psoriasis patients have Leaky Gut Syndrome and an overgrowth of microbes and organisms that produce toxins and inflammation,” explains Greenberg. “In conventional medicine, psoriasis is in the dermatology and rheumatology bucket, and they’re not really looking at the gut. I have found that when I clean up problems in the gut, then I can clean up the psoriasis.”
“Psoriasis is an autoimmune condition, which means the body’s immune system is attacking itself,” adds Cates. “Why is the immune system overreacting? There can be genetic factors, but with autoimmune conditions, it all goes back to the gut.”
It turns out, Hippocrates was onto something when he said, ‘All disease begins in the gut.’ But what’s really going on in there? “The average adult human has three to five pounds of microbes living in their intestines,” says Greenberg. “This includes bacteria, yeast, single-celled organisms, and viruses. There are a lot of organisms living in the gut!”
Normally, this diverse microbial community stays safely within the gut, preventing the digestive tract lining from moving elsewhere. This lining has tiny gaps to allow small particles and nutrients to enter the rest of the body. But in Leaky Gut Syndrome, these gaps in the lining are bigger than they should be. Large particles can leak into the body, which were never meant to leave the digestive tract. “The body sees these large particles as foreign, so it creates an immune reaction to fight those foreign substances,” Cates explains. “That’s what causes the body to attack itself. There’s a lot of internal inflammation, and that can trigger things like psoriasis.”
What can psoriasis patients expect from a naturopathic doctor
Given this whole-person approach, how do Naturopathic Doctors diagnose psoriasis?
As there is no standard test to confirm psoriasis, conventional and naturopathic doctors use skin symptoms (what the rash looks like and where it appears) as part of their diagnosis strategy.
Naturopathic Doctors truly shine in the care and time they take to get to know you on the first appointment. It’s not only about current symptoms; past history can provide valuable clues about current ailments—if you know what to look for. “There’s a very strong connection between psoriasis and strep throat,” says Greenberg. “A lot of my psoriasis patients had a tonsillectomy when they were younger.”
In Dr. Cate’s experience, patients rarely have just one autoimmune condition. “I want to see if there are signs of other autoimmune conditions, like a thyroid condition, rheumatoid arthritis, diabetes, or Lupus,” says Cates. “There are so many different autoimmune conditions that completing a full history on patients is really important to look for early warning signs. When you balance the immune system, you can also help other autoimmune conditions.”
The systemic inflammation that underlies psoriasis can also raise the risk of developing other health conditions. “We also want to ask about systemic issues,” says Greenberg. “If they have joint pain, has it reached the point of psoriatic arthritis? I check on other risk factors like heart disease, fatty liver, and depression.”
Where does the gut come in? “My path is to test and treat the gut,” says Greenberg. “I order a stool test and a urine test called an organic acid test (OAT) because these two tests allow me to assess the gut microbiome. Once I see what’s wrong in the gut, I can start to address gut dysfunction with herbs and supplements.”
There is no standard naturopathic treatment for psoriasis. However, there are a few herbs and supplements that naturopathic doctors commonly use to address the psoriasis root cause by healing the gut. Dr. Cates points to supplements such as L-Glutamine, probiotics, collagen, and Omega 3 essential fatty acids. “Vitamin D is extremely important for treating psoriasis,” says Cates. “Work with a naturopathic doctor to determine which supplement dose is best, and check your levels every few months. Food sources include cod liver oil, egg yolks, shiitake mushrooms, and salmon.”
Value of treating root cause in psoriasis relief
“In almost all my first visits with psoriasis patients, the words ‘I want to treat the root cause, I don’t want to suppress symptoms’ are coming out of their mouth,” says Greenberg. “They’re looking for answers, and they are not getting them from their dermatologist. They’re only being offered suppressive medication.”
Addressing the root causes of psoriasis can also improve other health issues. Skin conditions can be the body’s way of letting us know that something needs attention internally. “If we just suppress it, we’re not listening to our bodies,” says Cates. “But if we stop and say, ‘Something’s out of balance here. What is that?’ We can use diet, lifestyle, and supplements to help restore balance and not only clear up things like psoriasis but other health issues too.”
Ultimately, it’s up to each person to decide which approach is best for them. “If people want to get a shot every few weeks, there are all sorts of medications,” says Greenberg. “But a lot of people don’t want that for themselves or their children. People are looking for this type of medicine but may have never heard of naturopathic medicine.”
In addition to her childhood struggles with eczema, helping people understand the roots of chronic skin conditions led Dr. Cates to write the book Clean Skin From Within. “The skin is treated as a separate issue, a separate organ,” says Cates. “But it’s so interconnected with the entire body. And especially with an autoimmune condition like psoriasis, which comes from deep within the immune system.”
Key Psoriasis Takeaways
- Psoriasis looks like thick, scaly, irritated skin. On Caucasian skin, it looks red, while on skin of color, it can look darker or lighter than the usual skin color.
- Conventional treatments may reduce skin symptoms. But as they work by suppressing the immune system, these treatments do not address the root causes of psoriasis and can lead to other health issues.
- Body-wide inflammation, imbalance in the gut microbiome, and Leaky Gut Syndrome are common root causes of psoriasis.
- Naturopathic psoriasis treatment may focus on healing the gut using herbs and supplements and reducing the risk for related health issues.
Are you ready to get to the root causes of psoriasis with the support of a Naturopathic Doctor? Use our Find an ND search tool to find a Naturopathic Doctor in your area.
Dr. Julie Greenberg, ND practices at The Centre for Integrative and Naturopathic Dermatology in Los Angeles, California. Dr. Greenberg is a regular contributor to Learn Skin (a dermatology education platform for health care professionals) and has been a guest lecturer in dermatology at Bastyr University. In May 2022, she is presenting talks on psoriasis and eczema to her colleagues at the California Naturopathic Doctors Association Conference.
Dr. Trevor Cates, ND, is the founder of The Spa Dr. (natural skincare products for beautiful skin and balanced hormones) and the author of the bestselling book, Clean Skin from Within. Her podcast, The Woman Doctor, empowers women to embrace their body and soul’s full potential. She is also the host of the 9-part documentary series Hormones, Health & Harmony.
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