Skin Specialists and Naturopathic Doctors Discuss Therapies for Psoriasis

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.

Naturopathic Therapies for Psoriasis
Julie Greenberg, ND and Trevor Cates, ND

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. 

Psoriasis symptoms

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.


This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

Anna-Liza Badaloo is a writer and program consultant, working at the intersection of health, environment, and social justice. With over 10 years of experience at non-profit organizations, she brings a combination of content writing, copywriting, and journalism to her work. Using her strong storytelling ethic, Anna-Liza strives to amplify traditionally silenced voices such as BIPOC, youth, and 2SLGBTQIA+ communities.

References

Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014;7(11):16-24.

Allen HB, Jadeja S, Allawh RM, Goyal K. Psoriasis, chronic tonsillitis, and biofilms: Tonsillar pathologic findings supporting a microbial hypothesis. Ear Nose Throat J. 2018;97(3):79-82. doi:10.1177/014556131809700322

Arribas-López E, Zand N, Ojo O, Snowden MJ, Kochhar T. The Effect of Amino Acids on Wound Healing: A Systematic Review and Meta-Analysis on Arginine and Glutamine. Nutrients. 2021;13(8):2498. Published 2021 Jul 22. doi:10.3390/nu13082498

Badri T, Kumar P, Oakley AM. Plaque Psoriasis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 11, 2021.

Garbicz J, Całyniuk B, Górski M, et al. Nutritional Therapy in Persons Suffering from Psoriasis. Nutrients. 2021;14(1):119. Published 2021 Dec 28. doi:10.3390/nu14010119

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.