I love to answer questions from readers… A reader asked me whether using hemp seed or its oil could help improve psoriasis?
The quick answer is – yes! Hemp seed contains oil that is rich in omega-3 fatty acids and these can reduce inflammation associated with psoriasis. Fish oils are also rich in these fats and would be equally useful (but not as tasty and definitely worse smelling…). Hemp seeds have a nutty flavour and can be sprinkled on cereal or salads. Hemp seed oil can be consumed, as is, or rubbed directly on the area of psoriasis. If a large area is affected, taking by mouth would certainly be easier. Hemp seeds are available in the natural food section of most large grocery stores and in some pharmacies.
But I thought I’d expand this article to include information about the disease and other things you can do for yourself if you are affected. So, here it goes…
What is psoriasis?
Psoriasis is a skin condition that is thought to be related to a problem with the immune system – an autoimmune condition. The immune system’s T cells mistakenly attack healthy skin cells. This causes them to over produce, building up in thick, scaly patches on the skin’s surface. It isn’t clear what causes T cells to malfunction, but both genetics and environment appear to play a role.
What can you do to prevent it?
Anyone can develop psoriasis, but your risk is higher if you have a parent who is affected, and higher still if both have it.
Psoriasis is typically started (or worsened) by triggers that you can avoid. These can include:
Infections of the skin or strep throat
Injury to the skin, like a cut, scrape, insect bite or severe sunburn
Stress
Smoking
Heavy alcohol use
Vitamin D deficiency
Certain medications, such as lithium, beta blockers (medications used for blood pressure), antimalarial drugs and iodides (iodine compounds, sometimes used in surgery prep)
So, obviously, avoiding these triggers or correcting them as soon as possible can result in improvement for many who suffer from psoriasis. Treat skin injuries with soothing creams that prevent infection, such as Polysporin Cream, to speed healing. Try a stress-reducing activity, like yoga or meditation, to reduce the effects of stress you can’t avoid. Don’t smoke and use alcohol in moderation. Get a controlled amount of sun exposure so you will produce your own vitamin D but avoid sunburn as the resulting skin damage can worsen psoriasis. Take a vitamin D supplement in the winter, if you live in a northern climate. Check with your pharmacist to find out whether any of your medications could be triggering your psoriasis.
Other non-prescription treatments
Besides the omega-3 supplements and topical oils mentioned above, there are several non-prescription treatments you could consider in mild cases of psoriasis. For severe psoriasis that causes you discomfort and pain, makes routine activities difficult, causes you concern about your skin’s appearance or is associated with painful, swollen joints, it is recommended to talk to your doctor. Be aware that there are more potent treatments that your doctor can prescribe.
Steroid creams and ointments are a mainstay of psoriasis treatment. Steroids block inflammation very effectively, reducing redness and plaque formation. Ointments are usually more effective than creams, as they provide occlusion and moisturize better than creams. True occlusion would be covering the area with a non-breathable material, like plastic wrap. This traps the medication in and makes it more potent. Ointment bases (like Vaseline) have a similar effect to covering the area, although not quite as efficient as plastic, and generally ointments are more potent than creams with the same strength of steroid. Ointment bases also trap moisture in more effectively than creams so are usually more moisturizing but greasy… less “cosmetically appealing”. Hydrocortisone cream up to 1% is available in many countries without a prescription now.
Salicylic acid, in creams and shampoos, helps to loosen and remove psoriasis skin scales. However, it can irritate the skin. Often, it’s combined with a steroid that will reduce the irritation and inflammation caused by both the salicylic and the psoriasis itself. Pharmacists will sometimes add this ingredient to an existing cream on a doctor’s order, but you can request them to do this for you too, as the ingredient doesn’t require a prescription.
Coal tar has been available in shampoo form for decades and is a common treatment for scalp psoriasis. Coal tar slows the division of skin cells, reducing the formation of plaques. As a pharmacist, I often added coal tar solution and salicylic acid to existing shampoos for clients, although they needed to be shaken well before use to remix the ingredients and had a strong smell. The combination is commercially available now, however. You would find is in the medicated shampoo section of the pharmacy.
Light therapy doesn’t actually require a prescription, although some forms are more potent and would only be administered by a therapist. A standard UV lamp could be used at home, but it’s recommended to discuss this with your doctor first to ensure you are using it safely.
Moisturizers alone won’t heal psoriasis, but they can reduce the symptoms of itching, scaling and dryness that accompany it. Apply immediately after a bath or shower, when the skin is more hydrated. Moisturizers with aloe vera and/or barberry (Oregon grape) may work better, as these ingredients can help reduce skin inflammation, redness, scaling and itching. Avoid scented products as these may be more likely to irritate the skin.
Prescriptions for psoriasis
Steroids that are much more potent than non-prescription hydrocortisone. There is a range of steroids of different strengths and in varying bases that can be tried. They generally have fewer side effects than other treatments so usually are the first prescription choice. The most common side effect is thinning of the skin, especially of concern in areas where the skin is already thinner (for example, the face), allowing the blood vessels to show through the skin. Loss of pigment from the skin at the application area can also be a side effect. As the drugs are absorbed through the skin, suppression of the immune system can occur when high-strength steroids are used on larger areas for a longer time, and especially if occluded (covered with a non-breathable dressing). Children are more susceptible to side effects because of their thinner skin and smaller body weight.
Retinoids, drugs that are similar to vitamin A, can improve psoriasis but have severe side effects, such as inflamed lips and hair loss. Pregnancy must be avoided in women taking these drugs and for 3 years afterward, as they can cause severe birth defects.
Methotrexate is a prescription drug that decreases the production of skin cells and reduces inflammation. It is used in high doses to treat some forms of cancer but, for psoriasis, it’s used in very low doses. Side effects of upset stomach, appetite loss and fatigue are related to the dose used and are generally not bothersome at the low doses used for psoriasis. Long-term use can cause more serious side effects, such as liver damage and decreased production of platelets and red and white blood cells.
Drugs that alter the immune system
Cyclosporin is a drug used mostly to prevent rejection of transplanted organs, but it can be used short-term to suppress the immune system, the underlying problem in psoriasis.
Biologics are a group of newer drugs that work by altering the immune system. They include expensive medications we see advertised on TV, such as Enbrel, Humira, Remicade, Otezla, Cosentyx and others. Because they have strong effects on the immune system that may result in life-threatening infections, they are used with caution and generally only after traditional treatments have failed.
Keep in mind that a healthy immune system is aided by a good diet, healthy lifestyle, a well-functioning digestive system and exercise (especially outdoors, where you are exposed to healthy bacteria in the environment). Eliminating chronic, low-grade infections can also help the immune system by decreasing its workload.
Which treatments are used for psoriasis depends on how severe it is, and how much it bothers you. Because of the side effects, generally the safest treatments are tried first. But keep in mind that trigger control and simple strategies like moisturizers to control dryness and itching will usually not interfere with prescription treatments you may need to try. However, always discuss any non-prescription or alternative medications you are using with your doctor.
References:
Psoriasis Symptoms and Causes Mayo Clinic
