Psoriasis

What is Psoriasis?

Psoriasis is a chronic proliferative and inflammatory condition of the skin. It causes red plaques covered with silvery scale, most often over the extensor surfaces, scalp and lower back, and it waxes and wanes with flare-ups.^[1]

Common symptoms

Plaque psoriasis is the most common type, with well-defined red, scaly patches on the trunk, limbs and scalp.^[1] Psoriasis can also affect the nails and joints, and about 10% of patients have eye involvement.^{[1, 2]}

• Red patches with silvery-white scale, sometimes itchy or sore
• Dry, cracked skin that may bleed
• Pitted or thickened nails
• Joint pain, stiffness or swelling, which may signal psoriatic arthritis^[2]

Causes and risk factors

Psoriasis results from genetic susceptibility, notably the HLA-C*06:02 risk allele, together with triggers such as streptococcal infection, stress, smoking, obesity and alcohol.^[2] Skin injury, some medicines and unhealthy lifestyle habits can also trigger onset or recurrence in people who are predisposed.^[3]

Researchers have identified IL-17, IL-23 and TNF-alpha as key immune drivers of the disease.^[2]

How it is diagnosed and treated conventionally

Psoriasis is usually diagnosed by a clinician from the appearance of the skin. It cannot currently be cured, but management aims to limit physical and psychological harm by treating early, preventing related conditions, supporting lifestyle changes and personalizing treatment.^{[1, 2]}

Biologic drugs that target IL-17, IL-23 and TNF-alpha have transformed care of severe chronic plaque psoriasis.^[2] Milder disease is typically treated with topical medicines, and your dermatologist decides which treatment suits you.

Why Psoriasis calls for a whole-person approach

Psoriasis is more than a skin problem. It is linked to depression, psoriatic arthritis and cardiometabolic syndrome, and stress and lifestyle both play a part.^[2]

Supportive care can address stress, sleep and daily habits next to the medical treatment of the skin.

Immune inflammation

Psoriasis is an immune-mediated inflammatory disease driven by cytokines such as TNF-alpha, IL-23 and IL-17, and this is the target of most modern drugs.^[2]

Stress

Between 31% and 88% of patients report stress as a trigger, and a higher incidence has been seen after a stressful event, which suggests stress may trigger disease in predisposed people. Stress is also a consequence of flares. Controlled studies show that relaxation, hypnosis, biofeedback and stress-management therapies help people with psoriasis.^[4]

Mood

Depression is common because psoriasis affects quality of life.^[1] A meta-analysis found moderate to severe psoriasis was associated with anxiety, though evidence on which factors raise depression risk was limited and conflicting.^[5]

Lifestyle and metabolic health

Smoking, obesity and alcohol are recognized triggers, and psoriasis is associated with cardiometabolic problems.^[2] Gut and skin microbiome imbalance and disordered lipid metabolism are also being studied as triggers.^[3]

Acupuncture for Psoriasis

What the research shows

The evidence that acupuncture helps psoriasis is limited. A review of 13 randomized trials with 1,060 participants found that acupoint stimulation worked better than non-acupoint stimulation in the short term, but the methods of the included studies were not rigorous. The most common side effects were thirst and dry mouth.^[6]

An earlier review of six trials with 522 people could not pool the results. It found some evidence of benefit with conflicting results among single studies and called for more research.^[7] A 2018 JAMA Dermatology review of complementary therapies listed acupuncture among those with the most evidence for psoriasis. It relied on that 13-trial meta-analysis, which it described as showing improvement over placebo.^[8] A 2024 review found positive early results for acupuncture but said better-designed trials are needed.^[9]

The 13-trial review covered acupuncture-related techniques such as acupressure and catgut embedding, and it found acupressure the most effective, so it says little about standard needle acupuncture alone.^[6]

How acupuncture may work

The mechanism in psoriasis is not established, and we found no solid mechanism research for acupuncture needling in psoriasis. Stress is linked to flares,^[4] so any benefit may come through general effects on stress and sleep, but this has not been tested in psoriasis.

What treatment involves

Treatment uses fine, sterile, single-use needles, usually left in place for about 20 to 40 minutes, with reassessment after a short course of visits. Serious problems are rare. In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000.^[10] Psoriasis can appear at sites of skin injury, so tell us about any new patches after treatment.^[3] Tell the practitioner first if you have a bleeding disorder, take blood thinners or immunosuppressants, are pregnant, or have a pacemaker (relevant to electroacupuncture).

Ayurvedic medicine for Psoriasis

The Ayurvedic view

Ayurveda describes psoriasis-like skin disease as Kitibha Kushta, a type of minor skin disorder in which Vata and Kapha are said to be disturbed. These are traditional categories used to choose treatment, not biomedical diagnoses.^[11]

Therapies that may be used

Care is individualized and traditionally may include:

• Diet and daily routine that avoid very heavy, sour or fermented foods and favor regular, simple meals
• Stress-reducing practices such as breathing exercises and regular sleep
• Oil therapies and herbal preparations applied to the skin, with transdermal medication therapy as a related option in our clinic; no study supports a benefit for psoriasis
• Herbs such as turmeric, prescribed individually

Classical Ayurveda also uses Panchakarma procedures, including therapeutic vomiting and purging, for skin disease.^[11] These are not appropriate during pregnancy, acute illness or frailty, and they should not be used by people with psoriasis on immunosuppressive drugs without their physician's agreement. Erythrodermic or pustular psoriasis needs medical care first.

What the research shows

The research on Ayurveda for psoriasis is very limited. A PubMed search found no systematic reviews and no controlled trials of Ayurvedic treatment as a system. What exists is case reports, such as one man treated with Panchakarma and a herbal-mineral preparation who improved on psoriasis scores and another treated with Ayurvedic purification and medicated ghee.^{[11, 12]} A single case cannot show that a treatment caused the improvement, since psoriasis often fluctuates.^[1]

Turmeric, a spice central to Ayurveda, has been studied for psoriasis and is discussed under herbal medicine.

Herbal medicine for Psoriasis

Herbs and formulas that have been studied

Herbal research in psoriasis covers topical and oral products. A 2025 review of 20 randomized trials with 1,115 patients included Aloe vera, indigo naturalis, Mahonia aquifolium, turmeric, St. John's wort and complex herbal preparations.^[13] Chinese herbal medicine is used as oral formulas, baths and applied preparations.^[14]

What the research shows

The evidence is limited and mixed. In the 2025 review, Mahonia aquifolium and indigo naturalis showed promise for reducing severity, while other herbs gave mixed results, and risk of bias varied.^[13] A 2018 review found that topical indigo naturalis improved psoriasis compared with placebo in five randomized trials with 215 participants, and that curcumin gave improvement in three randomized trials with 118 participants.^[8] A review of topical botanicals reached a similar picture, with Mahonia, indigo naturalis, aloe vera and, to a lesser degree, capsaicin the best studied and the overall evidence limited in quantity and quality.^[15]

A meta-analysis of 16 trials with 1,967 patients found Chinese herbal medicine outperformed Diyin tablet, a comparison drug, on response rates and PASI scores, but the authors called for large placebo-controlled trials.^[14] A meta-analysis of curcumin across autoimmune diseases found improvements in psoriasis from two small trials and asked for larger studies.^[16]

Safety and herb-drug interactions

Herbs are active substances. Topical botanical products commonly caused local irritation, redness, itching or burning in trials.^[15] Reviews also describe St John's wort lowering levels of ciclosporin, which is used in psoriasis, and enhanced bleeding with warfarin and danshen, garlic or ginkgo.^[17] Herbal and dietary supplements are a recognized cause of liver injury, which matters if you take medicines such as methotrexate that also affect the liver.^[18]

Product quality matters too. About one fifth of Ayurvedic medicines bought online contained detectable lead, mercury or arsenic.^[19] Tell us if you are pregnant or breastfeeding, or have liver or kidney disease. Herbs should come from tested sources and be prescribed individually.

Translating traditional medicine into modern biological language

These links are interpretation, not equivalence. Chinese medicine describes psoriasis through patterns such as blood heat, blood dryness and blood stasis. Modern research instead describes overactive immune signaling through IL-17, IL-23 and TNF-alpha.^[2] Ayurveda's disturbed Vata and Kapha with impaired digestion are described as the roots of Kushta. Researchers who study gut and skin microbiome imbalance in psoriasis may see a loose parallel to the digestion emphasis, but this is speculative.^[3] No study has shown that a dosha or TCM pattern corresponds to a specific biological process.

How this care fits with your medical care

Integrative care for psoriasis is complementary. Keep your dermatologist or rheumatologist and continue prescribed creams, light therapy, oral medicines or biologics. Do not stop or change prescribed treatment without your prescriber, since stopping can lead to flares. We do not diagnose psoriasis or psoriatic arthritis, so new joint pain should be evaluated medically.

Please bring your diagnosis, a full list of medicines and supplements including any biologics or immunosuppressants, recent test results, and details of any light therapy. For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care.

When to seek urgent medical care

Some forms of psoriasis can become severe quickly.^[2]

• Widespread, fiery red skin with shedding in sheets, especially with chills, fever or feeling very unwell
• Many small pus-filled blisters across large areas of skin, with fever
• Skin that is hot, swollen, painful or oozing, which may be infected
• Painful, swollen or stiff joints, particularly in the morning, or a swollen "sausage" finger or toe
• Eye pain, redness or changes in vision^[1]
• Feeling hopeless or thinking about harming yourself

If you have thoughts of harming yourself, call or text 988, the Suicide and Crisis Lifeline. For other emergencies such as chest pain, trouble breathing or severe widespread skin symptoms with fever, call 911 or go to the nearest emergency department.