Chinese Herbs for Psoriasis: Cooling the Blood, Calming the Plaques

Written and reviewed by Dr. Michael Koh, Chinese herbal medicine practitioner at The Oriental Herb, Cliffside Park, NJ

Psoriasis is an immune-driven skin condition, chronic, cycling between flares and quiet periods, and – unlike eczema – rarely cured by any approach. What Chinese herbal medicine offers is a way to shorten flares, lengthen the quiet periods and reduce the itching, scaling and dryness, working alongside whatever your dermatologist has prescribed. Chinese herbs for psoriasis are chosen by the stage the skin is in, because a red, spreading flare and a stable, thick plaque are treated almost oppositely. For the skin in general see our page on Chinese medicine for eczema and skin.

The three stages and their herbs

Blood heat – the active flare

Bright red, new lesions appearing quickly, intense itching, sometimes after a sore throat, stress or alcohol. Herbs that cool the Blood: Sheng Di Huang (raw Rehmannia), Mu Dan Pi (Moutan), Chi Shao (red peony), Zi Cao (Lithospermum), Bai Mao Gen. Formula: Xi Jiao Di Huang Tang (modified, without the animal ingredient) or Liang Xue Xiao Feng San.

Blood dryness – the stable, scaly stage

Pale pink or dull plaques, heavy silver scale, dry cracked skin, worse in winter and in heated rooms. Herbs that nourish Blood and moisten: Dang Gui, Shu Di Huang, He Shou Wu, Bai Shao, Hei Zhi Ma (black sesame). Formula: Dang Gui Yin Zi. See our post on Blood deficiency.

Blood stasis – the old, thick plaque

Dark red or purple, thick, leathery plaques that have been there for years, often on elbows, knees and scalp. Herbs that move Blood: Dan Shen, Tao Ren, Hong Hua, San Leng, E Zhu. Formula: modified Tao Hong Si Wu Tang. These herbs affect clotting – important if you take blood thinners.

Two herbs worth knowing

Tu Fu Ling (Smilax) is used in almost every modern psoriasis formula in China, for damp-heat in the skin and joints – useful where psoriatic arthritis is present (see Chinese herbs for joints). Bai Xian Pi (Dictamnus) is the classic anti-itch herb for scaling skin. Both are taken internally; we also prepare washes and oils for direct use on plaques.

Triggers and the Chinese diet view

Streptococcal throat infections, stress, alcohol, smoking, cold dry weather, some medications (beta blockers, lithium) and skin injury all provoke flares. TCM adds food: for the heat stage, less lamb, shellfish, spicy food and alcohol; for the dry stage, more oily fish, seeds, nuts and cooked greens; for everyone, less sugar and dairy. Sunlight in moderation helps most people.

Working with your dermatologist

Topical steroids, vitamin D creams, light therapy and biologics are not abandoned – herbs reduce the need for them over time rather than replacing them abruptly. If you take methotrexate or a biologic, we choose a conservative formula and ask for liver and blood tests to be monitored as usual. Psoriasis with joint pain, nail changes or a sudden widespread flare needs the dermatologist first.

FAQ

How long before Chinese herbs for psoriasis show results?

Itching and redness usually ease in two to four weeks; plaque thickness and scale over two to four months. Most clients stay on a maintenance formula through winter.

Can herbs cure psoriasis?

No treatment cures it. The realistic aim is fewer, milder, shorter flares and skin that is comfortable most of the year.

Are the Blood-cooling herbs safe long-term?

They are used during flares and reduced afterwards, because they are cold in nature and can weaken digestion if continued indefinitely. That is one reason the formula changes with the stage.

This article is for educational purposes only and is not medical advice. Chinese herbs are not a replacement for diagnosis or treatment from your physician. Always tell your doctor and your herbalist about every medication and supplement you take.