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Psoriasis is a chronic immune-mediated skin condition that affects approximately three percent of the population worldwide and may have a notable impact on quality of life.1 It is thought to be a T-cell mediated condition involving interferon-gamma producing Th1 T-helper cells and Th17 cells that results in keratinocyte proliferation and migration of immature cells toward the stratum corneum.2 Topical therapies, such as topical corticosteroids, retinoids, vitamin D analogs, and tar-based preparations, are the mainstay treatment for mild disease.3 Topical therapies are used either as monotherapy or in conjunction with traditional oral systemic agents, biologics, or phototherapy for moderate to severe disease.2

Despite the breadth of available treatments, 52 percent of patients with psoriasis were dissatisfied with their treatment and concerned about treatment inefficacy and adverse effects.4 These findings were consistent with Lebwohl et al’s large, multinational, population-based survey of patients with psoriasis and/or psoriatic arthritis (PsA), which found that the health risks of long-term biologic therapy were a concern for 53 percent of patients and that 46 percent of patients perceive current available medical therapy to be potentially worse than the condition itself.1 As a result, patients often seek complementary and alternative medicine (CAM) treatments for psoriasis, including herbs (the most commonly used modality),5,6 traditional Chinese medicine (TCM), dietary modifications, climatotherapy, and mind/body interventions.6

The public’s interest in alternative therapies for a variety of medical conditions has increasingly grown over the years, and the estimated prevalence of CAM use among psoriasis patients ranges from 42 to 69 percent.5-9 Lack of efficacy of traditional medicines and side effects have been reported as popular reasons for using CAM.7 Additionally, CAM attracts patients because it is frequently available over the counter in the US and often is less expensive than high-technology conventional health care.10 However, despite this growing popularity, a recent survey study found doctors were the least common source of patient knowledge about CAM (four percent), while the internet (49 percent) and other patients with psoriasis (42 percent) were the most common sources.11 This is because patients often do not willingly offer information regarding CAM use to their physicians because they do not consider CAMs to be pharmacologic.9 To this end, it is important for physicians to ask questions regarding CAM use and to be prepared to discuss this topic with patients, considering that herbs are not only pharmacologic but may also interact with conventional medications.

It is also essential for dermatologists to be aware of the available alternative therapies, because patients expect their dermatologists to have a basic knowledge of CAMs while discussing treatment options.12 Notably, a 2017 survey of dermatologists revealed 66 percent of participants indicated an interest in CAM education with only 10 percent of dermatologists reporting prior CAM training.13 This suggests that further educational resources are needed to fill these knowledge and practice gaps.

In an effort to address this need, the article by Hill et al in 2016 previously described a list of herbs with historical use in the treatment of psoriasis.14 We updated this list with newer herbs utilized by patients in psoriasis management today, with a renewed review of the literature on efficacy. It is our aim to bring an awareness of herbs potentially used by patients with psoriasis and to provide a quick reference for providers who may be interested in learning more about these herbs. It should be noted that there is a lack of evidence supporting the safety of these herbs during pregnancy and lactation as well as in children.

The table provides an “at-a-glance” chart of commonly used herbal treatments for psoriasis, along with their active ingredients and mechanisms of action. Readers should be directed to key references such as websites by WebMD, UptoDate, and Medscape which offer information regarding herbal supplements, side effects, and drug interactions. An expanded version of the table, including listings of Historical Background; Adverse Effects/Herb-drug Interactions; and Clinical Trials Findings is available below.

The authors have no conflicts of interest to report.


T 1. JDDG J der Dtsch Dermatologischen Gesellschaft. 2010;8(10):788-796.

2. J Pak Med Assoc. 2013; 63(2):225-230.

3. Mol Med Rep. 2018;18(3):3537-3543.

4. Phyther Res. 2015;29(5):648-655.

5. J Pharm Pharmacol. 2017;69(8):925-945.

6. Am J Health Syst Pharm. 2000;57(13):1221-1230.

7. Complement Ther Med. 2011;19(5):276-280.

8. Int J Mol Sci. 2018;19(1).

9. Am J Clin Dermatol. 2017;18(4):451-468.


11. Food Chem Toxicol. 2017;101:114-120.

12. Pharmacogn Commun. 2014;5(1):2-50.

13. Evid Based Complement Alternat Med. 2013;2013.

14. Dermatology. 2001;203(2):141-147.

15. Dermatol Ther. 2020;33(6).

16. Complement Ther Med. 2013;21(5):453-459.

17. Phyther Res. 2019;33(3):504-523.

18. Pak J Pharm Sci. 2007 Jan;20(1):83-92.

19. Cell Death Dis. 2019;10(4).

20. J Arak Uni Med Sci. 2013; 15 (8) :61-67.


22. Acta Dermatoven APA. 2007;16(1).

23. J Ethnopharmacol. 2021;276.

24. Arch Dermatol. 2003;139(3):325-328.

25. Dermatology Nurs. 2007;19(5):448-458.

26. Bioengineering. 2019;6(4).

27. Lab Anim Res. 2017;33(3):251.

28. J Adv Res. 2021;33:241-251.

29. Prostaglandins Leukot Essent Fatty Acids. 1994;50(5):279-284.

30. J Cutan Med Surg. 2018;22(2):194-199.

31. J Dermatol Sci. 2007;45(2):87-92.

32. Am J Med. 2019;132(11):1266-1270.

33. Brazilian J Psychiatry. 2006;28(2):153-157.

34. J Clin Pharmacol. 2020;60(4):432-438.

35. Eur J Pharmacol. 2013;720(1-3):55-62.

36. Skin Pharmacol Physiol. 2020;33(6):331-341.

37. J Am Acad Dermatol. 1993;29(3):438-442.

38. Eur J Pharmacol. 2020;887:173356.

39. J Am Acad Dermatol. 1986;15(3):504-507.

40. Lancet. 2000;355(9198):134-138.


42. J Pharm Pharm Sci. 2018;21(1):347-353.

43. J Ethnopharmacol. 2010;127(3):685-693.

44. Int J STD AIDS. 2017;28(1):4-15.

45. Phytother Res. 2012;26(3):458-461.

46. Molecules. 2019;24(1).

47. J Eur Acad Dermatology Venereol. 2020;34(S2):3-11.

48. J Ethnopharmacol. 2014;154(1):17-25.

49. J Am Med Assoc. 1948;136(7):451-457.

50. Mol Med Rep. 2010;3(6):895.

51. Arch Intern Med. 1998;158(20):2200-2211.

52. 2016;13(3):323-330.

53. Biomed Res Ther. 2018;5(11):2811-2819.

54. Phyther Res. 2015;29(1):108.

55. J Ethnopharmacol. 2016;190:116-141.

56. J Dermatolog Treat. Published online 2020:1-11.

57. Front Pharmacol. 2021;11:2129.

58. Arch Dermatol. 1998;134(11):1388-1393.

59. The Toxicology of Mercury. 2002;33(8): 614-625.

60. Bot Med Women’s Heal. Published online 2010:455-520.

61. Inflammopharmacology. 2014;22(5):305-317.

62. Clin Exp Dermatol. 1994;19(2):127-129.

63. Pharmacogn Rev. 2011;5(9):103.

64. J Food Sci Technol. 2014;51(9):1633.

65. BMJ Case Rep. 2020;13(12).

66. Dermatology Reports. 2011;3(1).

67. Pharmacogn Rev. 2010;4(7):106.

68. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2017;35(1):1.

69. Psychiatr Clin North Am. 2013;36(1):73-83.

70. Biol Pharm Bull. 2006;29(9):1862-1867.


72. Elife. 2020;9:1-31.

73. Br J Dermatol. 2008;158(2):375-381.

74. Br J Dermatol. 2003;148(4):779-783.

75. Pharmacol Res. 2020;160:105085.

76. Comput Biol Chem. 2019;78:64-73.

77. Foods. 2014;3(3):420.

78. J Cosmet Dermatol. 2013;12(4):306-313.

79. Wound Repair Regen. 2012;20(5):778-785.

80. Basic Clin Pharmacol Toxicol. 2007;100(4):269-272.

81. Exp Dermatol. 2010;19(8).

82. Complement Ther Med. 2003;11(4):226-234.

83. Skin appendage Disord. 2018;4(4):296-300.

84. Open Access Maced J Med Sci. 2018;6(5):839.

85. Front Pharmacol. 2020;11.

86. Phyther Res. Published online 2021.


88. Int J Dermatol. 2005;44(8):684-687.

89. J Evid Based Complementary Altern Med. 2017;22(3):385-394.

90. J Ethnopharmacol. 2016;188:204-228.

91. BMC Res Notes. 2021;14(1).

92. Pharm Biol. 2017;55(1):5.

93. G Ital Dermatol Venereol. 2010;145(6):789-792. Accessed December 8, 2021.

94. Turkish J Pharm Sci. 2019;16(3):292.

95. J Herb Pharmacother. 2006;6(3-4):135-159.

96. Indian J Exp Biol. 2009;47(2):113-120.


98. Altern Ther Health Med. Published online June 18, 2021.

99. Asian Pac J Trop Biomed. 2013;3(7):505.

100. Eur Rev Med Pharmacol Sci. 2018 Dec;22(23):8537-8551.

101. Indian J Dermatol Venereol Leprol 1994;60:63-67

102. Biomedicines. 2020;8(2).

103. Adv Exp Med Biol. 2016;928:291-327.

104. Clin Dermatology. Published online 2014.

105. Toxicon. 2010;56(3):273-281.

106. Clin Cosmet Investig Dermatol. 2015;8:239.

107. Int J Mol Sci. 2018;19(3):547.

108. J Clin Aesthet Dermatol. 2018;11(12):42.

109. Planta Med. 1995;61(4):372-373.

110. Am J Ther. 2006;13(2):121-126.

111. Forsch Komplementarmed. 1999;6 Suppl 2(SUPPL. 2):19-21.

112. Am J Ther. 2005;12(5):398-406.

113. Phytomedicine. 1996;3(3):231-235.

114. 2009;6(1):31-34.

115. Food Chem Toxicol. 2020;144:111586.

116. EPMA J. 2019;10(1):51.


118. Iran J Allergy, Asthma Immunol. 2018;17(5):409-417.

119. PLoS One. 2020;15(5).

120. Nutrients. 2020;12(3).

121. Bioorg Chem. 2020;104:104298.

122. Phyther Res. 2014;28(4):480-497.


124. Rev Alerg Mex. 2018;65(1):103-107.

125. Int J Biol Macromol. 2019;139:409-420.

126. Chinese Drugs Plant Orig. 1992:805-812.

127. Dermatology. 2007;214(2):155-161.

128. Arch Dermatol. 2012;148(3):397-400.

129. Arch Dermatol. 2008;144(11):1457-1464.

130. Phytomedicine. 2014;21(7):1015-1020.

131. pages/Red Clover/Red Clover.html

132. Nutrients. 2020;12(4).

133. J Ethnopharmacol. 2006;104(1-2):104-107.

134. Antioxidants. 2020;9(3).



137. Plants. 2020;9(5).

138. J Ethnopharmacol. 2019;240:111830.


140. Int Immunopharmacol. 2016;32:32-38.


142. Aliment Pharmacol Ther. 2002;16(2):197-205.


144. Praxis (Bern 1994). 2000 Dec 14;89(50):2102-9.

145. J Postgrad Med. 2017;63(4):215-220.

146. Australas J Dermatol. 2012;53(2):131-135.


148. Sci World J. 2012;6(4):13-16.

149. Int J Dermatol. 2013;52(7):784-790.


151. J Tradit Complement Med. 2016;6(4):395.

152. J Zhejiang Univ Sci B. 2020;21(4):280.

153. Evid Based Complement Alternat Med. 2018;2018.

154. Herb Med Biomol Clin Asp Second Ed. Published online March 28, 2011:263-288.

155. Adv Exp Med Biol. 2007;595:343-57.

156. FEBS Lett. 1994;341(1):19-22.

157. Eur J Dermatol. 2015;25(3):240-246.

158. Iran J Pharm Res IJPR. 2015;14(3):865.

159. Biomed Res Int. 2015;2015.

160. J Ethnopharmacol. 2021;271:113843.

161. J Ethnopharmacol. 2016;187:160-182.

162. Clin Exp Dermatol. 2010;35(7):717-722.

163. Vascul Pharmacol. 2019;113:1-8.

164. G Ital Dermatol Venereol. 2019;154(6):624-631.

165. Clin Toxicol (Phila). 2020 Mar;58(3):219-220.

166. Crit Rev Toxicol. 2017 Feb;47(2):98-120.

167. Food Funct. 2020;11(9):7532-7544.

168. JAAD Int. 2021;2:76.

169. Contact Dermatitis. 2015;72(4):193-205.

170. Br J Dermatol. 2013;169(4):769-782.

171. J Am Chem Soc. 2002;88(16):3888-3890.

172. Bioorg Med Chem Lett. 2017;27(4):701-707.

1. Lebwohl MG, Bachelez H, Barker J, et al. Patient perspectives in the management of psoriasis: Results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey. J Am Acad Dermatol. 2014;70(5):871-881.e30.

2. Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011;65(1):137-174.

3. Mason AR, Mason J, Cork M, Dooley G, Edwards G. Topical treatments for chronic plaque psoriasis. Cochrane database Syst Rev. 2009;(2).

4. Armstrong AW, Robertson AD, Wu J, Schupp C, Lebwohl MG. Undertreatment, Treatment Trends, and Treatment Dissatisfaction Among Patients With Psoriasis and Psoriatic Arthritis in the United States: Findings From the National Psoriasis Foundation Surveys, 2003-2011. JAMA Dermatology. 2013;149(10):1180-1185.

5. Fleischer AB Jr, Feldman SR, Rapp SR, Reboussin DM, Exum ML, Clark AR. Alternative therapies commonly used within a population of patients with psoriasis. Cutis. 1996 Sep;58(3):216-20.

6. Ben-Arye E, Ziv M, Frenkel M, Lavi I, Rosenman D. Complementary medicine and psoriasis: linking the patient’s outlook with evidence-based medicine. Dermatology. 2003;207(3):302-307.

7. Murphy EC, Nussbaum D, Prussick R, Friedman AJ. Use of complementary and alternative medicine by patients with psoriasis. J Am Acad Dermatol. 2019;81(1):280-283.

8. Talbott W, Duffy N. Complementary and alternative medicine for psoriasis: what the dermatologist needs to know. Am J Clin Dermatol. 2015;16(3):147-165.

9. Damevska K, Neloska L, Nikolovska S, Gocev G, Duma S. Complementary and alternative medicine use among patients with psoriasis. Dermatol Ther. 2014;27(5):281-283.

10. Herman PM, Craig BM, Caspi O. Is complementary and alternative medicine (CAM) cost-effective? A systematic review. BMC Complement Altern Med. 2005;5(1):1-15.

11. Wnuk-Kłosiǹska A, Bielanowska E, Adamski Z, Czajkowski R, Jenerowicz D. The use of complementary and alternative medicine by patients suffering from psoriasis and psoriatic arthritis. Postepy Dermatol Alergol. 2021 Jun;38(3):421-426.

12. See A, Teo B, Kwan R, et al. Use of complementary and alternative medicine among dermatology outpatients in Singapore. Australas J Dermatol. 2011;52(1):7-13.

13. AlGhamdi KM, Khurrum H, Asiri Y. The welcoming attitude of dermatologists towards complementary and alternative medicine despite their lack of knowledge and training. Saudi Pharm J. 2017;25(6):838-843.

14. Hill H, Anderson N, Malakouti M, Jacob SE. Herbals in the Holistic Treatment of Psoriasis. Practical Dermatology. 2016; 12(1): 46-63.

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