Complementary and alternative medicine (CAM) use is common among patients with psoriasis. CAM modalities include traditional Chinese medicine (TCM), herbal therapies, dietary supplements, climatotherapy, and mind/body interventions. In this review, evidence from clinical trials investigating the efficacy of CAM for psoriasis is reviewed. There is a large amount of evidence from controlled trials that have shown that the combination of TCM with traditional therapies for psoriasis is more efficacious than traditional therapies alone. Herbal therapies that have the most evidence for efficacy are Mahonia aquifolium and indigo naturalis, while there is a smaller amount of evidence for aloe vera, neem, and extracts of sweet whey. Dietary supplementation in patients with psoriasis demonstrates consistent evidence supporting the efficacy of fish oil supplements. Zinc supplementation has not been shown to be effective; however, some evidence is available (albeit conflicting) for vitamin D, vitamin B12, and selenium supplementation. Overwhelming evidence supports the effectiveness of Dead Sea climatotherapy. Finally, mindfulness-based stress reduction can be helpful as adjuvant treatment of psoriasis. There are potential benefits to these modalities, but also potential side issues. Concerns with CAM include, but are not limited to, contamination of TCM products with heavy metals or corticosteroids, systemic toxicity or contact dermatitis from herbal supplements, and ultraviolet light-induced carcinomas from climatotherapy. Dermatologists should be aware of these benefits and side effects to allow for informed discussions with their patients.

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Kristopher Denby is a clinical research fellow in dermatology at the University of Rochester in Rochester (NY, USA). He is a recent graduate of the University of Rochester School of Medicine and Dentistry. He was recognized both for teaching and community service. His areas of interest include psoriasis, chronic idiopathic urticaria, and atopic dermatitis. Nana DuffyNana Duffy is in private practice dermatology in Rochester, (NY, USA) and is an instructor of dermatology at the University of Rochester. She received Master of Science in Clinical Epidemiology) during her residency and has a particular interest in designing and critically evaluating clinical trials. She also has a particular interest in complementary and alternative medicine, nutrition and the connection between stress and dermatologic disease.For reprint orders, please contact: reprints@futuremedicine.com