Abstract
According to survey data, 35–69% of patients with skin disease have used complementary and alternative medicine (CAM) in their lifetime. A literature search on this subject reveals a number of studies on the efficacy of CAM treatment for dermatologic conditions, as well as a number of articles showing the growing prevalence of CAM use amongst patients suffering from these conditions. Given the consensus amongst these articles that dermatologists require increased education on CAM, this paper presents an overview of some of the most widely used systems of alternative medicine to serve as a tool for practicing dermatologists. Specifically, the history and theory behind psychocutaneous therapies, traditional Chinese medicine (including acupuncture), homeopathy, and Ayurvedic medicine will be described, along with current evidence for their efficacy and reports of their adverse effects. The authors conclude that more evidence and better studies are needed for each of the major CAM modalities before they may be considered as independent therapeutic options. Moreover, given the shortage of evidence supporting the efficacy and safety of CAM, dermatologists should obtain a thorough history of CAM use from their patients. In general, ingestible substances including most homeopathic, Ayurvedic, and traditional Chinese medicine herbal formulations that are not US FDA regulated should be viewed with caution as they may cause severe adverse effects such as arsenicosis and hepatotoxicity. On the other hand, less invasive techniques such as acupuncture and psychocutaneous therapies may be more acceptable given their low-risk profile. Ultimately, until the availability of more sound data, these treatments should primarily be used in combination with conventional treatment and rarely independently.
Similar content being viewed by others
References
Ernst E. CAM in dermatology: telling fact from fiction. Int J Dermatol 2003 Dec; 42(12): 979–80
Smith N, Shin DB, Brauer JA, et al. Use of complementary and alternative medicine in adults with skin disease: results from a national survey. J Am Acad Dermatol 2009 Mar; 60(3): 419–25
Shenefelt PD. Complementary psychocutaneous therapies in dermatology. Dermatol Clin 2005 Oct; 23(4): 723–34
Panconese E, editor. Lo stress, le emozioni, la pelle. Milan: Masson, 1998: 94
Seikowski K, Weber B, Haustein UF. Zum einfluss der hypnose und des autogenen trainings auf die krankheitsverarbeitung bei patienten mit progressive sklerodermie. Hautarzt 1995; 46: 94–101
Jordan JM, Whitlock FA. Emotions and the skin: the conditioning of the scratch response in cases of atopic dermatitis. Br J Dermatol 1972; 86: 574–85
Fried RG. Nonpharmacologic treatments in psychodermatology. Dermatol Clin 2002; 20: 177–85
Thomas JR, Greene SL, Dicken CH. Factitious cheilitis. J Am Acad Dermatol 1983; 8: 368–72
Bar LHJ, Kuypers BRM. Behaviour therapy in dermatological practice. Br J Dermatol 1973; 88: 591–8
Lichtenberg P, Bachner-Melman R, Gritsenko I, et al. Exploratory association study between catechol-omethyltransferase (COMT) high/low enzyme activity polymorphism and hypnotizability. Am J Med Genet 2000; 96: 771–4
Szekely A, Kovacs-Nagy R, Bányai EI, et al. Association between hypnotizability and the catechol-O-methyltransferase (COMT) polymorphism. Int J Clin Exp Hypn 2010 Jul; 58(3): 301–15
Shenefelt PD. Hyponosis in dermatology. Arch Dermatol 2000; 136: 393–9
Tausk F, Whitmore SE. A pilot study of hypnosis in the treatment of patients with psoriasis. Psychother Psychosom 1999; 495: 1–9
Surman OS, Gottlieb SK, Hackett TP, et al. Hypnosis in the treatment of warts. Arch Gen Psychiatry 1973; 28: 439–41
Creighton University School of Medicine. History of homeopathy [online]. Available from URL: http://altmed.creighton.edu/Homeopathy/history.hitm [Accessed 2009 Jun 15]
Davenas E, Beauvais F, Amara J, et al. Human basophil degranulation triggered by very dilute antiserum against IgE. Nature 1988; 333: 816–8
Hirst SJ, Hayes NA, Burridge J, et al. Human basophil degranulation is not triggered by very dilute antiserum against human IgE. Nature 1993; 366: 525–7
Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States. New Engl J Med 1996; 328: 246–52
Stibbe JR. Homepathy in dermatology. Clin Dermatol 1999; 17: 65–8
Hill N, Stam C, Tuinder S, et al. A placebo controlled clinical trial investigating the efficacy of a homeopathic after-bite gel in reducing mosquito bite induced erythema. Eur J Clin Pharmacol 1995; 49(1–2): 103–8
Labrecque M, Audet D, Latulippe LG, et al. Homeopathic treatment of plantar warts. CMAJ 1992; 146(10): 1749–53
Kainz JT, Kozel G, Haidvogl M, et al. Homoeopathic versus placebo therapy of children with warts on the hands: a randomized, double-blind clinical trial. Dermatology 1996; 193(4): 318–20
Ramelet AA, Buchheim G, Lorenz P, et al. Homeopathic Arnica in postoperative haematomas: a double-blind study. Dermatology 2000; 201(4): 347–8
Kuenzli S, Grimaître M, Krischer J, et al. Childhood bullous pemphigoid: report of a case with life-threatening course during homeopathy treatment. Pediatr Dermatol 2004 Mar-Apr; 21(2): 160–3
Prasad HR, Malhotra AK, Hanna N, et al. Arsenicosis from homeopathic medicines: a growing concern. Clin Exp Dermatol 2006 May; 31(3): 497–8
Brandt D, Park B, Hoang M, et al. Argyria secondary to ingestion of homemade silver solution. J Am Acad Dermatol 2005 Aug; 53 (2 Suppl. 1): S105–7
Porkert M, Ullman C. Chinese Medicine. New York (NY): William Morrow and Company, Inc., 1988
Tan EK, Millington GW, Levell NJ. Acupuncture in dermatology: an historical perspective. Int J Dermatol 2009 Jun; 48(6): 648–52
Koo J, Desai R. Traditional Chinese medicine in dermatology. Dermatol Ther 2003; 16(2): 98–105
Zhang W, Leonard T, Bath-Hextall F, et al. Chinese herbal medicine for atopic eczema. Cochrane Database Syst Rev 2005 Apr 18; (2): CD002291
Chiu TM, Huang CC, Lin TJ, et al. In vitro and in vivo anti-photoaging effects of an isoflavone extract from soybean cake. J Ethnopharmacol 2009 Oct 29; 126(1): 108–13
Ho SG, Yeung CK, Chan HH. Methotrexate versus traditional Chinese medicine in psoriasis: a randomized, placebo-controlled trial to determine efficacy, safety and quality of life. Clin Exp Dermatol 2010 Oct; 35(7): 717–22
Perharic-Walton L, Murray V. Toxicity of Chinese herbal remedies [letter]. Lancet 1992 Sep 12; 340(8820): 674
Lee L, Bebb G. A case of Bowen’s disease and small-cell lung carcinoma: long-term consequences of chronic arsenic exposure in Chinese traditional medicine. Environ Health Perspect 2005 Feb; 113(2): 207–10
Matsumoto K, Mikoshiba H, Saida T. Nonpigmenting solitary fixed drug eruption caused by a Chinese traditional herbal medicine, ma huang (Ephedra Hebra), mainly containing pseudoephedrine and ephedrine. J Am Acad Dermatol 2003 Apr; 48(4): 628–30
Oiso N, Yamadori Y, Higashimori N, et al. Allergic contact dermatitis caused by sesame oil in a topical Chinese medicine, shi-un-ko. Contact Dermatitis 2008 Feb; 58(2): 109
Iraji F, Saghayi M, Mokhtari H, et al. Acupuncture in the treatment of chronic urticaria: a double blind study [online]. Available from URL: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijd/vol3n2/urticaria.xml [Accessed 2009 Oct 16]
Wu J, Guo Z. Twenty-three cases of postherpetic neuralgia treated by acupuncture. J Tradit Chin Med 2000 Mar; 20(1): 36–7
Jerner B, Skogh M, Vahlquist A. A controlled trial of acupuncture in psoriasis: no convincing effect. Acta Derm Venereol 1997; 77: 154–6
Liao SJ, Liao TA. Acupuncture treatment for psoriasis: a retrospective case report. Acupunct Electrother Res 1992; 17: 195–208
White A. A cumulative review of the range and incidence of significant adverse events associated with acupuncture. Acupunct Med 2004 Sep; 22(3): 122–33
Ninivaggi FJ. An elementary textbook of ayurveda. Madison (WI): Psychosocial P, 2001
Routh HB, Bhoumik KR. Traditional Indian medicine in dermatology. Clin Dermatol 1999 Jan–Feb; 17(1): 41–7
Paranjpe P, Kulkarni PH. Comparative efficacy of four Ayurvedic formulations in the treatment of acne vulgaris: a double-blind randomised placebo controlled clinical evaluation. J Ethnopharrnacol 1995; 49: 127–32
Kuttan R, Sudheeran PC, Joseph CD. Turmeric and curcumin as topical agents in cancer therapy. Tumori 1987; 73: 29–31
Heng MC. Drug-induced suppression of phosphorylase kinase activity correlates with resolution of psoriasis as assessed by clinical, histological and immunohistochemical parameters. Br J Dermatol 2000; 143: 937–49
Cheng AL, Hsu CH, Lin JK, et al. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res 2001 Jul–Aug; 21(4B): 2895–900
Smith N, Weymann A, Tausk FA, et al. Complementary and alternative medicine for psoriasis: a qualitative review of the clinical trial literature. J Am Acad Dermatol 2009 Nov; 61(5): 841–56
Pandey SS, Jha AK, Kaur V. Aqueous extract of neem leaves in treatment of psoriasis vulgaris. Indian J Dermatol Venereol Leprol 1994; 60: 63–7
Datta HS, Mitra SK, Patwardhan B. Wound healing activity topical application forms based on Ayurveda. Evid Based Complement Alternat Med. Epub 2009 Feb 27
Acknowledgments
No sources of funding were received to prepare this article. The authors have no conflicts of interest that are directly relevant to the content of this article.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bhuchar, S., Katta, R. & Wolf, J. Complementary and Alternative Medicine in Dermatology. Am J Clin Dermatol 13, 311–317 (2012). https://doi.org/10.2165/11597560-000000000-00000
Published:
Issue Date:
DOI: https://doi.org/10.2165/11597560-000000000-00000