Dermatrol (PS) ™
TCM DIAGNOSIS: Toxic and damp-heat accumulation (severe)
* Psoriasis, parapsoriasis and other scaling diseases
* Severe acne with pus, abscesses and redness
* Dermatological disorders with sores, abscesses, lesions, blisters, and severe itching
WESTERN THERAPEUTIC ACTIONS
* Antiproliferative action to suppress proliferation of the psoriatic cells
* Immunosuppressive and immunomodulatory activities to control hyperactive immune system
* Antipruritic effect to inhibit scratching
* Antiallergic effect to alleviate allergies
* Antihistamine effect to relieve itching
* Anti-inflammatory effect to reduce tissue inflammation
CHINESE THERAPEUTIC ACTIONS
* Clears heat and detoxifies
* Invigorates blood circulation and nourishes blood
Take 3 to 4 capsules three times daily on an empty stomach with warm water. In acute conditions, dosage may be increased to 8 to 10 capsules three times daily for one week, or until symptoms subside. After relief of symptoms, dosage then can be reduced to 3 or 4 capsules daily.
Bai Hua She She Cao (Herba Hedyotis)
Bai Xian Pi (Cortex Dictamni)
Ban Lan Gen (Radix Isatidis)
Chan Tui (Periostracum Cicadae)
Chi Shao (Radix Paeoniae Rubra)
Da Qing Ye (Folium Isatidis)
Feng Fang (Nidus Vespae)
Gan Cao (Radix et Rhizoma Glycyrrhizae)
Jin Yin Hua (Flos Lonicerae Japonicae)
Ku Shen (Radix Sophorae Flavescentis)
Mu Dan Pi (Cortex Moutan)
Quan Xie (Scorpio)
Wu Shao She (Zaocys)
Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata)
Psoriasis, parapsoriasis and other scaling diseases are skin disorders with well-circumscribed, scaling papules or plaques without wetness, crusts, and fissures. The cause is unclear but involves immune stimulation of epidermal keratinocytes. Common triggers include emotional stress, sunburn, infection and use of certain drugs (alcohol, beta-blockers, lithium, ACE inhibitors, indomethacin, and interferon α).
Psoriasis and scaling diseases with severe itching in traditional Chinese medicine are amongst the most difficult disorders to treat since there may be various pathogenic factors involved. In addition, most conditions are chronic and may be complicated by the presence of both excess and deficient factors simultaneously, such as wind, toxic heat, dampness, and blood deficiency. To successfully treat such stubborn and complicated conditions, Dermatrol (PS) contains many strong and potent herbs to treat both the cause and the symptoms concurrently.
Dermatrol (PS) contains many medicinal substances that have potent actions to eliminate the heat and toxins that contribute directly to psoriasis or other dermatological conditions. Wu Shao She (Zaocys) has excellent dispersing functions that enter the internal organs and travel to the skin to relieve itching. It disperses wind, which is the predominant cause for itching. To further relieve itching and disperse wind, Ku Shen (Radix Sophorae Flavescentis), Bai Xian Pi (Cortex Dictamni) and Chan Tui (Periostracum Cicadae) are used. Da Qing Ye (Folium Isatidis), Ban Lan Gen (Radix Isatidis) and Bai Hua She She Cao (Herba Hedyotis) are used to clear heat and detoxify. Jin Yin Hua (Flos Lonicerae Japonicae) is commonly used to treat toxic heat in the exterior characterized by all dermatological sores, lesions, ulcerations, warts, and furuncles. To cool the blood and prevent further spreading of lesions, Mu Dan Pi (Cortex Moutan) and Chi Shao (Radix Paeoniae Rubra) are used. Quan Xie (Scorpio) and Feng Fang (Nidus Vespae) are used together to relieve toxicity, dispel wind and relieve pain. The use of these two substances is effective because in traditional Chinese medicine, it is sometimes necessary to “use toxin to attack toxin.” These two herbs are used to treat a wide range of dermatological disorders ranging from toxic sores, mastitis, mumps, swellings and scrofula. Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) tonifies blood and prevents flaring of wind associated with blood deficiency. Finally, Gan Cao (Radix et Rhizoma Glycyrrhizae) is used to harmonize the formula, reduce the toxicity of Quan Xie (Scorpio) and protect the stomach from the cold properties of the heat-clearing herbs.
CAUTIONS & CONTRAINDICATIONS
* This formula is contraindicated during pregnancy and nursing.
* Patients with weak Spleen and Stomach should take this formula with food to avoid stomach upset.
* According to most textbooks and contemporary references, the classic entry of “He Shou Wu” is now separated into two entries: the unprepared Sheng Shou Wu (Radix Polygoni Multiflori) and the prepared Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata), as they have significantly different therapeutic effects and side effects. Sheng Shou Wu (Radix Polygoni Multiflori) is a stimulant laxative that treats constipation, but may cause nausea, vomiting, abdominal pain, diarrhea, and in rare cases, liver disorder (dose- and time-dependent, and reversible upon discontinuation). On the other hand, Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) is a tonic herb that is safe and well-tolerated. The dramatic changes in the therapeutic effect and safety profile are attributed to the long and complicated processing of the root with Hei Dou (Semen Sojae) through repeated blending, cooking, and drying procedures. When properly processed, the chemical composition of the root changes significantly. Many new compounds are generated from the Maillard reaction (four furanones, two furans, two nitrogen compounds, one pyran, one alcohol and one sulfur compound). Furthermore, the preparation process causes changes in the composition of sugars and 16 kinds of amino acids; it also reduces the pH of the herb from 6.28 to 5.61.,, In summary, these changes give rise to the tonic effects of the prepared roots, and eliminate the adverse reactions associated with the unprepared roots. Note: Due to medical risks and legal liabilities, it is prudent to exercise caution and not use this herb in either prepared or unprepared forms in patients with pre-existing or risk factors of liver diseases.
* Because psoriasis is a difficult and stubborn disease, the treatment period is set at three months at a time, between intervals for evaluation and modification of the herbal formula(s).
* After the condition has stabilized, it is recommended that the patient take 2 capsules per day of Dermatrol (PS). Furthermore, those with qi deficiency or blood deficiency should take Immune + or Schisandra ZZZ, respectively.
Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:
* Wet skin lesions due to damp-heat accumulation: deep and forceful pulse on all three pulse positions (cun, guan, chi)
* Dry skin lesions due to dryness and heat accumulation in the Lung and Large Intestine: floating and forceful pulse on the right cun
* Allergy lesions due to fire and dryness in the Lung, Large Intestine and Liver: floating, forceful, and jumpy on the right cun and left guan
* Toxic lesions due to Liver fire: thick, long, wiry, forceful, and jumpy on both chi; and floating, forceful, and jumpy on the left guan
* Skin problems due to stress: forceful on the left guan
* For itching due to wind-heat, add Silerex.
* For acne with redness, pain and pus, add Dermatrol (Clear).
* For excess heat manifesting in redness, add Gardenia Complex.
* For yin deficiency with heat and dryness, add Nourish.
* For ulcerations and wet lesions on the skin due to damp-heat, add Gentiana Complex.
* For shingles, use Dermatrol (HZ) instead.
* For lupus, use LPS Support instead.
* Quchi (LI 11), Xuehai (SP 10), Zusanli (ST 36), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Feiyang (BL 58)
Classic Master Tung’s Points:
* Eczema: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Jinqianshang (T 88.24), Jinqianxia (T 88.23)
* Atopic dermatitis: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Zhisima (T 11.07)
* Herpes zoster: Linggu (T 22.05), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Shuitong (T 1010.19), Shuijin (T 1010.20)
* Tinea versicolor: Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Shuijin (T 1010.20), Shuitong (T 1010.19). Bleed the LR area T5 – T9 and KI area T9 – T12 on the back with cupping. Bleed before needling for best result.
* Hives: Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Zhisima (T 11.07)
Master Tung’s Points by Dr. Chuan-Min Wang:
* Psoriasis: Simazhong (T 88.17), Simashang (T 88.18), Simaxia (T 88.19)
Balance Method by Dr. Richard Tan:
* Left side: Dadun (LR 1), Zhongfeng (LR 4), Shangyang (LI 1), Hegu (LI 4)
* Right side: Zuqiaoyin (GB 44), Qiuxu (GB 40), Shaoshang (LU 11), Jingqu (LU 8)
* Left and right sides can be alternated from treatment to treatment.
* Main points: Lung, Endocrine, Shenmen, Occipital
* Adjunct points: Adrenal Gland, Liver, Spleen, Brain Stem, Heart
* Select four to five points each time, and needle for 30 to 60 minutes every other day. Ear seeds can also be used. Alternate ears every three to seven days.
Auricular Medicine by Dr. Li-Chun Huang:
* Psoriasis: corresponding points (to the areas affected), Gallbladder, Liver, Spleen, Lung, Large Intestine, Endocrine. Bleed Ear Apex and Helix 4.
* Cutaneous pruritis: Shenmen, Occiput, Liver, Spleen, Lung, Endocrine, Diaphragm, Allergic Area. Bleed Ear Apex.
* Urticaria: Liver, Lung, Spleen, Diaphragm, Shenmen, Occiput, Allergic Area, Sympathetic, Endocrine, Adrenal Gland. Bleed Ear Apex.
* Contact dermatitis: Liver, Spleen, Lung, Endocrine, Sympathetic, Adrenal Gland, Allergic Area, corresponding points (to the area affected). Bleed Ear Apex.
* Eczema: Allergic Area, Lung, Sympathetic, Spleen, Shenmen, Endocrine, Occiput, Diaphragm, corresponding points (to the area affected). Bleed Ear Apex.
* Successful treatment of psoriasis or any dermatological disorders with herbs is highly dependent on the patient’s cooperation in maintaining a proper diet. During the treatment period, alcohol, spicy food, seafood and anything that may be stimulating, or that may cause allergies should be avoided completely.
* Fish oil, flax seed oil, and primrose oil help to reduce inflammation, and are beneficial for the treatment of psoriasis.
* Make sure the diet contains adequate amount of fruits, vegetables, whole grains, and dietary fiber.
* Avoid citrus fruits, fried foods, processed foods, and saturated fats.
The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:
§ Recommendations: Chinese prunes, guava skin, pearl barley, vinegar, garlic, walnuts, cucumber, beet tops, dandelions, squash, and mung beans.
§ Take 15 peeled and sliced water chestnuts and 1 cup of vinegar (preferably aged rice vinegar), slowly simmer in a non-metal pot for 20 minutes until water chestnuts absorb most of the vinegar. Then mash into a paste and seal in a jar. Spread evenly on a gauze pad and apply to affected area, changing daily for mild to moderate condition, and three times daily for serious condition. Mild cases should show improvement within five days, but serious conditions may take up to two weeks.
§ Take peels from guava, char and powder it, mix with sesame oil into a paste and apply twice daily for one week.
§ Apply mashed garlic to the affected area, changing twice daily for one week.
§ Avoid spicy food, stimulating food, alcohol, caffeine, smoking, and excessive sun exposure.
§ Recommendations: squash, cucumbers, watermelon, winter melon, celery, carrots, cabbage, beet tops, dandelions, aloe vera, mulberry leaf, carrot tops, lettuce, potato, cherries, papaya, pear, persimmon, raspberries, buckwheat, alfalfa sprouts, millet, brown rice, mung beans, and plenty of water.
§ Apply plain, low-fat, no chemical yogurt to the affected area. Leave on for 20 minutes then wash off.
§ Rub watermelon rind on the acne.
§ Apply aloe vera.
§ Eat watermelon or drink watermelon juice.
§ Roast buckwheat, grind to powder and mix with rice vinegar into a paste, then apply to area.
§ For oozing acne condition, cover area with pearl barley powder over night, wash off with water.
§ For infected acne, apply a dandelion poultice to the area.
§ Avoid fried foods, fatty or oily foods, spicy foods, coffee, alcohol, sugar, smoking, stress, constipation, make-up, washing with chemicals, chocolate, ice cream, soft drinks, and emotional stress.
* Prevention of respiratory infections is also important. Adequate rest is essential.
* Do not scratch the affected area, which increase risk of infection and scarring.
* Avoid factors that trigger psoriasis outbreak whenever possible: alcohol consumption, emotional stress, sunburn, infection and drugs (beta-blockers, lithium, ACE inhibitors, indomethacin, and interferon α).
* D.D., a 45-year-old business owner, who is a single mom and received less than four hours of sleep for herself each night, presented with chronic eczema and itchy skin. Objective findings were red and heavy eyes and the location of her rash was mainly on her hands and feet. She had recently lost over 50 pounds and was still trying to lose more weight. The practitioner diagnosed this condition as damp-heat and Liver disharmony. Dermatrol (PS) was prescribed at three capsules three times daily along with Liver DTX at the same dosage. The results were positive; she experienced less itching and her rashes were less. However, during times of stress and lack of sleep the rash and itching symptoms would return. The patient’s compliance with her lifestyle was needed for prolonged results. Submitted by L.W., Arroyo Grande, California.
* A.K., a 13-year-old male, presented with acne, consisting of red and purulent appearance along with irritable sensation. The practitioner diagnosed this condition as Liver qi stagnation. Liver yang rising and dampness were also present. Dermatrol (PS) was prescribed for treatment. After taking the herbs, the acne had cleared more than 50% with minimal pus and redness; itching was no longer present. He was also receiving acupuncture twice a week. Submitted by A.D., Phoenix, Arizona.
* M.Z., a 15-year-old male, presented with a large amount of pimples over his face. Objective findings included blemishes and dark discoloration on the cheeks, forehead, and chin. It was mentioned that he had already tried Western topical creams and antibiotics. The practitioner diagnosed this condition as damp-heat. For treatment, Lonicera Complex and Dermatrol (PS) were both prescribed. It was reported after three weeks that his condition had improved; the blemishes and purple patches had vanished. He continued taking the Dermatrol (PS) at two capsules daily for maintenance. Submitted by G.G., East Lansing, Michigan.
* S.W., a 54-year-old female, presented with psoriasis in which she had been experiencing since she was a child. It consisted of patches that were scaly, dry, red, and itchy on different parts of her body. It was noted that gluten would aggravate her condition. The patient had restricted her diet by avoiding excess sugar, spicy food, and alcohol. Objective findings included pale face and agitated demeanor. The practitioner diagnosed this condition as blood heat, blood deficiency, and Liver qi stagnation. Dermatrol (PS) was prescribed at 6 capsules two times per day. Within two weeks of taking the herbs and receiving acupuncture, her skin had cleared. After four months of continuing, it was free of all signs of psoriasis. Submitted by N.V., Muir Beach, California.
* A 33-year-old female presented with eczema on localized areas of the hands, wrists and face. The affected skin was itchy and dry, and appeared thicker and paler than surrounding areas. The woman had tried steroid creams and prescription drugs for four years without satisfactory results. The Western diagnosis was eczema and atopic dermatitis; the TCM diagnosis was blood deficiency leading to blood dryness and wind. After taking Dermatrol (PS), the patient reported complete resolution of eczema on the face and arms. The skin on the wrists and hands may remain discolored. Overall, Dermatrol (PS) helped tremendously. [Note: This formula should be used with caution in patients with yin deficiency as it may cause hot flashes.] Submitted by M.M., Randolph, New Jersey.
* L.W., a 22-year-old male, presented with septic facial acne. Very depressed, he did not want to be seen in public. The TCM diagnosis was damp-heat with Liver qi stagnation. After one week of taking Dermatrol (PS) and Shine, the acne was 80% resolved and the depression was improving. After washing his face with a mild soap, the patient applied a topical skin wash [Yin Care] diluted with tea tree oil. The acne was gone in 28 days. The patient now socializes happily with family and friends. Submitted by H.C., Stephens City, Virginia.
* A 26-year-old farmer with a history of alcohol consumption reported a rash and itchiness of the body without any obvious cause. He was initially diagnosed with a skin rash, and treated with topical steroids without success. As the condition continued to deteriorate, with formation of white skin flakes, the diagnosis was changed to psoriasis. After three months of unsuccessful treatment with drugs, the patient then sought herbal treatment. The patient subsequently presented with severe itching, thirst, irritability, constipation, dysuria, and the presence of psoriatic flakes throughout his head and body. Open lesions resulted as a consequence of constant scratching. The tongue was red with a yellow, greasy coat, while the pulse was thready and rapid. The TCM diagnosis was accumulation of heat and toxins. After two weeks of herbal treatment with Dermatrol (PS), the patient reported marked improvement with reduction of itching and skin irritation, healing of skin lesions, and less psoriatic flakes. The patient was advised to continue with the herbs for another week until the psoriasis resolved completely. Submitted by C.S., Jilin, China.
* A 31-year-old female presented with a family history of chronic psoriasis, and outbreaks mainly on her elbows, knees and sacrum. She also suffered from vaginal itching and burning sensations. The TCM diagnosis was toxic damp-heat in the Liver. V-Support and Dermatrol (PS) were prescribed. A topical wash, Yin Care, was prescribed for external application for the psoriasis and vaginally for local itching. The patient had acupuncture treatments and was on the herbal formulas for two years. The patient was advised to stop smoking, eat less spicy food, and refrain from alcohol intake, but was unable to change her lifestyle. Nonetheless, her condition continued to improve, and she noticed that if she did not take the herbs, the symptoms would return. Submitted by M.C., Sarasota, Florida.
PHARMACOLOGICAL AND CLINICAL RESEARCH
Psoriasis is defined as a chronic and recurrent disease characterized by dry, well-circumscribed, silvery, scaling papules and plaques of varying sizes. Areas commonly affected by psoriasis include the scalp, sacral area, extensor surface of the extremities, buttocks, and penis. The exact cause of psoriasis is unknown, but the lesions are characterized by increased epidermal cell proliferation and inflammation involving immune stimulation. Therefore, optimal treatment must focus on controlling the immune system, suppressing cell proliferation and reducing tissue inflammation.
Psoriasis is directly associated with hyperactivity of the immune system. Therefore, successful treatment of psoriasis must include use of herbs to control and regulate the immune system. Bai Xian Pi (Cortex Dictamni) is an excellent herb with remarkable immunosuppressive activity to inhibit the proliferation of T-cells. In addition, Bai Hua She She Cao (Herba Hedyotis) is also used in this formula for its immunomodulatory effect.
Dermatrol (PS) contains many herbs with marked characteristics to treat psoriasis by suppressing the proliferation of cells. The inhibitory effect of these herbs slows or stops the abnormally high rate cell proliferation, as in cases of psoriasis. Herbs with this inhibitory effect include Ku Shen (Radix Sophorae Flavescentis),,,, Da Qing Ye (Folium Isatidis), Bai Hua She She Cao (Herba Hedyotis),, and Fang Feng (Radix Saposhnikoviae).
Dermatrol (PS) also employs many herbs with marked traits for treatment of psoriasis by suppressing the inflammation of tissue. The anti-inflammatory effect of the herbs helps to reduce swelling and facilitate recovery. Herbs with this anti-inflammatory activity include Bai Xian Pi (Cortex Dictamni), Da Qing Ye (Folium Isatidis), Jin Yin Hua (Flos Lonicerae Japonicae), Ku Shen (Radix Sophorae Flavescentis), Mu Dan Pi (Cortex Moutan), and Gan Cao (Radix et Rhizoma Glycyrrhizae). These herbs have excellent anti-inflammatory influences with differing mechanisms of action. Some reduce inflammation by inhibiting prostaglandin synthesis and decreasing the permeability of the blood vessels. Others reduce swelling by stimulating the release of glucocorticoids and delaying their breakdown. 17
In addition to herbs that suppress cell proliferation and tissue inflammation, Dermatrol (PS) contains many herbs that have excellent effects to treat general dermatological disorders. Pharmacologically, Ku Shen (Radix Sophorae Flavescentis) has an antipruritic effect to inhibit scratching in a dose-dependent manner. The antipruritic effect is attributed in part to its effect to reduce several eicosanoid-related skin inflammation, such as atopic dermatitis. Bai Xian Pi (Cortex Dictamni) has an antiallergic effect. It inhibits the scratching behavior in subjects with artificially-induced allergic atopic dermatitis and other allergy-related diseases in a dose-dependent manner. Mu Dan Pi (Cortex Moutan) has an antihistamine effect to significantly suppress histamine release and prostaglandin D(2) synthesis from mast cells. Indolinone, an alkaloid isolated from Da Qing Ye (Folium Isatidis), has been shown to block mast cell degranulation in vitro. Clinically, according to one study, the use of Chan Tui (Periostracum Cicadae) was successful in treating 27 out of 30 patients with chronic urticaria. In another study, use of Ku Shen (Radix Sophorae Flavescentis) was found to have a 79% effective rate in treating 148 patients with dermatological disorders, such as rash, itching and eczema. Furthermore, topical application of Bai Xian Pi (Cortex Dictamni) was found to be 100% effective in treating 33 cases of suppurative dermatological disorders. Lastly, 56 patients with pustular psoriasis of the palms were treated with great success (10 had complete recovery, 24 had significant improvement, 13 had moderate improvement, and 9 had no effect) using an herbal formula with Da Qing Ye (Folium Isatidis), Ban Lan Gen (Radix Isatidis), Bai Hua She She Cao (Herba Hedyotis), Bai Xian Pi (Cortex Dictamni), Chi Shao (Radix Paeoniae Rubra), and others.
In summary, Dermatrol (PS) is a well-balanced formula that addresses multiple aspects of psoriasis and other scaling diseases or dermatological disorders with severe itching. Dermatrol (PS) contains herbs that suppress the proliferation of cells, reduce the inflammation of tissue, and relieve itching and discomfort. It is one of the most effective formulas for the treatment of the challenging and stubborn disorder of psoriasis.
Successful treatment of psoriasis is one of the most challenging conditions for both Western and traditional Chinese medicine. There is no cure in Western medicine, and only a few effective treatments to control symptoms. Drug options include lubricants, keratolytics and corticosteroids. Lubricating cream is usually combined with coal tar, followed by exposure to ultraviolet (UV) light. Though this method may be effective, excessive exposure to UV light may cause sunburn and induce exacerbations. Keratolytics such as anthralin may be beneficial, but it is irritating and should not be used in intertriginous areas. Lastly, topical corticosteroids help to reduce itching and inflammation. However, they cause local side effects such as atrophy and telangiectases. Furthermore, continuous use of topical corticosteroids for just one to two weeks results in loss of steroid effectiveness.
Herbs are effective to treat both the causes and the symptoms of psoriasis. However, despite both short- and long-term improvements, herbs do not cure psoriasis. Therefore, it is necessary to periodically re-initiate herbal therapy to control psoriasis and prevent flare-ups. With persistent prevention and aggressive treatments, it will be possible to control psoriasis by reducing the frequency and severity of recurrences.
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