PhytoScience - Article

Psoriasis

Psoriasis is a common skin disease that affects the life cycle of skin cells. Normally, new cells take about a month to move from the lowest skin layer where they're produced, to the outermost layer where they die and flake off. With psoriasis, the entire life cycle takes only days. As a result, cells build up rapidly, forming thick silvery scales and itchy, dry, red patches that are sometimes painful.

Psoriasis is a persistent, long-lasting (chronic) disease. You may have periods when your psoriasis symptoms improve or go into remission alternating with times your psoriasis becomes worse.

For some people, psoriasis is just a nuisance. For others, it's disabling, especially when associated with arthritis. No cure exists, but psoriasis treatments may offer significant relief. And self-care measures, such as using a nonprescription cortisone cream and exposing your skin to small amounts of ultraviolet light, can improve your psoriasis symptoms.

Symptoms

Psoriasis symptoms can vary from person to person but may include one or more of the following:

Red patches of skin covered with silvery scales
Small scaling spots (commonly seen in children)
Dry, cracked skin that may bleed
Itching, burning or soreness
Thickened, pitted or ridged nails
Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. Mild cases of psoriasis may be a nuisance. But more severe cases can be painful, disfiguring and disabling.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission. In most cases, however, the disease eventually returns.

Several types of psoriasis exist. These include:

Plaque psoriasis. The most common form, plaque psoriasis causes dry, red skin lesions (plaques) covered with silvery scales. The plaques itch or feel sore and may occur anywhere on your body, including your genitals and the soft tissue inside your mouth. You may have just a few plaques or many, and in severe cases, the skin around your joints may crack and bleed.
Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails may become loose and separate from the nail bed (onycholysis). Severe cases may cause the nail to crumble.
Scalp psoriasis. Psoriasis on the scalp appears as red, itchy areas with silvery-white scales. You may notice flakes of dead skin in your hair or on your shoulders, especially after scratching your scalp.
Guttate psoriasis. This primarily affects people younger than 30 and is usually triggered by a bacterial infection such as strep throat. It's marked by small, water-drop-shaped sores on your trunk, arms, legs and scalp. The sores are covered by a fine scale and aren't as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes, especially if you have ongoing respiratory infections.
Inverse psoriasis. Mainly affecting the skin in the armpits, groin, under the breasts and around the genitals, inverse psoriasis causes smooth patches of red, inflamed skin. It's more common in overweight people and is worsened by friction and sweating.
Pustular psoriasis. This rare form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters dry within a day or two but may reappear every few days or weeks. Generalized pustular psoriasis can also cause fever, chills, severe itching, weight loss and fatigue.
Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely. It may be triggered by severe sunburn, by corticosteroids and other medications, or by another type of psoriasis that's poorly controlled.
Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes pitted, discolored nails and the swollen, painful joints that are typical of arthritis. It can also lead to inflammatory eye conditions such as conjunctivitis. Symptoms range from mild to severe. Although the disease usually isn't as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.

Causes

The cause of psoriasis is related to the immune system, and more specifically, a type of white blood cell called a T lymphocyte or T cell. Normally, T cells travel throughout the body to detect and fight off foreign substances, such as viruses or bacteria. In people with psoriasis, however, the T cells attack healthy skin cells by mistake as if to heal a wound or to fight an infection.

Overactive T cells trigger other immune responses that cause an increased production of both healthy skin cells and more T cells. What results is an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly; in days rather than weeks. Dead skin and white blood cells can't slough off quickly enough and build up in thick, scaly patches on the skin's surface. This usually doesn't stop unless treatment interrupts the cycle.

Just what causes T cells to malfunction in people with psoriasis isn't entirely clear, although researchers think genetic and environmental factors both play a role.

Psoriasis triggers
Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:

Infections, such as strep throat or thrush
Injury to the skin, such as a cut or scrape, bug bite, or a severe sunburn
Stress
Cold weather
Smoking
Heavy alcohol consumption
Certain medications, including lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs and iodides

Risk factors

Perhaps the most significant risk factor for psoriasis is having a family history of the disease. About one in three people with psoriasis has a close relative who also has the condition. On the other hand, roughly the same proportion of people carries genes that have been linked to C yet never develop skin problems, indicating just how complex and perplexing psoriasis is.

Other psoriasis risk factors include:

Other medical conditions. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
Stress. Because stress can have a strong impact on your immune system, high stress levels may increase your risk of psoriasis.
Obesity. Excess weight increases your risk of inverse psoriasis. In addition, plaques associated with all types of psoriasis often develop in skin creases and folds.
Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.

When to seek medical advice

If you suspect that you may have psoriasis, see your doctor for a complete examination. Also, talk to your doctor if your psoriasis:

Progresses beyond the nuisance stage, causing you discomfort and pain
Makes performing routine tasks difficult
Causes you concern about the appearance of your skin

Be sure to seek medical advice if your signs and symptoms worsen or they don't improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.

Tests and diagnosis

Most often, psoriasis can be diagnosed with a visual exam. Sometimes, however, your doctor may take a small sample of skin (biopsy) that's examined under a microscope to determine the exact type of psoriasis and to rule out other disorders. These include:

Seborrheic dermatitis. This type of dermatitis is characterized by greasy, scaly, itchy, red skin. It's often found on oily areas of the body, such as the face, upper chest and back. Seborrheic dermatitis can also appear on the scalp as stubborn, itchy dandruff.
Lichen planus. This is an inflammatory skin condition that appears as rows of itchy, flat-topped bumps (lesions) on the arms and legs. The rash can last months or even years and may reappear after it goes away.
Neurodermatitis. Also called lichen simplex chronicus, neurodermatitis occurs because of repeated scratching. Chronic scratching can cause patches of thickened, brownish skin. These patches have definite margins that are thick and leather-like (lichenified). Typically, neurodermatitis occurs on the scalp, neck, wrist, upper forearm and ankle.
Pityriasis rosea. This common skin condition usually begins as one large spot on your chest, abdomen or back (herald patch) which then spreads. The rash of pityriasis rosea often sweeps out from the middle of the body, and its shape resembles drooping pine-tree branches.

Complications

Depending on the type and location of the psoriasis and how widespread the disease is, psoriasis can cause complications. These include:

Severe itching, which can lead to thickened skin and bacterial skin infections
Fluid and electrolyte imbalance in the case of severe pustular psoriasis
Low self-esteem
Depression
Stress
Anxiety

In addition, psoriatic arthritis can be debilitating and painful, making it difficult to go about your daily routine. Despite medications, psoriatic arthritis can cause erosion in your joints.

Treatments and drugs

Psoriasis treatments aim to interrupt the cycle that causes an increased production of skin cells, thereby reducing inflammation and plaque formation. Other treatments, especially those you apply to your skin (topical treatments), help remove scale and smooth the skin.

Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments{ topical creams and ultraviolet light therapy (phototherapy)} and then progress to stronger ones if necessary. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.

In spite of a wide range of options, psoriasis treatment can be challenging. The disease is unpredictable, going through cycles of improvement and worsening seemingly at whim. Effects of psoriasis treatments also can be unpredictable; what works well for one person might be ineffective for someone else. Your skin can also become resistant to various treatments over time, and the most potent psoriasis treatments can have serious side effects.

Talk to your doctor about your options, especially if you're not improving after using a particular treatment or if you're experiencing uncomfortable side effects. He or she can adjust your treatment plan or modify your approach to ensure the best possible control of your symptoms.

Psoriasis treatments can be divided into three main types: topical treatments, light therapy and oral medications.

Topical treatments
Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis. When skin disease is more severe, creams are likely to be combined with oral medications or phototherapy. Topical psoriasis treatments include:

Topical corticosteroids. These powerful anti-inflammatory drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They slow cell turnover by suppressing the immune system, which reduces inflammation and relieves associated itching. Topical corticosteroids range in strength, from mild to very strong. Low-potency corticosteroid ointments are usually recommended for sensitive areas such as your face and for treating widespread patches of damaged skin. Your doctor may prescribe stronger corticosteroid ointment for small areas of your skin, for stubborn plaques on your hands or feet, or when other treatments fail. To minimize side effects and to increase effectiveness, topical corticosteroids are generally used on active outbreaks until they're under control.
Vitamin D analogues. These synthetic forms of vitamin D reduce skin inflammation and help prevent skin cells from reproducing. Calcipotriene (Dovonex) is a prescription cream, ointment or solution containing a vitamin D analogue that may be used alone to treat mild to moderate psoriasis or in combination with other topical medications or phototherapy.
Anthralin. This medication is believed to normalize DNA activity in skin cells and to reduce inflammation. Anthralin (Dritho-Scalp or Psoriatec) can remove scale and smooth skin, but it stains virtually anything it touches, including skin, clothing, countertops and bedding. For that reason doctors often recommend short-contact treatment; allowing the cream to stay on your skin for a brief time before washing it off. Anthralin is sometimes used in combination with ultraviolet light.
Topical retinoids. These are commonly used to treat acne and sun-damaged skin, but tazarotene (Tazorac) was developed specifically for the treatment of psoriasis. Like other vitamin A derivatives, it normalizes DNA activity in skin cells. The most common side effect is skin irritation. Although the risk of birth defects is far lower for topical retinoids than for oral retinoids, your doctor needs to know if you're pregnant or intend to become pregnant if you're using tazarotene.
Calcineurin inhibitors. Currently, calcineurin inhibitors (tacrolimus and pimecrolimus) are only approved for the treatment of atopic dermatitis, but studies have shown them to be effective at times in the treatment of psoriasis as well. Calcineurin inhibitors are thought to disrupt the activation of T cells, which in turn reduces inflammation and plaque buildup. Calcineurin inhibitors are not recommended for long-term or continuous use because of a potential increased risk of skin cancer and lymphoma.

Coal tar. A thick, black byproduct of the manufacture of gas and coke, coal tar is probably the oldest treatment for psoriasis. It reduces scaling, itching and inflammation. Exactly how it works isn't known. Coal tar has few known side effects, but it's messy, stains clothing and bedding, and has a strong odor.
Moisturizers. By themselves, moisturizing creams won't heal psoriasis, but they can reduce itching and scaling and can help combat the dryness that results from other therapies. Moisturizers in an ointment base are usually more effective than are lighter creams and lotions.

Light therapy (phototherapy)
As the name suggests, this psoriasis treatment uses natural or artificial light. The simplest and easiest form of phototherapy involves exposing your skin to controlled amounts of natural sunlight. Other forms of light therapy include the use of artificial ultraviolet A (UVA) or ultraviolet B (UVB) light either alone or in combination with medications.

Sunlight. Ultraviolet (UV) light is a wavelength of light in a range too short for the human eye to see. When exposed to UV rays in sunlight or artificial light, the activated T cells in the skin die. This slows skin cell turnover and reduces scaling and inflammation. Brief, daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms can cause skin damage. Before beginning a sunlight regimen, ask your doctor about the safest way to use natural sunlight for psoriasis treatment.
UVB phototherapy. Controlled doses of UVB light from an artificial light source may improve mild to moderate psoriasis symptoms. UVB phototherapy, also called broadband UVB, can be used to treat single patches, widespread psoriasis and psoriasis that resists topical treatments.
Narrowband UVB therapy. A newer type of psoriasis treatment, narrowband UVB therapy may be more effective than broadband UVB treatment. It's usually administered two or three times a week until the skin improves, then maintenance may require only weekly sessions. Narrowband UVB therapy may cause more severe and longer-lasting burns, however.
Photochemotherapy, or psoralen plus ultraviolet A (PUVA). Photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more sensitive to the effects of UVA exposure. This more aggressive treatment consistently improves skin and is often used for more severe cases of psoriasis. PUVA involves two or three treatments a week for a prescribed number of weeks. Short-term side effects include nausea, headache, burning and itching. Long-term treatment increases your risk of skin cancer, including melanoma, the most serious form of skin cancer.
Excimer laser. This form of light therapy, used for mild to moderate psoriasis, treats only the involved skin. A controlled beam of UVB light is aimed at the psoriasis plaques to control scaling and inflammation. Healthy skin surrounding the patches remains undamaged. Excimer laser therapy requires fewer sessions than does traditional phototherapy because more powerful UVB light is used. Side effects can include redness and blistering.
Combination light therapy. Combining UV light with other treatments such as retinoids frequently improves phototherapy's effectiveness. Combination therapies are often used after other phototherapy options are ineffective. Some doctors give UVB treatment in conjunction with coal tar, called the Goeckerman treatment. The two therapies together are more effective than either alone because coal tar makes skin more receptive to UVB light. Another method, the Ingram regimen, combines UVB therapy with a coal tar bath and an anthralin-salicylic acid paste that's left on your skin for several hours or overnight.

Oral medications
If you have severe psoriasis or it's resistant to other types of treatment, your doctor may prescribe oral or injected drugs. Because of severe side effects, some of these medications are used for just brief periods of time and may be alternated with other forms of treatment.

Retinoids. Related to vitamin A, this group of drugs may reduce the production of skin cells in people with severe psoriasis who don't respond to other therapies. Signs and symptoms usually return once therapy is discontinued, however. And because retinoids such as acitretin (Soriatane) can cause severe birth defects, women must avoid pregnancy for at least three years after taking the medication.
Methotrexate. Taken orally, methotrexate helps psoriasis by decreasing the production of skin cells, suppressing inflammation and reducing the release of histamine; a substance involved in allergic reactions. It may also slow the progression of arthritis in some people with psoriatic arthritis. Methotrexate is generally well tolerated in low doses, but when used for long periods it can cause a number of serious side effects, including severe liver damage and decreased production of red and white blood cells and platelets. Taking 1 milligram of folic acid on a daily basis may help reduce some of the common side effects associated with methotrexate.
Azathioprine. A potent anti-inflammatory drug, azathioprine may be used to treat severe psoriasis when other treatment options fail. Taken long term, azathioprine increases the risk of developing cancerous or noncancerous growths (neoplasias) and certain blood disorders. Other potential side effects include nausea and vomiting, bruising more easily than normal, and fatigue.
Cyclosporine. Cyclosporine works by suppressing the immune system and is similar to methotrexate in effectiveness. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. Cyclosporine also makes you more susceptible to kidney problems and high blood pressure: the risk increases with higher dosages and long-term therapy.
Hydroxyurea. This medication isn't as effective as cyclosporine or methotrexate, but unlike the stronger drugs it can be used with phototherapy treatments. Possible side effects include anemia and a decrease in white blood cells and platelets. It should not be taken by women who are pregnant or planning to become pregnant.
Immunomodulator drugs (biologics). Several immunomodulator drugs are approved for the treatment of moderate to severe cases of psoriasis. They include alefacept (Amevive), efalizumab (Raptiva), etanercept (Enbrel) and infliximab (Remicade). These drugs are given by intravenous infusion, intramuscular injection or subcutaneous injection and are usually used for people who have failed to respond to traditional therapy or for people with associated psoriatic arthritis. Biologics work by blocking interactions between certain immune system cells. Although they're derived from natural sources rather than chemical ones, they have strong effects on the immune system and likely pose many of the same risks as other immunosuppressant drugs.

Lifestyle and home remedies

Although self-help measures won't cure psoriasis, they may help improve the appearance and feel of damaged skin. These measures may benefit you:

Take daily baths. Bathing daily helps remove scales and calm inflamed skin. Add bath oil, oiled oatmeal, Epsom salts or Dead Sea salts to the water and soak for at least 15 minutes. Avoid hot water and harsh soaps, which can make your symptoms worse. Instead, use lukewarm water and mild soaps that have added oils and fats.
Use moisturizer. Blot your skin after bathing, then immediately apply a heavy, ointment-based moisturizer while your skin is still moist. For very dry skin, oils may be preferable; they have more staying power than creams or lotions do and are more effective at preventing water from evaporating from your skin. During cold, dry weather, you may need to apply a moisturizer several times a day.
Cover the affected areas overnight. To help improve redness and scaling, apply an ointment-based moisturizer to your skin and wrap with plastic wrap overnight. In the morning, remove the covering and wash away the scales with a bath or a shower.
Expose your skin to small amounts of sunlight. A controlled amount of sunlight can significantly improve lesions, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer. If you sunbathe, it's best to try short sessions three or more times a week. Keep a record of when and how long you're in the sun to help avoid overexposure. And be sure to protect healthy skin with a sunscreen of at least 15 SPF, paying careful attention to your ears, hands and face. Before beginning any sunbathing program, ask your doctor about the best way to use natural sunlight to treat your skin.
Apply cortisone. Apply an over-the-counter cortisone cream 0.5 percent or 1 percent, for a few weeks when your symptoms are especially bad.
Avoid psoriasis triggers, if possible. Find out what triggers, if any, worsen your psoriasis and take steps to prevent or avoid them. Infections, injuries to your skin, stress, smoking and intense sun exposure can all worsen psoriasis.
Avoid drinking alcohol. Alcohol consumption may decrease the effectiveness of some psoriasis treatments.

Coping and support

Coping with psoriasis can be a challenge, especially if the disease covers large areas of your body or is in places readily seen by other people, such as your face or hands. The ongoing, persistent nature of the disease and the treatment challenges only add to the burden.

Here are some ways to help you cope and to feel more in control:

Get educated. Find out as much as you can about the disease and research your treatment options. Understand possible triggers of the disease, so you can better prevent flare-ups. Educate those around you {including family and friends} so they can recognize, acknowledge and support your efforts in dealing with the disease.
Follow your doctor's recommendations. If your doctor recommends certain treatments and lifestyle changes, be sure to follow them. Ask questions if anything is unclear.
Find a support group. Consider joining a support group with other members who have the disease and know what you're going through. You may find comfort in sharing your experience and struggles and meeting people who face similar challenges. Ask your doctor for information on psoriasis support groups in your area or online.
Use cover-ups when you feel it necessary. On those days when you feel particularly self-conscious, cover the psoriasis with clothing or use cosmetic cover-up products, such as body makeup or a concealer. These products can mask redness and psoriasis plaques. They can irritate the skin, however, and shouldn't be used on open sores, cuts or unhealed lesions.

Complementary and alternative medicine

A range of dietary supplements and herbal medicines claim to offer new ways to prevent or treat diseases in general. Some supplements show promise and are slowly gaining acceptance in mainstream medicine. But the benefits and risks of many products and practices remain unproved in human clinical trials.

Although some complementary treatments can be a good addition to your regular treatment for psoriasis, take some precautions first:

Don't stop taking your prescribed medications or skip therapy sessions. Complementary medicine is not a substitute for regular medical care.
Be honest with your doctors and health providers. Tell them exactly which complementary treatments you practice or would like to explore. There have been many cases {based on patients test results} where doctors have reduced or stopped medications due to the benificial effects from natural health products.
Be aware that some complementary treatments can interfere with your regular treatment. Even over-the-counter or so-called natural supplements may interfere with your prescribed medications. When purchasing a health product; look for information that may be found in small print that would indicate drug interactions or product warnings.

Natural remedies that lower inflammation can also be very beneficial; when indicated they may be preferred over anti-inflammatory medications that have adverse effects with prolonged usage. Although long-term use of NSAIDs in high doses can provide great benefit in terms of anti-inflammatory effects, pain relief and cardioprotective effects, there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers, hemorrhage, and severe and potentially deadly gastrointestinal problems. Each year in the US, the side effects of long-term NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths.

Nutritional and dietary supplements
The most effective use of supplementation is to start at an early age where it can be used daily to prevent the onset of disease later in life. Good nutrition including vitamins and minerals is essential for maintaining good health.

Here's a look at some nutritional supplements commonly used with Parkinson's disease:

Evening primrose: Anecdotal reports suggest that a diet supplemented with evening primrose oil might prove helpful in psoriasis. Studies using evening primrose oil as a dietary supplement have not revealed any significant effect. Evening primrose oil can also be used on the skin as a topical product. For more information about using evening primrose oil topically.
Fish oil Dietary supplementation with fish oil is said to have a variety of favorable effects on both the cardiovascular and immune systems in laboratory animals. Psoriasis is an immune-mediated disease, so it follows that fish oil {if it alters immune reactivity} could improve psoriasis. Multiple studies have been conducted in humans, with mixed results.

Max-EPA fish oil supplement has been used in studies and has shown mild to moderate improvement in people's psoriasis. It is sold over the counter in health food stores in capsules. A study published in The Lancet in 1988 showed psoriasis patients who took 10 fish oil capsules daily for eight weeks had "significant lessening" of itching, redness and scaling. Patients in the placebo group who took 10 olive oil capsules saw no improvement. The patients were advised not to change their regular diet.
Shark cartilage: Studies have shown that shark cartilage extract prevents the formation of new blood vessels. The growth of new blood vessels is believed to play a role in the development and progression of psoriasis lesions. Shark cartilage is also known to have anti-inflammatory properties.

AE-941 is a shark cartilage extract that has demonstrated some promising results in treating psoriasis. It is currently in clinical studies for treating psoriasis. It is taken by mouth once a day. Short-term side effects of AE-941 include nausea and skin rashes. Long-term side effects are not known at this time. Shark cartilage is normally taken in pill form as a food supplement and can be found at most health food stores.
Turmeric: Turmeric is a primary component of curry powders used in cooking. The spice has a long history of being used in traditional Chinese medicine and has been reported to help relieve the symtoms associated with psoriasis. Turmeric can be found in capsules to be used as a dietary supplement.

Turmeric has also been reported to help relieve the swelling, pain and inflammation associated with arthritis. People suffering from gallstones or bile duct problems should avoid turmeric. A small study in 1999 showed that curcumin (a compound in turmeric) can cause contractions of the gallbladder. These contractions could potentially harm a person with gallbladder problems.
Mangosteen: Mangosteen juice from the whole fruit puree is one of the latest discoveries in the natural wellness arena to be uncovered and it may be the most promising to date. In a small study group using Xango mangosteen juice: all of the participants suffering with psoriasis had a healing response that ranged from 50% to 100% improvement over a six month period. Most of the participants displayed these improvements with significant reductions in medication and topical cream use. In several individual case studies using Xango, when the juice is consumed orally and applied topically daily, severe cases of psoriasis have cleared up completely in three to five weeks. However, the condition reappears when consumption of the juice is discontinued.
Xanthones, which are unique to the mangosteen, as a class of phytonutrients are polyphenolic bioflavonoids. Over 60 research papers show anti-tumor, anti-proliferative, anti-microbial, anti-histamine, anti-inflammatory, anti-oxidant and gastrointestinal protective effects. Mangosteen has been used successfully for microbial (Viral, Bacterial and Fungal) conditions for centuries throughout Southeast Asia. It also possesses many additional benefits over other natural products.
In some cases, people using mangosteen for the first time may experience a healing crisis or detoxifying effect {an increase or outbreak of symtoms that may last from 4 to 10 days} in the earliest stages of use. Once the body is cleared of the toxins that exasperate the condition, the healing process can get underway. This is normal and should be expected when using a quality natural product. Results will vary with individuals but the long term benefits are well worth the short term discomfort as mangosteen juice has been effective in some of the most severe cases of psoriasis.
Mangosteen juice from the whole fruit puree consumed daily, has successfully been used to treat inflammatory conditions and has demonstrated numerous additional benefits over other natural products. More mangosteen research is needed, but current scientific studies have demonstrated promising results with the treatment of psoriasis. Mangosteen Science

Updated 03Feb2009

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