SkinZinc: Psoriasis Treatment
Dr. Thomas Latino
Introduction
Psoriasis is a common skin condition that causes skin redness and irritation. The Food and Drug Administration, defines Psoriasis in The Code of Federal Regulations as a condition of the skin that leads to redness, swelling, inflammation and patches of dry, flaky skin. This common conception has been the hallmark of Psoriasis for many, many years. The premise of this review is two fold, provide a brief overview of the various forms and causes of the disorder and to scientifically examine the main chemical compounds that make up SkinZinc, a product designed specifically to help those suffering from psoriasis.
Psoriasis: Background
Psoriasis is a common skin condition that impacts roughly 1% to 3% of the world's population each year, this equates to approximately 30-90 million individuals exhibiting symptoms of varying degrees at one point or another. The exact causes of the disorder are unknown to this point; however, there is reason to believe the underlying cause may have genetic origins. Researchers have found four (4) key genes linked to Psoriasis. These genes regulate the Human Leukocyte Antigen System (HLA); which presents foreign substances to the immune system for destruction (i.e. phagocytosis). In an individual with Psoriasis, this mechanism is perverted and those with a specific HLA genetic factor, HLA-CW6 have a tendency to develop Psoriasis at an early age.
Psoriasis is very common, the condition tends to begin between the ages of 15 and 35. Under normal conditions, skin cells grow deep in the sub-dermal layers of the cutaneous tissue. These skin cells migrate to the surface roughly once every thirty (30) days. However, in an individual with the HLA-CW6 genetic marker, these same skin cells are over produced. As a direct and consequential result these skin cells surface roughly every 14 to 21 days, inevitably leading to dead skin cell accumulation on the surface of the dermal layer.
Aside from the genetic conditions that can cause Psoriasis there are a number of triggers that could bring the disease to the forefront. These common “triggers” could be bacteria, dry air or skin, injury to the dermis, medical reactions, secondary infections and the result of a weakened immune system from autoimmune diseases, such as AIDS/HIV and immune destruction resulting from Chemotherapy treatments for cancer. Psoriasis can appear suddenly or slowly; classifying it as a cyclical disorder that can appear and dissipate over time. Psoriasis can impact every part of the body; however it usually impacts the elbows, knees and trunk. The flaky, itchy patches that are the hallmark of Psoriasis are usually pinkish-red splotches.
The symptoms of Psoriasis are common, however, there are five distinct types of Psoriasis. (1) Erythrodermic-skin redness is very intense and covers a large area; (2) Guttate Psoriasis- small, pink-red spots appear on the skin; (3) Inverse- skin redness and irritation occurs in the armpit, groin and in overlapping skin; (4) Plaque- thick red patches of skin are covered by flaky scales and (5) Pustula- white blisters are surrounded by red, irritated skin. Currently, there are several main prescription treatments for Psoriasis.
These common treatments are Humira, Amevive, Enbrel, Remicade and Stelara. The side effects are relatively consistent across treatments. These common secondary symptoms can include but are not limited to: arthritis, pain, severe itching, secondary infections and skin cancer from photo-therapy treatments. Each of these side effects could potentially render the treatment worse than the disease. They appear, prima facie as invasive, intense and subjecting the patient to additional discomfort. However, there is a new product that takes Psoriasis patients to the same place as traditional OTC treatments-without the harmful side effects.
SkinZinc® combines the healing effects of over-the-counter treatments to combat the main symptoms of Psoriasis-inflammation and pain- while preserving the individual from the harsh impact of traditional pharmaceutical treatments. The remainder of this review will consist of a clinical examination of the main ingredients and compounds contained in SkinZinc®.
Clinical Review
A. Montana
The first compound present in SkinZinc® is A. Montana; this herbal remedy has been used in treatments ranging from gout to sciatic nerve pain. Arnica (Arnica montana) has been used for medicinal purposes since the 1500s and remains popular today. Applied topically as a cream, ointment, liniment, salve, or tincture, Europeans and Native Americans have used arnica to soothe muscle aches, reduce inflammation, and heal wounds. It is often the first remedy used for injuries such as sprains and bruises. Arnica is often used in homeopathy, and should be taken internally only in the extremely diluted form common to homeopathic remedies.
; Arnica is used topically for a wide range of conditions, including bruises, sprains, muscle aches, wound healing, superficial phlebitis, rheumatic pain, inflammation from insect bites, and swelling due to fractures. Homeopathic preparations are also used to treat sore muscles, bruises, and other conditions caused by overexertion or trauma. Homeopathic doses are extremely diluted. They have no detectable amount of the plant in them and are generally considered safe for internal use when taken according to the directions on the product labeling. A. Montana has been demonstrated, through clinical studies and research, to harbor and stimulate anti-inflammatory responses. This property has been demonstrated in numerous studies (See Kubo, 1994; Thiel, 2006; Conforti, 2004).
E. Angustifolium
E. Angustifolium is a common immunomodulator-it mediates specific immune responses. The main chemical compound found in E. Angustifolium is Oenthein B- a hydrolysable tannin which induces several responses including proinflammatory cytokine production. The dosage is extremely important when it comes to striking a delicate balance between immunomodulation and inducing inflammatory conditions (Scheptkin, 2009). Researchers have linked Oenthein B with the production of TNF-alpha and IL-6; two compounds that affect inflammation. Furthermore, research has shown that E. Angustifolium impacts the role and release of Interleukin-1-Beta from human macrophages.
In order to demonstrate the impact this regulation has on inflammation, Scheptkin, et. al. (2009) measured the dose-dependent threshold for inducing inflammation. Scheptkin, et. al., demonstrated that Oenthin B induced high levels of Interleukin-1-Beta and TNF-alpha in human monocytes and macrophages; furthermore the results clearly indicated an upregulation of Interferon gamma, GM-CSF, IL-6 and IL-8. These results are significant due to the fact that TNF-alpha and IL-6 are major immunomodulators and inflammatory mediators. Both compounds play a pivotal role in inducing the expression of inflammatory inhibitors.
M. Sativa
M. Sativa has long been used to treat conditions such as arthritis, kidney problems and boils (Foster, et al, 1990). Also, previous research has demonstrated that M. Sativa can ameliorate the autoimmune prone disease of lupus in mice; most likely by impugning an inflammatory response (Hong, et al, 2008). Hong, et al (2009) attempted to measure the anti-inflammatory effect of the ethyl acetate extract from M. Sativa. The preliminary results demonstrated the ethyl acetate extract suppressed the excessive effect of both TNF-alpha and IL-6.
Further research demonstrated that ethyl acetate extract was more significant in suppressing inflammatory levels of TNF-alpha and IL-6 by a 78% to 63% margin as compared to the PDTC control group (Hong, et al , 2009). Hung et al 92009) demonstrated that the ethyl acetate extract substantially inhibited the inflammatory impact of both TNF-alpha and IL-6 in the absence of harmful secondary conditions. Intuitively, M. Sativa and E. Angustifolium would work together within Skin Zinc to ensure the proper medium was attained between increasing inflammatory modulators while at the same time avoiding excess levels of TNF-alpha and IL-6 to increase the levels of inflammation.
M. Alternhifolia
Numerous recent studies now support the anecdotal evidence attributing anti-inflammatory activity to TTO. In vitro work over the last decade has demonstrated that TTO affects a range of immune responses, both in vitro and in vivo. For example, the water-soluble components of TTO can inhibit the lipopolysaccharide-induced production of the inflammatory mediators tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and IL-10 by human peripheral blood monocytes by approximately 50% and that of prostaglandin E2 by about 30% after 40 h (Hart, 2000). Further examination of the water-soluble fraction of TTO identified terpinen-4-ol, α-terpineol, and 1,8-cineole as the main components, but of these, only terpinen-4-ol was able to diminish the production of TNF-α, IL-1β, IL-8, IL-10, and prostaglandin E2 by lipopolysaccharide-activated monocytes. The water-soluble fraction of TTO, terpinen-4-ol, and α-terpineol also suppressed superoxide production by agonist-stimulated monocytes but not neutrophils (Brand, et al, 2001).
In contrast, similar work found that TTO decreases the production of reactive oxygen species by both stimulated neutrophils and monocytes and that it also stimulates the production of reactive oxygen species by nonprimed neutrophils and monocytes (Guerry, et al, 2004). TTO failed to suppress the adherence reaction of neutrophils induced by TNF-α stimulation (Abe, et al, 2003) or the casein-induced recruitment of neutrophils into the peritoneal cavities of mice (Abe, et al, 2004). These studies identify specific mechanisms by which TTO may act in vivo to diminish the normal inflammatory response.
Zinc Pyrinthione
Zinc Pyrinthione has been clinically determined to reduce the occurrences of dry, itchy skin. These symptoms are highly prevalent in Seborrheic Dermatitis-a skin condition wherein the skin demonstrates high levels of irritation, dryness, flaking and itching. Johnson and Nully (2000) reviewed the main pharmacological treatments of S. Dermatitis and stated that one of the main anti-fungal treatments that held significant abilities to reduce the main symptoms of S. Dermatitis including but not limited to the dry skin, irritation and redness that accompanies the onset of the condition. Additionally, Johnson and Nully (2000); demonstrated that Zinc Pyrinthione was included in many of the leading, conventional, S. Dermatitis treatments available over-the-counter.
Salicylic Acid
Salicylic acid psoriasis medications help to remove the thick layers of the dead skin from the psoriatic plaques, thus allowing the other medications and treatments to get to skin underneath the plaques more easily. Salicylic acid possesses keratoplastic (normalizes keratin and skin cell formation), keratolytic (dissolves, breaks down and removes the keratin-containing outer layer of skin; softens and removes the scales), antiseptic, disinfectant and bacteriostatic (inhibits bacterial growth) effects.
Salicylic acid psoriasis medications are available Over the Counter ( OTC) in concentrations up to 3% (usually used for psoriasis); concentrations over 3% require a doctor's prescription.
OTC Salicylic acid Psoriasis Treatment
Salicylic acid for psoriasis treatment is available in the following main OTC forms:
- gel/jelly:
- For psoriasis use the 1-3% gel 1 time a day. Usage: wet the skin for at least 5 minutes (i.e. take a shower). Cover the affected by psoriasis areas with a layer of gel and gently rub it in.
- lotion:
- For psoriasis use the 1-2% lotion on the scalp 1 time a day. Usage: Cover the affected by psoriasis areas with a layer of lotion and gently rub it in.
- ointment:
- For psoriasis use the 1-3% ointment 1 time a day. Usage: Cover the affected by psoriasis areas with a layer of ointment and gently rub it in.
- shampoo:
- For psoriasis use on the scalp 1-2 times a week. Usage: wet the scalp. Work up lather and rub it well into the scalp for 2-3 minutes, then rinse. Repeat the procedure and thoroughly rinse your scalp.
- dressing (occlusion):
- For psoriasis use as prescribed by your doctor.
- topical solution:
- For psoriasis use as prescribed by your doctor.
Salicylic acid products in various dosages and forms are also used for other skin disorders, such as acne, seborrheic dermatitis, dandruff, corns, calluses, warts etc.
Low potent Salicylic acid is available in pads, soap and foam form for acne treatment; high potent Salicylic acid is available in plasters and stick form - for corns, calluses and common warts.
Wart removers contain Salicylic acid at strengths about 10-20%. There are known cases when people with psoriasis have tried using wart removers to treat their psoriasis. The skin around the plaques, where the wart remover was applied, gets severely burned in this case.
The most often form of Salicylic acid used for scalp psoriasis treatment is a Salicylic acid shampoo. However, 2% Salicylic acid psoriasis ointments are also reported to be very effective for the scalp psoriasis treatment. One application of a Salicylic acid ointment on the scalp has helped some people to get rid of the "psoriatic helmet" on their heads. With the regular use it has completely freed them from the crusts. The negative of such treatment is that it is very hard to wash the Salicylic acid ointment off the scalp. Applying the ointment by thin layer on the partings and trying not to grease the hair may help to wash the ointment off more easily after the procedure.
Conclusion
In summation, the clinical review of the compounds contained in SkinZinc® reveal the optimal balance between over-the-counter treatment and the absence of harsh side effects. Each of the ingredients examined herein have been clinically substantiated to prevent the onset of inflammation while mediating specific immune responses to combat the root causes of Psoriasis. The anti-inflammatory characteristics of M. Sativa and E. Angustifolium working in tandem is just one characteristic of the highly beneficial impact SkinZinc® could potentially render upon those individuals who are suffering from Psoriasis.
