Complementary and Alternative Medicine in Dermatology

An Overview of Selected Modalities for the Practicing Dermatologist

Sunaina Bhuchar; Rajani Katta; John Wolf

Disclosures

Am J Clin Dermatol. 2012;13(5):311-317. 

In This Article

Abstract and Introduction

Abstract

According to survey data, 35–69% of patients with skin disease have used complementary and alternative medicine (CAM) in their lifetime. Aliterature search on this subject reveals a number of studies on the efficacy ofCAMtreatment for dermatologic conditions, as well as a number of articles showing the growing prevalence ofCAMuse amongst patients suffering fromthese conditions. Given the consensusamongst 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 thatmore evidence and better studies are needed for each of the major CAMmodalities 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 theymay cause severe adverse effects such as arsenicosis and hepatotoxicity. On the other hand, less invasive techniques such as acupuncture and psychocutaneous therapiesmay 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.

Introduction

According to survey data, 35–69% of patients with skin disease have used complementary and alternative medicine (CAM) in their lifetime.[1] A 2009 study found that 49.4% of patients with skin problems had used CAMwithin the previous year, and 6% had used it specifically for their skin disease.[2] A literature search finds a number of studies on the efficacy of herbal and non-pharmacologic CAM treatments for dermatologic conditions, as well as a number of articles revealing the growing prevalence of CAM use amongst patients with 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 alternativemedicine amongst dermatologic patients, to serve as a tool for practicing dermatologists. As CAM represents a vast and constantly evolving field, a discussion of all potential alternative therapies is beyond the scope of this paper. Specifically, we focus on the history and theory behind psychocutaneous therapies, traditional Chinese medicine (including acupuncture), homeopathy, and Ayurvedic medicine, along with current evidence for their efficacy and reports of their adverse effects.

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