Individualized homeopathic treatments address skin challenges safely, effectively.
article taken from dermatologytime
"We should be proud of what we can do with conventional dermatology, but homeopathic medicine can help sometimes when we have patients who don't seem to be getting better with the best conventional medicine," says Dr. Signore, a Tinley Park, Ill., dermatologist in private practice.
To date, "Three studies have suggested that classical homeopathic medicine can help reduce utilization of the usual conventional dermatologic therapies that we prescribe," Dr. Signore says. For example, a prospective observational study involving 225 children with atopic dermatitis (AD) who underwent both conventional and homeopathic treatments showed that after two years' follow-up, average eczema severity scores improved substantially.
Additionally, patients reduced their use of conventional drugs including corticosteroids and asthma medications (Witt CM, Ludtke R, Willich S. Acta Derm Venereol. 2009;89(2):182-183). The strongest improvements occurred in the first three months, but improvements persisted throughout the full observation period, investigators noted.
A similarly designed study involving 82 patients with psoriasis achieved similar results, including quality-of-life improvements, Dr. Signore says (Witt CM, Lüdtke R, Willich SN. J Eur Acad Dermatol Venereol. 2009;23(5):538-543).
In Japan, researchers added classical homeopathic medicine to conventional medications used by 17 patients with resistant AD. After treatment periods ranging from six to 31 months, all 17 improved (Itamura R, Hosoya R. Homeopathy. 2003;92(2):108-114). Overall, about half of these patients experienced 50 percent improvement in their symptoms; half got about 80 percent improvement, Dr. Signore says.
Whenever dermatologists start a patient on a topical steroid, they're already strategizing ways to transition the patient off the drug, Dr. Signore says, adding that even being able to shift patients to lower-potency steroids would be noteworthy.
"Most of us can probably come up with 17 patients whose AD is intractable. No matter what we're giving them — topical steroids, tacrolimus — they're just not under control," he says.
Regarding homeopathic medicine's mechanism of action, "We honestly don't know how it works," Dr. Signore says. However, its key concepts include high levels of dilution. "Every time the makers of homeopathic natural remedies dilute a medication, it's shaken by a machine in a process called succussion. However it works, it has to do not only with the dilution, but mainly with the shaking, because if you just dilute medicines, they don't work."
The most commonly used potency scale in homeopathic medicine is the centesimal, Dr. Signore says. "The potency of a homeopathic remedy is the ranking of its strength, which would be analogous to the ranking of topical steroid potencies, such as low-, mid- and high-potency (formulations). Homeopathic calcium 30C means that it's been diluted and shaken to a potency of 1x10-60. There would be way less than a gram of the original substance in there. So some people believe it's a form of energy medicine."
The success rate of homeopathic medicine in dermatology varies from patient to patient, Dr. Signore says. For some acne sufferers, "It works well enough that we can get them off oral antibiotics, and sometimes even off most of the topicals. Patients may still keep using a benzoyl peroxide wash." No two are alike
Classical individualized homeopathy differs from conventional dermatology in that conventional treatments are driven by the diagnosis, Dr. Signore says. In classical homeopathy, "The absolute hardest part is individualizing the right homeopathic medication to the right patient. You get better at it with time."
Even when one clinches the diagnosis, two patients with the same dermatologic condition often would require different treatments, he says. For example, a person with a warm body type and extroverted personality likely could benefit from orally taking a diluted form of sulfur. Conversely, a patient with a cool body type and timid personality might require calcium carbonate.
"It's not unusual for other seemingly unrelated medical conditions to improve during the holistic treatment with homeopathic medicine, sometimes even before the skin gets better," he explains.
It's helpful to counsel patients that "sometimes, what we're treating might get a little worse before it gets better," he says. For example, he says that homeopathic medication might initially aggravate acne for the first few weeks or less, though the aggravation resolves with continued treatment.
It's also important to educate patients not to expect overnight cures from homeopathic medicine, he says. "Some things get better faster. But for some chronic conditions like eczema and acne, it can take months and months, much like it would with conventional medicines. It's better to under-promise and over-deliver."
Fortunately, for most people, "Compliance is very easy because they actually like the treatment," Dr. Signore says. In homeopathic medicine, even dermatologic problems are usually treated by mouth.
Dr. Signore says that for physicians, homeopathic medicine requires a long learning curve. "You really have to take a course for at least two or three years and study it very deeply. That's when you start getting results. It's very safe. So even if you didn't take a long course, you probably won't hurt anyone. But you might get discouraged because you won't get as good a result."
For physicians just starting out in homeopathic medicine, "Probably the easiest form of eczema to help patients with is irritant contact dermatitis," he says. He also has found homeopathic medicine helpful for some patients with warts, and for one patient with minor aphthous ulcers.
Studies also have shown homeopathic medicine to be beneficial in oral lichen planus and uremic pruritus, Dr. Signore says. But skin diseases such as vitiligo, psoriasis and alopecia areata (particularly the totalis and universalis types) have proven very difficult to treat in his experience, he adds.
Overall, "Most of my patients still are on some conventional dermatological medicines. But for some people, classical individualized homeopathy is a good adjunct," Dr. Signore says. When a young child is first diagnosed with atopic eczema, "Some families will request homeopathic treatment, if they know about it, and skip conventional treatments altogether if possible."
Disclosures: Dr. Signore reports no relevant financial interests.