Client is a 65 year old female diagnosed with a sudden onset of psoriasis. The client reported never experiencing psoriasis previously. The rash appeared suddenly, and was widespread, covering most of her body. Psoriasis lesions were particularly severe under bilateral breasts and on bilateral legs. She described the rash as being painful, burning, and extremely itchy. She reported that she had not been able to sleep through the night since it began. It should also be noted that there had been no recent changes in diet or lifestyle. The rash began a month before her consultation and had progressively worsened.
Psoriasis is an autoimmune disorder characterized by inflamed, red, raised areas that often develop into silvery scales on the scalp, elbows, knees, and lower back. (Johns Hopkins, 2023). The cause is unknown, and presently, there are no cures. There are many different types of treatments to lessen the severity of flare-ups. The National Library of Medicine defines a flare-up as a transient exacerbation of symptoms of an existing disease or condition (National Library of Medicine, 2023). With psoriasis, you will see the rash very red, rough, often with silver scaly patches instead of mildly pink or not visible at all when you are not in a flare-up. The skin will feel rough and the areas can be raised. The skin will crack easily, often during bathing, and can become infected. The client was diagnosed via biopsies taken of the rash by a dermatologist.
Her only other medical issue was high blood pressure. She currently takes Metoprolol, a beta blocker, which is metabolized by the CYP2D6 enzyme and Benazepril, an ACE inhibitor, which is metabolized by the Carboxylesterases enzyme. (Zisaki, Miskovic, Hatzimanikatis 2015). Because of these medications, I chose to avoid Rosemary, Camphor, Sage, Hyssop, and German Chamomile (Dechen, 2021 & Mount Sinai, 2023). While Benazepril is not specifically listed in the report from Mount Sinai, due to its classification of an ACE inhibitor, I chose to err on the side of caution and avoid the oils listed regardless.
To improve skin integrity and promote rest, I kept the dilution rates low in my blend. As someone who suffers from psoriasis flare-ups, I understand the importance of using gentle products. By improving skin integrity, the severity of symptoms can be reduced.
The Comforting Psoriasis Blend was approximately 1.35% dilution rate, stored in a 1 oz/30ml. amber glass dropper bottle, and is as follows:
Carrier Oils
Calendula Oil Calendula officinalis 5 ml.
Grapeseed Oil Vitus vinifera 15 ml.
Borage Seed Oil Borago officinalis 5 ml.
Jojoba Oil Simmondsia chinensis 5 ml.
Essential Oils
Tea Tree Melaleuca alternifolia 3 drops
Sweet Orange Citrus sinensis 2 drops
Lavender Lavandula angustifolia 4 drops
Cedar Texas Juniperus mexicana 2 drops
Frankincense Boswellia serrata 1 drop
Calendula Oil Calendula officinalis was used based on its anti-inflammatory and vulnerary properties (Dechen, 2021). Grapeseed Oil Vitus vinifera was used due to its ease of absorption and because it is high in polyunsaturates, vitamin E, minerals and protein (Dechen, 2021). Borage Seed Oil Borago officinalis was used due to its high level of gamma-linolenic acid (GLA) and anti-inflammatory properties (Dechen, 2021). Jojoba Oil Simmondsia chinensis was chosen because it is very close in nature to human sebum and is beneficial because of its anti-inflammatory properties (Dechen, 2021). Tea Tree Melaleuca alternifolia was used because of its anti-inflammatory, antimicrobial and antifungal properties, as well as its analgesic properties (Battaglia, 2018, Dechen, 2021). Sweet Orange Citrus sinensis was used due its sedative and skin regenerative properties (Battaglia, 2018). Lavender Lavandula angustifolia was chosen for this blend because it has antiseptic, analgesic, sedative and cytophylactic properties, as well as the harmonizing properties it has on the nervous system (Battaglia, 2018, Dechen, 2021). Cedar Texas Juniperus mexicana was used for its calming and vulnerary properties (Dechen, 2021). Frankincense Boswellia serrata was used for its wound healing and anti-anxiety properties (Battaglia, 2018).
Precautions for this blend were:
Discuss with your medical practitioner prior to use to ensure you can use essential oil blends
Always do a skin patch test prior to use to ensure no allergic reactions will occur
Do not ingest
Do not use on pets
Do not share your blend with anyone other than you as it is made specifically with your needs in mind
If rash occurs at any time, discontinue use immediately and notify your medical practitioner
Keep out of reach of children
If pregnant or nursing, consult physician prior to use
Use caution if allergic to nuts or nut oils
Directions for use were to place a few drops in palms, rub hands together and apply even thin coat on affected areas to comfort skin. Suggested use was twice daily as needed for 2 weeks. She began using this formula on April 15, 2023 twice daily for 12 days. She reported she had better results if she applied it in the morning after her shower. I also suggested she try detergent free soap, and showering in warm (not hot) water, which she did and she also patted the areas dry after showering instead of rubbing dry to avoid further irritating the areas. The client reported the appearance of the areas had improved after 12 days of this regimen and that she had finally been able to sleep through the night instead of waking up due to extreme itching. The client’s physician approved of the use of the oils and the bathing methods. She did have to begin taking Methotrexate after her use of the oils in an attempt to prevent flare ups of this magnitude from occurring again. She now uses the oils on an as needed basis and continues to take the medication as prescribed. Her skin continues to improve, not only in reduction of the redness but an overall improvement in texture and softness. The client reports her sleeping patterns are back to normal. Images shown in this study are of my client before and after. Her name is being withheld to protect her privacy.
Originally Written 5/2/2023
References:
Battaglia, S. (2018). The Complete Guide to Aromatherapy, 3rd ed. Brisbane, Australia: Black Pepper Creative. P. 308, 367, 450, 558-559,
Dechen, S. (2021). Aromatherapy Certification Level 1 Text [eBook Edition].
Crested Butte: Aroma Apothecary Healing Arts Academy, p. 53, 55-56, 86, 93, 100, 105-106, 120, 125.
Mount Sinai.(Retrieved 4/13/2023). Rosemary. https://www.mountsinai.org/health-library/herb/rosemary
Aikaterini Zisaki,1,2,* Ljubisa Miskovic,1,2 and Vassily Hatzimanikatis1,2. (February 2015) (Retrieved 5/2/2023). Antihypertensive Drugs Metabolism: An Update to Pharmacokinetic Profiles and Computational Approaches.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435036/
Johns Hopkins Medicine.(Retrieved 4/13/2023). Psoriasis.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/psoriasis
National Library of Medicine. (Retrieved 4/13/2023). Symptom Flare-up.
https://www.ncbi.nlm.nih.gov/medgen/875730#:~:text=Definition,an%20existing%20disease%20or%20condition.%20%5B