Oregon Grape for Psoriasis

Topical 10 percent Mahonia cream improves psoriasis plaques modestly in small trials, less than calcipotriol but with good tolerability. Oral Oregon grape has no supporting evidence.

Overview

Topical 10 percent Mahonia cream improves psoriasis plaques modestly in small trials, less than calcipotriol but with good tolerability. Oral Oregon grape has no supporting evidence.

Verdict

Mixed evidence

Reasonable as a topical adjunct for mild plaque psoriasis. Do not use it orally for this purpose.

How It Works

Berberine-type alkaloids inhibit keratinocyte hyperproliferation and lipoxygenase-driven leukotriene production, the two processes that build and inflame a psoriatic plaque.

Dosing & Protocol

Typical dose

Recommended dose: Topical cream standardised to 10% Mahonia aquifolium extract, applied to plaques two to three times daily
Expected timeframe: 8-12 weeks

Protocol

not for: Oral use has no evidence for psoriasis
duration: Up to 12 weeks before assessing
patch test: Test on a small area first; irritation occurs in a minority
starting dose: 10% cream applied twice daily to plaques

Evidence

What the studies say

A randomised half-body trial in 82 patients compared 10 percent Mahonia aquifolium cream with calcipotriol over an average of ten weeks: both improved PASI, but calcipotriol was significantly superior, while Mahonia was better tolerated. A placebo-controlled trial in 200 patients found modest but statistically significant improvement in plaque severity. Open-label studies report PASI reductions in the 30 to 40 percent range over 12 weeks. All were small, several were manufacturer-sponsored, and none evaluated long-term maintenance or oral dosing.

Plant extracts for the topical management of psoriasis: a systematic review and meta-analysis

Score: 7/10

2013

meta_analysis

Deng S, May BH, Zhang AL +2 more

Topical Mahonia aquifolium showed benefit for psoriasis severity, but the evidence was of low methodological quality.

View source

Mahonia aquifolium in patients with psoriasis vulgaris: an intra-individual study

Score: 4/10

1999

rct

n=82

Augustin M, Andrees U, Grimme H +2 more

Mahonia ointment was less effective than dithranol but better tolerated in plaque psoriasis.

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Mahonia aquifolium ointment for mild to moderate psoriasis: a multicentre prospective open study

Score: 3/10

2005

observational

n=200

Gulliver WP, Donsky HJ

Most patients using Mahonia ointment for 12 weeks reported improvement in psoriasis severity.

View source

Safety

Caveats

Calcipotriol outperformed it head to head, so this is a secondary option. Oral Oregon grape carries berberine interaction risks including CYP3A4 inhibition and is contraindicated in pregnancy and infants. Product standardisation is inconsistent between brands.

Less likely to help if

People with extensive, guttate or pustular psoriasis, or anyone needing systemic or biologic therapy, will not get adequate control from a topical botanical.

Medical Disclaimer

The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.