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Individualized homeopathic treatments address skin challenges safely, effectively

Boston — For common dermatologic conditions such as acne, warts and eczema, classical individualized homeopathic medicine can provide a safe, inexpensive and nontoxic alternative or adjunctive treatment, said Robert J. Signore, D.O., at the 2012 American Academy of Dermatology Summer Academy Meeting.

"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.

Study data

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, Ldtke 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.

Homeopathy's effects

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."

Even though dermatology is the oldest medical specialty, there are probably more unanswered questions in the field than in other specialties because we can visualize our organ of study 24/7. Thus, more observations can be made, allowing the formulation of more questions to answer. Patients probably ask more casual questions of spouses, family members and physicians regarding their skin than any other organ, as well.

Treating severe atopic dermatitis presents numerous hurdles for patients and doctors alike. Many patients with severe atopic dermatitis disease have tried and failed numerous treatments in the past; part of the challenge is regaining their trust in medicine, says Peter Lio, M.D., a dermatologist in practice in Chicago and clinical assistant professor of dermatology, Feinberg School of Medicine, Northwestern University.

A disgruntled employee went on Facebook and described a salary disagreement with his boss, Dr. Labor. Dr. Labor found out about this and promptly fired the employee for violating an office policy on not discussing office-related issues on social media. The now-former employee filed a lawsuit against him with the National Labor Relations Board (NLRB) alleging that his former boss violated his First Amendment rights.

Patients who undergo a solid organ transplant procedure have an alarmingly higher incidence of skin cancers compared to the general population. Special care and management strategies involving a multidisciplinary approach are warranted in this group, says Mich?l O'Donoghue, M.D., a dermatologist in private practice in Oak Brook, Ill.

In treating children of color, promising breakthroughs include the discovery that nutritional deficiencies may have implications in vitiligo, said Nanette Silverberg, M.D., at the 2012 American Academy of Dermatology Summer Academy Meeting.