Monday, May 9, 2011

Gil Yosipovitch on alternative therapies for itch

The basic problem with treating chronic itch is that there is no cure for most conditions, including eczema. But several approaches reduce the severity by a significant amount. Some of these approaches are “Western” medicine, which I take to mean they are based on refined drugs manufactured by a pharma company. Some are “alternative,” which includes acupuncture, probiotics, “Chinese medicine” (that is, herbs that probably contain active ingredients that have not been isolated and refined into “Western” drugs), and others. Gil Yosipovitch, a world expert on itch, combines both in his approach, without overt prejudice--as long as the alternative component is not patently ridiculous.

Psychology plays a large part in Y’s method. “There are a lot of issues involved in the suffering that are beyond dermatology,” he says. “We use a lot of meds that come from psychology.”

He works with an acupuncturist. He collaborates with a practitioner of healing touch.

Here’s an aside: my own mother practices healing touch, and in past years I have mocked her for it, because there is no way that waving your hands over someone’s body is going to cause physiological changes through the medium of some imaginary “energy field” that has no connection with the laws of physics. But here’s the rub: if the patient believes there is such a connection, then I acknowledge that it is possible that undergoing healing touch could relax the patient and, via psychological paths, relieve itch or pain. Won’t work for me, though; I don’t believe in it!

“I’m a physician--I’m OK with the placebo effect,” Y says. Y doesn’t care, as long as the patient feels better. He found out that his acupuncturist has expertise in itch, and his patients who undergo acupuncture see their symptoms relieved by 20-30%. That’s better than he sees with most drugs. “Why should I prescribe drugs with side effects?” he asks. “We don’t know everything.” One of his patients was taking “enough meds for an elephant,” but they didn’t do much, and it was healing touch that appeared to improve his condition.

This holds, he says, only for chronic itch. Acute itch, that is caused by something like poison ivy or insect bite, likely has a well-defined treatment. And in any case, why worry about acute itch? It will go away. (That’s my opinion, not his.)

Probiotics: he’s not super-keen on them, but he sees a lot of people asking about them. “We have to address the issue,” he says. Again, if it works, it works, so why not try eating yogurt if it seems like a good idea.

But sometimes he sees ads for less legitimate treatments such as garlic pills or suppositories. “That’s not what I want my patients to try,” he says.

I’m confused. It seems hard to draw any sort of boundary between valid and invalid therapies, if you’re OK with healing touch. Perhaps with healing touch, or yoga, if you are “treated” or practice it regularly, there is a rhythmic relaxation effect, whereas garlic pills or their ilk are unlikely to produce anything but a weak, transitory placebo effect. However, Y knows what he sees, and he sees that healing touch has a practical, beneficial outcome.

Also, it could be that genuine caring human contact reduces anxiety. A theory occurs to me: maybe the apparent increase in incidence of eczema in developed countries is partly related to social alienation in modern life. We spend so much time dealing with machines instead of people, and so much time with strangers instead of friends and family. Can we improve our eczema symptoms by spending more time with family?

I doubt it, unfortunately. Ask any mother of a young child with eczema. It’s not that the mother doesn’t care, or isn’t doing her best to try to calm her child.

In this blog I intend mostly to pursue Western therapy as a means of treating eczema or relieving itch. I’m open-minded, though, and I hope not to bad-mouth any therapies without good reason. So, within reason, I’ll try anything myself and see if it works. That includes vitamin D. In the near future I will try a course of 4000 IU vitamin D per day, and we’ll see what happens.

With itch medicine, Y says, “large studies are a problem” because itch has so many potential causes and pathways that it’s hard to find a large identical test population. “You can’t give just one antibody for itch. That’s a simplistic approach.” And so personalized medicine, a customized approach for each of us, is our future. The responsibility lies with us. But we already knew that.


  1. I know I scratch when I am stressed at work or having a bit of anxiety.

  2. Welcome back.Glad to see you posting again-lots of great info as usual! I was interested to see this post from a while ago, as I am in the field of "alternative medicine" and do see a lot of eczema in my practice. I agree with Dr Yosipovitch that each person's itch can be from very different things, and that setting up a trial on acupuncture is hard because western medicine is looking at symptoms, but in Eastern philosophy there can be so many different reasons for the symptom- hence the treatments would be very different for each person(needles would go in different places, for different amounts of time-etc). I work a lot with food intolerances/allergies and find that itch can be caused by food- milk may make one person itch, and eggs make someone else itch. All (same)histamine reactions started by different things.Sometimes it is isn't any I do find it interesting that you don't believe in Healing Touch because there is "no way some person's energy field could influence someone else". I am again with Dr Y when he said "we don't know everything". I think we don't have the ability to measure energy fields yet. I know it doesn't make sense in Newtonian physics, but we have stepped beyond that now haven't we? Quantum physics? String theory? We are just on the eve of understanding much more than we ever have. It may seem incredulous I know-much like in the case of Dr.Semmelweis and Germ/Antiseptic Theory. I could just imagine traditional doctors of the time saying (which they did,apparently) "oh sure! there are little bugs that we can't see, all over our hands that KILL people..ha!- and we can kill them by washing our hands! you are crazy!" and actually he DID have a nervous breakdown. 20 years later they found out he was right. Something to think about?

  3. Thanks for your cheerful comment, Anonymous. It is good to be back and although if a general cure for eczema is to emerge, it will be from Western science, I have an open mind and continue to be interested in whatever works--including plausible alternative medicine.

  4. Thanks for posting Y's comments on alternative medicine! It nicely illustrates how difficult any approach to treating eczema is - and maybe sometimes it is better not to ask too many questions... It is great to see you posting again!

  5. As someone with eczema and a parent of a child with eczema, I know that traditional medicine can't solve the problem (dare I say "yet"?). So I understand why people go looking elsewhere. And because stress and psychology can have a big role in how severe one's eczema is, why not try an alternative therapy that you think might work? Just the feeling that you're taking control may have a positive effect.