Coenzyme Q10

Can the supplement Coenzyme Q10 help in the treatment of psoriasis?

Grade F

Coenzyme Q10 (CoQ10 from now on) is a molecule involved in the production of energy within cells. As a dietary supplement, it has been tested against a variety of diseases. Psoriasis, however, doesn’t appear to be one of them.

Most of the information about CoQ10 one can find on the Web doesn’t even mention psoriasis (for examples, see the Wikipedia or Mayo Clinic CoQ10 pages). So, I turned to Google, and started extensive searches.

One of the first things I found was an Innvista page which had a list of synonyms for CoQ10. I made full use of this, and along with information from other web pages, I created a list of keywords to search for with Google (using the keyword “psoriasis” as well):

Coenzyme Q10 is also known as: Adelir, Coenzime, Coenzym CoQ10, Coenzyme Q199, CoQ10, Co-Enzyme Q10, Heartcin, Ibidecarenone, Inokiton, Mitoquinone, Neuquinone, NSC 140865, Q-275, Taidecanone, Ubichromenol, Ubidecarenone, Ubiquinol, Ubiquinon, Ubiquinone, Udekinon, Vitamin Q10, 272-substance.

Many of these are probably incorrect or obsolete, however, as the only result Google would return for a search was that single Innvista page. But many results were returned for the few most-popular synonyms.

Having examined nearly 1,000 web pages, I can say that easily 90% of the results returned for these searches are for web sites which sell multiple products. For example, on the same page, they might be selling an anti-wrinkle cream containing CoQ10, and fish oil supplements for psoriasis. These pages contain no information about using CoQ10 for psoriasis.

Another 5% of the pages weren’t selling products, but instead were discussions about various supplements, and so, for example, would have a paragraph about how CoQ10 is good for the heart, and how Vitamin D is supposedly good for psoriasis. Again, no information about using CoQ10 to treat psoriasis.

A small percentage of the results were nothing more than lists of human genes, and including both the gene(s) for making CoQ10, and several suspected psoriasis genes. Again, nothing useful regarding treatment.

Several products have a mix of ingredients including CoQ10, but make no claims that it, in particular, can do anything for psoriasis. Some other ingredient is supposed to be taking care of the disease, while the CoQ10 is there just for its antioxidant capabilities. For example, while Skin Moritz Dry Skin FormulaBroken Link includes CoQ10, the product description says that yellow dock is in there for psoriasis. Pages describing such products won’t be included here, since they aren’’t claiming that CoQ10 treats psoriasis.

So out of hundreds of web pages, what’s left? Where are the actual claims? As far as I can tell, there are only eight.

Cosmetic CreationsBroken Link is a very short page with two links on it, one of which is to a “Comprehensive guide to scientific studies” which “details the use of Coenzyme Q10 as a treatment for” all sorts of diseases, psoriasis specifically included. Trouble is, that link takes one to a site, CoEnzyme Q10 SupplementBroken Link, which doesn’t mention psoriasis on any page I could find.

The description for Vita Sanus Skin Rejuvenator CreamBroken Link just says that this topical cream “has applications in” psoriasis, whatever that really means. Also note that this isn’t a case of CoQ10 being used as a dietary supplement, but in a cream one puts on the skin (more on this below).

Richard A. Kunin, M.D. wrote an article about CoQ10Broken Link, in 2000, which says, “Skin cells are responsive [to CoQ10] and psoriasis, in particular, may improve.” How he knows this is unclear, since he provided no references at all. And, given what CoQ10 does, if skin cells were not “responsive” to it, they’d be dead, and wouldn’t be causing psoriasis anyway. Dr. Kunin’s article has been widely reprinted — for example, in the February, 2003, Herbal Remedies Newsletter — but repetition doesn’t make it more correct.

None of the above are particularly impressive, of course. More impressive is an article from the March, 1997 Life Extension Magazine about CoQ10, which says,

Psoriasis is a serious medical condition that does not always respond to conventional corticosteroid therapy. High dose coenzyme Q10 appears to be an effective therapy against psoriasis. It works by improving the immune profile of the skin.

Unfortunately, even though “The Life Extension Foundation has a 23 year history of introducing life saving medical discoveries and funding scientific research,” it seems they weren’t able to publish any sort of citation for their claim, a major failure. And the first sentence, above, is faulty in that “conventional” psoriasis therapy involves more than just steroids. Also, “improving the immune profile of the skin” appears to me to be a meaningless concept.

But, the article appears to have impressed some people, since U.S. Health Club, a company which sells CoQ10, puts “Appears to be an effective therapy against psoriasis,” as the first line of their product information. Of course, by leaving out the “high dose” part, they’re leading people to believe that any extra amount will do the trick.

Most impressive is a page by Smart Nutrition (the company has at least half-a-dozen domains on which the same page can be found), which has a bunch of claims about the healthy aspects of the supplement, including “High doses of Coenzyme Q10 are an effective therapy for Psoriasis.” Well, that’s definite, no “appears to be” here, so surely they’ve got evidence…

…Um, maybe. Or maybe not. It’s hard to tell. Half of the page is devoted to references (and a third devoted to a product price list, leaving just a sixth for the claims themselves), but the text and references aren’t marked with footnotes or any other kind of indicator as to which reference goes with which claim(s). With 101 references for just 38 sentences of claims, and no reference mentioning psoriasis in its title, it’s impossible to tell where this specific psoriasis claim comes from without digging up and reading each individual reference, something few people will have time to do.

However, one of the references is to a 1996 Life Extension Magazine article, and another reference was published in August of 1997, so two things are fairly certain: that the Smart Nutrition article was published after March of 1997, and that the author knew about Life Extension Magazine. This makes it quite possible that the author read the Life Extension article on CoQ10 (see above), blew their claim up from “appears to be” into a sure thing, and then failed to reference the original source. I can’t say for sure that that’s what happened, but it’s possible.

Last along these lines is which says, “High doses of supplemental Coenzyme Q10 are an effective therapy for Psoriasis (CoQ10 improves the Immune function of the Skin).” This appears to be a mixture of Smart Nutrition’s surety with Life Extension’s “immune profile” nonsense. No references are given, and from the look of the page, it’s probably a slap-dash cut-and-paste job from other CoQ10 ad copy, anyway.

And finally, the eighth claim comes from Eucerin®, in an article titled, “Clinical and Biophysical Efficacy of Eucerin® Q10 Active, a Novel Coenzyme Q10 — Containing Anti-Wrinkle Cream.Broken LinkPDF File” Included in the tests of this product was a small (only 21 subjects), open-label trial of the product on “dermatological patients,” with either atopic dermatitis, contact dermatitis, or psoriasis.

Now, considering that patients with three different kinds of disease were lumped together into one group, the results aren’t particularly compelling. They’re even less compelling when the rating scale used to “measure” skin symptoms only went from 0 to 3, and the highest starting average for any measured symptom was only around 1.75 for dryness. Another nail in this test’s coffin is that the product was applied “once or twice” daily, meaning some patients got more than others.

And when you’ve got psoriasis, are “fine lines” in the skin a really big concern?

Even if this Eucerin® product works great on psoriasis, because it is a topical cream, it means nothing about whether taking CoQ10 supplements orally will do any good for your skin, since the routes of delivery are so vastly different (digestion versus rubbing it on). There are plenty of molecules which can get to the live skin cells in the dermis and epidermis via the bloodstream, but are unable to do so from topical application simply because they’re too large to get through the barrier of dead skin cells which make up the outermost layers of the skin. Of course, CoQ10 isn’t very big, but the point is that the assumption that anything you rub on your skin will also be effective if you digest it (or vice versa) is unwarranted, and thus the Eucerin® test tells us nothing about oral CoQ10.

Let’s go back to the Life Extension article. The author implies that the information given in that article was soon to be published (six years ago as of this writing) by saying that the article contains “‘inside’ information from physicians and scientists who have yet to publish the findings of their research on CoQ10.” So, one of the other places I searched was MEDLINE, the National Library of Medicine’s online database of over 4,500 peer-reviewed journals from 71 countries, containing over twelve million citations dating back to 1965. Again, using the keyword “psoriasis” and the list of names for CoQ10, above, I ran many MEDLINE searches…

…And came up with nothing. Not a single peer-reviewed article, letter, or review of the use of CoQ10 in the treatment of psoriasis. None. Zippy. In other words, even if the Life Extension Foundation was right, and there was a soon-to-be-published article about CoQ10 and psoriasis, it wasn’t actually published, at least not in any journal which meets MEDLINE standards for peer review. Considering the dubious reputation of some of the journals MEDLINE does carry, this says a lot.

It should also be noted that the Life Extension Foundation, since that 1997 article, has never again mentioned CoQ10 as a possible treatment for psoriasis (at least, not in the documents available on their web site, using their own search engine).

However, while searching MEDLINE, I did find one interesting article, “The antipsoriatic compound anthralin influences bioenergetic parameters and redox properties of energy transducing membranes” by Fuchs, Nitschmann, and Packer [Journal of Investigative Dermatology 1990 Jan;94(1):71-6]. In this article, the authors claim that when treated with anthralin, rat liver cells and cyanobacteria undergo drops in some ubiquinone activity.

This might mean that part of anthralin’s success against psoriasis may be due to its disruption of energy production within human skin cells, which might mean that supplementing with CoQ10 or using it topically might have the opposite of the desired effect. Also, the Side EffectsBroken Link page of the “CoEnzyme Q10 Supplement” site (see above) mentions “rashes.” And, the Annie Appleseed Project (AAP) claims that Paw Paw Fruit supposedly treats psoriasis, and paw paw fruit supposedly works against CoQ10 (note also that the article at the AAP link is much better referenced than most of those, above, though the AAP’s info may be a result of confusion of plant nicknames).

Finally, I need to mention Don Sipler’s Psoriasis Regimen. Although this web site has actually been down for more than three years now (the prior link is to the latest archived version), he claimed to have gotten rid of most of his psoriasis with a combination of several supplements, baths with oil, coal tar, and CoQ10.

If you read Sipler’s story, however, you’ll find out that his use of CoQ10 came last, after he’d gotten rid of much of his psoriasis, and after he began to get sunlight on his skin again. Most, if not all of his progress probably came from the oily baths, coal tar, and sunlight (all fairly mainstream), and the supplements he used were unlikely to do anything for his psoriasis, including the CoQ10. Note that at the end, he says whenever new spots of psoriasis show up, he gets rid of the scale and slaps on more MG217, his supplement dosages apparently not changing.

In conclusion, there appears to be no evidence that CoQ10 can do anything to treat psoriasis, and a couple miniscule tidbits of evidence which indicates it might make psoriasis worse. From what I’ve read, CoQ10 is rather on the expensive side, so “giving the stuff a try” might be more costly than it’s worth. Also, considering the fact that CoQ10 does seem to have effects on the heart, brain, and possibly other vital organs, a consultation with a doctor before starting a CoQ10 regimen seems to be a reasonable suggestion.