Herbal Therapeutics for Psoriasis: Molecular Mechanisms, Clinical Evidence, and Advanced Drug Delivery Strategies

Abstract

Psoriasis is a chronic immune-mediated inflammatory skin disease characterized by keratinocyte hyperproliferation, impaired epidermal barrier function, and dysregulated cytokine signaling. Although conventional therapies have improved disease management, their long-term use is often limited by adverse effects, high costs, treatment resistance, and variable clinical responses. This review aimed to critically evaluate the molecular mechanisms, clinical evidence, pharmacogenomic perspectives, and advanced drug-delivery strategies of herbal therapeutics for psoriasis. A structured narrative review was conducted using PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar to identify relevant studies published up to July 2025. Experimental, preclinical, clinical, and translational studies investigating herbal medicines, molecular mechanisms, pharmacogenomics, and nanocarrier-based drugdelivery systems for psoriasis were critically analyzed. Medicinal plants including Aloe vera, Curcuma longa, Indigo naturalis, Mahonia aquifolium, and Nigella sativa demonstrated anti-inflammatory, antioxidant, immunomodulatory, and antiproliferative effects by modulating the NF-κB, JAK/STAT, MAPK, Nrf2/HO-1, and IL-23/Th17 signaling pathways. Advanced nanocarrier systems such as liposomes, nanoemulsions, ethosomes, niosomes, solid lipid nanoparticles, and nanostructured lipid carriers improved phytochemical stability, skin penetration, controlled release, and local bioavailability. Although pharmacogenomic evidence remains limited, several herbal compounds target pathways associated with psoriasis susceptibility genes. The available evidence indicates that herbal therapeutics exert multitarget effects on key inflammatory and immune pathways involved in psoriasis and may complement conventional therapies. Integration with nanotechnology has the potential to overcome major pharmacokinetic limitations and improve therapeutic efficacy. However, most evidence remains preclinical or derived from small clinical studies, highlighting the need for standardized formulations, rigorous clinical validation, and pharmacogenomic investigations before these approaches can be incorporated into precision medicine. Herbal therapeutics combined with advanced drug-delivery technologies represent promising complementary approaches for psoriasis management. Nevertheless, challenges related to phytochemical standardization, regulatory approval, long-term safety, and the lack of large multicenter randomized clinical trials remain. Future studies integrating pharmacogenomics, multi-omics technologies, biomarker-guided clinical trials, and standardized formulations are essential to establish clinical efficacy and facilitate personalized treatment strategies.