DENVER — Nontraditional therapies are increasingly being subjected to clinical testing, providing clinicians in dermatology with an opportunity to counsel patients with some degree of objective information.

Although not necessarily evidence from a blinded, randomized trial, any data collected with some degree of rigor still provide the basis for a discussion, particularly if the option is safe and well tolerated, according to Steven D. Daveluy, MD, associate professor of dermatology, Wayne State University, Detroit.

Currently, about 40% of adults in the United States use some form of alternative or complementary therapies when dietary supplements are included, Daveluy reported. However, the proportion is even higher in the field of dermatology specifically, and it climbs further still with patient age. Citing evidence, Daveluy estimated that up to 85% of older individuals with a dermatologic disorder substitute or add nontraditional therapies.

Guidance Is Sought for Nontraditional Therapies 

“This is something patients want to talk about,” said Daveluy, who addressed this topic at the Society of Dermatology Physician Associates (SDPA) Annual Summer Conference 2026. 

As the terms imply, complementary medicine refers to a therapy added to a conventional drug or intervention. Alternative refers to a therapy that is substituted for a traditional therapy. The most common example of the former is diet, according to Daveluy. It’s an area of inquiry rendered increasingly mainstream by research implicating the gut microbiome in an ever-growing array of pathologies involving every or nearly every organ system, including the skin.

In a comprehensive review of complementary and alternative therapies in dermatology, he provided a broad array of examples, including those involving serious diseases. For psoriasis, he cited a controlled trial of the Mediterranean Diet in Patients with Psoriasis published last year in JAMA Dermatology. At the end of 16 weeks in this trial of 38 patients with mild-to-moderate psoriasis, who were on stable topical therapy, 47% of those on the diet vs none of the controls achieved a 75% reduction in the Psoriasis and Severity Index score from baseline.

For hidradenitis suppurativa (HS), there have been multiple studies evaluating the impact of diet on symptoms, including a recent review of all studies published between 1985 and 2026. There was substantial heterogeneity among the 11 studies included in the review, but the authors concluded that “overall, the available evidence suggests that nutritional and metabolic factors may meaningfully influence disease activity.” The findings, they added, “suggest that dietary influences in HS likely operate through broader metabolic and inflammatory pathways rather than isolated nutritional effects.” 

These studies are hardly a source of definitive evidence, but there is a substantial proportion of patients who want to do more to treat their disease than take medications, according to Daveluy. Proposing healthy dietary changes, such as a Mediterranean-style diet that is rich is fiber and other nutrients supporting biodiversity in the gut microbiome, is reasonable for anyone; and when there is evidence specific to the patient’s condition, it can be motivational, he said.

Sources of Reliable Information Are Not Obvious 

Yet, providing evidence to support any single diet over another, including an American diet rich in sugars and carbohydrates, is easier said than done, Daveluy acknowledged. Diet, nutritional supplements, and alternative topical therapies, are not generally included in traditional medical education, he noted.

While Daveluy, who has an interest in complementary and alternative medications, has been accumulating a set of references like those he included in his presentation, he has developed several other resources that he can consult when a patient asks about evidence for specific diseases, specific nutrients, specific alternative therapies, or all the above. 

Chief among these is an AI source, Open Evidence, which is free to health professionals. Daveluy often employs this as a starting point to determine whether there are supportive data for a therapy brought to him by a patient. The site does not necessarily answer the question reliably, but he pursues citations that the site provides. As often as possible, he tries to avoid the response of “I don’t know.”

Daveluy is empathetic to clinicians who remain reluctant to answer medical questions for which there is no level 1 evidence, but he argued that this results in a failure to address an increasingly common patient demand and — possibility — a medical need. Also, the evidence for complementary and alternative therapies as well as the quality control of available products, has been improving, he said.

“Supplements are not yet regulated like drugs, so you need to advise patients to look for products with a certification stamp for purity,” Daveluy said. Citing cases where tested products available on the internet have contained none of what was listed on the label, not just a low amount, he advised sticking with known brands that offer some quality assurance. 

For seeking information about nutrients and their relationship to dermatologic diseases, Daveluy also endorsed www.kattamd.com, a site maintained by Rajani Katta, MD, who runs a dermatology clinic in Bellaire, Texas, and is affiliated with Houston Methodist Hospital. A specialist in contact dermatitis, Katta has created videos, handouts, and other materials about diet and dermatologic disorders, including diets that reduce risk of skin wrinkles.

Asked about her sources, Katta, who was also a speaker at the SDPA meeting, told Medscape Medical News that she routinely surveys the literature for new information on this topic. She has also employed Open Evidence, but she cautioned that the original source of AI references, including those from Open Evidence, must be verified and vetted.

“We have all heard the stories about AI,” she said, cautioning that AI is capable of making up information and citing sources that do not exist. However, she agreed that AI can be one of the starting points for clinicians trying to develop a base of knowledge about complementary and alternative drugs for patient counseling.

Daveluy reported financial relationships with AbbVie, Incyte, Insmed, Moonlake, Novartis, Regeneron, Sanofi, and UCB. Katta reported a financial relationship with Vichy Laboratories.