Skin conditions

The Marshall Protocol is a therapy designed to activate the body's innate immune response against persistent infections. The treatment generates a healing response known as immunopathology. Immunopathology can manifest in a variety of ways including a temporary rise in markers of inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue.. For patients with skin disease, this may mean an increase in existing symptoms.

Patients whose cutaneous immunopathology is intolerable may wish to ignore it, or treat it palliatively until it resolves, while continuing the MP. Relief of immunopathology symptoms may be obtained by adhering to the standard methods for reducing immunopathology including adjusting olmesartanMedication taken regularly by patients on the Marshall Protocol for its ability to activate the Vitamin D Receptor. Also known by the trade name Benicar. or antibiotics. At least several MP patients have been treated for the following skin conditions:

  • atopic dermatitis – involves scaly and itchy rashes
  • edema – swelling
  • erythema nodosum – involves tender, red bumps (nodules) under the skin
  • <html><b>lupus pernio</b></html> – red-to purplish lesions that can appear on the nose, face, ears or hands of sarcoidosis patients; not related to lupus
  • moles
  • psoriasis – a common skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales. Discussed at length in the Psoriasis article.
  • pruritus – rash and itching
  • skin tags (acrochordons) – common, acquired, benign skin growths that look like a small piece of soft, hanging ski
  • shingles – a painful, blistering skin rash due to the varicella-zoster virus
  • vitilligo – loss of brown color (pigment) from areas of skin, resulting in irregular white patches that feel like normal skin

Skin microbiome

A decade ago, Chiller et al. concluded, “The skin is a poor media for bacteria given the large number of inherent defense mechanisms.”1) This assessment was undermined seven years later by Fierer et al.’s work, which found that the average human palm harbors at least 150 bacterial species – an order of magnitude greater than previous estimates.2) A 2009 Science study expanded on this understanding of microbial diversity in skin, showing that forearms and underarms, though located just a short distance apart, are as “ecologically dissimilar as rainforests are to deserts.”3) Trillions of bacteria, fungi, viruses, archaea, and small arthropods colonize the skin surface, collectively comprising the skin microbiome.4) One prominent researcher called human skin a “virtual zoo of bacteria.”5)

Novel insights are being revealed about the extent to which skin microbiota affects health. For example, odors produced by skin microbiota are attractive to mosquitoes as shown by in vitroA technique of performing a given procedure in a controlled environment outside of a living organism - usually a laboratory. studies, and variation in bacterial species on the human skin may explain the variation in mosquito attraction between humans.6)

Immune response and skin disease

In human skin antimicrobial peptide (AMP) are produced mainly by keratinocytes, neutrophils, sebocytes or sweat glands and are either expressed constantly or after an inflammatory stimulus.7) As Schittek et al. explain, in several human skin diseases, there is an inverse correlation between severity of the disease and the level of AMP production. Skin lesions of patients with atopic dermatitis show a diminished expression of the beta-defensins and the cathelicidin LL-37 (both of which are strongly expressed by the Vitamin D Receptor). Furthermore, these patients have a reduced amount of the AMP dermcidin in their sweat which correlates with an impaired innate defense of human skin in vivoA type of scientific study that analyzes an organism in its natural living environment.. In addition, decreased levels of AMPs are associated with burns and chronic wounds. In contrast, overexpression of AMPs can lead to increased protection against skin infections as seen in patients with psoriasis and rosacea, inflammatory skin-diseases which rarely result in superinfection. In other skin diseases, e.g. in patients with acne vulgaris, increased levels of AMPs are often found in inflamed or infected skin areas indicating a role of these peptides in the protection from infection. These data indicate that AMPs have a therapeutical potential as topical anti-infectives in several skin diseases.8)

Immunopathology in the skin

The Marshall Protocol is a therapy designed to activate the body's innate immune response against persistent infections. The treatment generates a healing response known as immunopathology. Immunopathology can manifest in a variety of ways including a temporary rise in markers of inflammation. For patients with skin disease, this may mean an increase in existing symptoms.

People on the Marshall Protocol have reported exacerbation of skin lesions or acne, minor skin rashes and severe cutaneous reactions. These can be similar to previous skin rashes or entirely new.

Trevor Marshall, PhD

Managing skin symptoms

Patients whose cutaneous immunopathology is intolerable may wish to ignore it, or treat it palliatively until it resolves, while continuing the MP. Relief of immunopathology symptoms may be obtained by adhering to the standard methods for reducing immunopathology including adjusting olmesartan or antibiotics.

Topical steroids

As is the case with other immunosuppressive medications, steroids should only be used in limited quantities, and only for intolerable symptoms.

Topical steroid creams are available OTC and may be needed to relieve intolerable itching. Use them sparingly. If intolerable itching is not helped by OTC steroid cream, talk to your doctor about a prescription strength topical corticosteroid preparation and use it sparingly.

All topical corticosteroids are absorbed through the skin and enter the circulation. See for example this report of a person who lost their femoral head joint (hip) due to steroidal cream being applied to the face.9)

All steroids are bad in high dose – they differ only in their efficacy vs dose characteristics. So if you have to use them, then please do it very sparingly. Additionally, any skin that you apply the creams to will not be doing any healing, as the steroid will heavily suppress the immune system in the region it is applied.

Trevor Marshall

Over the counter remedies

Benadryl is an over-the-counter antihistamine that will relieve itchiness. The oral medication causes sleepiness so it might be contraindicated during the daytime but it can be particularly useful at bedtime. Benadryl cream has worked better for some than cortisone cream for just about any kind of skin lesion, whether it's something that “just” itches, or something that is irritated. Another antihistamine patients have used for intolerable itching is Cyproheptadine, but it requires a prescription. If using hydrocortisone over the counter, use it sparingly.

I've had good results applying Campho-Phenique (for lip cold sores) on my raw skin lesions when not able to use Benadryl. This OTC medicine stops the itching and burning fast.

Donna, MarshallProtocol.com

Benadryl cream helps the bits that aren't raw. A little hydrocortisone on a few places to make life bearable, but as little as possible. Zyrtec daily helps the itch, especially at night.

Julia, MarshallProtocol.com

The thing that finally calmed my face itch down was washing with soap and water and a cream called Florasone (homeopathic for eczema).

Prugg21, MarshallProtocol.com

I have had a skin rash on my hands a couple of times since starting the MP, that was similar to yours by the sound of it. I found that a low dose of antihistamine helped to reduce the itching. I also used a natural moisturizer containing oatmeal, apparently oats are quite soothing for skin rashes. You can put some oats in a small cloth bag (or an old sock/pantyhose) and put it in the bath, or use it under the shower.

Mel (shadowfeet), MarshallProtocol.com

I have been using a honey and blackberry soap (from Walmart: in the dish soap area for sensitive skin) My skin sensitivity has eased some and the skin issues that I was having on the backs of my knees have disappeared… no more itching!

Gail, MarshallProtocol.com

I had lots of itching and breaking out (skin sarcs) got worse…all herx symptoms. Benadryl cream (slathered entire areas) and 2% Ketoconzole cream (treated spots only) worked great to relieve the itching for me…also used Nizoral shampoo for an itchy scalp with total success.

DNStog, MarshallProtocol.com

Sween makes a cream called Atrac-tain which contains urea and lactic acid to gently exfoliate the skin. It works remarkably well to remove crusty tissue and restore smooth skin. Try it on a small area first to make sure you are not sensitive to any of the ingredients. It can usually be purchase at a local pharmacy.

Meg, MarshallProtocol.com

The Body Shop has a dry olive oil mist that comes in a spray mister….I really like it. It's not quite as oily as olive oil. You may want to try it. I got mine online at bodyshop.com .

Joy, MarshallProtocol.com

The chlorine in tap water can be very drying to the skin. You can purchase, for about $45, a charcoal filter for your shower-head which will filter it out. I think it makes a world of difference, you (and anybody else with dry skin) might want to give this a try.

Aunt Diana, MarshallProtocol.com

Lotions and ointments

Although the skin problem is likely due to immunopathology, as has been said, I wonder if part of the problem might be alleviated by switching ointments/lotions. Perhaps your immune system has temporarily gotten more sensitive to the ingredients in the products you are using and that is worsening things. I have some experience with this from the realm of multiple chemical sensitivities. I did not tolerate things with petroleum products (included in various medicated oinments too), which are in almost everything.

For years, I have been using 100% pure glycerin (from a drug store or health food store). This is the part of many of the best moisturizers that really does the most effective moisturizing. I then add about 1/3 to ½ part water and it makes a nice soothing moisturizer.

Another place with good products for the sensitive is Special Foods (visit the web site and click on products or call 703-644-0991), which has a line of lip balms and lotions that only use beeswax, combined with a variety of oils. Their lip balm is still the only kind I can use and you can't believe how valuable it has been to me over the years (my lips used to become cracked and bleed etc.. using every other product, until I discovered this).

For a lotion, they may be rather expensive and perhaps there would be other options for hypoallergenic lotions at a health food store if you want to order it (try needs.com), or just using a hypoallergenic vegetable oil? You could try more than one option. Also, in case you might have become sensitive to the soap you are using, there is a pure glycerin unscented soap at the health food store that I like called Clearly Natural glycerin soap.

Joyce Waterhouse, Ph.D., MarshallProtocol.com

Trader Joe's has a Liquid Glycerin Soap and also a solid bar of Glycerin Soap. If you have a store near you, take a look for these options.

Trevor Marshall, Ph.D., MarshallProtocol.com

Aubrey Organics had some shampoos that I could use in place of soap, and at one point I was tolerating Kirk's Coco Castille bar soap.

P.B., MarshallProtocol.com


As the skin recovers from inflammation, what may remain is skin that is either darker or lighter in color than normal skin. Either condition is usually temporary but it may take months or even years for skin pigmentation to return to normal. Cosmetics may help cover a discoloration. Use moisturizers as needed and avoid sunlight and extreme heat. Patients should consult their physician if they continue to have concerns.

Avoid toxic exposures

I would suggest that the patient ensure that they avoid any other toxic exposure such as cleaning products, chemicalized foods, unnecessary meds supplements etc. plus adjust lifestyle to support the process, i.e., adequate rest, fresh foods, water.

Greg Blaney, M.D.

Patients experiences


Ah bunions… I had a beauty on my right foot. Left foot was normal. It's not there any more. It became progressively smaller in the first 18 months on MP. I noticed the burning, redness and pain from time to time but did not pay it much heed. Just thought it was the big toe thing that many complain of on the MP.

I was genuinely shocked when one day lying on the couch with my feet up and there it was… or wasn't… just a small bump left to resolve.

It hurt, it burnt and it got angry red from time to time but it went.

You have a bunion? I am sure not for long!

Scarab, MarshallProtocol.com

Discolored skin

The skin color around my jaw line and chin area was considerably darker than the rest of my face, close in color to what I've termed previously as a “pregnancy mask” around my forehead and left eye area. The “mask” became visible during my pregnancy in '73, '74 time frame and never left.

Also need to report that the skin on the knuckles of both hands is real dark in comparison to the skin on my fingers. And the skin on the top of both feet seems to be darker than the skin on my legs.

I had previously reported: Small dark spots have appeared on my lower legs with little grain-like round lumps in them. I felt what I initially thought was an insect bite.

My face is developing more pigment changes, likewise. the left side of my face, mainly forehead, brow area down to cheek is the darkest spot. I too have freckles which seem to be fading, now that I've taken a good look at them.

Toni D., MarshallProtocol.com

I think you are the only one Ive read about that has the blue marks appear. I had taken 9 mos of doxy before MP and had been off it quite awhile before I relapsed and that was when I had the purple marks come up all accross the back of my hand. Didn't hurt and I hadn't hit my hand. Slowly faded to a brown then go away.

Then I did MP for last two years. About six weeks ago I was really pushing to the max herx and had one appear on my wrist near my pulse. It too is now almost gone. I looked online and found some websites that reported people in Europe with Borrelia having this type of skin issue. I remember I may have gotten mine in Spain when I lived there.

I found the explanation of the skin discoloration that can be from third stage Borrelia. See this link. I'm sorry that some of the pictures are so graphic but I wanted to show you to make sure your doctor is just thinking the skin changes you are having are just related to minocycline. My purple marks occurred on knuckles of lt hand, wrist, very delineated around the pulse area, toe, near joint and on back near spine. They have occurred pre MP and during severe herx and luckily have faded with MP. I don't know if they occur only in European Borrelia but I may have been exposed in Spain. I think this web info has a number of dermatology research groups connected to it, at least they seem to connect the word Herxheimer to this skin condition. I don't know exactly why they happen but I believe that staying the course on the MP will slowly clear the pathogens that cause this conditions. If your marks are similar maybe your doctor would be interested to look further at a connection to your Lyme.

Melinda, MarshallProtocol.com

Many of the white areas on my skin have disappeared!

Alayne, MarshallProtocol.com


In my last report I forgot to tell you the most visible improvement. I have/had haemangioma on my upper legs. Left it is a myriad of threads and spots, difficult to say how much it is decreased. On my right leg it was a big united round spot of about 70 cm2. Now it is about 7 cm2. On my under legs I had some ACA. It diminishes in the same way. ACA is seen in Europe as a very late -after 20 years or more- symptom of Borrelia afzelii.

Han.V, MarshallProtocol.com


Another great thing that is happening to me is my granulomatous raised red skin lesions that had covered 80% of by body has literally cleared up. It's flattened out and browned back to nearly my original olive skin colour.

All this has made me contact the skin and cancer foundation of Australia where I originally went and got my diagnosis of sarcoidosis 8 years ago. I spoke to them and told them about all this. It flew over there heads but they are willing to see me because my case was very interesting for them at the time and I think they want to know how all this stuff works because I'm the living proof of the MP working.

Simonc, MarshallProtocol.com

I've been on the MP now for one year this month. I have skin lesions on my face and i noticed them get better, texture and inflammation wise, when i started the the first meds, olmesartan and then the first antibiotic. Now texture has greatly improved, lesions were very dry, inflamed and flakey and hurt a lot when touched before starting MP. A few months ago I noticed, not only have they improved in texture but some are actually starting to fade on some sides. I've gotten a few new lesions since starting but there also improving. None have actually completely gone or disappeared but I think now there starting to show signs of great improvement ahead and i feel that from the improvements i have witnessed that they will fade away and leave no marks, some time in the near future. I haven't yet reached the the optimal level of all antibiotics yet but hopeful will in November and then stay at that optimal level for the next 12-24 months, so I'm sure I will see more improvement and disappearance of the lesion.

sd, MarshallProtocol.com

I had many skin lesions come and go in first year of MP, and just two month ago had a large raised lesion (AK) just slough off and disappear.

P.B., MarshallProtocol.com

Lupus pernio

My experience with <html>lupus pernio</html> is that it flares with exposure to light plus cold and wind. I suspect you have still been having a good bit of cool wind and weather in your part of the world. You may need to keep your nose better protected. I know that's hard to do, so if nothing else, you can stay indoors during daytime as much as possible and wrap a scarf around your nose if it is cool or windy.

Warning of the risk of scarring, whether on the skin or in the lungs, is a common tactic to pressure patients to use the treatment a physician prefers. <html>Lupus pernio</html> has a reputation for being difficult to treat. In reality, the doctor has no way to know whether you will scar. Certainly I sustained no scars from my winter bouts with <html>lupus pernio</html>.

Belinda, MarshallProtocol.com


I have had some interesting changes in areas where I had sun damaged skin. Particularly my neckline and the backs of my hands. At first, the MP seemed to exacerbate the redness in these areas, especially my neckline. For the first two years the skin was very red and irritated. But recently, I've started to notice it feeling much softer to the touch. There seems to be a new layer of fat making the skin feel much softer and the irritation has disappeared. I find myself constantly wanting to touch this skin it is so soft…it is an amazing difference.

Aunt Diana, MarshallProtocol.com

I have several scars on my hands that have turned a little brown some of them even a little red. One of them has been there since I was a kid and it is even starting to level out it used to stick up a little bit. I've had fifteen or more skin tags fall off. I've had small moles disappear and my larger ones are about the size of my small ones. Mine all started improving in the higher up on phase two. I am having all kind of crazy stuff on my skin happen right now dark spots coming and going, rashes, try spots but none of it is lasting more than a couple weeks.

Ival, MarshallProtocol.com

About a month ago I had a mole on my arm just turn to a sort of sludge and disappear. It felt itchy one day and I just wiped it off with a handkerchief. It left a small hole (about 6mm by 9mm), very clean on the bottom, and that healed up quickly and looks like it will leave no scar. I'm assuming my immune system took a dislike to this mole!

Just FYI, the other two chronic lesions on my arms have also healed since I started the MP (they were sores that scarred up, then they would crack open and bleed spontaneously and then erode to a sore again, over and over for about 3 years) There is a very little scarring there now, but it's just a mark and not the thick knob of scar that it used to form between breakouts.

Knochen, MarshallProtocol.com

A few days ago I noticed several small red, raw spots on the side of my face. I wondered how they got there. Only today did I recall that these are at the sites of some tiny moles (I prefer to call them beauty marks).

Carol, MarshallProtocol.com

Those very itchy, scabby patches are completely gone.

Adrianne, MarshallProtocol.com

===== Notes and comments =====

Curr Pharm Des. 2006;12(29):3787-98. Functional genome and proteome analyses of cutaneous autoimmune diseases. Trcka J, Kunz M. Source Department of Dermatology and Venerology, University of Rostock, 18055 Rostock, Germany. Abstract The use of functional genomics and proteomics technologies has dramatically increased through recent years with a special emphasis on cancer biology. However, a series of more recent reports has also addressed inflammatory diseases. These included studies on different autoimmune diseases, such as rheumatoid arthritis, lupus erythematosus, and systemic sclerosis. Gene and protein expression profiles from these studies have emphasized the role of cytokinesAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system., chemokines, and apoptosis-related molecules for the pathogenesis of autoimmune diseases. Much less is known about gene and protein patterns of these diseases in dermatology. Here we provide an overview on current knowledge about genomics and proteomics analyses of cutaneous autoimmune diseases. These diseases include psoriasis, lupus erythematosus, systemic sclerosis, vitiligo, and alopecia areata. The presented findings not only provide deeper insights into the pathogenesis of each individual disease but also show overlapping gene patterns suggestive for common pathogenic mechanisms. However, many open questions remain to be resolved since data about local gene expression pattern in affected tissues are still scarce. PMID: 17073677

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7) , 8)
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