There is a plethora of complementary and alternative medicines (CAM) used by sufferers of skin diseases. For the most part, the use of these therapies is based on anecdotal evidence or on traditional patterns of use. Relatively little empirical evidence exists for the use of CAM therapies in skin diseases. Those studies that have examined CAM skin disease therapies have often been flawed methodologically. A small number of CAM therapies have been accepted or are on the cusp of acceptance in dermatological practice. Even here, the evidence for CAM use is often limited or equivocal. Equally, issues of poorly documented adverse effect profiles, quality control of preparations and product adulteration and contamination hamper the integration of CAM therapies into orthodox dermatology practice. Thus, it may be more appropriate to consider `pluralism' rather than `integration' in the relationship of CAM and conventional medicine.