Psoriasis is a skin condition in which the skin doesn’t shed and rather accumulates to form dry, red patches. It is fairly common and the psoriasis symptoms can be managed by lifestyle changes or psoriasis treatments.
What is Psoriasis?
Psoriasis is a long term, autoimmune condition affecting the skin. Psoriasis affects millions of people worldwide, it can occur at any age although symptoms often start between 15-25 years of age.
A normal cell cycle if growth and shedding within a month, however in psoriasis this process occurs in 3-4 days and skin cells don’t shed and accumulate instead.
People with psoriasis often get a rash with itchy, scaly patches or plaques and it mostly occurs on the knees, elbows, trunk and scalp. It can be dry, raised and red patches of skin. Also it can appear on any part of the body and the plaques can be in small patches or on large multiple areas.
Causes of psoriasis
The cause of the condition is not entirely understood and it’s thought to be an immune system problem where infection fighting cells attack healthy skin cells by mistake.
Triggers
Psoriasis symptoms can be triggered by infections, viral or on the skin. Further it can be due to injury to skin or smoking and heavy alcohol consumption. Similarly some medication can increase the flare up and cause psoriasis to become more severe.
Risk Factors
Anyone can develop psoriasis, however the chances can increase the risk of developing if there is family history and smoking tobacco increases the risk of psoriasis.
Psoriasis symptoms
Red and inflamed patches, Itching and discomfort, nail changes and joint pain.
Types of Psoriasis
There are 5 types of psoriasis and it is possible to have more than one type at one time and more than one type can be experienced during a lifetime.
Plaque Psoriasis
It is the most common type and in this the plaques can appear anywhere on the body as raised inflamed patches with itchy painful skin with scales (red with silvery white). Also for some people the plaques would be of purple colour and that merely depends on person to person skin type.
Inverse Psoriasis
This type of psoriasis includes the inflamed sharp edged, red or darkened skin which is smooth and not scaly mainly affecting skin folds such as underarms, under breasts and the genital/buttocks areas.
Guttate Psoriasis
This occurs after a viral infection. In this small round, red or discolored spots are caused by inflammation and often appear on legs, arms and torso.
Pustular Psoriasis
These symptoms include pustules, which have raised bumps filled with non-infection pus on tender red skin. Thus usually requires oral medication to treat the condition.
Erythrodermic psoriasis
This skin condition is very rare and can cause intense redness or discolouration and shedding of skin layers. It can be extremely painful and be life threatening in some cases.
Other symptoms of this could include severe itching, changes in heart rate and temperature and dehydration. It is very important to seek immediate medical attention during an erythrodermic flare.
Diagnosis of psoriasis
To diagnose psoriasis the healthcare provider examines the skin, scalp and nails. In some cases they may also take a biopsy to determine the type of psoriasis. There is no cure for psoriasis however the aim is to stop skin cells from growing quickly and removing scales.
Psoriasis treatment options
There are various treatment options to help manage psoriasis symptoms. They could include creams or ointments (topical therapy), light therapy (phototherapy), oral medications and also lifestyle and home remedies.
Topical therapy
Corticosteroids are the most commonly prescribed therapy to treat mild to moderate condition. Mild steroid ointments are for sensitive areas such as face, skin fold and for treating widespread patches. They may be applied once a day during flare ups and alternate days or on weekends during remission. Oils, ointments, creams, lotions and gels are the available forms.
A stronger steroid topical may be used for smaller or less sensitive or tougher to treat areas. It is important to not use strong corticosteroids for long term as this can thin the skin.
Retinoids are available as gel or cream formulation and are applied once or twice daily. It can cause skin irritation and increased sensitivity to light.
Salicylic acid shampoo and scalp solution reduce the scalp psoriasis symptoms. They are available as a single product or with other topical therapy as it prepares the scalp to absorb the medication.
Coal tar reduces scaling, itching and inflammation. These are messy and can stain clothing, bedding and also may have a strong odour.
Light therapy
This is the preferred first line treatment for moderate to severe psoriasis symptoms. In this the skin is exposed to some amounts of natural and artificial light. Daily sunlight exposure might improve psoriasis while being the safest way to use natural light.
Oral/Injected medications
In moderate to severe conditions the doctor may prescribe oral/injected medications. These can be used in combination with topical therapy. Additionally for small persistent patches steroid injections may be suggested along with retinoids pills to reduce production of skin cells.
Methotrexate is given weekly as a single oral dose. This decreases the production of skin cells and suppresses inflammation. However side effects include upset stomach, loss of appetite and fatigue. Individuals taking the medication long term need to have regular blood and liver function tests.
Lifestyle and Home remedies
It is important to keep the skin hydrated through moisturizers to alleviate dryness and reduce itching. Individuals should also avoid triggers such as stress, certain medications and infections to help manage psoriasis symptoms.
Consult a doctor
It is important to seek medical care if the condition becomes severe or causes discomfort and pain. Furthermore, if psoriasis symptoms are not well controlled a medical opinion should be consulted. If the appearance of the skin worsens and it doesn’t improve with treatment it would be best to speak to the doctor about trialing other treatments if the current one is not sufficient.
People should talk to their doctor about their psoriasis. A registered doctor can help provide the treatment options and recommend the modifications to lifestyle to live a comfortable life with psoriasis.
Resources
Symptoms, Treatment, Images and More – DermNet (dermnetnz.org)
