Psoriasis
Everything You Need to Know About Psoriasis
Psoriasis is a skin condition that causes red, itchy scaly patches on the knees, elbows, trunk, and scalp, among other places. Psoriasis is a chronic (long-term) condition that has no cure. It goes through cycles, with flare-ups lasting a few weeks or months, then diminishing or going into remission.
Understanding Psoriasis
Psoriasis is a chronic autoimmune condition that causes a rapid buildup of skin cells that exhibit red, itchy scaly patches on the knees, elbows, trunk, and scalp, among other places, this buildup of cells causes scaling on the skin’s surface.
Psoriasis is a chronic (long-term) condition that has no cure. It goes through cycles, with flare-ups lasting a few weeks or months, then diminishing or going into remission. There are treatments available to assist you in managing your symptoms. You can also use lifestyle behaviours and coping skills to improve your psoriasis-related quality of life.
Psoriasis severity varies widely from person to person. For some, it’s simply a small annoyance, but for others, it can have a significant impact on their quality of life.
Scales commonly form on joints such as the elbows and knees. They can appear on any part of the body, including:
- hands
- feet
- neck
- scalp
- face
Psoriasis affects the nails, the mouth, and the area around the genitals is less common forms.
In the United Kingdom, psoriasis affects about 2% of the population. It can begin at any age, although it is more common in adults under the age of 35, and both men and women are affected equally. It’s frequently linked to a variety of different conditions, including:
- Type 2 diabetes
- Inflammatory bowel disease
- Heart disease
- Psoriatic arthritis
- Anxiety
- Depression
Psoriasis
Types
Psoriasis types
Plaque Psoriasis
Nail psoriasis
Guttate psoriasis
Inverse psoriasis
Pustular psoriasis
Erythrodermic psoriasis
Psoriatic arthritis
What are the
symptoms of
Psoriasis?
What are the symptoms of Psoriasis?
- Red patches of skin covered with thick, silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed or itch
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis patches can range in size from a few spots of dandruff-like scaling to large-scale outbreaks. Lower back, elbows, knees, legs, soles of feet, scalp, face, and palms are the most usually affected locations.
Most kinds of psoriasis have flare-ups that last a few weeks or months before diminishing or even going into remission.
All of these symptoms are not experienced by everyone. If you have a less common kind of psoriasis, you may notice completely different symptoms.
The majority of persons with psoriasis experience “cycles” of symptoms. For a few days or weeks, the illness may cause significant symptoms, which subsequently go away and become nearly unnoticed. The problem may flare up again in a few weeks or if made worse by a common psoriasis trigger. Psoriasis symptoms might sometimes go away completely.
You may be in “remission” if you have no active symptoms of the disease. That doesn’t imply your psoriasis won’t return, but you’re free of symptoms for the time being.
What Causes
Psoriasis?
What Causes Psoriasis?
Psoriasis is believed to be a problem with the immune system that causes the skin to regenerate at a quicker rate than normal. This high turnover of cells causes scales and red areas in plaque psoriasis, the most common kind of psoriasis.
It’s not totally apparent what causes the immune system to malfunction. Both genetics and environmental variables are thought to play an impact, according to researchers. The condition isn’t contagious.
Psoriasis triggers
Many people who are prone to psoriasis may go years without experiencing symptoms unless the condition is triggered by an external environmental factor. The following are some of the most common psoriasis triggers:
- Infections, such as strep throat or skin infections
- Weather, especially cold, dry conditions
- Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
- Stress
- Smoking and exposure to secondhand smoke
- Heavy alcohol consumption
- Certain medications — including lithium, high blood pressure medications and antimalarial drugs
- Rapid withdrawal of oral or systemic corticosteroids
Is psoriasis contagious?
Psoriasis is not a contagious disease. The skin disorder cannot be passed from one individual to another. You will not develop psoriasis by touching a psoriatic lesion on another person.
Psoriasis triggers: Stress, alcohol, and more
External “triggers” can set off a new psoriasis flare-up. These triggers differ from person to person. They may also alter for you over time.
The following are the most prevalent psoriasis triggers:
Stress
A flare-up could be triggered by very high stress. You can lessen and possibly prevent flare-ups if you learn to manage and reduce your stress.
Injury
A flare-up might be triggered by an accident, a cut, or a scrape. A new outbreak can also be triggered by shots, immunizations, or sunburns.
Alcohol
Psoriasis flare-ups can be triggered by excessive alcohol consumption. Psoriasis flare-ups may be more common if you drink too much alcohol. Reducing your alcohol intake is good for more than simply your skin. If you need assistance, your doctor can assist you in developing a strategy to stop drinking.
Infection
Psoriasis is caused, in part, by the immune system attacking healthy skin cells by mistake. Your immune system will go into overdrive to battle an infection if you’re unwell or have one. This could trigger a new psoriasis flare-up. A common cause is strep throat.
Medications
Some drugs are known to cause psoriasis flare-ups. The following drugs are among them:
- Lithium
- Medication to treat malaria
- Medicine for high blood pressure
Here are 12 psoriasis triggers to avoid
How is
psoriasis
diagnosed?
How is psoriasis diagnosed?
Physical examination
A simple physical examination is enough for most doctors to make a diagnosis, they will ask questions about your health and examine your skin, scalp and nails. Psoriasis symptoms are usually obvious and distinguishable from those of other illnesses that can generate similar symptoms.
Make careful to show your doctor any areas of concern during this exam. Also, tell your doctor if any members of your family have the disease.
Biopsy
A small sample of skin may be taken if the symptoms are unclear or if your doctor wants to confirm their initial diagnosis. A biopsy is the medical term for this procedure.
The skin will be transported to a lab and inspected under a microscope. The test can determine which type of psoriasis you have. It can also be used to rule out other illnesses or infections.
The majority of biopsies are performed on the day of your appointment in your doctor’s office. To make the biopsy less unpleasant, your doctor will most likely inject a local anaesthetic. The biopsy will then be sent to a lab for analysis.
When the results come back, your doctor may schedule an appointment with you to go over the findings and treatment options.
Treatment
Treatment
There is no cure for psoriasis. The goal of treatment is to minimise inflammation and scales, slow skin cell proliferation, and eliminate plaques.
Topical therapy (creams and ointments), phototherapy (Red light therapy), and oral or injectable medicines are all options.
The type of treatment you use is determined by the severity of your psoriasis and how well it responded to previous therapies. Before you find a treatment that works for you, you may need to try a variety of medications or a combination of treatments. The sickness, on the other hand, usually reappears.
There are three types of psoriasis treatments:
Topical therapy
- Corticosteroids – These are the most commonly prescribed psoriasis treatments for mild to moderate psoriasis. Ointments, creams, lotions, gels, foams, sprays, and shampoos are all available. Mild corticosteroid ointments (hydrocortisone) are frequently used for delicate areas including the face and skin folds, as well as for treating large patches. During flares, topical corticosteroids may be administered once a day, but only on alternate days or weekends to maintain remission.For smaller, less-sensitive, or difficult-to-treat regions, your doctor may prescribe a stronger corticosteroid cream or ointment, such as triamcinolone (Acetonide, Trianex), or clobetasol (Temovate).Strong corticosteroids can thin the skin if used for a long time or in excess. Topical corticosteroids may lose their effectiveness over time.
- Vitamin D analogues – Skin cell growth can be slowed by synthetic versions of vitamin D, such as calcipotriene and calcitriol (Vectical). This medication can be used alone or in combination with topical corticosteroids. In highly sensitive locations, calcitriol may produce less irritation. Topical corticosteroids are frequently more expensive than calcipotriene and calcitriol.
- Retinoids – Tazarotene (Tazorac, Avage) is a gel or cream that can be used once or twice a day. Skin discomfort and increased sensitivity to light are the most typical side effects. Tazarotene should not be used if you are pregnant, breastfeeding, or planning to become pregnant.
- Calcineurin inhibitors -Calcineurin inhibitors like tacrolimus (Protopic) and pimecrolimus (Elidel) lower inflammation and plaque formation. They’re especially useful in regions with thin skin, such as around the eyes, where steroid creams or retinoids might irritate or injure the skin. Calcineurin inhibitors should not be used if you are pregnant, breastfeeding, or planning to become pregnant. Because of the increased risk of skin cancer and lymphoma, this medicine is not recommended for long-term usage.
- Salicylic acid – Shampoos and scalp treatments containing salicylic acid help to minimise scalp psoriasis scaling. It can be taken on its own or in combination with other treatments to help them permeate the skin more easily.
- Coal tar – Scaling, irritation, and inflammation are all reduced by coal tar. It comes in a variety of forms, including shampoo, lotion, and oil, and is accessible over-the-counter or by prescription. These products have the potential to irritate the skin. They’re also filthy, leave stains on clothing and bedding, and have a strong stink. Women who are pregnant or breastfeeding should avoid coal tar treatment.
- Goeckerman therapy – Some doctors use Goeckerman therapy, which combines coal tar treatment with light therapy. Because coal tar makes skin more susceptible to UVB rays, the two therapies are more successful when used combined than when used alone.
- Anthralin – Anthralin (another tar product) is a lotion that is used to decrease the proliferation of skin cells. It can also be used to eliminate scales and smooth the skin. It is not recommended for use on the face or genitals. Anthralin irritates the skin and stains practically everything it comes into contact with. It’s normally applied for a short period of time before being wiped away.
Light therapy
Light therapy, alone or in combination with pharmaceuticals, is the first-line treatment for moderate to severe psoriasis. It entails the application of controlled amounts of natural or artificial light to the skin. Treatments must be repeated on a regular basis. Consult your doctor to see if light therapyis a viable choice for you.
- Sunlight – Heliotherapy (short, daily exposures to sunlight) may help with psoriasis. Ask your doctor about the healthiest approach to use natural light for psoriasis treatment before starting a sun regimen.
- UVB broadband – Single patches, extensive psoriasis, and psoriasis that does not respond to topical treatments can all be treated using controlled doses of UVB broadband radiation from an artificial light source. Redness, irritation, and dry skin are possible short-term adverse effects. Moisturizing your skin on a regular basis can assist to alleviate your discomfort.
- UVB narrowband – UVB narrowband light therapy may be more successful than UVB broadband light therapy, and it has largely supplanted broadband therapy in many locations. It’s normally given two or three times a week until the skin clears up, then less frequently for maintenance. Narrowband UVB phototherapy, on the other hand, may result in more severe and long-lasting burns.
- Psoralen plus ultraviolet A (PUVA) – Before being exposed to UVA light, you must take a light-sensitizing drug (psoralen). UVA radiation penetrates the skin deeper than UVB light, and psoralen increases the skin’s sensitivity to UVA exposure. This more intensive treatment regularly improves skin and is frequently used for cases of psoriasis that are more severe. Nausea, headaches, burning, and itching are some of the short-term side effects. Dry, wrinkled skin, freckles, increased UV sensitivity, and an increased risk of skin cancer, including melanoma, are all long-term adverse effects.
- Excimer laser – A powerful UVB light is used to target only the diseased skin in this type of light therapy. Because more strong UVB radiation is utilised in excimer laser therapy, it requires fewer sessions than regular phototherapy. Redness and blistering are possible side effects.
Oral or injected medications
If prior treatments haven’t worked and you have moderate to severe psoriasis, your doctor may give oral or injectable (systemic) medications. Some of these medications are only administered for a short time and maybe alternated with other therapies due to the risk of significant adverse effects.
- Steroids – Your doctor may recommend injecting triamcinolone directly into the lesions if you have a few small, persistent psoriasis spots.
- Retinoids – Acitretin (Soriatane) and other retinoids are medications that suppress skin cell formation. Dry skin and muscle discomfort are possible side effects. These medications should not be used if you are pregnant, breastfeeding, or planning to become pregnant.
- Methotrexate -Methotrexate (Trexall) is a drug that reduces the creation of skin cells and reduces inflammation. It is usually given once a week as a single oral dose. It’s not as good as adalimumab (Humira) or infliximab (Remicade). It may result in an unsettled stomach, a loss of appetite, and exhaustion. Long-term methotrexate users require regular blood tests to evaluate their blood counts and liver function. Men and women should wait at least three months after stopping methotrexate before trying to conceive. When you’re breastfeeding, you shouldn’t use this medication.
- Cyclosporine -Cyclosporine (Neoral) inhibits the immune system when used orally for severe psoriasis. It’s effective in a similar way to methotrexate, but it can’t be administered for more than a year. Cyclosporine, like other immunosuppressive medicines, raises your risk of infection and other health issues, including cancer. People on cyclosporine should have their blood pressure and kidney function checked on a regular basis. These medications should not be used if you are pregnant, breastfeeding, or planning to become pregnant.
- Biologics -These medications, which are commonly given as injections, change the immune system in such a way that they break the disease cycle and relieve symptoms and signs of disease in a matter of weeks. Several of these medications have been approved to treat moderate to severe psoriasis in persons who haven’t responded to first-line treatments. The number of therapy choices is continually increasing. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), secukinumab (Cosentyx) and ixekizumab (Taltz). These medications are costly, and health insurance companies may or may not cover them. Because biologics have the potential to suppress your immune system in ways that increase your risk of serious infections, they should be administered with caution. People who are receiving these medications, in particular, must be tested for tuberculosis.
- Other medications – Thioguanine (Tabloid) and hydroxyurea (Droxia, Hydrea) are medications that can be utilised when other medications are not available. Apremilast (Otezla) is taken twice a day by mouth. It helps to relieve itching in particular. Consult your doctor about the potential negative effects of these medications.
Treatment considerations
Although doctors choose treatments based on the type and severity of psoriasis as well as the areas of skin affected, in people with typical skin lesions (plaques), the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy) — and only progress to stronger ones if necessary. Systemic therapy is frequently required from the start of treatment for people with pustular or erythrodermic psoriasis or concomitant arthritis. The goal is to identify the most effective strategy to reduce cell turnover while causing the fewest negative effects feasible.
Alternative medicine
Psoriasis is treated with a variety of alternative therapies, including special diets, creams, nutritional supplements, and herbs. None of them has been definitively proven to be effective. Alternative remedies, on the other hand, are generally considered harmless and may help people with mild to moderate psoriasis reduce itching and scaling. Other complementary therapies can help you avoid triggers like stress.
- Aloe extract cream – Aloe extract lotion, made from the leaves of the aloe vera plant, can help with redness, scaling, itching, and irritation. To observe any improvement in your skin, you may need to use the cream multiple times a day for a month or longer.
- Fish oil supplements – When combined with UVB therapy, oral fish oil therapy may help to lessen the quantity of damaged skin. Scaling may be improved by applying fish oil to the afflicted area and covering it with a dressing for six hours a day for four weeks.
- Oregon grape – This substance, sometimes known as barberry, is applied to the skin and may help to reduce the severity of psoriasis.
- Essential oils – Aromatherapy with essential oils has been found to alleviate tension and anxiety.
Consult your doctor if you’re thinking about using dietary supplements or other forms of alternative medicine to help with psoriasis symptoms. He or she can assist you in weighing the benefits and drawbacks of various alternative therapies.
treatment modalities to treat chronic health issues, including:
Hyperbaric oxygen therapy
Accumulated data show that Hyperbaric oxygen therapy (HBOT) has anti-inflammatory effects and other positive influences on the immune system, making it a rational treatment in the management of psoriasis plaques and arthritis.
Cryotherapy
Cryotherapy can be used in therapeutic treatments to target plaques of psoriasis. Whole-body cryotherapy may also help offer relief to psoriasis symptoms. One study found that 72 percent of patients saw their psoriasis plaques clear up after a cryotherapy treatment.
Ozone therapy
Ozone therapy can attenuate local inflammatory reactions and the activation of Th17 cells in psoriasis by inhibiting the NF-κB pathway. Our results show that ozone therapy is effective in treating psoriasis.
Red Light Therapy
Infrared Sauna therapy
Infrared sauna therapy provides a non-invasive, relaxing and refreshing approach to soothe itchy, sore, dry and reddened skin to help manage the symptoms of skin conditions including eczema and psoriasis.
IV Drip Therapy
Hyperbaric oxygen therapy
Accumulated data show that Hyperbaric oxygen therapy (HBOT) has anti-inflammatory effects and other positive influences on the immune system, making it a rational treatment in the management of psoriasis plaques and arthritis.
Cryotherapy
Cryotherapy can be used in therapeutic treatments to target plaques of psoriasis. Whole-body cryotherapy may also help offer relief to psoriasis symptoms. One study found that 72 percent of patients saw their psoriasis plaques clear up after a cryotherapy treatment.
Ozone therapy
Ozone therapy can attenuate local inflammatory reactions and the activation of Th17 cells in psoriasis by inhibiting the NF-κB pathway. Our results show that ozone therapy is effective in treating psoriasis.
Red Light Therapy
Infrared Sauna therapy
Infrared sauna therapy provides a non-invasive, relaxing and refreshing approach to soothe itchy, sore, dry and reddened skin to help manage the symptoms of skin conditions including eczema and psoriasis.
IV Drip Therapy
Diet recommendations
for people with psoriasis
Diet recommendations for people with psoriasis
Although food cannot cure or even treat psoriasis, it can help you manage your symptoms. These five lifestyle adjustments may help to alleviate psoriasis symptoms and flare-ups:
Lose weight
If you’re overweight, decreasing weight may help to lessen the severity of your ailment. Treatments may be more successful if you lose weight. Because it’s unknown how weight affects psoriasis, lowering weight is still beneficial to your general health even if your symptoms don’t alter.
Eat a heart-healthy diet
Saturated fats should be avoided. Animal items, such as meat and dairy, contain them. Increase your consumption of omega-3 fatty acid-rich lean proteins like salmon, sardines, and shrimp. Walnuts, flax seeds, and soybeans are all good sources of omega-3s from plants.
Avoid trigger foods
Inflammation is a symptom of psoriasis. Inflammation can also be caused by certain diets. Avoiding those foods may help to alleviate symptoms. Among these foods are:
- Red meat
- Refined sugar
- Processed foods
- Dairy products
Drink less alcohol
Consumption of alcoholic beverages can raise your chances of experiencing a flare-up. Reduce your intake or stop completely. If you have an alcohol abuse issue, your doctor can assist you in developing a treatment plan.
Consider taking vitamins
Some experts believe that eating a vitamin-rich diet is preferable to taking vitamins in pill form. Even the healthiest eater, though, may require assistance in obtaining appropriate nutrition. Consult your doctor to see whether you should take any vitamins to augment your diet.
Find out more about your nutritional choices.
Living with Psoriasis
Living with Psoriasis?
Diet
Losing weight and eating a nutritious diet can go a long way toward alleviating and reducing psoriasis symptoms. Eating a diet rich in omega-3 fatty acids, whole grains, and vegetables is one way to do this. You should also avoid meals that can make you more prone to inflammation. Refined sugars, dairy products, and processed foods are examples of these foods.
Psoriasis symptoms have been linked to nightshade fruits and vegetables, according to anecdotal evidence. Tomatoes, white potatoes, eggplants, and pepper-derived foods like paprika and cayenne pepper are all nightshade fruits and vegetables (but not black pepper, which comes from a different plant altogether).
Stress
Psoriasis is known to be triggered by stress. Stress management and coping skills can help you reduce flare-ups and symptoms. To relieve tension, try the following:
- Meditation
- Journaling
- Breathing
- Yoga
Emotional health
Psoriasis patients are more likely to suffer from depression and low self-esteem. When new spots show, you may lose confidence. It can be difficult to talk to family members about how psoriasis affects you. The condition’s continual cycle might be aggravating as well.
All of these emotional concerns are legitimate. It’s critical that you discover a way to deal with them. This could involve chatting with a mental health practitioner or joining a psoriasis support group.
Learn more about psoriasis and how to manage it.
Psoriasis and arthritis
Psoriasis and arthritis
The joints in the fingers and toes are usually affected by this illness. Your lower back, wrists, knees, and ankles may also be affected.
Psoriasis affects the majority of persons who develop psoriatic arthritis. It is possible, however, to acquire the joint issue without having psoriasis. The majority of persons who are diagnosed with arthritis but do not have psoriasis have a family relative who does.
Psoriatic arthritis treatments can help to alleviate symptoms, relieve pain, and enhance joint mobility. Losing weight, eating a balanced diet, and avoiding triggers can all assist with psoriatic arthritis flare-ups, just as they can with psoriasis. A timely diagnosis and treatment plan can help to limit the risk of serious problems, such as joint injury.
Get more information on psoriatic arthritis.
Statistics
Statistics
In the United Kingdom, the prevalence of psoriasis is believed to be between 1.3 and 2.2 percent. Psoriasis can strike at any age, but it is most frequent in children (0.71 percent) and occurs before the age of 35. In a considerable number of patients, psoriasis is linked to joint problems (reported in one study at 13.8 percent ).
Males and females are both impacted, according to the WHO. White folks are disproportionately affected. People of colour account for a tiny percentage of psoriasis diagnoses.
Psoriasis is more likely to develop if you have a family member who has it. Many persons with the disease, on the other hand, have no family history. Some persons with a family history of psoriasis do not develop the disease.
Psoriatic arthritis affects about one-third of those who have psoriasis. Psoriasis patients are also more likely to acquire disorders such as:
- Diabetes type 2
- Renal failure
- heart disease
- High blood pressure
Psoriasis is getting more widespread, according to the study, however, the data isn’t full. It’s unclear whether this is because more people are developing the skin ailment or because doctors are growing better at diagnosing it.
More psoriasis statistics can be found here.