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What is Psoriasis and How to Treat It
Skin, the body’s largest organ, is a protective barrier between our inner selves and the external world. But for millions of individuals worldwide, this protective shield becomes a battleground where a chronic condition known as psoriasis wages a relentless war.
Psoriasis is more than just skin deep; it’s an intricate interplay of genetics, immune response, and environmental factors that leads to discomfort, self-consciousness, and, often, confusion.
Here, we will embark on a journey to demystify psoriasis, exploring its origins, manifestations, and available treatments. Whether you’re someone grappling with psoriasis, seeking information to support a loved one, or simply eager to expand your knowledge, this guide will shed light on psoriasis and how to navigate its challenges.
What is Psoriasis?
Psoriasis prevalence worldwide is estimated to be around 2-3%, making it a relatively common skin condition that affects a significant portion of the global population. With a worldwide population of approximately 8 billion people, this means that there are roughly 160 million individuals living with psoriasis.
Psoriasis is a chronic autoimmune disease known for its rapid and excessive growth of skin cells, as stated by the American Academy of Dermatology. This condition causes the skin cells to build up rapidly on the skin’s surface, forming raised, red, scaly skin patches known as plaques. These plaques appear anywhere on the body.
Psoriasis can persist for years or even a lifetime. It often goes through cycles of flare-ups, during which psoriasis outbreaks worsen, followed by periods of remission when symptoms improve or disappear.
Psoriasis can affect individuals of all skin tones, including those with darker skin tones. The cracked skin patches may exhibit pink or red hues on light skin tone, while the scales can appear white or silvery. In the case of brown and black skin, the patches might also display shades of purple or dark brown, with scales possibly taking on a grayish appearance.
People with psoriasis develop severe medical conditions, including celiac disease, diabetes, heart disease, metabolic syndrome, liver disease, low self-esteem, and depression. If you’re wondering, “Is psoriasis contagious?” it’s not. Autoimmune diseases like psoriasis cannot be transmitted from one person to another through physical contact.
While there is no cure for psoriasis, various treatment options are available to help manage and improve symptoms, providing relief and improving the quality of life for individuals affected. Treatment approaches are tailored to the severity of psoriasis and the specific needs of the individual.
What Causes Psoriasis?
Psoriasis affects skin cell production, leading to an accelerated cycle of new skin cells. Without psoriasis, skin cells typically take about a month to mature and move to the skin’s surface before shedding. However, this process is dramatically accelerated with skin conditions like psoriasis, with skin cells growing in just a few days.
The exact cause of psoriasis is not fully known, but it is believed to be a complex interplay of genetic, immune system, and environmental factors. Researchers have made significant progress in understanding the mechanisms behind psoriasis. While the precise cause remains elusive, several key factors are known to contribute to the development of the condition:
Genetics
Family history plays a substantial role in psoriasis. This skin disease is considered a hereditary condition, and people with family members who have psoriasis may develop it too.
Immune System Dysfunction
Psoriasis is often described as an autoimmune disease. In individuals with psoriasis, the body’s immune system mistakenly identifies healthy skin cells as foreign invaders and launches an immune response against them.
This immune system malfunction leads to inflammation and the rapid growth of skin cells, resulting in the characteristic plaques and symptoms of psoriasis. Basically, white blood cells mistakenly attack the skin.
Environmental Triggers
While genetics and immune system dysfunction are significant factors, specific environmental triggers can exacerbate or activate psoriasis in susceptible individuals. Common psoriasis triggers include:
- Infections: Streptococcal throat infections, for example, are common triggers that can sometimes worsen psoriasis symptoms.
- Injury or Trauma: Skin injuries, such as cuts, burns, or insect bites, can lead to psoriasis lesions in a phenomenon known as the Koebner response.
- Stress: High stress levels or emotional trauma can provoke or worsen psoriasis flare-ups.
- Medications: Some medications, including lithium, antimalarial drugs, and certain beta-blockers, can induce or exacerbate psoriasis in susceptible individuals.
- Smoking and Alcohol: Both smoking and excessive alcohol consumption have been associated with an increased risk of psoriasis and may worsen the condition in those already affected.
Hormonal Changes
Hormonal changes, such as those that occur during puberty, pregnancy, and menopause, can impact psoriasis. Some women find that their symptoms improve during pregnancy but worsen after giving birth.
Obesity
There is a correlation between psoriasis and obesity. Excess body weight can increase the risk of developing psoriasis and may make existing symptoms more severe.
It’s important to note that while these factors contribute to the development and exacerbation of psoriasis, not everyone with a genetic predisposition or exposure to triggers will develop the condition.
Psoriasis is a complex and multifactorial disease, and its onset and course can vary significantly from person to person.
How is Psoriasis Diagnosed?
Diagnosing psoriasis involves a medical history review, a physical examination of skin lesions, and, in some cases, additional tests. A thorough skin examination helps identify typical psoriasis signs like red plaques with silvery scales, often occurring on the scalp, elbows, knees, lower back, and nails.
When needed, a skin biopsy may confirm the diagnosis. Blood tests can be helpful, particularly if psoriatic arthritis is suspected. Once diagnosed, personalized treatment plans are developed to improve symptoms.
What are the Common Types of Psoriasis?
Psoriasis is a diverse condition, and several common types have been identified, each with its distinct characteristics and symptoms. Here are some of them:
Plaque Psoriasis (Psoriasis Vulgaris)
80-90% of psoriasis is plaque psoriasis. It is characterized by raised, red, and inflamed patches of skin covered with silvery-white scales. These patches, known as plaques, can appear on any part of the body but are often found on the elbows, knees, scalp, lower back, and face.
Some of the common plaque psoriasis are:
Scalp Psoriasis
Scalp psoriasis exclusively affects the scalp and is characterized by red, scaly patches. This type of psoriasis causes itching and flaking, often mistaken for dandruff. In severe cases, it can extend beyond the hairline onto the forehead, neck, and ears.
Nail Psoriasis
Nail psoriasis affects the fingernails and toenails. This type of psoriasis can cause nail changes, including pitting (small dents or depressions), thickening, discoloration, ridges, and nail separation from the nail bed.
Inverse Psoriasis (Intertriginous Psoriasis)
Inverse psoriasis develops in skin folds and creases, such as the armpits, groin, under the breasts, and around the genitals. Unlike classic plaque psoriasis, this type presents as smooth, red, and inflamed patches without the typical scaling seen in other forms of psoriasis.
Psoriatic Arthritis
Individuals with psoriasis develop arthritis called psoriatic arthritis. It is a type of inflammatory arthritis that causes swollen joints, pain, swelling, stiffness, and reduced joint mobility.
At times, psoriasis and psoriatic arthritis are collectively referred to as “psoriatic disease.” Psoriatic arthritis is often associated with skin psoriasis, but not always.
Psoriatic arthritis ranges from mild to severe and may affect any joint in the body, including the fingers, toes, spine, and larger joints like the knees and elbows. Studies have found that at least 15% of the patients with plaque psoriasis will develop psoriatic arthritis.
It’s essential to treat patients with psoriatic arthritis as soon as possible to prevent further complications.
Pustular Psoriasis
Pustular psoriasis is identified by pus-filled bumps and blisters (pustules) on the skin. These are surrounded by red, inflamed skin, and individuals may experience fever, chills, and malaise.
Some of the typical pustular psoriasis are:
Generalized Pustular Psoriasis (GPP)
This is the most severe and rarest form of pustular psoriasis. GPP can cover large areas of the body and is often accompanied by fever, chills, fatigue, and malaise. It’s a severe medical condition that requires immediate medical attention and hospitalization.
GPP can occur suddenly and may be triggered by various factors, including medications, infections, or the withdrawal of systemic corticosteroids.
Palmoplantar Pustulosis (PPP)
PPP is a localized form of pustular psoriasis that primarily affects the palms of the hands and the soles of the feet. Painful pustules in these areas can significantly impact an individual’s ability to use their hands and walk comfortably. PPP tends to be chronic and recurrent.
Acrodermatitis Continua of Hallopeau (ACH)
ACH is a rare and localized form of pustular psoriasis that typically affects the fingertips and nails. It leads to pustules forming around the fingertips and can result in nail changes and deformities.
Guttate Psoriasis
Guttate psoriasis often develops suddenly and can be triggered by various factors, with infections being a common trigger, especially strep throat infections. Guttate psoriasis typically impacts children and young adults and, in the majority of instances, resolves spontaneously.
Erythrodermic Psoriasis
Erythrodermic psoriasis is rare and is the most severe psoriasis. This condition is characterized by widespread redness, inflammation, and shedding scales in sheets over a large portion of the body. Erythrodermic psoriasis is often considered a medical emergency because it can seriously affect a person’s health and well-being.
Where Does Psoriasis Start, and What Body Part Does Psoriasis Affect?
Psoriasis can occur on any body part, but certain areas are more commonly affected. The location of symptoms can vary from person to person, and it can even change over time. Some of the most common areas where psoriasis plaques develop include:
- Scalp: Scalp psoriasis can lead to red, scaly patches on the scalp, often accompanied by itching and flaking. It may be mistaken for dandruff.
- Elbows and Knees: Psoriasis frequently appears on the extensor surfaces of the elbows and knees. The plaques here can be particularly thick and scaly.
- Lower Back: Psoriasis can affect the lower back, appearing as plaques that extend from the waistline to the buttocks.
- Nails: Nail psoriasis can cause changes in the appearance of the fingernails and toenails. This may include pitting (small dents), thickening, discoloration, and nail separation from the nail bed.
- Palms and Soles: In some cases, psoriasis can affect the palms of the hands and the soles of the feet. This form of psoriasis is known as palmoplantar psoriasis.
- Face and Flexures: While less common, psoriasis can also occur on the face and in skin folds.
Can Psoriasis Be Cured?
Psoriasis is considered a chronic condition for which there is no known cure. However, it is essential to note that various treatment options are available to effectively manage and alleviate psoriasis symptoms. Certain medications can help control the condition, reduce flare-ups, and improve the quality of life for individuals with psoriasis.
Common psoriasis treatments include topical retinoid creams, ointments, phototherapy (ultraviolet light therapy), oral medications, and other treatments. Treatment choice depends on the severity of the condition, its location on the body, and individual factors.
The typical ingredients found in topical creams for psoriasis are corticosteroids, salicylic acid, coal tar, vitamin D analogues, calcineurin inhibitors, and tazarotene.
NOTE: Before buying any products containing the abovementioned ingredients, consult your dermatologist via teledermatology and patch test if they suit your skin.
To effectively treat psoriasis, people should work closely with healthcare professionals. It is to properly diagnose psoriasis and develop a psoriasis treatment plan that addresses your specific needs and concerns.
While there is no cure, many people with psoriasis can achieve significant symptom relief and long-term control of their condition through appropriate treatment and lifestyle management.
Recommended Products
CeraVe Psoriasis Cream
The CeraVe Psoriasis Skin Therapy Moisturizing Cream offers targeted relief for psoriasis symptoms. Developed by dermatologists, this non-prescription cream moisturizes and addresses common psoriasis issues.
What sets this cream apart is its dual-action formula. It removes scales and dry skin, relieving itching and improving skin appearance. Additionally, it focuses on repairing the skin barrier, reducing moisture loss, and preventing symptom recurrence.
The cream is rich but absorbs well without greasiness. It’s fragrance-free and suitable for daily use. While results vary, it’s a practical over-the-counter option for managing psoriasis discomfort. For personalized guidance, consult a dermatologist.
MG217 Psoriasis Shampoo with Coal Tar
The MG217 Psoriasis Shampoo with Coal Tar is a standout choice for soothing seborrheic dermatitis and scalp psoriasis. Recognized by the National Psoriasis Foundation, this shampoo offers targeted relief for troublesome scalp conditions.
This shampoo’s key ingredient, coal tar, is renowned for alleviating seborrheic dermatitis symptoms, like flaking and itching, after a few weeks. It is also a trusted psoriasis scalp treatment, making it a versatile solution for scalp-related skin concerns.
While this shampoo has received positive reviews for its effectiveness, it’s essential to remember that individual experiences may vary.
Scalp conditions are complex, with different triggers and responses to treatment. Therefore, consulting a dermatologist for a personalized approach to managing these conditions is advisable.
Final Thoughts
Psoriasis is a complex and often challenging condition that can significantly impact a person’s quality of life. Understanding the nature of psoriasis, its various types, triggers, and available treatment options is crucial for individuals living with this condition.
While there may not be a one-size-fits-all approach to psoriasis management, working closely with healthcare professionals, adopting a healthy lifestyle, and exploring a personalized treatment plan can help individuals find relief, regain confidence, and enjoy a better quality of life.
With ongoing research and advancements in psoriasis treatments, there is hope for improved outcomes and a brighter future for those affected.
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