Psoriasis
Psoriasis is a common, long-term (chronic) disease with no cure. It can be painful, interfere with sleep and make it hard to concentrate. The condition tends to go through cycles, flaring for a few weeks or months, then subsiding for a while. Common triggers in people with a genetic predisposition to psoriasis include infections, cuts or burns, and certain medications.
What are the symptoms of psoriasis?
The following are the most common symptoms of psoriasis. Psoriasis comes in several forms and severities. Symptoms may include:
Plaque psoriasis
This type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds.
Guttate psoriasis
This type of psoriasis affects mostly children. Symptoms may include many small spots of red, raised skin. A sore throat usually proceeds the onset of this type of psoriasis.
Pustular psoriasis
Symptoms may include small pustules (pus-containing blisters) all over the body or just on the palms, soles, and other small areas.
Causes
Psoriasis is thought to be an immune system problem that causes skin cells to grow faster than usual. In the most common type of psoriasis, known as plaque psoriasis, this rapid turnover of cells results in dry, scaly patches.
The cause of psoriasis isn’t fully understood. It’s thought to be an immune system problem where infection-fighting cells attack healthy skin cells by mistake. Researchers believe that both genetics and environmental factors play a role. The condition is not contagious.
Risk factors
Anyone can develop psoriasis. About a third of instances begin in childhood. These factors can increase the risk of developing the disease:
Family history
The condition runs in families. Having one parent with psoriasis increases your risk of getting the disease. And having two parents with psoriasis increases your risk even more.
Smoking
Smoking tobacco not only increases the risk of psoriasis but also may increase the severity of the disease.
How is psoriasis diagnosed?
When the condition progresses to the development of silvery scales, the healthcare provider can usually diagnose psoriasis with a medical exam of the nails and skin. Confirmation of diagnosis may be done with a skin biopsy (taking a small skin specimen to examine under a microscope).
Treatment for psoriasis
Specific treatment for psoriasis will be discussed with you by your healthcare provider based on:
- Your age, overall health, and medical history
- Severity of the condition
- Your tolerance of specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
The goal of treatment is to reduce inflammation and slow down the rapid growth and shedding of skin cells. At the present time, there is no cure for psoriasis.
Treatment may include:
- Ointments and creams (to moisturize the skin)
- Sunlight or ultraviolet light exposure (under a healthcare provider’s supervision)
- Laser treatments
- Topical steroid creams
- Vitamin D cream
- Creams containing salicylic acid or coal tar
- Anthralin. An anti-inflammatory drug that treats the thicker, hard-to-treat patches of psoriasis.
- Oral or topical retinoids
- Immunosuppressive medicines (such as cyclosporine or methotrexate)
- Newer injectable biologic medicines
Treatment considerations
You and your health care provider will choose a treatment approach based on your needs and the type and severity of your psoriasis. You’ll likely start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy). Then, if your condition doesn’t improve, you might move on to stronger treatments.
People with pustular or erythrodermic psoriasis usually need to start with stronger (systemic) medications.
In any situation, the goal is to find the most effective way to slow cell turnover with the fewest possible side effects.
Coping and support
Coping with psoriasis can be a challenge, especially if the affected skin covers a large area of your body or is visible to other people. It can cause discomfort and embarrassment. The ongoing, persistent nature of the disease and the treatment challenges only add to the burden.
Here are some ways to help you live with psoriasis and feel more in control:
Learn more about psoriasis. Find out as much as you can about the disease, and research your treatment options.
Understand possible triggers of the disease so that you can better prevent flare-ups.
Educate those around you — including family and friends — so that they can recognize, acknowledge and support your efforts in dealing with the disease.
Follow your health care provider’s recommendations. Try to adhere to medical advice about treatment and lifestyle changes. Ask questions if anything is unclear.
Find a support group. Consider joining a support group of people who have the disease. Some people find comfort in sharing their experiences and meeting people who face similar challenges. Ask your health care provider for information on psoriasis support groups in your area or online.
Use cover-ups as needed. On those days when you feel particularly self-conscious, cover the psoriasis with clothing or use cosmetic cover-up products, such as body makeup or a concealer. These products might irritate the skin, so don’t use them on open sores, cuts or unhealed patches. Reduce stress.
The relationship between stress and psoriasis is unclear and needs further study. But it’s possible that easing stress in your life might help reduce psoriasis flares and itchiness. Try doing things you enjoy and activities that focus your mind on something other than your stresses. Consider meditation, tai chi, yoga, and spending time with friends and loved ones.
Outlook
There is no known way to prevent psoriasis. Although it is a lifelong condition, it often can be controlled with appropriate treatment. Keeping the skin clean and moist, and avoiding person-specific psoriasis triggers (excessive stress, for example) may help decrease flare-ups.
