Psoriasis is a chronic, skin condition that affects about 2-3% of the general population in the United States. Individuals with psoriasis have thick, red, and scaling patches on their skin. Psoriasis is not contagious. And, there is no cure for psoriasis but effective treatment options exist to manage symptoms.
Signs and Symptoms of Psoriasis
The severity of psoriasis varies from person to person. Some individuals may have mild severity, with only a few scattered areas of involvement. In contrast, some individuals have severe cases, with near complete total body involvement. Common signs and symptoms include:
- Red, raised skin patches with thick, silvery scales
- Dry, cracked skin that may bleed
- Skin itching or burning
- Thickened, pitted or ridged nails
- Swollen and stiff joints
There are several types of psoriasis including:
- Plaque psoriasis – the most common form of psoriasis
- Nail psoriasis – affecting the fingernails and toenails
- Guttate psoriasis – often triggered by a bacterial infection such as strep throat
- Inverse psoriasis – found in the armpits, under the breasts, and in the groin
- Pustular psoriasis – an uncommon form of psoriasis
- Erythrodermic psoriasis – a rare, yet severe exfoliative form of psoriasis
Causes of Psoriasis
The exact cause of psoriasis is not fully understood. It is thought to be related to problems of the immune system. More specifically, the immune system will send errors in signaling that tells the skin to grow too quickly. Consequently, skin cells form in days instead of weeks. The body does not shed these excess skin cells. The skin cells accumulate on the surface of the skin, thereby creating patches of psoriasis.
Factors that may trigger psoriasis include:
- Infections (such as, strep throat),
- Emotional stress,
- Injury to the skin (such as, cuts or scratches),
- Smoking, and
- Certain medications (such as, lithium for bipolar disorder, beta blockers for high blood pressure, antimalarial drugs, and iodides).
Self-Care for Psoriasis
The aim of therapy is to reduce number of skin lesions and improve skin symptoms including skin itching and irritation. Several recommendations include:
- Bathe daily using mild soaps to help remove scale and moisten your skin.
- Moisturize your skin with thick, oil-based moisturizers after bathing.
- Use cleansers or ointments containing salicylic acid to help remove thick scaling
- You can try applying over-the-counter hydrocortisone 0.5% or 1% cream to help reduce itching and redness. However, these are usually too weak to provide significant relief. Many patients require prescription-strength topical therapies.
Take good care of yourself. Eating healthy diet, exercising regularly, not smoking, and avoiding alcohol can help prevent flare-ups or worsening of psoriasis. If these self-care measures are not adequate in controlling your symptoms, you should see a dermatologist for further evaluation and treatment.
There are many prescription-strength treatments that are highly effective in controlling psoriasis.
Topical therapies include:
- Corticosteroids – considered the mainstay of treatment – for example, clobetasol 0.05% ointment or triamcinolone 0.1% ointment
- Topical immunosuppressants – for example tacrolimus (Protopic) and pimecrolimus (Elidel)
- Retinoids (vitamin-A derivatives) – for example, tazarotene (Tazorac)
- Vitamin D analogues – for example, calcipotriene (Dovonex)
- Coal tar-based therapies and anthralin – for example, anthralin cream (Drithocreme)
For more extensive psoriasis, therapies may include:
- Ultraviolet (UV) light therapies – including UVB phototherapy and PUVA (psoralen photosensitizer + UVA)
- Oral retinoids (vitamin-A derivatives) – such as acitretin (Soriatane)
- Oral immunosuppressive medications – such as, cyclosporine and methotrexate
- Drugs that alter the immune system (known as biologics) – such as, etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), golimumab (Simponi), apremilast (Otezla), secukinumab (Cosentyx) and ixekizumab (Taltz)
If you are interested in learning more about treatment options for your psoriasis, please call Heller Dermatology & Aesthetic Surgery to schedule your appointment!