Psoriasis

What are the symptoms of Psoriasis?

Psoriasis is characterised by red, scaly patches of skin, which usually have very well defined edges. It is often symmetrical, affecting both sides of the body. The scale is typically silvery white. This typical scale may not be so obvious if the psoriasis affects a body fold such as the armpit or the patient is using a moisturizer regularly. Then it is more likely to be smooth and shiny.

Psoriasis is often very minor, causing a few dry patches on the backs of the elbows and knees, some irritation in the belly button and between the buttocks or scaling in the scalp. It can, however, affect any area of skin and it may be severe.

The most common ages for psoriasis to first appear are in the late teens and in the 50s. It affects men and women equally.

Psoriasis is often so mild it is barely noticed by the affected person, but it can occasionally so severe the patient must be admitted to hospital for treatment. It may or may not be itchy.

About 5% of those with psoriasis will also develop joint pains (psoriatic arthritis), which may involve one or more joints. This can be very debilitating.

After the psoriasis has cleared up, it may leave dark or pale marks. These marks will gradually fade over a period of several months.

How can I treat it?

Natural Remedies

An important aspect of treatment is to identify and tackle the contributing factors.

• Use a moisturizer frequently. Apply shea butter or another active moisturizer liberally and often to prevent your skin from cracking and becoming sore.
• Soaking in warm water with a bath oil or tar solution can soften the psoriasis and lift the scale.
• Sunshine may help to clear psoriasis; in many people it improves dramatically during sunny holidays. Take care, as psoriasis may develop in areas of sunburn, and fair skin exposed to ultraviolet radiation becomes prematurely aged and may develop skin cancer.
• Avoid harsh soaps. Reduce how often you bath or shower, using lukewarm water. Showers are better. Replace standard soap with a substitute such as a mild detergent soap-free cleanser.
• Avoid substances that will irritate your skin. Protect your skin from dust, water, solvents, detergents, injury; wear soft smooth cool clothes; wool is best avoided.

Prescription Medications

If your condition persists, we encourage you to see a dermatologist. The dermatologist may prescribe one or more of the following:

• Corticosteroids
• Antibiotics
• Antihistamines
• Psoralens
• Immunosuppressants
• Topical Immunomodulators
• Biologic Response Modifiers
• Antimetabolites
• Retinoids

How long will it take to go away

If you apply an active moisturizer to your skin two or three times a day, you are likely to begin to see an improvement in less than a week.

Most forms of psoriasis run a fluctuating course with periods of marked improvement and even complete clearance, only to relapse at a later time. There may be several years between relapses.

If your symptoms persist for longer than two weeks during any episode, you may want to consult a dermatologist.

What causes Psoriasis?

There is a genetic predisposition to psoriasis i.e. it tends to run in families. Psoriasis is also influenced by many environmental factors. It is not contagious and is not due to an allergy.

Exactly what causes psoriasis is not fully understood. The immune system is involved and appears to be overactive in a way that causes inflammation. This also causes growth of extra blood vessels within the skin (causing the red colour) and increased turnover of the skin cells (causing the scaling and thickening of the skin).

Like most diseases, psoriasis is influenced by inherited characteristics. Up to 50% of people with psoriasis will know of another affected family member. Patients with a family history of psoriasis tend to develop psoriasis earlier in life than those without a family history.

Physical and emotional stress may precipitate psoriasis and are hard to avoid.

Infections may cause flares of psoriasis. Sometimes, treatment of the infection may result in clearing or improvement of the psoriasis.

Psoriasis often localises around the site of physical, chemical, electrical, infective and inflammatory injury as it heals. Less often, psoriasis may localise to old scars.

Several medications can precipitate or aggravate psoriasis:

• Lithium (an antidepressant)
• Beta blockers (used to treat high blood pressure)
• Anti-malarials e.g. hydroxychloroquine
• Stopping oral corticosteroids
• Stopping strong topical corticosteroids.