Psoriasis is a common chronic inflammatory skin disease that may affect any area of skin. A staggering 7.5 million people suffer from the skin disease in the United States alone, and it affects more than 3% of the world’s population.
Psoriasis is a skin condition where the skin cells grow about five times faster than normal skin cells. The body cannot keep up with the new cells, piling up the old ones and creating thick, flaky, itchy patches. Researchers don’t know an exact psoriasis cause but have linked a combination of genetics and certain triggers to the skin ailment.
Not every person with psoriasis experiences the same symptoms, and in fact, symptoms can vary based on the severity and type of psoriasis. However, some of the common symptoms may include:
- Small, red, individual spots
- Raised, red, inflamed lesions
- Burning, soreness, or itching of the skin
- Silvery scaly plaques
- Dry skin that cracks or bleeds
- Pitted nails or separation from the nail bed
The most common area for psoriasis include the knees, elbows, and torso. Psoriasis less frequently appears anywhere else on the body, including the face, hands, genitals, feet, nails, and in skin folds. If there is a pain, stiffness, or swelling of the joints, combined with skin irritation, can show a related condition called psoriatic arthritis.
Psoriasis treatments can vary depending on the type of psoriasis, the severity, and the location. Some people find the itch more difficult to tolerate than visible redness and scales on their skin and seek treatment for that reason. Whatever the reason, there is no one treatment option for psoriasis. A doctor might prescribe a steroid cream or antihistamine to help calm symptoms.
Despite the fact that psoriasis is incurable, it does respond well to topical creams and prescription drugs. Even people with severe psoriasis can get relief during a breakout in about 85% to 90% of cases.
Topical treatments are creams or lotions that are rubbed directly onto the affected skin to provide relief without the amount of side effects of oral medication. Some of the most commonly prescribed ones for psoriasis include:
- Salicylic acid – This treatment smooths the skin by promoting the shedding of psoriatic scales. When used in high dosages, however, the body could absorb too much of the medication, leading to side effects.
- Steroid-based creams – The number one prescribed cream for psoriasis, it decreases inflammation, relieves itching, and blocks the production of cell that are Some of the stronger prescriptions can cause side effects such as burning, dryness, and thinning of the skin.
- Calcipotriene – A topical ointment related to vitamin D that has been proven to be effective for treating psoriasis when combined with a topical corticosteroid cream.
- Coal-tar – These ointments can help slow the rapid growth of skin cells and alleviate symptoms. The shampoo is especially helpful to those who suffer from the skin condition on the scalp.
- Prescription retinoids – These topical prescriptions contain a synthetic form of vitamin A and can help improve a psoriasis outbreak.
Light therapy for psoriasis is one of the most effective treatments, however, it is used far less today because it has been shown to increase the risk of developing skin cancer. Some doctors will prescribe ultraviolet B light (UVB) treatment using a light box, which doesn’t carry as much risk of skin cancer.
For severe psoriasis, doctors may prescribe oral drugs to treat the skin disease. Many of these medications are mainly used for other ailments such as methotrexate, which is also used as a chemotherapy drug for cancer and rheumatoid arthritis. These medications have many side effects and should only be prescribed as a last effort to get psoriasis under control.
Psoriasis prevention is the key to keeping the disease under control. Most people with psoriasis go through cycles where their symptoms may seem to almost disappear for a period of time, only to flare back up again. It may not be possible to completely control or prevent a flare-up of psoriasis, but staying away from certain behaviors that may worsen existing symptoms or cause flare-ups helps in the prevention. Making lifestyle changes that can help with prevention of outbreaks, including eating healthy, not smoking, avoiding cold weather, and limiting alcohol consumption.
Scientists have found that in people with psoriasis, there are approximately 25 genes that are different to those without the skin disease. With psoriasis, the genes that control the immune system signals get mixed, and instead of protecting the body from invaders, it promotes inflammation and turns cells onto overdrive.
Research in the genetics of psoriasis didn’t begin until the early 1970’s, but recently have seen an influx in scope thanks to improvements in genetic and medical technology, as well as increased funding.
Even with research being able to identify some triggers of psoriasis, not all are universal. What may cause one persons symptoms may not affect another. Some triggers may include;
- Stress – Being under stress can cause psoriasis to begin to flare up for the first time, or aggravate existing patches. Stress reduction techniques like meditation may help prevent stress from impacting psoriasis.
- Injury to Skin – Areas of the skin that have been injured or traumatized can develop psoriasis, called a Koebner phenomenon. This type of psoriasis can be treated if it is caught early.
- Medications – Certain medications are associated with triggering psoriasis including Lithium, Anti-malarial, Inderal, Quinidine, and Indomethacin.
- Infection – Any type of infection that affects the immune system can affect psoriasis. In particular, streptococcus infection (strep throat) is associated with psoriasis, but other infections including bronchitis, tonsillitis, or a respiratory infection can also lead to a psoriasis flare up.
Other possible triggers, although scientifically unproven for psoriasis, include allergies, diet, and weather.
Psoriasis on the Face
Those with psoriasis on the face often suffer from psychosocial problems due to the highly visible presence of the skin disease. It is extremely rare to have psoriasis occurring solely on the face. Most patients also have scalp psoriasis and may also have moderate to severe psoriasis on other parts of the body. When present on the face, the skin disease prevents a therapeutic challenge because facial skin is thin, sensitive, and more complicated to treat. This is the area where people turn to natural remedies such as aloe vera and fish oil.
Nail psoriasis can appear when there is a presence of the skin disease elsewhere on the body. It can cause nails to become discolored, get thick, and can even become tender and hurt. Good nail care is the best way to treat and prevent psoriasis on this part of the body. Keep nails trimmed and short and wear gloves to clean or do other work with the hands, moisturize every day, and wear comfortable and properly fitting shoes.
It is important that people who have psoriasis learn as much as possible about their condition and understand that it is a medical problem and seek medical advice. Severe psoriasis has been associated with risks for developing comorbid conditions, such as hypertension, the metabolic syndrome, and liver disease to name a few. It is, therefore, important to both monitor and treat psoriasis closely and efficiently.
“Nail Psoriasis,” Web MD web site, last accessed January 12 2017; http://www.webmd.com/skin-problems-and-treatments/psoriasis/nail-psoriasis#1
Marianne K., “Facial psoriasis,” Dermnet New Zealand web site, 2012; https://www.dermnetnz.org/topics/facial-psoriasis
“What is psoriasis?” Psoriasis speaks web site, last accessed January 12 2017; https://www.psoriasis.com/what-is-psoriasis