August marks Psoriasis Awareness Month, a time to learn more about this chronic skin disease and its treatments. It’s also an opportunity to offer support to the more than 8 million people in the US who suffer with it.
There are several types of psoriasis. The most common type — plaque psoriasis — affects about 80 to 90 percent of people with the condition. It causes dry, raised, pink or red patches covered with white or silvery scales. These scaly patches, called plaques, are typically found on the elbows, knees, scalp, lower back, face, palms and soles of the feet but can occur elsewhere.
Other symptoms of psoriasis include dry, cracked skin that itches or bleeds, and thick, ridged or pitted nails. About 25 to 30 percent of people with psoriasis have a related condition called psoriatic arthritis, which causes stiff, swollen, painful joints. The symptoms of psoriasis typically go through cycles, getting worse for a while (flares) and then getting better (remissions).
While psoriasis can occur at any age, it has two peaks of onset. The first is between the ages of 20 and 30, and the second is between the ages of 50 and 60. Men and women are at equal risk for developing the disorder.
Psoriasis is an autoimmune disease, a condition in which your body’s protective immune system — which normally guards against germs such as bacteria and viruses — malfunctions and attacks healthy cells by mistake. With psoriasis, white blood cells called T cells mistakenly attack your skin cells, causing the skin cell production process to speed up.
Typically, new skin cells grow every 28 to 30 days. In people with psoriasis, however, the cycle of new cell growth is shortened to every three to four days. The buildup of new skin cells outpaces the sloughing off of old cells. The excess cells are pushed to the skin’s surface, where they pile up and form the scaly patches commonly associated with psoriasis.
Researchers don’t fully understand what causes this to occur, but they believe a mix of genetics and environmental factors are involved in the development of psoriasis. Certain factors have been identified that trigger an outbreak of symptoms.
Common psoriasis triggers include an injury to the skin; stress; infection that affects the immune system; certain medications, including lithium, high blood pressure medications and anti-malarial drugs; smoking; heavy alcohol consumption; rapid withdrawal from oral or systemic corticosteroids; and cold weather, when people are routinely exposed to hot, dry indoor air.
Your doctor can typically diagnose psoriasis based on your history of symptoms and a physical exam. The doctor may take a small sample of skin, which is called a biopsy, to examine it closely under a microscope. This helps your doctor determine the type of psoriasis as well as rule out other disorders as the cause of your symptoms.
There is no cure for psoriasis. The goals of treatment are to reduce inflammation and scales, slow the growth of new skin cells and remove plaques. Treatment for mild to moderate psoriasis often begins with topical creams, ointments or lotions, including topical corticosteroids, retinoids, synthetic vitamin D and coal tar extracts.
Light therapy is a first-line treatment for moderate to severe psoriasis. It may be used alone or in combination with medication. It involves exposing your skin to controlled amounts of natural or artificial light. The light, which may be sunlight, broadband or narrowband UVB light, or an excimer laser, can improve skin affected by psoriasis.
If your psoriasis is moderate to severe and has not responded to other therapies, your doctor may recommend an oral or injected medication. These include steroids, methotrexate and cyclosporine. Drugs called biologics may also be tried. They alter the immune system and disrupt the disease cycle. Common biologics used to treat psoriasis include ENBREL®, HUMIRA®, STELARA® and COSENTYX®.
To live your best life with psoriasis, follow your doctor’s advice carefully. Also try some of these self-care strategies to better manage your condition:
• Use moisturizer regularly, especially after bathing. Avoid harsh soaps.
• Maintain a healthy weight. Obesity makes psoriasis symptoms worse.
• Quit smoking.
• Drink alcohol in moderation.
• Expose your skin to small amounts of sunlight. Limited sunlight can help alleviate psoriasis symptoms, but too much can make symptoms worse. Seek advice from your doctor before doing this.
• Avoid known triggers.
• Lower your stress. Try meditation, deep breathing, yoga or tai chi.
• Join a support group to learn more about living and coping with psoriasis.
If you develop a problem with your mental health, such as anxiety and/or depression, as a result of your psoriasis, visit a mental health provider for support and treatment. Don’t suffer in silence.