Psoriasis is an autoimmune condition in which the immune system is fighting with the body’s skin cells. According to the National Psoriasis Foundation, psoriasis affects about 3% of the population, where a third of cases start in childhood but a majority develop in a person’s 20s or 30s. It’s estimated that more than 7.5 million adults in the United States are affected by the condition.
If you have a family history of psoriasis, your risk of developing the condition is much higher. Classic symptoms of psoriasis are red, scaly patches on the skin generally found outside of the elbows, on the front of the knees, and on the scalp. In some cases joints are also affected, where the main joints such as fingers, shoulders, knees, hips and the spine can get puffy, swollen or ache.
Psoriasis is typically a long-term issue in which there is no cure. The symptoms of psoriasis include rashes, which can appear randomly as well as come and go based on a person’s triggers. Triggers can be a variety of things, including an infection like strep, weather, environment or stress, that can all affect the immune system.
Sometimes psoriasis can be mistaken for other conditions like when found in the folds of skin or on the scalp where the rash can appear similar to a yeast infection or eczema. In other cases arthritis develops before a psoriasis rash, so it can also be confused with rheumatoid arthritis because similar joints are affected.
Psoriasis exists in several types, including erythrodermic, guttate, and plaque. Each having its own collection of symptoms.
The symptoms of erythrodermic psoriasis can be chronic or only last for a short time. This least common form of the condition appears as a peeling rash which can spread to the entire body. Typically, the rash is accompanied by intense burning or itching.
A main trigger of guttate psoriasis is bacterial infection. This type of psoriasis typically affects children and young adults, and can be identified by small and scaly spots on the legs, arms and trunk.
Plaque psoriasis, the most common form of the condition, is characterized by a few to several raised patches of skin, which typically appear on the scalp, lower back, elbows or knees. These patches are usually itchy, dry and covered with scales.
Scalp psoriasis scales or patches can be silver or gray in appearance, and inflamed. Patches can be thick and crusted, and bleeding can occur when removal is attempted.
Psoriasis is diagnosed in several ways. A healthcare practitioner or dermatologist will conduct a visual examination of affected areas, as well as ask questions about your health. They may also remove a piece of skin and conduct a biopsy to confirm the type of psoriasis and rule out other conditions which may be causing your symptoms.
For more severe psoriasis that covers more than 10% of the skin or is in tricky areas like the scalp or nails, or for those with joint issues, treatment usually includes a combination of things along with topicals like pills to regulate the immune system or injections to improve symptoms and calm inflammation.
For mild cases, the treatment is typically topical. If less than 10% of the skin is covered with a rash it can be treated with a topical steroid or vitamin D. As well, cream or ointment that generally have salicylic acid or vitamin A in them can be used to reduce the scaliness.
Calcineurin inhibitors can be effective to reduce the buildup of scaly skin and lessen the burning and itchiness of rashes. Coal tar is another product which is available in prescription strengths in the form of shampoos, oils and creams.
Many non-pharmaceutical treatments have been studied and have shown to be effective at improving the condition.
An anti-inflammatory diet can be one of the most effective means of addressing psoriasis. This diet should include probiotics like fermented vegetables, yogurt or kefir, high-fiber foods, wild-caught fish, spices like turmeric and pepper, and aloe vera. High zinc, vitamin A and antioxidant foods are also suggested.
With the recommendation of your doctor, some essential oils, including lavender, tea tree, geranium and frankincense, may help soothe inflamed skin and promote healing. At least 20 minutes of daily sunshine exposure and light therapy can also help psoriasis.
Other ways to help psoriasis is to:
Whether pharmaceutical or non-pharmaceutical, treatment for psoriasis is tailored to the individual and depends on where the rash is found as well as how much of the skin is covered. The American Academy of Dermatology suggests that people with psoriasis identify anything that triggers flare-ups, and avoid them where possible. They also recommend the use of psoriasis-friendly products for skin care.
Before starting any treatment for psoriasis, or adding to your existing treatment regimen, it’s important to consult with your healthcare provider. Even herbal treatments can interact with pharmaceutical psoriasis medications.
You may be taking medication for other conditions. If this is the case, consult with your healthcare provider before beginning psoriasis treatment to ensure no interactions occur, and that nothing you are taking will reduce the effectiveness of other medications.
Many medications have serious side effects, including compromised liver function, which your doctor should discuss with you prior to prescribing. If you are pregnant or are breastfeeding, notify your healthcare provider, as some treatments shouldn’t be used in these instances.
The more skin that is covered with a rash, the more inflammation is likely to be going on internally. Therefore, seeking medical care to evaluate and discuss a treatment plan is important sooner rather than later.
Psoriasis and psoriatic arthritis can also put you at a higher risk for other medical issues such as diabetes, heart disease, risk of stroke, anxiety and depression, so if you are experiencing any of these issues or want to reduce your risk of other conditions, it is best to speak with a doctor.
Overall you should not hesitate to seek treatment options, get care or try alternative opinions if you’re not seeing any results from current treatment. There are many options available for psoriasis, and clear skin is achievable.
Note that if you stop a treatment after your skin has recovered there is a good chance your rash will come back within a few weeks to a few months as your treatment plan should be long term, even if your skin has cleared.
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