Psoriasis Care Includes Medication, Lifestyle Changes
While there’s no cure for psoriasis, your dermatologist can create an individualized treatment plan to manage the symptoms and prevent flare-ups.
Our skin is our body’s largest and fastest-growing organ—it protects us from harmful bacteria, keeps us warm when it’s cold and cool when it’s hot, and allows us to feel the outside world through the nerves that exist beneath it. But sometimes our immune system, which is also meant to protect us from harm, starts attacking the skin, making it scaly, itchy, swollen, and painful. This condition is known as psoriasis.
Psoriasis is an autoimmune disease that causes a fast turnover of skin cells on some or all parts of the body. While cell turnover normally takes about a month, the turnover of skin cells in psoriasis sufferers takes only a few days, which causes them to pile up too quickly and form red, scaly patches. Certain genes have been linked to this disease, although not everyone who inherits these genes will get psoriasis.
Risk Factors & Triggers
Psoriasis can start any age, but according the American Academy of Dermatology, most people will start to notice symptoms between the ages of 15 and 30 or between the ages of 50 and 60. Caucasians are more likely to get the disease than other races.
As mentioned earlier, inheriting psoriasis genes is not enough to cause symptoms. There are both external and internal triggers that a carrier must be exposed to first. Common psoriasis triggers can include:
- Dry skin
- Cuts, scratches, or severe sunburn
- Strep throat
- Medications, including lithium and malaria treatments
Psoriasis Types and Symptoms
Before a treatment plan is recommended, your doctor will need to determine which type of psoriasis you have:
- Plaque: Also known as psoriasis vulgaris, this type can cause thick, itchy patches of skin that are covered in silvery-white scales. These patches most commonly appear on the knees, elbows, lower back, and scalp, but can appear anywhere on the body. This condition can also cause weak and brittle nails. About 80 percent of psoriasis sufferers are afflicted with this type.
- Guttate: Small, red spots can appear anywhere on the body with this type—usually after an illness, such as strep throat. This type of psoriasis can sometimes clear up on its own after a few weeks or months.
- Inverse: Also known as flexural or intertriginous psoriasis, this type causes raw, smooth patches only where skin touches skin, such as the groin, armpits, breasts, genitals, or buttocks. This type, as well as guttate, are common in infants and young children.
- Pustular: Skin on the feet and/or hands becomes red, swollen, and covered with pus-filled bumps. Fever, fatigue, chills, severe itching, and rapid pulse may accompany this type of psoriasis.
- Erythrodermic: The most serious form of psoriasis, this type can turn skin bright red and affect the body’s ability to regulate temperature. It can also cause intense pain and itching, as well as heart palpitations. Those suffering from this type of psoriasis should seek immediate medical attention as soon as symptoms develop.
About 15 percent of psoriasis sufferers will also experience joint pain and stiffness that can affect the lower back, knees, ankles, wrists, and fingers. For more information about psoriatic arthritis, check out “Psoriatic Arthritis Causes and Symptoms.”
While there’s no cure for psoriasis, your dermatologist can create an individualized treatment plan to manage the symptoms and prevent flare-ups. Depending on the type and severity of the disease, treatment can sometimes result in completely clear skin. Treatments can often include:
- Topical corticosteroids, which can reduce inflammation and itching associated with mild-to-moderate psoriasis.
- Topical retinoids, which contain vitamin A derivatives, to reduce inflammation.
- Salicylic acid to remove dead skin cells.
- Anthralin, which slows down cell growth and removes scales.
- Calcineurin inhibitors to reduce inflammation and plaque buildup. These medications are only used for short periods of time due to a potential risk of skin cancer and lymphoma.
- Coal tar to reduce scaling, inflammation, and itching.
- Moisturizers to reduce dryness and itching.
Your dermatologist may also recommend light therapy, oral medication, and/or injected medication as treatment if you suffer from severe psoriasis, or if your skin doesn’t respond to more common treatments.
Naturopathic doctors often recommend alternative psoriasis treatments that include Oregon grape, aloe vera, and omega-3 fatty acids. For more information about these psoriasis home remedies, check out “3 Top Psoriasis Home Remedies: Oregon Grape, Omega 3, and Aloe Vera for Rash Treatment.”
It’s also important to make the following lifestyle changes to prevent flare-ups and improve the look of your skin:
- Take lukewarm baths daily. Add colloidal oatmeal, Epsom salts or bath oil to the water and soak for no longer than 10 minutes to remove dead skin. Pat your skin gently and always follow up with a gentle moisturizer. Avoid harsh soaps and hot water, which can make skin worse.
- Recognize and avoid the triggers. Keep your stress levels low, your skin moisturized, and avoid smoking and long-term sun exposure (although small amounts of sunlight may improve psoriasis).
- Stay away from alcohol, which can prevent your psoriasis medications from working properly.
PSORIASIS’S LINK TO HEART DISEASE
The inflammatory effects of psoriasis can impact the entire body, which may lead to cardiovascular issues, including coronary artery disease (CAD), according to recent studies.
A study conducted by Baylor Medical Center and published in JAMA Dermatology found that the prevalence of moderate to severe coronary calcification was similar between patients with type 2 diabetes and those with psoriasis, and about five times higher than in the healthy control patients.
While the lack of biological data prevented them from establishing a cause-and-effect relationship between CAD and psoriasis, the researchers believe that the coronary artery calcium (CAC) screening is appropriate for those who do not have any heart disease symptoms, and have at least one risk factor for heart disease, such as psoriasis, lupus, or rheumatoid arthritis.
“The point of the CAC test is primarily to identify higher-risk individuals that were labeled ‘low risk’ using other risk calculators,” cardiologist Boback Ziaeian, MD, PhD, clinical instructor, UCLA Division of Cardiology, told UCLA Health’s Healthy Years. “For people with psoriasis and a calculated risk of less than 7.5 percent, it may be reasonable to obtain a CAC screening test to further assess cardiovascular risk to determine if an individual is at higher risk for cardiovascular events and would benefit from statin therapy and more rigorous management of cardiovascular risk factors.”
Before a treatment plan is recommended, your doctor will need to determine which type of psoriasis you have
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