Psoriasis is a skin disease that causes red, itchy, scaly patches, most commonly seen on the knees, elbows, trunk and scalp. Psoriasis is a common, long-term (chronic) disease with no cure, so those who struggle with the condition have it for life. With it being so common, many of us have at least heard of it or know someone who has it. So in this Health Journal, we’ll break down what psoriasis is, what some common symptoms and triggers are and how you might be able to find some relief if you happen to have the condition.
Symptoms and Triggers of Psoriasis
As we discussed above, psoriasis is a chronic skin disease that causes red patches over the body. Psoriasis is thought to be an immune system problem that causes the skin to regenerate at faster than normal rates. What causes the immune system to malfunction isn’t entirely clear, but researchers believe both genetics and environmental factors play a role.
The signs and symptoms of psoriasis can vary from person to person, since each person can be affected differently. Psoriasis patches can range from a few spots of dandruff-like scalping to major eruptions that cover large areas of the body. The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face and palms.
Common signs and symptoms include:
- Red patches of skin covered with thick, silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed or itch.
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
For many people and types of psoriasis, the symptoms go through cycles that flare up for a few weeks or months, then subside for a time or even go into remission. Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor.
Common psoriasis triggers include:
- Infections, such as strep throat or skin infections
- Weather, especially cold, dry conditions
- Injury to the skin, such as a cut or scrape, a bug bite, or severe sunburn
- Smoking or exposure to secondhand smoke
- Heavy alcohol consumption
- Certain medications – including lithium, high blood pressure medications and antimalarial drugs
- Rapid withdrawal of oral or systemic corticosteroids.
Types of Psoriasis:
Psoriasis like we mentioned above, contains a variety of different types that each affect the body differently, but there are a few common types that we see. We have broken down some of the commonly seen forms of psoriasis down below and how they work.
- Plaque psoriasis: This is the most common form of psoriasis and causes dry, raised, red skin patches covered with silvery scales. The plaques might be itchy or tender and usually appear on the elbows, knees, lower back or scalp.
- Nail psoriasis: Psoriasis can affect the fingernails and toe nails, causing pitting, abnormal growth or discoloration. Psoriatic nails might become loose and separate from the nail bed, while in severe cases, the nail may even crumble.
- Guttate psoriasis: This from of psoriasis in primarily seen in young adults and children. It’s commonly triggered by a bacterial infection such a strep throat and is marked by small drop-shaped, scaling lesions on the trunk, arm or legs.
- Inverse psoriasis: This version mainly affects the skin folds of the groin, buttocks and breasts. Inverse psoriasis causes smooth patches of red skin that worsen with friction and sweating. Fungal infections have also been known to trigger this type of psoriasis.
- Pustular psoriasis: This form of psoriasis is rare and causes clearly defined pus-filled lesions that occur in widespread patches or in smaller areas on the palms of the hands or the soles of the feet.
- Erythrodermic psoriasis: This is the least common type of psoriasis and can cover your entire body with a red, peeling rash that can itch or burn intensely.
Psoriasis treatments aim to stop skin cells from growing so quickly and to remove scales. Options for treatment often include creams and ointments, light therapy, and oral or injected medication. Which treatments you use depends on how severe the psoriasis is and how responsive it has been to previous treatment. However, even with these different treatments, the disease will return, but at the very least these treatments can help manage it. Below we have broken down some of the common treatments and how they work.
- Corticosteroids: These drugs are the most frequently prescribed medication for treating mild to moderate psoriasis. They come in a variety of forms from ointments and creams, to sprays and shampoos. Mild corticosteroid ointments are usually recommended for sensitive areas, such as the face or skin folds or for treating wide spread patches. These topical corticosteroids might be applied once a day during flares or alternate days or weekends to maintain remission. Long-term use of these strong corticosteroids can thin the skin and may stop working over time.
- Vitamin D analogues: Synthetic forms of vitamin D slow skin cell growth, so this type of drug is sometimes used in conjunction with topical corticosteroids.
Light therapy is a first-line treatment for moderate to severe psoriasis, either alone or in combination with medication. It involves exposing the skin to controlled amounts of natural or artificial light, with treatments being repeated as necessary.
- Sunlight: Daily exposures to sunlight for short durations might help improve psoriasis. Sunlight regimens have been known to help, but as always, consult your doctor before starting this form of treatment to ensure it will have positive benefits.
- UVB broadband: UVB broadband light in controlled doses from an artificial light source can treat single patches, widespread psoriasis and psoriasis that doesn’t improve with topical ointments. Short-term side effects include redness or itching and dry skin, so moisturizing regularly can help ease discomfort.
Oral or Injected Medications:
If you have moderate to severe psoriasis or other treatments haven’t worked, your doctor may prescribe oral or injected drugs. These drugs can have severe side effects, so often these medications are used for only brief periods of time and might be alternated with other treatments.
- Steroids: If you have a few small, persistent patches of psoriasis, your doctor might suggest an injection of triamcinolone directly into the lesions.
- Retinoids: These are pills that are used to reduce the production of skin cells. These drugs are not recommended when you’re pregnant or breast-feeding and carry side effects that include dry skin and muscle soreness.