Studies estimate that close to 7.5 million Americans have psoriasis, making it the number one autoimmune disease in the nation. Often, psoriasis causes uncomfortable pain and itchiness in infected areas. It is also associated with a form of arthritis that prevents many patients from enjoying an active life. In addition to health problems psoriasis can often be an embarrassing condition for many people. The red patches of scaly skin caused by psoriasis are aesthetically unpleasant and can hinder dating, work and social life.
Individuals with psoriasis should know that they are not alone. Unlike many skin conditions, psoriasis has been heavily researched and does respond to treatment. Here’s a quick glance at the disease, its causes and what patients can do to limit psoriasis outbreaks.
The Causes of Psoriasis
Psoriasis is an autoimmune disease, meaning that it stems from a faulty immune system. In the case of psoriasis, the immune system mistakenly recognizes the skin cells as pathogens and sends out signals to produce more skin cells. As the skin multiplies at rates up to 10x faster than normal, dead skin cells pile up on the skin surface. These dead cells cause the reddened skin and white scales commonly associated with the disease.
Scientists believe that psoriasis is brought on by the combination of a genetic predisposition for psoriasis and an exterior “trigger.” Therefore, close to 10% of the population inherits the genetic characteristics for psoriasis but only 2-3% actually develops the disease.
Triggers for psoriasis are life events that cause psoriasis outbreaks on the skin. Though not all psoriasis triggers have been documented, a few of the most common include:
- Injuries such as sunburns and scratches
- Medications such as lithium, antimalarials, Inderal (for high blood pressure) and Indomethacin (for arthritis)
Other triggers could include infection, cold weather, heavy smoking and heavy drinking. Increases and decreases in hormone levels can also bring about changes in psoriasis outbreaks, though more research is needed to understand these effects fully.
Types of Psoriasis
Like many other skin diseases, psoriasis has a few different types.
- Plaque Psoriasis is by far the most common form of psoriasis, occurring in about 80% of all psoriasis infected individuals. It is characterized by inflamed and scaly skin on the elbows, knees, scalp and lower back.
- Guttate Psoriasis appears suddenly as a breakout of red dots on the torso, back, arms or legs. It is prevalent among children and young adults.
- Inverse Psoriasis occurs in skin folds including armpit, groin and breast areas. It is characterized by red, smooth, shiny skin.
- Pustular Psoriasis is characterized by the appearance of white blisters surrounded by red skin. It can be contained to one area or, in severe cases, cover most of the body.
- Erythodermic Psoriasis results in red, fiery and painful skin. Skin cell shedding occurs in sheets rather than flakes. It is often accompanied by body temperature fluctuation.
While psoriasis may seem like an unbeatable and persistent opponent, there are ways to combat psoriasis outbreaks. The first step towards any effective psoriasis treatment is a visit to the doctor or dermatologist. They will be able to better recognize psoriasis and prescribe the proper treatments.
The first wave of treatment will likely include topical medications such as creams or ointments. The most common are corticosteroid creams which reduce swelling and redness in the skin. Corticosteroids subdue the faulty immune system responsible for psoriasis outbreaks and thereby reduce skin swell and reddening.
Some over-the-counter creams may also be helpful for reducing itching and shedding. The FDA has approved two active ingredients (salicylic acid and coal tar) for psoriasis treatments. Coal-tar, in particular, has a long history in psoriasis treatments. Before the advent of modern medicine, people with psoriasis used to take coal-tar baths. Today, however, it’s only recommended for mild cases of psoriasis.
Depending on the severity of the case, a physician may recommend UVB phototherapy. Phototherapy works by exposing the infected skin to UVB rays. The rays penetrate the skin and slow skin growth. To an extent, it’s like getting a mild sunburn. The treatment should be repeated regularly to ensure that the psoriasis outbreak doesn’t reoccur. Some physicians may recommend home UVB phototherapy. Instead of going to the clinic to receive the UVB rays, patients can expose themselves to the rays using prescription home UVB equipment.
In moderate to severe cases of psoriasis, a physician may recommend systemic medications. Unlike steroid creams, these medications affect the entire body. Before starting any systemic medications, however, patients should be aware of potential side effects and health issues.
Know the Triggers
One of the most effective ways to treat psoriasis is to recognize the triggers that bring on outbreaks. Those who suffer from psoriasis should keep a diary of when outbreaks occur and what happened on those particular days. If cold weather or stress cause outbreaks, patients can takes steps to minimize their time outdoors or in stressful situations.
Most importantly, individuals with psoriasis should know that they are not alone. It’s always a good idea to talk with a doctor or physician and there are numerous groups available online with more detailed information on psoriasis and its treatments. Psoriasis can be beatable and it shouldn’t be ignored.
About the Author: Dr. Scott Darling practices dermatology at KC Healthy Skin, a Kansas City dermatology institute.