Psoriasis is a common skin condition characterized by a rapid buildup of rough, dry, dead skin cells forming thick scales. The inflammation can be frustrating if you have it, causing unsightly patches of skin, discomfort and even pain.
Normally, it takes about a month for new skin cells to move from the lowest layer of your skin, where they first form, to the outermost layer, where they die and scale off in flakes. In psoriasis, the life cycle of skin cells speeds up, resulting in a multitude of dead cells on the outermost layer of your skin.
A persistent, chronic disease that tends to flare periodically and may go into remission, but usually remains active for years. It affects an estimated 5.5 million Americans. Psoriasis can occur at any age, but the onset is usually gradual and the diagnosis is commonly made between the ages of 15 and 35.
Psoriasis Signs and Symptoms
- Dry, red patches of skin covered with silvery scales
- Pustules on top of the patches
- Small scaling dots(guttate), which occur most commonly in children
- Swollen and stiff joints
The signs and symptoms may occur in just a few places on your skin or affect large areas. Psoriasis commonly occurs on your knees, elbows, trunk and scalp. The scales from scalp patches may resemble dandruff. In severe cases, you may also experience cracked skin, minor bleeding, redness of your skin all over or raised bumps containing pus (pustular). In some cases, there may be pitting, ridging and discoloration of fingernails, toenails and may also affect the genitalia.
You can’t spread it to other parts of your body, or to other people, simply by touching it.
The condition typically goes through cycles. It may flare for weeks or months, then subside for a time. But it almost always returns and can occur anywhere on your body. This condition is sometimes confused with seborrheic dermatitis, a different common skin condition that’s characterized by greasy-appearing, scaling areas.
About 15 percent of people with this condition also have signs and symptoms of arthritis. This condition is called psoriatic arthritis. For most people, the effects of psoriatic arthritis are minor. It produces some pain and discomfort in affected joints but has little effect on overall health. Less commonly, the joint symptoms can lead to disability similar to that found in rheumatoid arthritis.
Causes of Psoriasis
If you cut yourself, the skin heals by regenerating the top layers. When the wound is healed, the process stops. But with psoriasis, skin cells in the top layer of your skin (epidermis) continue to proliferate. This proliferation usually doesn’t stop unless treatment interrupts the cycle.
Factors that may trigger this exaggerated skin turnover of psoriasis include:
- A systemic infection such as strep throat
- An immune system response to disease
- An injury to your skin
- A reaction to a medication or vaccine
- Alcohol — the poor nutrition that may accompany heavy drinking may make psoriasis worse
- Environmental factors, such as overexposure to sun or prolonged contact with chemicals such as disinfectants and paint thinners
Doctors believe psoriasis is an inherited disease, influenced by many factors. But researchers haven’t yet been able to identify the gene or genes responsible.
One of the things that make psoriasis so difficult to control is its wide variation in type, severity and response to treatment. Because each case of psoriasis is unique, your doctor will tailor a treatment to you. The goal of treatment is to suppress the growth of your skin cells. Among the treatment approaches:
- Creams and ointments.
Calcipotriene (Dovonex) is an ointment available by prescription that contains a derivative of vitamin D. Calcipotriene controls the overproduction of skin cells. It’s a useful treatment for mild to moderate psoriasis. Steroid creams, coal tar, anthralin and a topical form of retinoic acid are other topical treatments.
- Oral medications.
Retinoids are a group of drugs related to vitamin A. Retinoids reduce the proliferation of skin cells in cases of severe cases. They can produce side effects such as eye and lip inflammation, bone spurs and hair loss, as well as birth defects if taken during pregnancy. Other oral medications include methotrexate, an anticancer drug that blocks the growth of skin cells, and cyclosporine (Gengraf, Neoral), which suppresses your immune system. Though these drugs are effective in treating severe cases, they may also cause side effects, including liver and kidney toxicities.
Psoralen plus ultraviolet A (PUVA), a combination of light-sensitizing medications (psoralens) and ultraviolet A light, is effective in suppressing the growth of skin cells in severe cases. However, long-term — 250 treatments or more — use of PUVA may increase your risk of skin cancer and possibly melanoma, a deadly form of skin cancer. The higher risk begins about 15 years after the first PUVA treatment. Exposure to moderate sunlight — being careful to avoid sunburn — as well as the topical application of coal tar combined with ultraviolet radiation also are effective treatments. A form of phototherapy treatment called narrow-band ultraviolet B (UVB) has emerged in the past decade. This treatment may be as effective as PUVA but doesn’t require that you take oral medications before each treatment. It’s not thought to carry as high a potential for skin cancer as PUVA does. Some doctors also give UVB treatment in conjunction with coal tar in a method called Goeckerman treatment. Using the two approaches together is more effective than using either alone. Doctors don’t know exactly how the dual approach works, but using the coal tar seems to make the skin more receptive to the UVB light. Goeckerman treatment is available only at a few large medical centers in the United States. Doctors sometimes use phototherapy and oral medications in rotation to minimize side effects of both.
- Intravenous medication.
In 2003, the Food and Drug Administration approved the immune-suppressing drug alefacept (Amevive). The drug appears to work through the lymphocytes, a type of white blood cell, to slow down the proliferation of skin cells. Alefacept is a treatment option for more severe cases or for those that don’t respond to other treatments. The drug is given by intravenous infusion, usually once weekly for 12 weeks, though you may need a repeat course.
Troubled skin can become hypersensitive, especially after several different treatments have been tried. With enough annoyance, conventional skincare treatments themselves can become a source of irritation, not to mention the associated side effects. Below is one and only one product that we recommend as an affective natural alterative to medication in treating and preventing psoriasis. DermaMed Psoriaderm is proven to alleviate the symptoms while it encourages healing at the sub-dermal level.
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