UNDERSTANDING PSORIASIS: WHAT IT IS AND HOW TO TREAT IT

Tags : Autoimmune diseases Dermatology Health implications Psoriasis Skin care Treatment options Vitiligo

UNDERSTANDING PSORIASIS: WHAT IT IS AND HOW TO TREAT IT

Our autoimmune system is one of the important components of our wellbeing. It plays an important role in keeping our immunity strong and hence the skin and organs healthy and protected. When it starts to behave in an erratic way, the human body suffers. Psoriasis and Vitiligo are two of the main issues that show up the skin when the auto immune system starts to malfunction.

While vitiligo appears in painless white patches, psoriasis is a condition that causes painful, itch, fish scales like silvery scales on the body. Psoriasis can sometimes affect full body or can remain contained and keep recurring in one area of the body. This autoimmune condition can trigger anytime and is not limed by age, sex, or ethnicity of the person. In psoriasis the skin becomes thick, inflamed and red and the person feels an urge to itch at all times. Unfortunately there is no single or a permanent cure to psoriasis, it is easy to manage the symptoms with careful and monitored treatments.

What causes psoriasis?

Psoriasis is one of the main causes of social embarrassment in many people. It affects about 3 % of the world population and still there is no single treatment line or medication for it that give guaranteed relief.

Research has shown that the cause of psoriasis lies inside the immune system. Our blood contains T cells (a type of white blood cells) whose main function is to activate and protect the body from outside infections and virus attacks. Because of some unknown triggers the T cells sometimes become active even when there is no foreign body attack and start producing cytokines. This sets of a chain of other immune responses that cause the skin cells to proliferate at a rate much faster than the normal. The immune system things of the healthy skin cells as foreign bodies and starts destroying them. The result is that dead skin cells start to accumulate on the surface along with inflammation or swelling. and new cells keep forming (keratinocytes). In a normal human body, it takes 30 days for new skin cells to form whereas in people suffering from psoriasis this cycles is shortened to just 3-4 days.  This causes formation of dry, flaky slivery scales and plaques on various parts of the body such as elbow, knees, scalp ears, nails, feet, hands, lips and eyelids.

The scales usually start as small red patches that are often mistaken as an allergy or injury but they can become bigger and itchier. There are many different kinds of psoriasis and it can happen in different parts of body. the correct treatment plan begins with correctly identifying the type of psoriasis, party of body it affects and the severity of it.

Types of psoriasis

• Plaque psoriasis: this is the most common type of skin condition and affects about 80-90% of people. This causes raises red patches on the skin. that can be itchy or painful sometimes.
• Inverse psoriasis which mainly affects the skin folds and causes shiny and discoloured scratches to appear on different parts of body such as armpits, groin, and other skin folds. They can even be red, purple or brown in colour.
• Guttate psoriasis appears like small spots on the skin and is often seen after a throat infection. The spots are drop shaped and can be pink, red or purple in colour.
• Pustular psoriasis looks like pus filled blisters on the skin sitting on top of the red plaques. It usually affects palms and soles.
• Erythrodermic psoriasis usually affects large areas of skin and is a severe form of this skin diseases. Skin shedding is widespread in it appears as if sheets of skin are peeling. It causes discoloration of the skin and is often trigged by sunburn, infection and not taking psoriasis treatments.
• Sebopsoriasis affects face and scalp the most and the scales appear like dandruff and are greasy and yellow scales.
• Nail psoriasis has symptoms like pitting of nails and changes in the structure of fingernails and toenails.

Why is psoriasis treatment necessary?

For most people, skin care and dermatologist visits are often the last priority and they try to treat this skin condition with home remedies such as using moisturizing creams and gels. However, when not treated in time the flaky, slivery scales of psoriasis can have severe health implications such as

• Pain and inflammation joints that makes it difficult for a person to walk or do daily activities normal. This is termed as psoriasis arthritis.
• Inflammatory diseases in other organs of body
• Heat diseases and hypertension
• Diabetes
• Lupus
• Weight gain and obesity
• Irritable bowel syndrome
• Septicaemia
• Heart failure
• Eyes disorders and conjunctivitis
• Complications in normal pregnancy
• PCOS
• Pneumonia

Suicidal tendencies, depression, shame and mental trauma are some of the common psychological damages of psoriasis. These challenges can be long lasting. The age group of 15-35 is most commonly affected by this condition. Psoriasis can be genetic too and biological parents can pass this condition down to their children. The good news is that it is not contagious i.e., does not spread on contact. The main roadblocks in time treatment of psoriasis are lack of awareness, and education among people. Ignorance in seeking the correct diagnosis can make psoriasis a life long suffering for those effected.

Treatment options for psoriasis

The quest for finding the permanent treatment for psoriasis dates back to the 1800s. The right doctor to treatment psoriasis is an experience dermatologist. The effects of this condition are more than skin deep. Apart from genetics, environmental factors are also seen as primary causes of psoriasis. Simple treatments go a long way in making its management easier and bringing the much needed relief to the patient.

There is no known pattern of psoriasis, it can improve or become worse at any time. Some people do not see any flare of psoriasis for years and then suddenly see a flare up. One needs to be on a constant watch with psoriasis and work closely with the dermatologist to work out a skin care routine that works well. Psoriasis can show up on elbows, knees, scalp, genitals, lower back, palms and feet, fingernails and toenails and insides of the mouth. You need to talk to your doctor if you notice:

• Raised and scaly skin plaques
• Dry skin with cracks on surface that bleed
• Burning, itching, and soreness sensations on the affected kin
• Random discoloured patches
• Swelling and pain in joints
• Cracked, pitted and weak nails.

Psoriasis treatment plan

The treatment for psoriasis includes both lifestyle changes and professional treatments. Here is how you can use the modern treatments and modify your lifestyle to manage psoriasis symptoms and ease the discomfort.

• Understand the symptoms: Shiny, small, slivery scales on the skin are the most common symptom of psoriasis. They are often accompanied by dryness, cracks, itching, rashes on the skin. The symptoms come and go and therefore keep a close watch on the skin and consult the doctor immediately on noticing any symptoms.
• Know the triggers: Psoriasis can be triggered by many things such as obesity, stress, cold weather, changes in the environment, pollutants etc. These triggers are different for everybody. Understand what triggers skin changes in your body and learn to manage them.
• Treatment options: Doctors use a combination of various treatments and therapies to reduce the symptoms and appearance of psoriasis. These include
  • Topical or over the counter medications: these include creams, lotions, foams etc. that are applied directly on the affected areas of the skin. they are the first line of treatment and used to treat mild to moderate psoriasis. They contain various options are corticosteroids, emollients, coal tar, retinoids etc that slow down the effect of immune cells on the skin. They should only be used as directed. Oral retinoids are used to reduce cell grown is used to treat pustular psoriasis.
  • Biologics: These are the new age treatments that are made from the living materials. These drugs are immune therapy medications and alter the immune system. They also bring down skin inflammations. Biologics are suitable for treatment of moderate to serious arthritis. The most commonly used biologics are Adalimumab, Bimekizumab, Brodalumab, Tofacitinib (oral), Ustekinumab etc.
  • Dithranol: This is the oldest known treatment for treating plaque psoriasis. This medicine is applied on the skin and reduces the production of new skin cells. Using a very concentrated form of this cream can cause burns on the skin and hence it should be used under supervision.
  • Coal tar ointment and shampoo: This age old treatment reduces itching and scaliness but can make the skin sensitive to sunlight and dryness.
  • Phototherapy: Sitting in sun is an age old treatment for psoriasis. Phototherapy uses a combination of natural and artificial light to target the fast shedding skin cells and slow down the growth of the new cells. This treatment is only done in the doctor’s office as an outpatient procedure.

Follow the instructions of your dermatologist regarding right way to use the treatments. Do not try to over use tor underuse the treatments. It can cause skin damage and spread of the disease. You can also use some home treatments such as

• Salt baths
• Colloidal oatmeal
• Application of aloe vera gel
• Apple cider vinegar

Skin, hair and nail care in psoriasis

This is an important part of psoriasis treatment. Here are some simple tips to help you along

• Don’t buy any product that claims to be the ‘cure’ of psoriasis
• When choose skin and hair products choose those which are alcohol free, hypoallergenic. Look for ingredients like ceramides, lipids, hyaluronic acids since these help in keeping the skin moisturized and reduce the scaling and salicylic acid that helps by reducing flaking. Also include retinoids in your night skin care to reduce the dark spots caused because of psoriasis.
• Gel based products are a no-no as they can aggravate the symptoms
• UV light slow down the growth of skin cells and small healthy doses of sun are good for your skin. but avoid the peak sunlight hours and always use sunscreen.
• Protect the skin from injury. Cuts, nicks and scrapes can cause skin irritation and increase the symptoms.
• Don’t scratch your skin even when it is itching. Use the itch cream as directe4d
• Avoid using hot and long showers as they strip the body of the essential moisture.
• Don’t rub the skin with towel. Just pat dry
• Prevent dry skin at all times. Apply a moisturizer immediately after shower, carry a bottle of moisturizer with you and use it every time the skin feels dry.
• Use a soft bristle hair brush and brush gently, don’t press it against the scalp.
• Limit hot treatments to the hair
• Avoid colouring and perming during the psoriasis flares.
• Keep your nails short
• Wear gloves and mask when doing housework. If you have nail psoriasis then wear cotton gloves and latex gloves on top of them when doing housework.
• Avoid irritating the cuticles
• Don’t bite or chew your nails
• Avoid nail treatments.
• Wear soft fabrics that do not rub against the skin
• Give up on smoking and drugs
• Cut down on alcohol
• Treat any skin injuries immediately
• Take a diet rich in fish oil, vitamin D, seeds, nuts, turmeric, and omega 3- fatty acids .
• Exercise daily to reduce the risk of chronic issues and keep the weight under control.

Psoriasis treatment cost

Psoriasis is a chronic autoimmune disorder which can flare up anytime. There is no definite cost of the treatment because it is a lifelong process. The cost depends on the type of treatment and severity of the condition. Topical medications cost very less whereas treatments like the use of biologics can be high. Other hidden costs in psoriasis treatments comprise of consultation fees, diagnostic tests, follow up visits etc. To endure you get a treatment for psoriasis that is not only cost effective but also successful, discuss both aspects with your doctor and insurance provider.