Psoriasis

Psoriasis is a chronic, non-contagious skin disorder characterized by an excessive immune response that accelerates skin cell growth. Normally, skin cells mature and shed over a 30-day cycle, but in psoriasis, this cycle accelerates to 3 to 4 days, causing fast skin cell buildup. This results in thick, itchy, and sometimes painful patches on the skin. While these symptoms can be a minor nuisance for some, they significantly impact the daily lives of others. Psoriasis affects over 3% of adults, amounting to more than 7 million people in the United States. The condition is indiscriminate of gender, skin color, or age, commonly beginning between the ages of 20 to 30 or 50 to 60.

Causes

Although there is no single cause of psoriasis, several contributing factors are recognized:

• Immune System: An overactive immune response leads to rapid skin cell growth, causing the formation of thick, scaly patches.

• Genetics: A family history of psoriasis increases the likelihood of developing the condition, which is more common among non-Hispanic whites.

• Environmental Triggers: Elements such as skin injuries, infections, smoking, alcohol, certain medications, and stress can trigger or worsen symptoms. Diet and gut microbiome health also appear linked, though the connection remains unclear.

While these factors influence psoriasis, it is crucial to remember the condition is not contagious.

Symptoms

Psoriasis presents various symptoms affecting the skin, scalp, and nails:

• Rash or Plaques: Thick, scaly patches known as plaques can appear anywhere on the body. On darker skin tones, the rash may look purple or brown; on lighter skin tones, it appears pink or red.

• Commonly Affected Areas: Scalp, elbows, knees, lower back, and trunk are frequently involved.

• Varied Manifestations: Psoriasis can cause pustules, plaques, and smooth reddish-purple patches.

• Additional Symptoms: Dry or cracked skin, itching or burning sensations, and nail irregularities like thickening or pitting also occur.

• Symptom Cycles: Psoriasis often flares and subsides cyclically, with symptoms ranging from mild to severe.

Diagnosis

Diagnosing psoriasis usually involves a healthcare professional, typically a dermatologist, examining the skin, scalp, and nails for characteristic signs. Consideration of family medical history, recent stressors, illnesses, or medication use may further guide the diagnosis. For a definitive diagnosis, a skin biopsy—analyzing a small skin sample under a microscope—can confirm psoriasis and determine its specific type, essential for effective treatment planning.

Treatments

Psoriasis treatments aim to relieve symptoms and improve skin appearance. Options include:

• Topical Treatments: Applied directly on the skin, corticosteroids, vitamin D analogues, and moisturizers are effective for mild to moderate psoriasis.

• Phototherapy: Controlled ultraviolet (UV) light exposure treats persistent cases, administered 2-3 times weekly for up to three months.

• Systemic Treatments: Oral or injectable immune-modulating drugs, like Methotrexate, manage more severe symptoms.

• Biological Treatments: Target the immune system specifically and are often reserved for challenging cases.

Additionally, complementary therapies and lifestyle changes—such as diet and stress management—can improve quality of life. Collaboration with healthcare providers ensures treatment effectiveness and manages side effects. The National Psoriasis Foundation offers further resources on natural treatment options.

Medications

Although incurable, psoriasis symptoms can be managed through various medications:

• Prescription Medications:

• Topicals: Creams or ointments for mild cases; may be combined with other treatments for moderate to severe cases.

• Oral Medications: Effective for moderate to severe psoriasis and managing psoriatic arthritis symptoms.

• Biologics: Used for severe cases, target specific immune components via injections or infusions.

• Over-the-Counter (OTC) Medications:

• Products like moisturizers, Coal Tar, Salicylic Acid, and Hydrocortisone offer additional relief.

• Advanced Systemic Treatments:

• Drugs like Methotrexate and Cyclosporine target immune overactivity. Biologics like adalimumab provide targeted therapy but may require monitoring due to side effects.

Living

Living with psoriasis involves managing both physical and mental health challenges:

• Engage in stress management, build a support network, and educate loved ones about the condition.

• Work with a committed care team and advocate for yourself during medical appointments.

• Joining support groups and therapy can offer emotional support.

• Resources such as those from the National Psoriasis Foundation are valuable for guidance and support.

Prevention

To reduce flare-ups, consider:

• Identifying and managing triggers like stress, infections, injuries, and weather changes.

• Adopting a balanced diet, regular exercise, and getting enough sleep.

• Maintaining moisturized skin and using gentle soaps.

• Avoiding smoking and pursuing stress-reduction methods like meditation.

• Seeking professional advice for persistent symptoms.