Psoriasis

Psoriasis Awareness Month

What is Psoriasis?

Psoriasis is a skin condition that causes flaky patches of skin which form scales. Psoriasis is a common, long-term (chronic) disease with no cure. It can be painful, interfere with sleep and make it hard to concentrate.

People with psoriasis have an increased production of skin cells. Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days.

These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body. Most people are only affected with small patches. In some cases, the patches can be itchy or sore.

Psoriasis is an autoimmune condition. Autoimmune conditions are the result of your body attacking itself. In the case of psoriasis, white blood cells known as T cells mistakenly attack your skin cells.

Generally, in the body, white blood cells are deployed to attack and destroy invading bacteria and mount a defense against infections. This mistaken autoimmune attack causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. They are pushed to the skin’s surface, where they pile up.

This results in the plaques that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop.

What are the symptoms?

The signs and symptoms of psoriasis can vary depending on the type of psoriasis you have. The 5 most common symptoms of psoriasis include:

• Rashes or patches of red, inflamed skin, often covered with loose, silver-colored scales; in severe cases, the plaques will grow and merge into one another, covering large areas.
• Itchy, painful skin that can crack or bleed
• Small areas of bleeding where the involved skin is scratched
• Problems with your fingernails and toenails, including discoloration and pitting; the nails may also begin to crumble or detach from the nail bed.
• Scaly plaques on the scalp

Psoriasis can also be associated with psoriatic arthritis, which causes achy, swollen joints. Between 10% and 30% of people with psoriasis also have this painful joint condition.

What Causes Flare-Ups?

Every person with this condition has their own triggers. Things that cause your psoriasis to become active may not affect another person.

Cold, dry weather - Any climate that relieves dry skin will help. Try to spend some time in warm sunny weather and high humidity.

Stress - Keep calm and try to stay relaxed. Outbreaks are more likely to pop up when you are anxious.

Some medicines - These include some ”beta-blocker” drugs used to treat high blood pressure and heart disease; lithium, a treatment for bipolar disorder; and pills taken to treat malaria. 

Infections - There is a short list of infections including strep throat and tonsillitis that can trigger a special kind of psoriasis outbreak. It looks like small drops that show up mainly on your torso and limbs. 

Skin Injury - In some people, the tiniest cuts, bruises, and burns can cause an outbreak. Even tattoos and bug bites might trigger a new lesion. You can wear gloves or put on an extra layer of clothes to avoid a break in your skin.

Alcohol - Drinking, especially heavy drinking in young men, may trigger or worsen symptoms and interfere with treatments. Combining certain psoriasis medications with alcohol can have dangerous side effects, especially for women in their child-bearing years.

How do you treat Psoriasis?

Psoriasis treatments aim to stop skin cells from growing so quickly and to remove scales.

Topical Therapy

Corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They are available as oils, ointments, creams, lotions, gels, foams, sprays and shampoos. Mild corticosteroid ointments (hydrocortisone) are usually recommended for sensitive areas, such as the face or skin folds, and for treating widespread patches. Topical corticosteroids might be applied once a day during flares, and on alternate days or weekends during remission.

Vitamin D analogues. Synthetic forms of vitamin D — such as calcipotriene (Dovonex, Sorilux) and calcitriol (Vectical) — slow skin cell growth. This type of drug may be used alone or with topical corticosteroids. Calcitriol may cause less irritation in sensitive areas.

Retinoids. Tazarotene (Tazorac, Avage, others) is available as a gel or cream. It's applied once or twice daily. The most common side effects are skin irritation and increased sensitivity to light. 

Calcineurin inhibitors. Calcineurin inhibitors — such as tacrolimus (Protopic) and pimecrolimus (Elidel) — calm the rash and reduce scaly buildup. They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are irritating or harmful.

Salicylic acid. Salicylic acid shampoos and scalp solutions reduce the scaling of scalp psoriasis. 

Coal tar. Coal tar reduces scaling, itching and inflammation. It's available in nonprescription and prescription strengths. It comes in various forms, such as shampoo, cream and oil. These products can irritate the skin. They're also messy, stain clothing and bedding, and can have a strong odor.

Light Therapy

Light therapy is a first line treatment for moderate to severe psoriasis, either alone or in combination with medications. It involves exposing the skin to controlled amounts of natural or artificial light. Repeated treatments are necessary. 

Alternative Skin Treatments

There are many things you can put on your skin to relieve itching, burning, and redness:

Aloe vera: Comes from inside the leaves of the aloe vera plant. It’s believed to have soothing properties when applied to irritated, sunburned, or environmentally damaged skin. The gel may also have antibacterial properties. Because of its soothing abilities, aloe vera may be helpful as a supplemental treatment for psoriasis. Look for a topical gel or cream with aloe vera that contains at least 0.5 percent pure aloe vera.

Oat extracts: These can be found in many skin care products. They may ease itching and cut redness. Soaking in an oatmeal bath may also help.

Dead Sea salts or Epsom salts: These can remove scales and relieve itching. Add them to a warm bath and soak for about 15 minutes. Use a lotion or cream to return moisture to your skin afterward.

Apple Cider Vinegar. Choose organic apple cider vinegar, which you can find at many grocery stores. Dilute it by adding one part water to one part vinegar. Straight apple cider vinegar may cause a burning feeling to your scalp.
Carefully pour the diluted vinegar onto your scalp. Tip your head back so it doesn’t get in your eyes. Let it sit on your scalp for a minute or two. Then rinse your scalp thoroughly with water. Repeat a few times a week.

Health Management 

Ease Your Stress
Stress can trigger a new outbreak and make an existing one worse. These techniques won't replace your medicines, but they might make them work better:

• Meditation. This focuses your attention to quiet your mind. A few studies suggest it can help with psoriasis when practiced along with traditional treatments.
• Yoga. People have used yoga to improve their health and relieve stress for thousands of years. If it helps you relax, it's worth a shot.
  
  

Eating a heart-healthy diet
Reducing your intake of saturated fats, which are found in animal products, like meats and dairy, can be helpful in managing psoriasis.

It’s also important to increase your intake of lean proteins that contain omega-3 fatty acids, such as salmon, sardines, and shrimp. Plant sources of omega-3s, including walnuts, flax seeds, and soybeans, are also helpful sources, especially if you’re looking for plant-based options.

Avoiding trigger foods
Psoriasis causes inflammation. Certain foods can cause inflammation as well. Avoiding those foods might help improve symptoms. These foods include:

• red meat
• refined sugar
• highly processed foods
• dairy products

Glucosamine and chondroitin.

Both are found in your body’s cartilage. Experts think glucosamine may help with pain relief. Likewise, chondroitin might help cartilage stay elastic and prevent it from breaking down. Some people with psoriasis take these supplements, but there’s no evidence they help with psoriasis or psoriatic arthritis.

Drinking less alcohol
Alcohol consumption can increase your risk of a flare-up. Cutting back or quitting entirely can help lower your risk. If you have alcohol use disorder, your doctor can help you create a treatment plan.

Emotional health
People with psoriasis are more likely to experience depression and self-esteem issues, according to research. You may feel less confident when new spots appear. Talking with your support network about how psoriasis affects you may be difficult. The constant cycle of the condition may also be frustrating.

All emotional issues associated with psoriasis are valid. Connecting with supportive resources is important for handling them. This may include speaking with a mental health professional or joining a support group for people with psoriasis.

Complementary & Alternative Therapies

Massage

Holistic Massage - includes long strokes and kneading. It can increase circulation, stimulates the lymphatic system - which is a major part of the immune system. Massage may also help reduce pain or stiffness associated with psoriatic arthritis (PsA), which affects about 30 percent of people with psoriasis. 

Manual Lymphatic Drainage Massage - is effective at reducing inflammation and improving lymph circulation, which soothes psoriasis and aids in its healing. Aids the immune system and can be very relaxing. 

Aromatherapy 

Essential oils are used in aromatherapy massage and can help a wide range of health issues, including skin conditions. If applying essential oils to the skin, they must first be diluted in a carrier oil. 

Carrier oils:

Argan oil - It’s rich in vitamin E, which is hydrating to the skin. It may also improve your skin’s metabolism, reduce inflammation, and protect your skin from the sun. Argan oil may work on psoriasis because it’s both anti-inflammatory and antiseptic. This means that the oil has properties that help to reduce redness, dryness, swelling, and itchiness.

Coconut oil - When you put Virgin cold-pressed coconut oil on your skin, it can help hold in moisture, ease redness and swelling, and keep certain bacteria from growing. 

Avocado Oil - The antioxidants and vitamins in avocado oil can help to heal the dry, irritated, and flaky skin associated with eczema and psoriasis.

Essential Oils:

Lavender - If you're under stress, consider applying diluted lavender oil to your temples. This may help ease your mind, which might lessen certain emotional triggers of psoriasis. Lavender oil may also help to lessen itching on the skin when mixed with a lotion or carrier oil and applied to the skin.

Rosehip - The application of Rosehip Oil keeps the skin moist and nourished to reduce the itching and scaling

Tea tree oil -  can be helpful due to its anti-inflammatory and antifungal properties. It may help reduce scaliness as well.

Rose oil - contains anti-inflammatory properties which are great for calming redness and for helping relieve sensitive skin. It’s very emollient, meaning that it’s good for locking in moisture and hydration as well.

Acupuncture

Acupuncture is the ancient Chinese practice of inserting thin needles through the skin to stimulate specific points on the body. 

Acupuncture may help treat psoriasis in several different ways. It’s an effective stress reliever — and stress is a common trigger of psoriasis flares. It can also help relieve pain, especially in cases of psoriatic arthritis.

Some people with psoriasis find that acupuncture helps to relieve some of their symptoms. 

Herbal Medicine

Herbs are a way to strengthen and tone the body's systems. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts).

Herbal treatments — Mahonia aquifolium, indigo naturalis, and Aloe vera — can improve psoriasis symptoms by reducing inflammation or skin cell growth. The effectiveness of treatment will depend on many factors, such as the severity of the condition or the time of diagnosis.

Vicki Taylor - Massage & Beauty Therapist

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