Psoriasis: Symptoms, Types and Treatments
Psoriasis is an autoimmune skin disease that causes rapid multiplication of skin cells.
This leads to the formation of red bumpy and scaly patches on the skin.
Psoriasis mostly happens on the knees, elbows and scalp.
This is a long-term skin condition where symptoms may appear from time to time.
They will flare up for months, then subside for a while and the cycle repeats.
The main symptoms of Psoriasis are red patches and white scales.
These patches are itchy, raised, painful, inflamed and can even bleed. White scaling spots appear on the red patches and mostly on children.
The skin folds around the red patches will swell up and there will be burning and soreness around and on the patches.
These plaques can also merge together to grow and affect a larger area.
Psoriasis also affects the nails making them pitted and thick. You will also see some discoloration and they may also crumble.
The joints swell up and become stiff.
The skin will also become dry and itchy, extreme dryness can result in skin cracking and bleeding.
Plaques will also form on the scalp. These plaques will be of crusts and scales.
Psoriasis affects everyone differently. Some may only have scales and others may have a lot of skin covered with red patches.
However, this also changes repeatedly when these symptoms might flare up and subside down time and again.
You will find these signs and symptoms on your lower back, knees, elbows, scalp, face and legs.
Types of Psoriasis
Different types of Psoriasis affect different areas of the body.
There are around 7 types of Psoriasis.
The most common among them is Plaque Psoriasis.
These are red bumpy patches with white or silvery scales.
They are dry itchy patches that are mostly around the elbow, back and scalp and knees.
The plaques can either be few and a small number or many spread all over.
Plaque Psoriasis is the most common form of psoriasis in people.
Psoriatic Arthritis is just like any other arthritis with swollen and painful joints.
It can cause pain and swelling in any joint. Progressive joint damage and stiffness can occur as a result of long-term psoriasis and psoriatic arthritis eventually leading to permanent joint damage in some cases.
Joint swelling may be the only symptom, sometimes alongside nail changes.
These could also be severe or mild differing from person to person.
Psoriasis also affects the nails, both finger and toe.
It can cause nail pitting, abnormal growth, discoloration and detachment from the nail bed. Nails may also crumble.
Inverse Psoriasis affects the buttocks, groin and breasts.
The red patches are not dry rather smooth which can increase due to sweating and friction.
Fungal infections can be responsible for triggering it.
In this rare psoriasis, pus-filled lesions form in patches usually in the palms and or feet soles.
This occurs as a result of strep throat infection that affects young adults and children.
Pea size scales form in the arms and legs.
This is the rarest form of Psoriasis that occurs on the entire body.
The itchy rashes burn and are red and peeling.
Causes of Psoriasis
Three of the most common causes of Psoriasis has been linked to immunity, genetics and the environment.
Psoriasis is considered an autoimmune disease that causes faster skin regeneration.
White blood T cells attack the skin cells mistakenly.
As white blood cells aim to destroy harmful invading bacteria, this attack leads to rapid skin cell production.
New skin cells are produced rapidly, in fact five times more than regular cells and they pile up on the skin surface.
This leads to plaques and the skin gets red and inflamed.
If an immediate family has Psoriasis, you have higher chances of getting it too.
That means you can inherit Psoriasis due to your genetic makeup.
Though there are fewer chances of genetic predisposition with psoriasis.
Only 2-3% have that gene and the main cause behind psoriasis remains the immune system.
Psoriasis may remain under control without any symptoms until some environmental factors trigger it.
In children infections, such as strep throat can trigger psoriasis.
A skin injury like a cut or bites by bugs can trigger the otherwise predisposed psoriasis.
Cold, dry weather can increase your psoriasis. Dryness can flare up the patches and contrarily in summer, the symptoms remain under control.
Heavy drinkers are more susceptible and alcohol can make the treatments less effective as well.
Smoking or even being a passive smoker can lead to psoriasis. Pustular psoriasis affecting the palms and soles of feet are linked to smoking in fact, it can also increase the severity of psoriasis.
Taking lots of stress affects the immunity which in return can result in a higher risk of psoriasis.
Using medications for high blood pressure, lithium for bipolar disorder or antimalarial medication can induce flare-ups.
Moreover, withdrawing corticosteroids immediately, which are useful in treating psoriasis can also increase your symptoms.
Hence, along with immunity and genetics, environmental factors play an equal role in triggering your psoriasis.
If you have developed Psoriasis, you will be at an increased risk of developing other conditions such as:
- Psoriatic Arthritis is a type of Psoriasis that causes inflammation of the joints
- Sclerosis, IBD, and other autoimmune diseases
- Type 2 diabetes and high blood pressure leading to heart diseases
- Conjunctivitis and other eye conditions
- Upset mental health from depression and low self-esteem
Your doctor may either take a physical exam or a biopsy to diagnose Psoriasis.
Treatments are done to reduce the growth rate of skin cells and eliminate any scales.
Topical therapy (creams and ointments)
Doctors usually prescribe corticosteroids for mild to moderate psoriasis.
They are not only in creams and ointments but also in lotions, gels and shampoos.
Mild corticosteroids are recommended for sensitive areas like the face and folds of skin or wherever there are widespread patches.
You will require to apply it once a day during flare-ups and once in two days otherwise.
However, One side effect of using corticosteroids is the eventual thinning of skin due to regular application.
They are available in the form of gels and ointments to be applied once or twice in a day.
This can cause skin irritation and sensitivity to light.
3. Calcineurin inhibitors
These help reducing swelling and plaque and will be more useful around the eyes or other areas with thin skin.
That is because retinoids and corticosteroids can be irritating and dangerous there.
4. Salicyclic acid
You must have heard the name salicylic acid. It is popularly used in skincare.
However, it can 9also help with treating Psoriasis.
Salicylic acid shampoos help reduce the scales in scalp psoriasis.
They are also used to increase the absorption and penetration of other products.
Other treatments include using coal tar, synthetic vitamin D and Goeckerman therapy.
Phototherapy (Light therapy)
Light therapy is mostly used for psoriasis ranging from moderate to severe levels.
Common light therapies include:
Sunlight can help reduce psoriasis when exposed to it.
You should consult your doctor regarding the right way to give yourself sunlight exposure and to what extent.
UVB treatments are used to target that specific area affected by Psoriasis.
UVB broadband and narrowband treatments are used to treat this condition by artificial light.
The narrowband therapy is more effective and is given twice a week.
However, these are not free from causing side effects. Narrowband may cause long term burns and broadband may induce short term itching.
Other treatment of psoriasis include excimer laser and PUVA.
Your doctor prescribes oral and injected medication only when topical treatment and light therapy does not work.
The reason being that these medications may have high side effects.
Therefore, they are used to treat mild to severe Psoriasis but after everything else do not work.
Small persistent psoriasis patched can be treated by an injection of steroid triamcinolone.
Retinoids like Acitretin decrease the build-up of plaque by slowing the growth of skin cells and is taken orally.
Methotrexate is taken as a single dose to reduce skin cell growth and production and decrease inflammation.
Other medications include Cyclosporine and Biologics drugs that are either immunosuppressant drugs or alter the immune system to fight the disease.
Your treatment is dependant on the severity of your condition and how you have responded to previous treatments.
You may need several trials and errors before you find the right treatment.
Lifestyle changes and remedies for Psoriasis
You may treat your condition by the treatments and therapies the doctor prescribes but you will also want to cope up with your symptoms.
You should try these lifestyle changes and home remedies to incorporate them into your life with Psoriasis.
Washing up daily can ease the inflammation and reduce your scales.
Add bath oil and oatmeals in your bathtub and soak your body for ten to fifteen minutes.
Also try to only use lukewarm water mild soaps that do not have added fragrances and oils.
Apply a moisturizer
As soon as you are done bathing, apply a moisturizer to moist skin.
If you have extremely dry skin you may need to apply an oil instead.
Also, apply the moisturizer or ointment overnight and cover the affected are with plastic wrap. Remove the wrap next day to wash away the scales.
Give yourself some sunlight
While artificial light treatments exist, natural light i.e. sunlight exposure can also decrease condition.
However, you will have to definitely consult your doctor about using sunlight exposure at home.
Sometimes, it may flare up the patches and longer exposures can even lead to skin cancer.
Smoking, alcohol consumption and stress can flare up your condition. Therefore, it is best to avoid anything that can reduce your treatment efficacy and increase your symptoms.
We know that Psoriasis affects you physically as well as mentally.
Therefore, keep yourself stress-free by exercising and maintaining a healthy lifestyle.
Remember that your stress will only increase your condition.
So, fight it gracefully!