Understanding Psoriasis: Causes and Treatments

Types of Psoriasis

Plaque Psoriasis

The most common type, with dry, raised patches covered in scales.

Guttate Psoriasis

Small, drop-shaped spots that usually appear on the trunk and limbs, often triggered by infections like strep throat.

Inverse Psoriasis

Affects skin folds (such as the groin, underarms, and breasts) and appears as smooth, red patches.

Pustular Psoriasis

Characterised by pus-filled blisters, it can be widespread or localised to areas like the palms or soles.

Erythrodermic Psoriasis

A severe, rare form that covers large areas of the body, causing intense itching and burning – this form can become life-threatening.

Causes of Psoriasis

What Causes Psoriasis?

Psoriasis happens when the immune system attacks healthy skin cells, speeding up the skin cell turnover process. Normally, skin cells take about a month to grow and shed. With psoriasis, this cycle speeds up, causing skin cells to pile up on the surface of the skin.

Psoriasis and Genetics

While the exact cause of psoriasis isn’t fully understood, genetics play a big role. If you have a family member with psoriasis, you’re more likely to develop it yourself. However, not everyone with a family history will get it, and it can also appear in people without any family history.

Common Triggers of Psoriasis Flare-Ups

Certain factors can trigger or worsen psoriasis flare-ups. These triggers can vary from person to person, but some common ones include:

• Stress: Emotional stress is a well-known trigger for many people with psoriasis.
• Injury to Skin: Cuts, scratches, sunburns, or even bug bites can cause a flare-up.
• Infections: Infections like strep throat or the flu can trigger guttate psoriasis.
• Smoking: Smoking increases the risk of developing psoriasis and can worsen existing symptoms.
• Weather and UV: Extreme temperatures can trigger psoriasis. UV light in a controlled setting can help improve symptoms for some people, however it is harmful in excess.
• Other Triggers: Medications, alcohol, and even certain foods can also trigger flare-ups for some people.

Symptoms of Psoriasis

How to Recognise Psoriasis Symptoms

The symptoms of psoriasis can vary depending on the type, but the most common include:

• Raised, red patches of skin covered with silvery-white scales.
• Dry, cracked skin that may bleed.
• Itching, burning, or soreness in affected areas.
• Nail changes, like pitting or separation from the nail bed.

When to See a Doctor

If you notice patches of skin that resemble psoriasis, or if your condition is causing discomfort or affecting your quality of life, it’s a good idea to see a doctor. If you have symptoms like swelling, pain in the joints, or if the psoriasis isn’t improving with treatment, seek medical advice.

How Psoriasis is Diagnosed

How is Psoriasis Diagnosed?

Your doctor will ask about your medical history and perform a physical exam, looking closely at your skin, scalp, and nails. In some cases, a skin biopsy may be done, where a small sample of skin is taken for further examination. This helps rule out other conditions and confirms the type of psoriasis.

Psoriasis Treatments: How to Manage the Condition

Topical Treatments for Psoriasis

The first line of treatment for psoriasis is usually topical creams and ointments. These can include:

• Corticosteroids: The most commonly prescribed treatment for mild to moderate psoriasis.
• Vitamin D analogues: Help slow down skin cell growth.
• Retinoids: Reduce cell production but may cause skin irritation.
• Coal tar: Reduces itching and scaling but has a strong smell.
• Calcineurin inhibitors: Great for sensitive areas like around the eyes.

Light Therapy (Phototherapy)

Phototherapy involves exposing the skin to controlled doses of natural or artificial light. This treatment is particularly helpful for moderate to severe psoriasis and can include:

• UVB broadband or UVB narrowband light therapy.
• Psoralen plus UVA (PUVA), a more intense treatment involving a light-sensitising medication.
• Excimer laser, which targets only the affected skin.

Systemic Treatments: Oral and Injected Medications

For more severe cases, doctors may recommend oral or injected medications, such as:

• Biologics: These drugs alter the immune system to disrupt the disease cycle.
• Methotrexate and Cyclosporine: These suppress the immune system and are used for severe cases.

Alternative and Complementary Treatments

Some people find relief from alternative treatments like:

• Aloe vera creams for reducing scaling and inflammation.
• Fish oil supplements which may reduce psoriasis symptoms.
• Herbal remedies like Oregon grape applied to the skin.

Managing Psoriasis When Conventional Treatments Don’t Work

If traditional treatments aren’t effective, your doctor may suggest trying a combination of therapies or switching to stronger options like biologics or phototherapy.

Lifestyle Changes and Home Remedies for Psoriasis

Daily Skin Care Tips for Psoriasis

Taking good care of your skin can help reduce flare-ups and ease symptoms:

• Moisturise your skin regularly to prevent dryness.
• Use gentle, fragrance-free products that won't irritate your skin.
• Avoid hot showers, as they can dry out the skin.

Diet and Psoriasis

A healthy diet can support overall skin health. Some people find that certain foods, like fatty fish or leafy greens, help reduce inflammation. Others may notice flare-ups after eating spicy foods or alcohol.

Stress Management Techniques

Since stress can trigger psoriasis flare-ups, practicing relaxation techniques such as meditation, deep breathing, or yoga can help manage stress and reduce the frequency of flare-ups.

Psoriasis Outlook and Prognosis

What Can You Expect with Psoriasis?

Psoriasis is a lifelong condition that can go through cycles of flare-ups and remission. With the right treatment and lifestyle changes, most people can manage symptoms effectively.

Can Psoriasis Be Cured?

Currently, there is no cure for psoriasis, but treatments can help manage the symptoms and improve quality of life. In some cases, symptoms may subside for long periods of time.

Coping with Psoriasis: Support and Resources

Psychological Impact of Psoriasis

Dealing with the physical symptoms of psoriasis can be challenging, but the emotional toll can also be significant. Many people with psoriasis experience stress, anxiety, or depression. Seeking support from friends, family, or a therapist can be really helpful.

Support Networks and Communities

Joining a psoriasis support group, whether online or in person, can provide a sense of community and understanding. It’s important to know you’re not alone in this.

How Psoriasis is Affected by Sun Exposure

The Impact of Sun on Psoriasis

For many people, exposure to sunlight can actually help improve psoriasis symptoms. UV rays slow down the rapid skin cell turnover that causes psoriasis. However, its important to note that it is only the UVB component of the sun's UV rays that can help. The remaining UVA component of UV rays is not beneficial for psoriasis and will damage your skin. Consequently, it is recommended to receive UVB rays in a controlled setting and protect yourself from the sun to avoid sunburn, as this can trigger flare-ups.

Sun Protection: Clothing and Other Preventive Measures

The Role of Sun Protective Clothing

With Psoriasis, it is even more important that you manage your UV radiation exposure, and ensure that you are not overexposing yourself to the sun.Sun protective clothing provides a great option for shielding your skin from harmful UV rays whenever you are outside, and the best bit is you don't need to keep re-applying them (like suncream). Look for clothing with an ultraviolet protection factor (UPF) rating of 50+ to ensure you're getting effective protection.

Other Sun Protection Tips

When out in the sun, don’t forget to apply a broad-spectrum sun cream with an SPF of at least 30, and wear a wide-brimmed hat and sunglasses to protect your skin from further damage.

FAQs about Psoriasis Causes and Treatments