Psoriasis - Causes, Symptoms and Treatment
What is Psoriasis?
Psoriasis is a fairly common skin disorder. It is immune-mediated, which means that it is caused by dysfunction and inflammation of the immune system. When this occurs, the disease causes the cells in the skin to multiply much faster than usual, resulting in bumpy red patches with white scales.
The patches, called plaques, will appear differently depending on each person's skin type. While they can appear anywhere, they most commonly show up on the elbows, knees, scalp, and lower back. The patches can be present in multiple locations at the same time. There are five different types of psoriasis, and those who are afflicted can be affected by the various types at once.
Plaques appear in cycles, being visible for a period of time before healing and disappearing for a while. This is because of the overactivity of the immune system. While normal skin cells grow and shed for a month, this process lasts for about four days in people with psoriasis. Instead of shedding, the cells begin to quickly amass and pile up on each other, causing the appearance of scales. They eventually shed and the skin begins the healing process, only to begin again later, though not necessarily in the same area.
This condition is not contagious and cannot be passed from body to body. However, it does have a pattern of presenting itself in families. Typically, the symptoms do not appear on children, and spots do not begin to show up until late adolescence or early adulthood.
While psoriasis is known primarily as a disease of the skin, the inflammation associated with it can negatively impact other tissues and organs in the body. There is a high co-morbidity with arthritis, which is characterized by swelling, stiffness, and pain in the joints. If this does occur, it's important to administer treatment early to avoid permanent damage to the joints.
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What Causes Psoriasis?
Unfortunately, doctors and researchers do not yet know the exact cause of psoriasis. However, scientists have been able to confirm that genetics, as well as the immune system, play a significant role in its development. When a person has psoriasis, visible symptoms are not frequently present; instead, they are triggered. What exactly triggers an outbreak varies from person to person, but there is a list of common risk factors that have been identified.
The number one risk factor for the disease concerns the genes and the immune system. Our genes instruct the cells on how to work and behave, determining our physical traits. Psoriasis often runs in families, though the exact genetics behind it is tricky and complicated.
Some people, however, develop the condition even in the absence of a familial history of it. In these cases, a triggering event can cause disruption and change in the immune system, resulting in the onset of symptoms.
Triggering events will vary based on the individual, but some common ones include stress, injury or trauma to the skin, and certain medications. Certain illnesses can also trigger psoriasis. These can be mild and seemingly inconsequential, such as an ear infection, or more serious, such as tonsillitis and strep throat.
Another, perhaps surprising trigger, is the weather. Both the immune system and the skin are sensitive to changes in the weather, with colder temperatures increasing flare-ups due to decreased light and humidity, drier air, and the likelihood of developing an illness, such as the flu.
Warmer weather often improves the appearance of psoriasis-affected skin, as it is exposed to natural light and increased humidity in the air. While it is a bit less common, the allergies that many people experience with the changing seasons can also trigger a psoriasis outbreak, as can sensitivity to certain foods. Figuring out which triggers affect a person can significantly assist in managing or even preventing outbreaks and symptoms.
Symptoms of Psoriasis
The symptoms that indicate this condition will vary and depend on which type of psoriasis the person has. The most common signs are:
- patches of red rash on the skin, often covered with loose scales
- itchy and painful patches of skin that crack
- bleeding skin
- discoloration and weakness of the finger and toenails, sometimes resulting in detachment from the nail bed
- shedding plaques on the scalp of the head
For patients who develop arthritis due to psoriasis, or 'psoriatic arthritis', achy and swollen joints may also be present as symptoms.
How to Treat Psoriasis?
Although psoriasis is an incurable condition, there are ways to treat and manage it. Some of these treatment options can be entirely done on one's own, such as limiting alcohol intake, avoiding foods that tend to cause breakouts, and, where possible, staying in warmer, moist air.
Most cases of psoriasis respond well to different topical treatments. These are rubbed directly onto the skin, relieving discomfort and keeping the area moisturized and supple. There are several options available at the local pharmacy for those experiencing a flare-up.
A salicylic acid ointment is one such option, as it promotes the shedding of the dry scales caused by the condition. These easy to obtain ointments are recommended for a plethora of skin conditions. However, they should be used in moderate amounts and only on small areas, as salicylic acid is a potent substance that could cause a few side effects if overused. The same advice applies to ointments and shampoos containing coal and tar that are particularly popular in natural health circles.
Steroid-based creams are also popularly used to treat psoriasis, though these will require a prescription from a provider. These creams address many symptoms across the psoriasis spectrum, reducing inflammation and itching while blocking the overproduction of cells. Two other topical ointments, calcitriol and calcipotriene, may also be used, and are often combined with a corticosteroid cream. Once again, it's essential to follow a provider's instructions to prevent overuse and adverse side effects.
How to Treat Psoriasis Naturally?
These can be efficiently utilized to prevent flare-ups and control milder cases. Using phototherapy can be as simple as making sure to get enough sunlight. However, more chronic and severe cases may need to seek out light therapy in a specialized clinic.
Water is an excellent tool for a variety of conditions, including psoriasis. Many patients utilize bath solutions, such as oils, salts from the Dead Sea, and even simple Epsom salts, to shed skin scales and ease the uncomfortable itching that often plagues those with this condition. After soaking, it's just as important to moisturize the skin. While this will not make the condition disappear, it can provide temporary relief while reducing stress and inflammation.
Aloe vera is another versatile gift from the Earth that can come in handy for those with psoriasis. Its well-known cooling and moisturizing effects can nourish the cracked and irritated skin, reducing redness and promoting healing.
However, a far lesser-known trick comes from an unlikely source: the hot and spicy cayenne pepper. These have been used medicinally across the world throughout the ages to relieve pain, and are most effective when incorporated into a gel or cream. Nonetheless, because they contain the heat-producing ingredient capsaicin, these products can cause a burning sensation, so be sure to avoid contact with the eyes, washing the hands after use.
Finally, one of the most controllable changes that a person can make to improve their health is with his/her diet. Some studies have shown that reducing or eliminating gluten significantly reduces inflammation in the body. However, there is no one-size-fits-all diet to improve health. Eating a balanced diet full of fruits and vegetables and consuming copious amounts of water is the best bet to have healthy skin. Learning which foods to avoid to prevent flare-ups will vary individually.
When over-the-counter and natural home remedies do not alleviate psoriasis symptoms, a doctor has several options to explore with a patient. Prescription retinoids are a popular choice and can help to alleviate symptoms quickly. They are a more mild topical ointment and do not work as quickly as steroid-based creams.
UVA and UVB light therapy are also known to be effective treatments, often in conjunction with the drug psoralen. However, due to the increased risk of developing skin cancer from exposure, they are used less today and only in situations where the potential benefits outweigh the inherent risks.
Although less common, some doctors prescribe injectable or oral medications to treat psoriasis which affects the immune system directly. Biologics are one such type of this medication. Made from human or animal proteins, they are effective despite being costly. Examples include adalimumab, apremilast, guselkumab, and secukinumab, to name just a few. These work by suppressing the enzyme responsible for triggering inflammation.
Oral retinoids, with properties similar to Vitamin A, are also utilized in patients with prolonged and severe cases. One of the most potent medications prescribed for psoriasis is methotrexate, which is also used in chemotherapy for treating cancer. This drug works to improve skin lesions caused by psoriasis dramatically but can have extreme side effects and require regular blood test monitoring.
Homeopathic claims are not backed by scientific evidence – they are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.
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