Psoriasis: Symptoms, Diagnosis, Causes & Treatment
What is Psoriasis?
Psoriasis is a long-term chronic autoimmune skin disorder. It is characterized by red, itchy, and scaly patches that usually appear on knees, elbows, scalp, and lower back. It can, however, appear anywhere on the body.
Psoriasis usually occurs in early adulthood, and it doesn’t pass on through touch from one person to another. There is no cure for psoriasis; however it can be effectively managed through medication, diet, and lifestyle changes.
Read more to understand the symptoms, diagnosis, treatment, and management of psoriasis.
Let’s now look at some types of psoriasis and their locations:
It’s the most common form of psoriasis that can itch or hurt. It’s characterized by raised red patches caused by dead skin called scales on the elbows, knees, scalp, and lower back.
It usually affects young adults and children. However, it’s less common and occurs to less than a third of the population having psoriasis.
It’s characterized by several small drop-shaped, scaly, and red spots on your arms, legs, stomach, and chest. But sometimes, it can also spread to your ears, face, and scalp. It usually develops after bacterial infections like streptococcal infections.
Guttate psoriasis isn’t as thick as plaque psoriasis.
Scalp psoriasis looks like dandruff or appears as a thick plaque that covers the entire scalp. Scalp psoriasis is associated with psoriatic arthritis, as many people have both. See a dermatologist if you have scalp psoriasis.
It’s characterized by smooth patches of red skin that can worsen with friction and sweating. It usually occurs in the skin folds of the groin, buttocks, and breasts. It’s thought to be triggered by fungal infections.
It’s characterized by tiny pin-prick holes, discoloration, and crumbling of fingernails and toenails in severe cases. They may feel tender and hurt. Consult a dermatologist who can repair and make your nails look better.
It’s a rare form of psoriasis characterized by pus-filled lesions on the soles of your feet or small areas on the palms of the hand.
It’s another rare form of psoriasis characterized by a red, peeling rash that can cover the entire body. It can feel itchy or burn intensely.
Sometimes psoriasis can affect more than the skin; it can affect your joints, a condition known as Psoriatic Arthritis which causes swollen and painful joints. Most people develop psoriasis years before developing Psoriatic Arthritis.
It’s uncertain what causes psoriasis, but researchers believe it is caused by the immune system attacking skin cells and various triggers like injury, weather, stress, smoking, and infections.
Psoriasis is an autoimmune disease, meaning the body’s immune system mistakenly attacks your own body.
Generally, the immune system protects your body from invading bacteria or pathogens by destroying them. But, in psoriasis, the immune system mistakes the skin cells to be a foreign substance and attacks them, leading to inflammation, soreness, and pain.
Psoriasis can also be inherited from your family. If someone in the family has psoriasis, you may also develop psoriasis. However, this is extremely unlikely as less than 5 percent of people with the gene develop the condition. (National Psoriasis Foundation).
People with cardiovascular diseases, diabetes, hypertension, obesity, and infection are more likely to develop psoriasis.
Triggers — Alcohol, Stress & Injuries
If you already have psoriasis, external triggers can lead to flare-ups or the development of new psoriasis in other areas of your body.
These triggers aren’t the same for everyone and may vary from person to person. The most common triggers include:
(1) Alcohol: Excessive alcohol consumption can trigger psoriasis flare-ups.
(2) Stress: High stress can trigger psoriasis flare-ups. Managing stress can help reduce or even prevent future flare-ups.
(3) Injury: Accidents, cuts, wounds, and even sunburns can trigger new psoriasis flare-ups at the injury site. Proper care, thus, needs to be taken to avoid any external injuries.
(4) Infection: Psoriasis may flare up among young adults after an infection such as strep throat, bronchitis, and tonsillitis.
When you have psoriasis, it’s crucial to see a doctor. Seeing a doctor can help you keep psoriasis-related pain and inflammation under control. Signs that you need to see a doctor:
- Skin plaques that are red, bleeding, or won’t stop itching.
- Joint pains or stiff joints that are getting worse.
- Skin infections, swelling, pus coupled with a fever.
- Changes in your fingernails and toenails.
- Sudden changes to your health, such as weight gain, dizziness, or heart palpitations.
The diagnosis of psoriasis involves a physical examination and a lab test.
Physical examination: The doctor will examine the skin on your
- Soles of your feet
- Knees and
Lab test: A lab test involves a skin biopsy and a blood test.
The doctor may perform a biopsy of the skin, i.e., remove a small piece of skin and examine it under the microscope to tell if you have psoriasis.
The doctor may also prescribe a blood test to check for the levels of WBCs in the blood. Abnormally high levels of WBCs are present in psoriasis.
There is no cure for psoriasis. But luckily, there are many treatments to slow the growth of new skin and relieve dry and itchy skin. Based on the severity of the skin disease, your age, and overall health, the doctor may prescribe the following treatment:
(1) Topical Treatments:
It includes applying creams and ointments directly over the affected skin to help manage mild to moderate psoriasis. They include;
- Salicylic acid
- Vitamin D analogs and
- Topical retinoids
(2) Systemic Medication:
It’s for people with moderate to severe psoriasis and for people who haven’t responded well to other treatments. It involves the use of oral and injected medications. Most of these medications have severe side effects; therefore, doctors prescribe them only for a short duration.
- Biologics. They help reduce inflammation and pain in your body by interrupting the immune system attacking the body.
- Retinoids. They help reduce the production of new skin cells.
- Methotrexate. They suppress the immune system.
- Cyclosporine. They, like Methotrexate, suppress the immune system.
(3) Light Therapy:
Here, ultraviolet (UV) or natural light is used to treat mild to moderate symptoms of psoriasis. Sunlight helps mitigate the effects of WBCs attacking healthy skin cells.
Limited studies suggest that removal of tonsils can result in the improvement of chronic plaque psoriasis (Thorleifsdottir et al., 2012).
You can effectively manage psoriasis at home through medication, diet, and lifestyle changes.
(1) Diet recommendations:
Foods cannot cure or prevent psoriasis, but eating right can help relieve your symptoms. Studies show that people with psoriasis can benefit significantly from eating wild fish (and not farmed fish) such as salmon, herring, mackerel, extra virgin oil, legumes, vegetables, fruits, and whole grains.
(2) Lose weight:
Cardiovascular diseases, hypertension, diabetes, obesity, and infections are some risk factors for psoriasis. Physical activity and exercise help reduce inflammation and stress, improve cardiovascular strength, and help manage or prevent diabetes.
(3) Avoid trigger foods:
Alcohol, red meat, processed foods and dairy products are some foods you may have to avoid. Avoid smoking.
(4) Be mindful of the weather conditions:
Weather changes can cause throat infections such as strep throat, bronchitis, and tonsillitis. They can flare up psoriasis.
(5) Avoid injuries or getting bruised:
Injuries such as a cut, bruise, or even sunburn can result in psoriasis at the site of injury.
(6) Watch your medications:
Medication for hypertension and malaria can trigger Psoriasis. Keep the doctor informed about your medications.
Have psoriasis and don’t know what to do?
At MFine, your health is our top priority. You can consult one of our dermatologists online on MFine. You can call, chat, or video call with one of our doctors available online. You can even order medicines online using the MFine app.
How do dermatologists control psoriasis?
Psoriasis treatment aims to slow down the skin cells from growing too quickly and remove scales. To do so, dermatologists may prescribe medications to reduce inflammation pain or momentarily suppress the immune system to manage psoriasis.
People with psoriasis are more likely to get depressed.
According to a study published by Archives of Dermatology, people with psoriasis are 39% more likely to be diagnosed with depression, and they are 31% more likely to be diagnosed with anxiety. Also, the likelihood of having suicidal thoughts doubles compared to people with other chronic conditions.
The depression and anxiety interfere with their motivation to stick with treatment and may lead to risky behaviors such as substance & alcohol abuse, emotional eating, and isolation.
But the good news is that when people work with their symptoms, they will see an improvement in their emotions.
Therefore, the best possible outcome results when you combine physical treatment with mental health care.
If you or your loved ones have psoriasis, these tried and tested methods can help you cope with your medical condition.
Avoid unnecessary stress from your daily routine in whatever way you can.
Work out and exercise; they decrease psoriasis flare-ups’ risk factors such as diabetes, obesity, and cardiovascular diseases.
Be careful when you play a sport. Injuries such as a cut or a bruise may flare up new cases of psoriasis. Alternatively, you could practice yoga, meditation, or breathing exercises.
Medication for Anxiety and Depression
If you’re depressed or anxious, see a psychiatrist. Medication and therapy go a long way in helping you feel better emotionally.
Don’t know where to find one?
There are times when your mind is clouded with confusion and chaos. But there is help. Psychotherapy can help you find relief. It’s also called talk therapy, where a trained psychotherapist will help you effectively manage your emotions.
Work on your symptoms
This might seem obvious, but when you’re depressed, it can be hard to stay motivated to take care of your body. But when you work on your symptoms, you are more likely to feel better about yourself.
Lead a Healthy Lifestyle
Eating a balanced diet, getting plenty of sleep, and exercising can significantly improve your condition. The better you feel about yourself, the better you’re able to deal with psoriasis.
Q. How common is psoriasis?
As per IJMR, psoriasis has a prevalence of 0.44-2.8 percent in India. Males are twice as likely as females to get psoriasis.
Q. What plays a major role in psoriasis?
The immune cells, primarily the WBCs, play a major role in developing psoriasis. Psoriasis is an autoimmune disease.
Q. What can make psoriasis worse?
Stress, weather conditions, external injuries, alcohol, tobacco are some factors that can make psoriasis worse.
Q. What organs can be affected by psoriasis?
Psoriasis affects more than skin and joints. It can also affect vital organs like the heart, lungs, and kidneys.
Q. Why is my psoriasis spreading?
When you have psoriasis, your skin cells start to grow more quickly than they should. Factors such as stress, excessive alcohol, and tobacco use can cause psoriasis flare-ups causing your psoriasis to spread.
Q. Does psoriasis get worse as you age?
You may have to keep adjusting your medications as you get older.
Q. Can psoriasis affect the brain?
Psoriasis alters the levels of chemicals in your brain that affect your mood. As a result, you may feel depressed.
Q. How serious is psoriasis?
Psoriasis isn’t life-threatening, except in erythrodermic psoriasis, which can affect the entire body.
Q. Is it ok to scrape off psoriasis?
It’s not advised to scrape off as the skin tends to get damaged and bleed. You need to consult a doctor for the right treatment
Q. Does psoriasis affect hair growth?
Psoriasis hair loss is temporary, and hair tends to regrow once psoriasis clears.
Q. Can psoriasis affect your heart?
Psoriasis causes inflammation on your skin and inside your body. Prolonged inflammation in your body can affect your blood vessels, putting you at a higher risk of cardiovascular diseases and strokes.
Q. Can psoriasis cause dementia?
Some studies suggest that psoriasis can cause dementia.
Q. Does psoriasis shorten life expectancy?
Psoriasis by itself does not shorten life expectancy. However, psoriasis can increase your risk of other health conditions like diabetes and cardiovascular diseases, which in turn affect your lifespan.
Q. Does psoriasis mean a weak immune system?
Psoriasis by itself doesn’t weaken the immune system. However, it does mean that your immune system isn’t working the way it should be.
Q. How often should you shower with psoriasis?
Showering can lead to a loss of moisture from your body. Bathing once or twice a day for not more than five minutes is recommended and applying moisturizer after shower is advised.
Q. What causes Psoriasis outbreaks?
Common psoriasis triggers include infections, weather, injuries to skin, smoking, alcohol, and stress.
Q. What if Psoriasis treatment doesn’t work?
If your topical treatment doesn’t work, your doctor will prescribe a combination of topical and systemic medication to help ease your symptoms.
Q. Will Psoriasis ever go away? Can it be cured?
There is no cure for psoriasis. However, it isn’t fatal and can be managed with diet, medication, and lifestyle changes.
Q. Do you need a Covid-19 vaccine booster if you have psoriasis?
The Covid-19 vaccine booster dose is safe and recommended for everyone, including those with psoriasis.
Q. Is psoriasis contagious?
Psoriasis is an autoimmune disease and cannot be transmitted through touch from one person to another.