Psoriasis

Identification

One of the most common skin disorders, Psoriasis affects approximately 4.5 million Americans. It is characterized by the overproduction of skin cells, resulting in a build-up of dead cells. The most common form, Plaque Psoriasis, often occurs as raised red patches covered by silvery dead cells. Psoriasis is a genetic condition where there is a “short circuit” in the activity level of the immune system. This ultimately affects the way in which skin is produced. With sheer unpredictability, the immune system becomes “overactive”, and random sites begin to experience an increased rate of skin cell turnover. Skin forms thick white flaking plaques, often compared to the appearance of mica (hence the term micaceous flakes). Cracks, bleeding and discomfort accompany flare-ups. No skin is immune to the potential of developing psoriasis. Psoriasis is not only disfiguring, it can destroy joints (psoriatic arthritis) and it can take an emotional toll. An equal opportunity skin disorder, men and women are equally affected. Children and infants are also potential victims and most are at risk when battling a strep infection.

Flare factors

include:
  • stress and illness
    • strep
    • mycoplasma
    • staph infections
  • lack of light exposure (hence the flare often experienced every fall and winter)
  • hormonal imbalances (i.e. pregnancy)
  • and sometimes for no reason at all.

Prevention

Unfortunately, since Psoriasis is genetic, there is no guaranteed prevention. There are however many therapies. You can also try to simply avoid triggers.

Treatment

“The elbows, knees, sacrum, scalp, nails, palms and soles are the sites most commonly affected by Psoriasis.”

There are many therapies for Psoriasis, many of them relatively new. Unfortunately there is no cure for Psoriasis. However, finding the right treatment can help tremendously or even eliminate symptoms. Treatments can come in many forms: topical, oral, intravenous, and laser.

Cortisol/Hydrocortisone

Topical steroids have been used as a treatment. However they run the risk of causing “addiction”. This causes the symptoms to worsen while off and only abate with the reapplication of steroids. Additionally, side effects can occur. Use of topical steroids can thin the skin.

Keratolytics

Keratolytic agents can be used to soften and exfoliate the thickened psoriatic scales. While they do not address the underlying problems that cause psoriasis, thinning and smoothing out thickened, often cracking skin can palliate discomfort as well as improve the overall skin aesthetics. Both AHAs and BHAs can be used as keratolytics.

Tazorac

A topical Vitamin-A treatment, Tazorac can have excellent results for moderate Psoriasis. Tazorac is a relatively recent discovery and is worth discussing with you physician.

Biologics

Biologics work on the immune systems’s side of things. Extra cell growth is a result of instruction from the body’s immune system. The biologics will either prevent T-cells from communicating the bad instructions or prevent the T-cells from becoming activated at all.

Salicylic Acid

Salicylic Acid is very good at loosening the rough scales. Many people have gotten excellent results by applying the Salicylic/20 three times a week, and weekly applying Lactic/50. This is a very aggressive treatment, and you have to be careful to watch for skin irritation.

Moisturize

Apply a hydrating agent immediately after bathing, washing your hands (if that area is affected) to protect the skin from the environment and from drying out. The topicals will hydrate the skin and in addition can help actively treat the psoriasis, so starting them early can really make a difference.