If you’re living with psoriasis, I don’t have to tell you what it looks like: red scaly plaques often located on the skin of the elbows, knees and scalp. I also don’t have to tell you how uncomfortable and difficult it can be.
Fortunately, there are effective ways to manage psoriasis, lower inflammation and prevent flare-ups so you can enjoy healthy, happy skin.
What causes psoriasis?
Psoriasis is a chronic, inflammatory skin disease that affects more than 3% of the general population. Symptoms can start in early childhood, but most people develop psoriasis in adulthood.
The cause is thought to be multifactorial, likely due to both genetic and environmental factors that lead to uncontrolled cell turnover in the upper layer of the skin. That leads to the common skin condition that we see: red plaques often covered with thick white scale.
Psoriasis types and affected areas
- Plaque psoriasis: most common type of psoriasis. The plaques are located over the elbows, knees, lower back and scalp.
- Guttate psoriasis (guttate meaning teardrop-like): many small red scaly papules scattered on the trunk and extremities.
- Inverse psoriasis: develops in the skin folds like your armpits and groin.
- Pustular psoriasis: presents as small sterile pustules on the palms and soles.
What is psoriatic arthritis?
You might not know it, but psoriasis affects more than just the skin. It is also a multisystem disease. Most commonly, the skin and nails are involved, but up to 30% of people with psoriasis will have joint involvement. This is called psoriatic arthritis.
People with psoriasis often experience “morning stiffness.” Typically, their joints feel stiff in the morning, and it can take them more than 30 minutes to get going. The arthritis usually affects hands and feet but can be seen in larger joints as well. Unfortunately, it is progressive and, if left untreated, can lead to joint destruction.
Recent research has shown that people with psoriasis have an overall increased risk of other health problems, including heart and blood vessel disease and diabetes. That’s why it’s important for people with psoriasis, especially with more extensive disease, to stay up to date on their health visits and screenings.
Preventing a psoriasis flare-up
If you’re living with psoriasis, you’re probably looking for ways to prevent it from flaring up. Many environmental, as well as personal factors, can flare psoriasis. It’s helpful to understand and manage psoriasis triggers.
Common triggers include:
- Trauma to the skin
- Dry skin can exacerbate psoriasis.
- Some medications (like lithium and beta-blockers)
Sunlight, on the other hand, has known anti-inflammatory properties and can help treat psoriasis. Diligent dry skin care, like avoiding hot showers and moisturizing the skin daily, can be beneficial as well.
Effective psoriasis treatments
Treatment of psoriasis often depends on the severity of the symptoms and follows somewhat of a treatment ladder. Milder cases can be treated with topical creams (often steroids, but some non-steroidal anti-inflammatory medications are being used as well), and UV light therapy.
For more severe cases, we may turn to systemic treatments. This is usually a good option for people with large areas of affected skin or psoriatic arthritis. There are several anti-inflammatory oral medications, but new developments over the past decade have revolutionized the treatment arsenal.
The so-called “biologics” are drugs that specifically target a part of the immune system that is overactive in psoriasis. Most of them are injectable medications that have been shown to be very effective and safe and have been a real game-changer in the treatment of psoriasis.
So, which systemic medication is best? Talk to your dermatologist about which option is right for you. This is a very individualized decision based on personal preferences (taking a pill vs an injection) as well as potential side effects and contra-indications.
Next steps for your psoriasis
If you think you may have psoriasis or you’ve been diagnosed with psoriasis and have questions about treatment options, please don’t hesitate to contact a dermatologist.
Find a dermatologist near you today.
About the author
Kirstin Altman, MD, is a dermatologist on the medical staff at Baylor Scott & White Medical Center – Temple.