Psoriasis is a common skin condition where people have a buildup of rough, dry, dead skin cells. They look like raised, reddish-pink areas covered with silvery scales and red borders.
Psoriasis usually occurs on the scalp, elbows, knees, groin, and lower back. It is a long-lasting or chronic disease that "comes and goes," and may show up as a few spots, or involve large areas. It is not contagious. You can't spread it from one part of your body to another, or from person to person.
More than 6 million people in the United States have psoriasis. You can develop psoriasis at any age, though it tends to come on during adolescence and old age. It usually comes on gradually, in both men and women. Doctors think psoriasis may be an inherited disease that can be triggered by emotional stress.
Most cases are not painful, although severe ones can be. About 5% of people with psoriasis also get psoriatic arthritis, a serious condition that involves painful and swollen joints.
Signs and Symptoms
The following are symptoms of psoriasis:
What Causes It?
Researchers don't know what causes psoriasis. They do know that people who have it make more skin cells than normal. A faulty immune system seems to be involved. In people with psoriasis, T-cells (a kind of white blood cell) mistakenly attack skin cells. The new skin cells move to the outer layer of the skin too quickly, where they build up and form thick patches.
There seems to be a genetic component. You are more likely to develop psoriasis if a close relative also has the condition. Several underlying factors may trigger the condition or flare ups, including:
What to Expect at Your Doctor's Office
Your doctor will examine your skin and ask questions about your physical and emotional health. You may need a blood test to check levels of calcium, zinc, and certain other elements, and a skin biopsy to confirm the diagnosis.
Your doctor may suggest one or several different treatment options, including:
Creams for your skin include:
Systemic drugs, used for more severe symptoms, are taken by mouth, injection, or infusion. All may have serious side effects when used for a long time. They include:
Phototherapy (Light Therapy)
One of the treatments for psoriasis involves ultraviolet light. Some people may get relief from symptoms through brief exposure to sunlight each day. Too much sun can make symptoms worse. So your doctor will need to set up a treatment program for you. Be sure to wear sunscreen with an SPF of 15 or higher and avoid sunburn. Artificial ultraviolet light may also be used, often along with medications, under your doctor's supervision.
Complementary and Alternative Therapies
Mind-body therapies and stress management, including meditation and hypnosis, may help treat psoriasis. Studies show that people who practice meditation before getting light therapy do better than people who had light therapy alone. Exercise can help, too, as can drinking plenty of water.
Taking daily baths with lukewarm water and mild soap can help slough off scales. After your bath, gently pat skin dry and immediately apply a moisturizer to seal in water.
Talk to your doctor before taking any supplements or herbs, because some can have serious side effects or interact with common prescription medications, such as blood thinners and birth control pills. If you are pregnant or breastfeeding, ask your doctor before taking any supplement, herb, or over-the-counter medication. Be sure all your health care providers know about all therapies you use, including complementary and alternative therapies.
Nutrition and Supplements
Do not take vitamin A and D supplements. Both are used in prescription medications in high doses. Also, taking a supplement with your prescription medication could be dangerous if you get too much of these vitamins.
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Few studies have examined the effectiveness of specific homeopathic remedies. However, professional homeopaths may recommend one or more of the following treatments for psoriasis based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
No well-designed studies have looked at using chiropractic care to treat psoriasis. A few case studies have reported that spinal manipulation may reduce skin lesions in some people. Researchers don't know whether chiropractic care is helpful for all people with psoriasis.
Acupuncture may help some people with psoriasis, although the evidence isn't clear.
See your doctor regularly until your psoriasis is under control.
Many of the conventional medications used for psoriasis can cause birth defects. Pregnant women and those planning to become pregnant should not take these medications. Tell your doctor if you plan to become pregnant so you can talk about changing your medication.
Psoriasis may increase the risk of heart attack. Studies also show that people with psoriasis are at increased risk of developing psychiatric disorders, including depression and anxiety, compared to unaffected individuals. Check with your doctor for follow up.
Berstein S, Donsky H, Gullver W, et al. Treatment of mild to moderate psoriasis with Relieva, a Mahonia aquifolium extract - a double blind, placebo-controlled study. Am J Ther. 2006;13:121-126.
Brenaut E, et al. Alcohol consumption and psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013;27:Suppl 3:30-5.
Castela E, et al. Topical corticosteroids in plaque psoriasis: a systematic review of efficacy and treatment modalities. J Eur Acad Dermatol Venereol. 2012;26 Suppl 3:36-46.
Eskicirak B, Zemheri E, Cerkezoglu A. The treatment of psoriasis vulgaris: 1 percent topical methotrexate gel. Int J Dermatol. 2006;45(8):965-969.
Ferri: Ferri's Clinical Advisor 2014, 1st ed. St. Louis, MO: Mosby; 2013.
Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735-1741.
Gulliver WP, Donsky HJ. A report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasis. Am J Ther 2005;12:398-406.
Gyulai R, Kemeny L. The immunology of psoriasis: from basic research to bedside. Orv Hetil. 2006;147(46):2213-2220.
Horreau C, et al. Cardiovascular morbidity and mortality in psoriasis and psoriatic arthritis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013;27 Suppl 3:12-29.
Kimball AB, Wu EQ, Guerin A, Yu AP, Tsaneva M, Gupta SR, Bao Y, Mulani PM. Risks of developing psychiatric disorders in pediatric patients with psoriasis. J Am Acad Dermatol. 2012;67(4):651-7. e1-2.
Liu Y, Krueger JG, Bowcock AM. Psoriasis: genetic associations and immune system changes. Genes Immun. 2007;8(1):1-12.
Malerba M, Gisondi P, Radaeli A, Sala R, Calzavara Pinton PG, Girolomoni G. Plasma homocysteine and folate levels in patients with chronic plaque psoriasis. Br J Dermatol. 2006;155(6):1165-1169.
Marqueling A, Cordoro K. Systemic Treatments for Severe Pediatric Psoriasis. Dermatologic Clinics. 2013;31(2).
Prince J, Bhosle M, Fledman SR, Balkrishnan R. Outcomes associated with the use of biologic agents in moderate to severe psoriasis. J Drugs Dermatol. 2007;6(3):259-267.
Shenefelt PD. Hypnosis in dermatology. Arch Dermatol. 2000;136:393-399.
Shutty BG, et al. Sleep disturbances in psoriasis. Dermatol Online J. 2013;19(1):1.
Wolters M. The significance of diet and associated factors in psoriasis. Hautarzt. 2006;57(11):999-1004.
Woniak A, Drewa G, Krzyzyska-Maliniowska E, Czajkowski R, Protas-Drozd F, Mila-Kierzenkowska C, Rozwodowska M, Soposka M, Czarnecka-Zaba E. Oxidant-antioxidant balance in patients with psoriasis. Med Sci Monit. 2007;13(1):CR30-CR33.
Review Date: 4/8/2014
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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