Psoriasis is a disease that causes itchy or sore patches of thick, red, dry skin.
While any part of your body can be affected, psoriasis most often occurs on the elbows, knees, scalp, back, face, palms, and feet.
Like other autoimmune diseases, psoriasis occurs when your immune system which normally attacks infectious germs begins to attack healthy cells instead.
And, like other chronic diseases, the symptoms of psoriasis are cyclical, flaring for a few weeks or months and then subsiding for a time or even going into remission.
According to the American Academy of Dermatology, about 7.5 million people in the United States have psoriasis, with the disease affecting Caucasians more than any other race.
The disease occurs about equally among men and women.
People with psoriasis generally see their first symptoms between 15 and 30 years of age; however, developing the disease between 50 and 60 years of age is also common.
There are five types of psoriasis, yet people most often have only one type of psoriasis at a time.
Plaque psoriasis (also called psoriasis vulgaris) is the most common form of psoriasis, and appears as raised, red patches covered with a silvery white buildup of dead skin cells or scale.
The itchy, painful patches can crack and bleed, and commonly affect the scalp, knees, elbows, and lower back.
Guttate psoriasis often begins in childhood or young adulthood and is the second most common type of psoriasis.
Nearly 10 percent of people who get psoriasis develop guttate psoriasis, reports the National Psoriasis Foundation (NPF).
Inverse psoriasis, also known as intertriginous psoriasis, causes red lesions in folds of the body that may look smooth and shiny.
These lesions can occur on the genitals or areas near the genitals like the upper thighs and groin.
Its common for people with inverse psoriasis to have another type of psoriasis somewhere else on their body at the same time.
Pustular psoriasis causes white blisters of pus that surround red skin. The pus consists of white blood cells.
Erythrodermic psoriasis is a dangerous and rare form of the disease characterized by a widespread, fiery redness and exfoliation of the skin that causes severe itching and pain.
This type of psoriasis occurs once or more in 3 percent of people with psoriasis, according to the NPF.
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Psoriasis is a chronic disease that lasts a lifetime, and the signs and symptoms of psoriasis vary depending on the person and type of psoriasis.
For some, psoriasis can clear up for months or even years at a time. This is known as remission.
Others experience psoriasis flares (or flare ups) in cyclical patterns; for instance, the disease will improve in the summer and worsen in the winter.
Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.
Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into complete remission.
When pus-filled bumps cover the body, you may have bright-red skin and feel ill, exhausted, have a fever, chills, severe itching, rapid pulse, loss of appetite, or muscle weakness.
Figuring out what causes your skin to flare up is one of the best ways to try to control your symptoms.
Here are some of the most common psoriasis triggers:
Most of the time, your physician can diagnose psoriasis by taking your medical history and examining your skin, scalp, and nails.
In some cases, a skin biopsy may be done to determine the type of psoriasis, and to rule out other disorders that look similar to psoriasis, such as dyshidrotic eczema, seborrheic dermatitis, lichen planus, ringworm, and pityriasis rosea.
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While the exact cause of psoriasis is unknown, its an autoimmune condition in which a faulty immune system changes the life cycle of skin cells in the body.
This change causes the cells to build up rapidly on the surface of the skin in just a few days (for those without psoriasis, this process usually takes about a month).
These extra skin cells form thick, itchy, dry, red patches on the skins surface.
While more research is needed to fully understand psoriasis, we do know that the condition is not contagious.
In other words, you cant spread the disease through touch, salvia, or during sexual contact.
In addition to your immune system, genetic factors have a lot to do with whether youll develop psoriasis.
People who get psoriasis usually have one or more family members with the condition. Having family members with the disease does not mean youll definitely get it, however.
At least 10 percent of the general population inherits one or more of the genes that create a predisposition to psoriasis.
Despite this, only two to three percent of those people actually develop the disease, according to the National Psoriasis Foundation.
The best explanation: The individuals who do get the disease have a certain combination or mix of genes and are exposed to environmental triggers some of which are still unknown that lead to the development of psoriasis.
For many people, psoriasis begins after experiencing one of the following triggers:
While anyone can develop psoriasis, the following factors can increase your risk:
Family history: Having one parent with psoriasis increases your risk, and having two parents with the condition puts you at greater risk.
Infections: People with HIV are more likely to develop psoriasis. Additionally, kids and young adults with recurring infections, such as strep throat, may be at increased risk.
Stress: Since stress can impact your immune system, high stress levels may increase your risk of psoriasis.
Obesity: Being overweight increases your risk, and psoriasis often develops in the creases and folds of skin.
Smoking: Smoking tobacco increases your risk and the severity of psoriasis, and may initiate the development of the disease.
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Some treatments for psoriasis are more effective than others depending on the person, so it can take trial and error until you find the treatment that works best for you.
Physicians tend to start with the mildest approaches (topical treatments) and move from there.
Topical treatments that are applied to the skin are the most commonly prescribed medications for treating mild to moderate psoriasis.
These anti-inflammatory medications slow cell turnover by suppressing the immune system, which reduces inflammation and relieves itching.
Topical treatments come in both over-the-counter (OTC) forms and as prescriptions.
Corticosteroids are commonly prescribed topical treatments that reduce the swelling and redness of lesions.
Anthralin (Zithranol-RR), synthetic vitamin D3, and vitamin A are also used in prescription topical treatments to control psoriasis lesions.
OTC treatments may contain salicylic acid and coal tar, which help with lesions and are approved by the Food and Drug Administration.
Products that contain aloe vera, jojoba, zinc pyrithione, or capsaicin may help moisturize, soothe, remove scale, or relieve itching.
Also called biologics, these are protein-based drugs derived from living cells cultured in a laboratory .
Biologic drugs are administered through an injection or IV, and target specific parts of the immune system.
Biologics work by blocking the action of a specific type of immune cell and proteins in the immune system that play a major role in developing psoriasis and psoriatic arthritis.
Systemic medications work throughout the body, and are most often prescribed for those with moderate to severe psoriasis and psoriatic arthritis.
Theyre also useful for those who need to be treated with something other than topical medications or UV light therapy.
Used for more than 10 years to treat psoriasis, systemic psoriasis drugs are taken orally in liquid or pill form or given by injection.
Also called phototherapy, this is a treatment that targets specific types of light onto the skin.
The preferred sources of UV light used in psoriasis phototherapy are UVB (ultraviolet light B), PUVA (psoralen UVA), and lasers.
The therapy is done in a doctors office, psoriasis clinic, or at home with a phototherapy unit.
Before starting any phototherapy treatment, tell your doctor about any new drugs youre taking, and protect unaffected areas of skin during your treatment.
New oral medications that target molecules inside immune cells are now being used to treat psoriasis.
These treatments correct the overactive immune response that causes inflammation in people with psoriasis and psoriatic arthritis, leading to improvements in redness, scaliness, joint tenderness, and swelling.
Apremilast (Otezla) is the newest of these oral medications being used. Apremilast can be used with other treatments such as phototherapy or topicals, as well as with methotrexate (Rheumatrex Dose Pack, Trexall).
According to the National Psoriasis Foundation, at least half of those with psoriasis have it on their scalp.
Treatments for scalp psoriasis may include the following:
Systemic treatments , such as methotrexate, oral retinoids, cyclosporine, biologics and ultraviolet light may be used if psoriasis is also on other parts of the body.
Topical treatments for scalp psoriasis include:
Shampoo both coal-tar and non-coal-tar medicated are available to treat scalp lesions.
Steroid medications may be injected into scalp lesions that are mild and appear in few areas.
Some people with psoriasis choose to try alternative therapies to help keep psoriasis flares at bay and to manage pain.
Therapies may include the following:
There isnt much scientific evidence to prove the effectiveness of diet or alternative therapies for psoriasis, but researchers do know that some supplements can interact with medications.
While most of these approaches are safe, talk with your doctor before trying any of them.
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While home remedies wont cure psoriasis, the following may help improve the appearance and feel of damaged skin.
Daily baths can help remove scales and calm inflamed skin. Here are some tips for making the most out of your bath:
Moisturizer should be applied after bathing. First lightly dry your skin and then immediately apply a heavy, ointment-based moisturizer. Oils may be a better choice than moisturizer and creams since they lock in moisture better.
Sometimes you may need to reapply moisturizer throughout the day.
Getting some sunlight can help lesions improve, but too much sun can trigger or worsen outbreaks and increase the risk of skin cancer.
Ask your doctor about the best way (and how often) to get sun exposure. Keep the following in mind:
Identify what triggers your psoriasis and try to avoid those triggers, such as abstaining from drinking alcohol and smoking.
The following tips can help with another common trigger, stress:
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Psoriasis flares typically occur on the arms, neck, and legs, but they actually can appear anywhere on the body.
"And that includes the scalp," says Dina D. Strachan, M.D., a board-certified dermatologist in Manhattan and assistant clinical professor of dermatology at New York's Columbia University.
"While some people only have psoriasis on the scalp, most people with scalp psoriasis have it on other parts of their body as well." Dr. Strachan adds.
At the onset, scalp psoriasis often is confused with seborrheic dermatitis (a.k.a. dandruff).
"Dandruff tends to itch more, and it has a greasy-appearing yellow scale; in contrast, psoriasis whether it's on your scalp or any other body part tends to have a thick, silvery scale," Strachan explains.
Adds Joy Alpert Levine, M.D., co-founder of Plastic Surgery & Dermatology of NYC, "Scalp psoriasis may itch and become easily irritated during a flare, however, and it also may affect your hairline or creep down onto your forehead, nape of your neck, or your ears."
The first step in treating scalp psoriasis effectively involves removing or lifting thick scales, which helps medication penetrate the plaques and clear them up.
"One common way to do this is by using keratolytics treatments, which contain active ingredients, such as salicylic acid, urea, lactic acid, or phenol, that are designed to dissolve skin flakes or scales," says Strachan.
"Another way to soften and loosen scalp scales is to apply oils, lotions, creams, or ointments to a damp scalp."
Once the psoriasis scale has been softened, you can remove it with a fine-tooth comb or brush.
"Gently comb the scalp in a light circular motion, holding the comb almost flat against the scalp," advises Strachan.
"Once the scale is loosened, shampooing is a good way to get the scale away from your scalp and out of your hair. But be gentle. Brushing or combing too vigorously can break the skin and lead to an infection. It can also break hair off at the scalp, causing temporary hair loss."
Shampoos with ingredients such as tar and salicylic acid also may be helpful. "Liquid or foam topical medications [like steroids and calcipotriene] are easy to apply to the scalp," says Strachan.
However, severe flares may require the use of oral medications in conjunction with such topical treatments.
Before starting any topical scalp treatment, Dr. Strachan suggests applying a test patch of the medication to an inconspicuous spot on your head.
"In some cases, treatments may cause irritation or temporary hair loss," she says. "Your hair should grow back. However, if hair loss persists after you've treated your psoriasis, you should consult a dermatologist."
While your scalp is clearing up, talk with your hairstylist about alternative hairstyles that can help conceal affected areas.
Also, consider wearing light-colored tops or shirts to help to disguise the falling silvery plaque scales that are easily mistaken for dandruff.
While the symptoms of scalp psoriasis may seem to come and go, psoriasis is a chronic condition that will need to be treated and managed over time.
And, according to Dr. Strachan, treating your psoriasis promptly is the best way to reduce its impact on your appearance.
If you are not sure whether you actually have scalp psoriasis, consult your doctor as soon as you can for an accurate diagnosis and to develop a psoriasis treatment strategy that works for you.
Having psoriasis can increase your risk of developing the following conditions:
Psoriatic arthritis, a condition that can cause joint damage and loss of function in some joints.
Eye disorders, such as conjunctivitis, blepharitis, and uveitis.
Obesity is more common in people with psoriasis, though the link between the two is not known. One explanation is that the inflammation linked to obesity may affect the development of psoriasis.
People with psoriasis are also more likely to gain weight because their psoriasis restricts their activity level.
Type 2 diabetes, a disease that's characterized by high blood sugar, has a greater risk of occurring in those with moderate-to-severe psoriasis.
High blood pressure, or hypertension, occurs when the force of blood pushing against the walls of the arteries that the heart pumps remains high.
If this continuously happens it can lead to conditions, including coronary heart disease, heart failure, stroke and kidney failure.
Cardiovascular disease is a greater risk for those with psoriasis due to excess inflammation in the body, an increased risk of obesity, and other factors.
People with psoriasis are almost three times more likely to have a heart attack compared to those who dont have the condition.
Additionally, irregular heartbeats and stroke risk are higher for those with psoriasis.
Some psoriasis medications may also cause abnormal cholesterol levels and increase the risk of hardened arteries.
Metabolic syndrome is a group of risk factors that raises a persons risk of heart disease, diabetes, and stroke.
The conditions include high blood pressure, obesity, elevated insulin levels, and abnormal cholesterol levels.
Celiac disease is an autoimmune disorder that causes damage to the small intestine when gluten is eaten.
One study found that more than a third of people with psoriasis have elevated antibodies to gliadin in their blood (gliadin is the protein in wheat that cannot be properly digested by people who have celiac disease and gluten sensitivities).
Sclerosis occurs when an abnormal response of the bodys immune system is directed against the central nervous system, which includes the brain, spinal cord, and optic nerves.
Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract, which can cause diarrhea, rectal bleeding, an urge to go to the bathroom, abdominal cramps and pain, sensation of incomplete evacuation, and constipation.
Parkinson's disease is a chronic neurological condition that progresses slowly in most people.
Kidney disease occurs when the kidneys can no longer filter blood properly, which causes wastes to buildup in the body.
Psoriasis can also cause the following:
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Source: http://www.everydayhealth.com
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