Psoriasis is a chronic autoimmune condition that speeds up the life cycle of skin cells, causing them to build up rapidly on the surface of the skin. This buildup of cells leads to scaling on the skin’s surface. Inflammation and redness around the scales are common, and psoriatic scales are typically whitish-silver and develop in thick, red patches.
Types of psoriasis
There are several types of psoriasis, each with unique characteristics, says dermatologist Dr Neha Awasthi.
Plaque psoriasis:
Most common form: Affects 80-90 per cent of people with psoriasis.
Symptoms: It can appear as raised, red patches covered with a silvery-white buildup of dead skin cells (plaques). Typically found on the scalp, knees, elbows, and lower back.
Guttate psoriasis (second most common):
Symptoms: This type of psoriasis manifests as small, dot-like lesions. It often starts in childhood or young adulthood and can be triggered by a bacterial infection like strep throat.
Inverse psoriasis:
Symptoms: Bright red, shiny lesions that appear in body folds such as the armpits, groin, under the breasts, and around the genitals and buttocks. It is often worsened by friction and sweating.
Pustular psoriasis:
Symptoms: Symptoms include white pustules (blisters of noninfectious pus) surrounded by red skin. It can be localised to certain areas of the body (e.g., hands and feet) or generalised, covering most of the body.
Erythrodermic psoriasis (rare and severe):
Symptoms: Widespread redness, severe itching, and pain. The skin appears as if it has been burned, and this type can lead to serious illness, such as heart failure or pneumonia.
Nail psoriasis:
Symptoms: It affects the nails, causing them to become pitted, thickened, and yellowish-brown. It can cause the nails to separate from the nail bed.
Psoriatic arthritis (affects joints):
Symptoms: Joint pain, stiffness, and swelling. It can affect any part of the body, including the fingertips and spine, and ranges from mild to severe.
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Triggers of psoriasis
According to Dr Awasthi, psoriasis triggers vary from person to person, but common triggers include:
Stress: High levels of stress can cause psoriasis to flare up.
Infections: Infections like strep throat can be a serious trigger of guttate psoriasis.
Injury to the skin: Cuts, scrapes, or severe sunburns can trigger a psoriasis flare (known as the Koebner phenomenon).
Cold weather: Dry, cold weather can lead to dry skin, which can exacerbate psoriasis.
Smoking and alcohol: Severe addiction can lead to an increased risk of psoriasis and can worsen the condition.
Certain medications: Lithium, antimalarial drugs, and some blood pressure medications can trigger or worsen psoriasis.
Hormonal changes: Psoriasis can be affected by hormonal changes, particularly in women during puberty, pregnancy, and menopause.
Treatments for psoriasis
Treatment options for psoriasis aim to stop the skin cells from growing so quickly and to remove scales. Options include:
Topical treatments:
Corticosteroids: Reduce inflammation and slow down skin cell turnover.
Vitamin D analogues: this treatment slows down the growth of skin cells.
Topical retinoids: Normalise DNA activity in skin cells and reduce inflammation.
Salicylic acid: It helps to remove scales.
Coal tar: This can help you reduce scaling, itching, and inflammation.
Phototherapy:
UVB phototherapy: Exposing the skin to ultraviolet B (UVB) light.
PUVA: A combination of a drug called psoralen and UVA light.
Excimer laser: A targeted form of light therapy.
Systemic medications (for moderate to severe cases):
Methotrexate: Reduces the production of skin cells and suppresses inflammation.
Cyclosporine: Suppresses the immune system.
Biologics: Target specific parts of the immune system. Examples include adalimumab, infliximab, and ustekinumab.
Oral retinoids: It is similar to vitamin A and are used to reduce skin cell production.
Lifestyle and home remedies:
Moisturisers: Keeping the skin moist is crucial to managing dryness and scaling.
Baths: Soaking in a bath with Epsom salts or oatmeal can help to remove scales and reduce itching.
Healthy diet: A diet low in inflammatory foods and rich in fruits, vegetables, lean proteins, and omega-3 fatty acids may help reduce flare-ups.
Managing psoriasis
Regular monitoring: Working closely with a healthcare provider to monitor the condition and adjust treatments as needed.
Stress management: Practice relaxation techniques like yoga and meditation to reduce stress.
Avoiding triggers: Identifying and avoiding personal triggers can help in managing the condition.
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