Psoriasis is a non-contagious chronic skin condition characterized by thick discolored patches of skin. It most typically affects adults, but younger children and teenagers can have it, as well. Because of its unsightly nature, people with psoriasis often feel very ashamed and embarrassed about having it and go through great lengths to cover it up in public. Understanding how to treat psoriasis is crucial in learning how to properly manage its symptoms. Having a general understanding of what it is and what causes it helps in understanding the treatment methods available.

Pronounced “suh-ry-uh-sus”, psoriasis is caused by an overreaction of the immune system, which then causes skin inflammation and skin flaking. Normally, in skin where psoriasis is not present, new skin cells grow and are shed within about 4 weeks. Skin cells affected by psoriasis, however, grow at a much faster rate and do not shed like healthy skin cells should. The result is a build up of excess skin, which is referred to as psoriasis plaques.

Many fear that psoriasis is contagious, but it is not and there is no chance at all of it being spread by coming in contact with a person who has it. Psoriasis may be hereditary, as it does seem to run in some families. However, researchers are not yet sure of exactly how it is passed through family members.

Once a person has psoriasis, there are certain conditions that trigger its flare-ups. These conditions include, but are not limited to:

· Stress
· Certain types of mental illness (and certain medications used in treatment)
· Cigarette smoking (particularly in women)
· Certain medications (especially high blood pressure medications or nonsteroidal anti-inflammatory drugs)
· Cold and/or very dry weather

Psoriasis symptoms can seem to come and go, even without treatment. Also, some people only have a very mild case while others experience far more severe symptoms. When symptoms do arise, the following are the most recognizable:

· Thick skin rash (generally located on the hands, feet, knees, elbows, scalp or lower back areas)
· Rash may be red, white or a silver looking color
· Itchiness
· Tender skin

In more severe cases of psoriasis, people can experience arthritic symptoms known as psoriatic arthritis. People with this type of psoriasis commonly complain of swollen, painful joints. Severe psoriasis even sometimes causes a loss of finger and toe nails as a result of dead skin building beneath both surfaces and pushing the nail out of the nail bed.

Psoriasis treatments largely consist of managing and controlling flare-ups by reducing the probability of them through lifestyle changes. Therefore, it is important that a person with psoriasis take the following daily precautions:

· Avoid stress as much as possible
· Maintain a healthy diet and a healthy weight
· Keep the immune system strong and avoid infections, such as strep throat, which can trigger a psoriasis outbreak
· Avoid excessive exposure to the sun (and especially avoid sunburns)
· Avoid all skin injuries (including even minor injuries to the skin surrounding the fingernails and toenails)
· Avoid medications that trigger or increase psoriasis symptoms
· Avoid cigarette smoking
· Avoid alcohol consumption

Proper skin care is always in order for those with psoriasis. This includes keeping the skin as moist as possible throughout the day. A person with psoriasis should make an effort to discover which bath and skincare products work best in this effort and use those products regularly. For some, products containing Aloe Vera gel may be particularly soothing to the skin.

If psoriasis appears in the scalp, there are over the counter shampoos that can help with this condition. Psoriasis shampoos are normally found alongside dandruff shampoos and are known to be very effective. Regular shampoos may contain alcohol and other ingredients, which deplete the skin’s moisture and should, therefore, be avoided by those who suffer from psoriasis.

Although over exposure to sunlight can cause sunburn or otherwise trigger symptoms of psoriasis, short daily exposure to the sun or other ultraviolet lighting is recommended in controlling psoriasis. Regular sunlight exposure for approximately 15 – 20 minutes at a time may help. If this amount of time begins to irritate or dry skin too much, consider reducing it to a level that feels more comfortable.

Skin patches that appear during a psoriasis flare-up are often itchy and uncomfortable. It is never recommended that these be scratched, however, as this could cause further injure the skin, cause a worsening of symptoms or infection. Instead, a person can try to moisturize and soften the patches before attempting to pull them from the skin. However, never forcefully tear patches away, as this could further damage skin and cause conditions to worsen.

Psoriasis is considered a chronic condition and, though it can go into remission for long periods of time, it is generally one that people must live with forever. However, with adequate skin care and by avoiding conditions that trigger flare-ups, a person with psoriasis can manage the condition well and help minimize its occurrences. When psoriasis symptoms do surface, following the simple steps outlined above are beneficial and should be regularly practiced for best results. In severe cases, including those that are accompanied by psoriatic arthritis, medical treatment can provide relief.

Those with more severe cases of psoriasis are often noted to experience bouts of depression and feelings of low self-esteem. Research has even shown that people with severe symptoms often report problems engaging in daily activities in the same ways that are recognized among cancer patients or those with heart disease. Because stress largely contributes to psoriasis, these conditions can lead to seemingly never-ending cycles of psoriasis flare-ups. If you or someone you know is emotionally affected by psoriasis, it is important to note that support groups for people living with psoriasis or emotional counseling with a qualified therapist may help. Even in the most severe cases of psoriasis, there are empowering steps, such as those previously described, which a person can and must make in order to improve their overall quality of life and largely reduce the impact that psoriasis can have on daily living.

Bernadette Maclennan

We at East Coast Dermatology, understand that there are two main reasons why patients visit a dermatologist. The first one is to treat a problem and the other one is to look better. We offer a full range of services including detection, analysis, and treatment of various skin conditions, both medically necessary and aesthetic. We treat sun damaged skin, acne in teenagers, red rash in babies, skin cancer, skin lesions, hair disorders, nail disorders, psoriasis skin of color, actinic keratoses, eczema and rosacea.

We are committed to explaining your medical problem and guiding you through the medical or cosmetic solutions and options for your treatment. Knowledge about your particular problem will improve the outcome of your treatment. Your questions are always welcome and are a valuable part of our patient-doctor relationship.

Please do not hesitate to call our office to set up an appointment or an evaluation or treatment.

East Coast Dermatology is a Leading Charleston Dermatology provider.