Psoriasis - Symptoms, Causes & Treatments
If you are suffering with flaky patches of skin that form white scales then this could be down to a condition called psoriasis.
But what is psoriasis? Psoriasis is an immune-mediated disease that happens due to systemic inflammation.
Sometimes, psoriasis causes embarrassment and low self-esteem due to its appearance. Psoriasis affects around 2 in 100 people in the UK, so don’t worry, you’re not alone!
There is no cure for psoriasis, but with the right psoriasis treatment you will be able to manage the condition and keep flare-ups at bay.
Symptoms of psoriasis present differently from person to person and you can develop it at any age. Typically, it causes patches of skin that are dry and covered in scales. Some people might find that side effects include itching or soreness.
There are many different types of psoriasis. People with psoriasis usually only have 1 type at a time, although you can have 2 different types together.
Plaque psoriasis (psoriasis vulgaris)
The most common type of psoriasis is plaque psoriasis. The symptoms present themselves as dry skin lesions (plaques) covered in scales.
They can appear anywhere on your body but they are mostly found on your elbows, knees, scalp and lower back.
The lesions can be itchy, sore or both. In some cases, the skin around your joints might crack or bleed.
Scalp psoriasis can occur on your entire scalp or just parts of it. It causes patches of skin that are covered in thick scales.
Some people who suffer from scalp psoriasis find it extremely itchy, meanwhile others have no discomfort at all.
Extreme cases of scalp psoriasis causes temporary hair loss.
Psoriasis causes you to develop small dents in your nails that become discoloured or grow abnormally.
The nail can become loose and detach itself from the nail bed. In severe cases, nails may crumble.
Guttate psoriasis causes drop-shaped sores on your chest, arms, legs and scalp. They are usually small in size.
This type of psoriasis usually disappears after a couple of weeks, however, some people will go on to develop plaque psoriasis.
Inverse (flexural) psoriasis
Inverse psoriasis causes large, smooth patches of skin. It affects the folds or creases in your skin such as your armpits, groin, between the buttocs and under the breasts.
Pustular Psoriasis is a type of psoriasis that causes reddish, scaly, pus filled bumps. Anyone suffering from this must seek immediate medical care.
Generalised pustular psoriasis
This kind of psoriasis causes widespread pus-filled bumps. Symptoms of generalised pustular psoriasis include fever, chills, dehydration and a rapid pulse.
It is important to seek immediate medical care if you think you have this type of psoriasis.
Palmoplantar pustulosis is a rare, recurrent inflammatory disorder. You usually develop blisters on the palm of the hands or soles of the feet.
Erythrodermic psoriasis is a rare skin condition that causes a red rash to form over most of your body.
The immune system
Your immune system is your body’s defence against disease and it plays a huge role in fighting infection.
T-cells travel through your body to detect invading germs and fight them. In people with psoriasis, they begin attacking healthy skin cells by accident.
It is unknown what causes this issue, however, certain genes and environmental triggers could be to blame.
Psoriasis can also be hereditary. You are at higher risk of developing psoriasis if you have a close relative with the condition.
Triggers of psoriasis
Most people who suffer from psoriasis notice that their symptoms get worse because of certain triggers. Being aware of your triggers can help you avoid a psoriasis flare-up.
The most common triggers of psoriasis are:
- Drinking excessive amounts of alcohol
- A skin injury e.g. cuts, insect bites or sunburn
- Hormonal changes (particular in women) such as puberty and menopause
- Medications (lithium, antimalarial medication, ACE inhibitors and anti-inflammatory medications like ibuprofen) play a part in triggering a psoriasis flare-up
- Throat infections
- Immune disorders e.g. HIV
If you know that drinking alcohol or smoking causes you to have a psoriasis flare-up, then you should try and avoid them completely.
If you are a smoker then you should consider quitting to improve your overall health and reduce the risk of a psoriasis flare-up.
If stress is one of your triggers, then managing your stress can be helpful, too.
If you think you have psoriasis it is important that you speak to your GP or a healthcare professional.
Your doctor will usually examine your skin, scalp and nails for signs that you have the condition. They will also ask you questions such as:
- Have you experienced certain symptoms such as itchy skin or a burning sensation?
- Have you recently had an illness or experienced extreme stress?
- Do you take certain medications?
- Do you have any relatives who have psoriasis?
- Have you experienced any tenderness in your joints?
This information will help your GP to understand if you have psoriasis. It will also help them to identify which type of psoriasis you have. In some cases, your doctor might take a small sample of your skin to examine it under a microscope.
As mentioned earlier, there is currently no cure for psoriasis. There are, however, treatments that can help to keep your condition under control.
Topical treatments can be used if you have psoriasis. They are usually the first treatments used if you have mild or moderate psoriasis. Topical treatments are creams and ointments that are applied to the affected areas of your skin.
For some people, topical treatments are all that is needed to control the condition. It can take up to 6 weeks before you notice the effect of topical treatments.
If you have scalp psoriasis, treating psoriasis might include a combination of shampoo and ointment.
If you suffer with mild psoriasis, an emollient is usually the first treatment your GP will try you with. An emollient is a moisturising treatment that is applied directly to your skin. An emollient reduces water loss and covers your skin with a protective film.
The main benefit of an emollient is that it moisturises your skin and reduces itching and scaling caused by psoriasis.
Some other topical treatments work better on your skin if it is moisturised. You should make sure you wait at least 30 minutes after applying an emollient before using another topical treatment.
Steroid creams and ointments (topical corticosteroids)
Steroid creams and ointments are used to treat mild to moderate psoriasis. A steroid treatment works by reducing inflammation, slowing the production of skin cells and reducing itching.
Stronger topical corticosteroids can be prescribed by your doctor if necessary. Overusing topical corticosteroids can cause the skin to get thinner.
Phototherapy uses both natural and artificial light to treat the symptoms of psoriasis. Artificial light therapy is given under the care of a dermatologist. It is not the same as using a sun bed.
Ultraviolet B (UVB) Phototherapy
UVB phototherapy works by slowing down the production of skin cells and can be effective for certain types of psoriasis. Each session lasts a couple of minutes, however, it might require you to make 2 or 3 trips to the hospital for 6 to 8 weeks.
Psoralen plus ultraviolet A (PUVA)
This treatment is usually used if you have severe psoriasis that has not been resolved with other treatments.
Psoralen plus ultraviolet A involves exposing your skin to a wavelength of light called ultraviolet A. The ultraviolet A light penetrates your skin more deeply than UVB.
If other psoriasis treatments have been unsuccessful you might be prescribed systemic treatments. A systemic treatment works throughout the whole body.
The 2 main types of systemic treatments are non-biological (tablets or capsules) and biological (injections).
Systemic medications are highly effective but they do have potentially serious side effects. It is important to discuss your treatment with a GP before starting it.
Your doctor will be able to talk you through your treatment options and discuss the benefits and risks associated with them.
If you think you have psoriasis or you are worried about your psoriasis symptoms then you should make an appointment with your GP. They will be able to diagnose you and talk you through your treatment options.
Although psoriasis can be embarrassing or frustrating to deal with, there are many ways to treat it!