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About Psoriasis / What is Psoriasis? / Treatments

What is Psoriasis?

Psoriasis is a complex skin disease that affects people both physically and emotionally. It is still unknown what causes psoriasis. Psoriasis skin cells reproduce in about 3-4 days compared to a normal skin that reproduce in 28 to 30 days. Such rapid skin reproduction builds up and form inflamed scaly lesions.

On the scalp, psoriasis can manifest itself as stubborn dandruff. It could be both itchy and painful. Psoria­sis usually appears as red scaly patches over the external areas of joints like the elbows and front of the knees. Sometimes pressure oc­curring on these joints from kneel­ing or by leaning on the elbows at a desk, can cause mild psoriasis outbreaks. However, psoriasis may occur on any part of the body even on the face, armpits, palms and genitals.

Psoriasis is a chronic disease that affects about than 1.8 million Filipinos or 125,000 million people all over the world. There are reported cases in all age groups but more prevalent on adults. Both male and female can get psoriasis. No one can “catch it” since it is not communicable. Though it is not common, there are reported cases of psoriasis in infants.

Psoriasis is an auto-immune disease and no one exactly knows what causes it. Many believed that it could run in the family. People with psoriasis may notice that sometimes the skin gets better and sometimes it gets worse. Things that can cause the skin to get worse include: infec­tion, stress, change in weather con­dition and certain medicines.

Since it may manifest like other skin disease, Psoriasis can be tough to diagnose. Some doctors may need to extract small skin samples and looked under a microscope. This procedure is also known as  biopsy.

Treatments

Treatment depends on: the severity of the disease, size of patches, type or kind of psoriasis and patient’s reaction to certain treatments. Ef­fective treatment for some may not necessarily be good for everyone. Doctors may switch treatments if one doesn’t work, if there is a bad reaction, or if the treatment seems ineffective. The treatment catego­ries for psoriasis are: Topical Medi­cations, Ultraviolet therapies, sys­temic medications and combination therapies.

Topical Medications:

Treatments applied right on the skin (creams, ointments) may help. Treatments can: Help reduce swell­ing and skin cell turnover, Suppress the immune system, Help the skin peel and unclog pores, Reduce cell turnover and swelling.

Emollients and Salicylic Acid

Cream emollients or greasier ones such as petroleum jelly may help to reduce scaling. These can be ap­plied whenever the skin feels dry. Preparations containing salicylic acid can be used on very scaly patches (known as plaques) as it removes built-up scales so that medications can penetrate the le­sions. It is often mixed with tars and steroid medications to increase its affectivity.

Steroids

Topical steroids are normally used when psoriasis affects the face, hairline, ears, umbilicus (tummy but­ton), or groin. They are also used when there is psoriasis present on the scalp. Potent (strong) steroids are required to control psoriasis in these areas. If ongoing treatment is required on a non hair bearing area then close supervision is required and an ongoing potent treatment should not be encouraged because of serious future side effects. Once psoriasis has cleared up, a milder preparation can be used for safer long-term usage.

Coal Tar

There are purified tar prepara­tions which can help to reduce the inflammation and irritation of pso­riasis, as well as being effective at clearing the disease. Tar may be applied to the skin, mixed with bath water or applied to the scalp in the form of shampoo or hair treatment preparation. Few side effects are associated with using coal tar and are often combined with ultraviolet light therapy. Its downside is its smell and can stain clothing as well as bedding.

Dithranol

Dithranol slows up cell turnover in the surface of the skin and may be effective in treating resistant pso­riasis. Dithranol has to be used with utmost care especially when used at home for it may cause burn­ing skin and stain clothing. As the psoriasis starts to clear the treated areas will gradually stain brown, particularly on the skin around. This staining will disappear once the Dithranol is discontinued. The Dithranol has to be repeated on a daily basis and after the first week the strength can be increased. The strength of the Dithranol is usually increased at weekly intervals to the maximum that an individual is able to tolerate without burning. Dithra­nol treatment is mainly used for psoriasis on the trunk and limbs.

Vitamin D Analogues

Calcipotriol and Tacalcitol Prepa­rations can be helpful in some indi­viduals and are cosmetically highly acceptable. They are relatively safe and are usually of benefit in reducing scaling but may not ac­tually clear psoriasis completely when compared to Dithranol thera­py. Irritation can occur if the vitamin D analogue is applied onto facial skin or genital skin.

Vitamin A Analogues

A topical retinoid, Tazarotene is new vitamin A gel prescribed for mild to moderate psoriasis. The doctor may prescribe it for a limited time only. Some irritation may occur with its usage though it appears to be a cosmetically acceptable product effective in some individuals.

Light Therapy

Natural ultraviolet light from the sun and artificial ultraviolet light are used to treat psoriasis. One treat­ment, called PUVA, uses a combi­nation with psoralen that makes skin more sensitive to light and ul­traviolet A light. Psoralen should not be used when sunbathing for it may cause severe burns.

Systemic Medications:

For severe psoriasis, doctors might prescribe oral medications or through injection. This is called sys­temic treatment. Topical medica­tions are sometimes combined with this treatment to speed up clear­ing.

Combination Therapy

PUVA and Psoralen, Systemic Drugs with topicals are combination ther­apies that seem to be effective to many. When you combine cream or ointment, light, and systemic treat­ments, you can often use lower dos­es of each. Combination therapy can also speed the clearing proc­ess.

biologics:

These drugs are given by intramuscular injection, intravenous infusion, or subcutaneous injection.  These new drugs are used for people who have moderate to severe pso­riasis who have failed to respond to traditional treatment.

Biologics are made to block the de­velopment of psoriasis and psoriat­ic arthritis as it confronts the over­active cells believed to be causing the development of psoriasis on the immune system level.