MILD, CHRONIC AND SEVERE PSORIASIS
Psoriasis is a non-contagious, life-long condition that affects the skin due to an inefficient immune system. It causes the skin cells to grow very quickly resulting in patches of skin which are thick, white, silvery or red. Some people with psoriasis may also have arthritis known as psoriatic arthritis. There is no cure but various treatments can help to control the symptoms.
Though the exact cause of psoriasis is still unknown, it is believed to be a combination of genetics and environment.
- Heredity. Psoriasis is known to run in families and is therefore, hereditary.
- Autoimmune condition. A faulty immune system is believed to attack and destroy healthy body tissue leading to a buildup of dead skin cells on the surface of the skin.
There are certain trigger factors which could cause an attack of psoriasis:
- Viral and bacterial infections such as upper respiratory infections.
- Injury to the skin caused due to insect bites, cuts and burns.
- Dry skin.
- Exposure to too much or too little sunlight.
- Excessive alcohol intake.
- Certain medicines such as anti-malaria drugs, lithium and beta blockers.
- Weak immune system due to AIDS, chemotherapy and autoimmune disorders such as rheumatoid arthritis.
The onset of psoriasis may be slow or sudden. It often recurs through the lifetime of a person. It usually affects the elbows, knees, scalp and trunk but can occur anywhere on the body.
The common symptoms include:
- Itching of skin.
- Dry skin covered with silvery scales.
- Red patches which are thick and raised.
- Joint pain.
- Genital sores in males.
- Severe dandruff on scalp.
- Changes in nails such as thickening, yellowish-brown coloring, dents and nail lifting off its bed.
The treatment for psoriasis is decided on factors such as the type of psoriasis, the area of skin affected, its impact on the person’s life and the health of the person. A Koo-Menter Psoriasis Instrument or KMPI, a self-assessment questionnaire answered by the patient helps the doctor to determine the type of treatment to be followed. Psoriasis is classified as mild if it affects less than 3% of the body and severe if more than 10% of the body is affected.
- Over-the-counter products. These include moisturizers, bath solutions, anti-cream creams and scale-lifters.
- Corticosteroids. They are the most common form of topical treatment used to reduce the growth of skin cells and reduce inflammation. They are available as creams, lotions, gels and shampoos. Steroids of low strength are used for short periods on sensitive areas such as the face, breasts and groin. Steroids of higher strength are used to treat conditions which do not respond to milder steroids and have thicker plaques.
- Vitamin D Analogues. These creams include Calcipotriene and Calcitriol and used to slow down the growth of skin cells.
- Coal tar. It is used in the form of shampoos, lotions and creams to reduce the growth of skin cells, itching, swelling and scaling.
- Anthralin. In the form of Zithranol- RR, Dritho-Scalp and Micanol are used to slow the growth of skin cells.
- Retinoids. This man-made vitamin A found in Tazarotene cream reduces skin inflammation and slows the growth of skin cells.
- Salicylic acid. Found in shampoo, gel and lotion form, it helps to lift and remove scales.
For the treatment of chronic psoriasis, topical steroids and Vitamin D derivatives such as Calcipotriene form the main medications of topical therapy. Usually a combination of both works better than individually. When psoriasis affects more than 20% of the skin or if treatment with topical steroids does not have a positive result, then other forms of treatment such as light therapy and systemic therapy are resorted to. Immunomodulatory drugs such as efalizumab, etanercept and alefacept are also used.
This form of psoriasis is usually treated using a combination of therapies. Other than topical treatments, photo or light therapy and systemic medications including biologic drugs are used. While phototherapy involves exposure to light, systemic medications are drugs which are administered either orally or by injection to work on the whole body.
Natural and home remedies go a long way in taking care of and reducing the symptoms of psoriasis.
Dietary supplements such as fish oil, milk thistle, Vitamin D and evening primrose oil help to ease symptoms and bring relief. Fish oil may also be applied directly to the skin.
Moisturizers meant for sensitive skin can be used to keep the skin moist and reduce dryness. A humidifier should be used to keep the air moist inside the house.
Avoid the use of strong perfumes and dyes in soaps and other skin care products as they cause drying of the skin.
Fatty foods and red meats should be eliminated from the diet.
Bathe in lukewarm water to which milk, Epsom salts or olive oil has been added.