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In this section, you or a loved one can find out more about medical treatments, research studies and practical information about psoriasis. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step towards becoming an active decision-maker in your care plan.
Psoriasis is a disease that causes the skin cells to grow too quickly. Rough, dry and thick patches of dead skin called lesions or plaques appear on the skin. The lesions can appear red and irritated with silvery scales and a distinct border between the plaque and normal skin. Sometimes the lesions itch, burn or bleed. Plaques are most often seen on the elbows, knees and torso, but can appear anywhere, including the scalp. Fingernails and toenails can also be affected. The nails can become discoloured, thickened, lift up from the skin and even become “pitted” as small holes form in them.
Scientists do not yet know the precise cause of psoriasis or how to cure it. But scientists do know about the types of psoriasis symptoms, how to treat the symptoms and how the disease progresses.
Unfortunately, psoriasis is a chronic disease, meaning that once it starts, it is likely to persist for the rest of your life.
The lesions you see on your skin are the result of an overactive immune system, which mistakenly attacks your own healthy skin cells. So, psoriasis is an “autoimmune disease”. In fact, psoriasis is the most common autoimmune disease. Scientists are not sure why this happens. But, psoriasis is not contagious — you or your loved ones cannot catch it from someone who has it. Someone who smokes, is overweight or has a relative with psoriasis is also at higher risk of developing the disease.
Scientists are studying the potential causes and progression of psoriasis:
There are some important factors about psoriasis and the disease progression that are known:
Inflammation is a natural process that your body normally uses to protect itself from harm. When a portion of skin is affected, it becomes red, swollen and painful, and feels hot or warm to the touch: this is called inflammation.
A normal skin cell forms at the bottom layer of your skin and slowly makes its way to the surface as more new skin cells form underneath it. The skin cell reaches the surface and eventually falls off without you noticing. A normal skin cell lasts 28 to 30 days. In psoriasis, however, when your immune system malfunctions and produces inflammation in an area of your skin, it only takes three to four days for new skin cells to mature and reach the surface. The old skin cells do not have time to fall off and build up with other skin cells instead, creating inflamed skin scales and skin plaques.
The severity of psoriasis is measured by how much skin is covered by lesions or plaques. The body surface area or BSA is the percentage of your skin surface area affected by plaques. The size of your palm is usually 1% of the total body surface and acts as the reference point. The severity classifications are:
Severity can also be measured by how psoriasis affects your quality of life. For example, even a mild case affecting only a small area on the scalp or the palms or soles of the feet can have a significant impact on your life.
Psoriasis symptoms tend to change over time, appearing differently in each person. People with psoriasis often suffer from a cycle with periods of active disease that are called flare-ups, followed by periods when symptoms disappear that are called remissions. The triggers, which can set off psoriasis in the first place, often worsen symptoms or cause a flare-up after a period of remission.
If inflammation from psoriasis is left untreated, it can eventually lead to thickened skin, scarring, disfigurement and bacterial skin infections caused by scratching and touching plaques. Fortunately, there are many ways to treat psoriasis and prevent complications before they happen.
Psoriasis plaques can appear anywhere on the body. Plaques can range from a few pinhead-sized spots to major eruptions that cover large areas of the body.
If you have psoriasis, you are at greater risk of developing other diseases, such as:
Many psoriasis patients also feel embarrassed by their appearance, avoiding social situations or other daily activities, and intimacy with their partners.
For most people, regardless of having psoriasis or not, exercise, healthy eating, good sleeping habits, soothing skin care routines and relaxation techniques are recommended. A healthy lifestyle can lead to an enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.
First identify the triggers that bring about your flare-ups or make your symptoms worse. Then try to avoid them. For example:
On days when you might feel particularly self-conscious about the appearance of your skin, you can cover the affected areas with clothing, or use make-up or concealer to mask redness and plaques.
However, never cover open sores or unhealed lesions; make-up, concealer and even clothing may irritate the skin even more.
For some people with psoriasis, treatments that fall outside the scope of traditional western medicine can sometimes work very well for symptom relief. Ask your doctor about alternative therapies.
The goals of medical treatment for psoriasis are:
Your doctor can explain the different medications, their benefits and side effects. It is likely that you will try different therapies or combinations before finding the best prolonged symptom relief.
Biologic response modifiers, or “biologics” for short, are medications (given by injection) specifically designed to target your body’s immune system. Like Disease-modifying anti-rheumatic drugs (DMARDs), biologics are used to slow the production of skin cells, and ease the pain and swelling of psoriasis plaques and scales.
Biologics can take some time to work. Some people notice the effects of the medication quickly (within a week), while other patients may take months to feel the effects. They are also prescribed when other psoriasis therapies are not effective, and in people with moderate-to-severe cases. Common side effects with biologics include mild skin reactions at the injection site, nausea, abdominal pain and headaches. Rarely, people who take biologics may develop serious infections, lupus-like reactions, nervous system diseases and cancer. You should not take a biologic if you are pregnant or breastfeeding, or have a history of multiple sclerosis or cancer. Inform your doctor if you have a history of tuberculosis, hepatitis B or recurrent infections.
Please note that the information on this website is intended for informational purposes only and should not be used as a substitute for seeking medical advice or treatment from a healthcare professional. You should not use this information to diagnose or treat a medical condition or health problem. Speak to a healthcare professional if you have any questions about your health, medical condition, symptoms or treatment options.
A leading national charity and membership organisation for people affected by psoriasis in the UK
The National Psoriasis Foundation (NPF)is a non-profit, voluntary health agency in the USA dedicated to finding a cure for psoriasis and psoriatic arthritis and eliminating their devastating effects through research, advocacy and education.