Psoriasis: symptoms & treatment

Psoriasis affects a significant part of the population (1-3%), and can occur in both adults and children, of all genders and races. In Greece, the percentage approaches 2.5%! Often, the initial stage shows up between the ages of 15-25, but this is not the norm.

What is psoriasis?

Psoriasis is a chronic skin condition in which the immune system is overactive, causing skin cells to be produced at a very rapid rate.

What happens is that the skin cells that gradually rise to the epidermis, in the case of psoriasis they do so very quickly. If the typical life cycle of a skin cell is 28 days, in psoriasis it can be reduced to 4-5 days!

Thus, the cells accumulate on the surface and the so-called hyperkeratosis is caused. The following areas are mainly affected:

• Scalp
• Elbows
• Knees
• Face
• Hands & fingers
• Nails
• Genitals
• Palms and soles
• Neck 
• Area behind the ears

However, psoriasis can appear on any other part of the body.

Symptoms

Although the symptoms of psoriasis vary from person to person, the most common are:

• Red scaly plaques
• Red, dry skin that peels or bleeds
• Itching
• Heartburn
• Pain (in severe cases)
• Claws thick with ridges

Generally, symptoms come and go and vary in severity and duration. They often worsen in the winter, when there is little sunshine.

Also, it is important to emphasize that 1 in 3 patients with psoriasis may develop psoriatic arthritis. In this case, these symptoms also appear:

• Stiffness, swelling and pain in the joints
• Back and neck pain
• Heel pain

What causes psoriasis?

Although the mechanism of psoriasis has not been fully understood, most experts conclude that hereditary, psychological and environmental factors play a decisive role in its appearance. Often, patients with psoriasis have a family history of the disease, while an event (eg intense stress) is able to trigger its appearance, as it activates the immune system to a greater extent (autoimmune).

Trigger factors are:

1. Stress: Unusually high stress can trigger psoriasis and lead to frequent flare-ups.
2. Injury: A cut or scratch on the skin can cause inflammation. Don’t get a tattoo if you have psoriasis. Injuries, vaccinations and sunburns can also trigger a new outbreak.
3. Infection: If you are sick or fighting an infection, your immune system goes into overdrive to cope. This can lead to a flare-up of psoriasis. A typical example is streptococcus infection.
4. Medical treatments: Certain preparations can trigger psoriasis in some patients. Such are those that include lithium and certain treatments for hypertension.
5. Weather conditions: changes in the weather, such as low winter temperatures or a very dry environment, trigger the disease in most people.
6. Alcohol: If you drink a lot of alcohol, flare-ups may be more frequent.
7. Smoking or exposure to smoke.
8. Obesity: Psoriasis is more common in obese people.

Types

There are several types of psoriasis, including:

1. Plaque Psoriasis: Affects about 80% of people with psoriasis and appears as dry, red plaques covered by white or silvery scales.
2. Inverse psoriasis: Found in areas such as the armpits, groin, under the breasts and on the genitals.
3. Guttate Psoriasis: It mostly affects young adults and children. It is associated with a bacterial infection – usually strep.
4. Pustular psoriasis: Causes rashes with non-infectious pus to form in various areas of the body.
5. Erythrodermic psoriasis: It is the rarest, but also the most severe form of psoriasis, affecting only 2% of people with psoriasis. Symptoms such as severe itching, increased redness and peeling are found all over the body. It can cause increased heart rate, hypothermia, heart failure, dehydration, as well as serious infections such as pneumonia and sepsis.

How to treat psoriasis

Psoriasis cannot be cured, but it goes through periods of remission and flare-ups. Since it is a multifactorial disease, its treatment should be aimed at several points, including:

1. Topical treatment with ointments or creams
2. Stress management
3. Proper diet
4. Food supplements
5. Sun exposure
6. Avoid dry air

So what should we pay attention to in the above and how can they help us?

1. Topical treatments

The search for the best ointment or cream for psoriasis is a marathon for many! Often, most people get disappointed when they don’t see an immediate result or when this doesn’t last.

To choose the most suitable product for you, it is advisable to consult an expert, since there are a variety of options, depending on the area and the severity of the problem. The aim of topical treatments is to:

• reduce skin inflammation
• reduce itching
• moisturize dry and rough skin
• help remove scales
• smooth the skin and reduce its roughness

At the same time, there are many moisturizing creams and emulsions for greater comfort, while in many cleaning products (shampoo, shower gels, etc.), you will find ingredients such as tar and sulfur that especially relieve psoriatic skin.

You should not forget that in order to see a substantial and longer-lasting result, it is important to take care of the following:

2. Stress management

Those who suffer from psoriasis often experience flare-ups during periods of intense stress. Therefore, a good solution is to adopt ways to help reduce this, such as:

• Relaxation
• Deep breaths
• Yoga
• Stress management therapies (behavioral, cognitive, etc.)
• Meditation
• Relaxing massage
• Engaging in activities

3. Proper diet

Many studies in patients with psoriasis have shown that the Mediterranean diet makes the symptoms of the disease less severe. This includes foods rich in vitamins A, D, E, folic acid (e.g. fresh fruits and vegetables), but also omega-3 fatty acids (e.g. olive oil, fatty fish), which have anti-inflammatory properties.

In addition, weight loss in overweight or obese people with psoriasis appears to reduce the severity of symptoms.

Foods to avoid in psoriasis

Since this is an autoimmune disease, it is important to avoid or reduce foods that worsen our health. Such are:

• Highly processed foods, rich in saturated and trans fats e.g. Sweets, soft drinks, ready meals, junk food, etc.
• Red meat and dairy
• Foods with a high glycemic index (eg white bread, pasta, rice, juices)
• Nightshade vegetables (potatoes, tomatoes, eggplants, peppers and spices derived from them, eg paprika, cayenne pepper). Although there is insufficient scientific data, many people notice improvement when they limit those in their diet.
• Alcohol. Often, its high consumption is associated with the onset of psoriasis, but also with outbreaks of the disease.
• Foods with gluten. Several patients have gluten sensitivity. Thus, they see improvement when they reduce the foods that contain it.

4. Food supplements

Supplements that seem to help improve symptoms are:

• Omega-3 fatty acids (fish oils)
• Selenium (mainly in erythrodermic psoriasis)
• Vitamins D, E and A (as they are often deficient in these)

Various vitamin deficiencies, as well as gluten sensitivity or intolerance can be identified with relevant blood tests.

5. Sun exposure 

Sun exposure for 15-30 minutes without sunscreen is beneficial, although the mechanisms are unknown. It also causes vitamin D production and this may be another mechanism of action. It should be noted that the sun is not always beneficial, as sunburn can be a triggering factor of the disease.

6. Avoid dry air in winter

Winter causes flare-ups in 80% of patients. Dry indoor air worsens symptoms. Sufferers should not forget to hydrate their skin very well, but also to drink enough water.

Is it contagious?

It is important to emphasize that psoriasis is not contagious, so there is no risk of it being passed from person to person.

Also, it is different from scabies, which is a contagious skin disease caused by the parasite Sarcoptes scabiei (mite).

Conclusion

In conclusion, psoriasis is a skin disease that affects the quality of life. That is why lifestyle changes and proper skin care are important. In addition, if you have psoriasis it is good to be monitored by a specialist dermatologist.