If you thought you'd never wear shorts again because of your blotchy, flaking skin, take heart. You--and more than 4 percent of the general population with psoriasis--will be glad to hear that treatment option for this unsightly condition have doubled recently.
This chronic skin disease isn't something you can easily ignore: its raised red patches covered with silvery scales make their presence known (fittingly, 'psoriasis' comes from the Greek for 'itch'). It also affects your self-image. (The fact that old references mention the heartbreak of prosiasis' isn't surprising.) The condition occurs when the production of new skin cells abnormally speeds up without a corresponding increase in the rate that old ones are shed. As a result, live cells accumulate in raised areas covered with whitish flakes of immature skin cells (or plaques). Researchers say this rapid cell turnover relates to an inherited immune system disorder that can be
activated by stress, cold weather, an infection or even an abrasion.
Plaque psoriasis often appears on elbows, knees, palms, soles, the lower back and the scalp. Less common forms of psoriasis include: guttate, with teardrop-shaped spots; pustular, with pus-filled skin lesions; inverse, appearing in skin folds; and erythrodermic, with widespread skin scaling and inflammation. Psoriasis flates up periodically and can persist for long periods before going into remission. Although it can cover large areas, usually it's mild and manageable.
LIKELY FIRST STEPS
There is no cure for psoriasis but can you definitely control it and minimise its symptoms. Milder cases usually respond well to respond well to topical drugs and shampoos as well as sunlight. For more severe cases, you'll need oral drugs and specialised light therapy. Most doctors use a combination of treatments and you may need to experiment to find the mix that best suits your particular case.
Lifestyle changes
The first relief for your psoriasis is as close as your yard: expose affected areas to sunlight for 15 to 30 minutes a day, taking care not to sunburn. This brings movement within six weeks in about 80 percent of people who try it. (Be sure to protect unaffected areas with sunscreen.) Soaking in a bath solution enhanced with coal tar, Epsom salts or finely powdered oatmeal can soften scaly build-up. As soon as you get out of the bath, apply a heavy moisturer, such as cetaphil, liquor picis carbonlis (LPC) and menthol (or salicylic acid) in sorbolence, to soften and soothe and soothe your skin. Your doctor may also recommend watertight (occlusive) tapes, especially if you have psoriasis-related cracks on your palms and soles.
Treatment Options
LIFESTYLE CHANGES
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Sunlight Brings relief in 80% of cases.
----------------------------------------------------------------------------------------------------------------------------------------------
Bath soaks Various products help soften scaly build-up. ----------------------------------------------------------------------------------------------------------------------------------------------
Moisturisers Apply after bath to soothe skin.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Topical medications Salicyclic acid, coal tar, corticosteroids.
------------------------------------------------------------------------------------------------------------------------------------------
Medicated shampoo Also steroid foam; stops scalp flaking.
-------------------------------------------------------------------------------------------------------------------------------------------
Oral medications Immunosuppresants, Oral retinoids
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Light therapy Ultraviolet B or PUVA (with psoralen).
---------------------------------------------------------------------------------------------------------------------------------------------
Intralesional corticosteroids Good for small to moderate-sized plaques.
TAKING CONTROL
PROMISING DEVELOPMENTS
Most psoriasis requires medication. To begin, a topical formulation (cream, gel, ointment) can be very helpful. Try salicylic acid to dissolve scales or coal tar gels to slow skin growth. Prescription topical corticosteroids can reduce more severe inflammation. For more severe psoriasis, a common regimen is the daily use of a topical corticosteriod, such as I per cent hydrocortisone, until the patch clears up and then application just on the weekends. Or you can try the combination of weekend steroid use with weekday use of calcipotriol ointment (Daivonex), a form of vitamin D3.
For scalp psoriasis, try a medicated shampoo such as coal tar (Polytar, Ionil-T) or anthralin (Dithrasal). Be aware that both stain and anthralin can irritate normal skin so use them carefully.
For severe psoriasis, an oral immunosuppressant drug such as cycloporine or methrotrexate may be needed to clear up your outbreak. Once this drug begins working, an oral retinoid (vitamin A derivavative), usually acitretin (Neotigason), is added. The immunosuppressant will then be gradually
withdrawn and a low maintenance dose of Neotigason continued. Switch approaches after a couple of years to prevent serious of effects or drug resistance.
Procedures
With moderate to severe psoriasis, you'll need light therapy with ultraviolet B (UVB) rays, done at your dermatologist, a hospital or with a home unit. For more severe psoriasis, a special therapy called PUVA may be necessary; it combines the psoriasis drug psoralen with deeper-penetrating ultraviolet A (UVA) rays. Such treatments are very effective but can up your skin cancer risk.
Injecting plaques of psoriasis with corticosteroids can also be very effective, particularly for isolated small or moderate-sized lesions.
What is happening
This chronic skin disease isn't something you can easily ignore: its raised red patches covered with silvery scales make their presence known (fittingly, 'psoriasis' comes from the Greek for 'itch'). It also affects your self-image. (The fact that old references mention the heartbreak of prosiasis' isn't surprising.) The condition occurs when the production of new skin cells abnormally speeds up without a corresponding increase in the rate that old ones are shed. As a result, live cells accumulate in raised areas covered with whitish flakes of immature skin cells (or plaques). Researchers say this rapid cell turnover relates to an inherited immune system disorder that can be
activated by stress, cold weather, an infection or even an abrasion.
Plaque psoriasis often appears on elbows, knees, palms, soles, the lower back and the scalp. Less common forms of psoriasis include: guttate, with teardrop-shaped spots; pustular, with pus-filled skin lesions; inverse, appearing in skin folds; and erythrodermic, with widespread skin scaling and inflammation. Psoriasis flates up periodically and can persist for long periods before going into remission. Although it can cover large areas, usually it's mild and manageable.
- Sunbathing treatment baths and moisturisers to soothe irrated skin.
- Topical medications and shampoos to treat mild or moderate cases.
- Oral medication for more sever cases.
- Light therapy, if necessary, from artificial sources.
QUESTIONS TO ASK
- When can I expect to see some improvement?
- How far is m psoriasis likely to spread ?
- I'm trying to conceive. Which psoriasis drugs are unsafe for me?
Treatments
There is no cure for psoriasis but can you definitely control it and minimise its symptoms. Milder cases usually respond well to respond well to topical drugs and shampoos as well as sunlight. For more severe cases, you'll need oral drugs and specialised light therapy. Most doctors use a combination of treatments and you may need to experiment to find the mix that best suits your particular case.
Lifestyle changes
The first relief for your psoriasis is as close as your yard: expose affected areas to sunlight for 15 to 30 minutes a day, taking care not to sunburn. This brings movement within six weeks in about 80 percent of people who try it. (Be sure to protect unaffected areas with sunscreen.) Soaking in a bath solution enhanced with coal tar, Epsom salts or finely powdered oatmeal can soften scaly build-up. As soon as you get out of the bath, apply a heavy moisturer, such as cetaphil, liquor picis carbonlis (LPC) and menthol (or salicylic acid) in sorbolence, to soften and soothe and soothe your skin. Your doctor may also recommend watertight (occlusive) tapes, especially if you have psoriasis-related cracks on your palms and soles.
Treatment Options
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Sunlight Brings relief in 80% of cases.
----------------------------------------------------------------------------------------------------------------------------------------------
Bath soaks Various products help soften scaly build-up. ----------------------------------------------------------------------------------------------------------------------------------------------
Moisturisers Apply after bath to soothe skin.
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Topical medications Salicyclic acid, coal tar, corticosteroids.
------------------------------------------------------------------------------------------------------------------------------------------
Medicated shampoo Also steroid foam; stops scalp flaking.
-------------------------------------------------------------------------------------------------------------------------------------------
Oral medications Immunosuppresants, Oral retinoids
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Light therapy Ultraviolet B or PUVA (with psoralen).
---------------------------------------------------------------------------------------------------------------------------------------------
Intralesional corticosteroids Good for small to moderate-sized plaques.
TAKING CONTROL
- Be aware certain drugs can make your psoriasis worse. Lithium, antimalarials and such heart drugs as ACE inhibitors and beta-blockers are the worst offenders.
- Winterwise your program. Winter's dry, cold air can mean more psoriasis. Be careful not to scratch; it can make lesions worse. Instead, slather on moisturer more thickly, applying it while your skin is damp. And get some sun (using sunscreen of course).
- Try mediatation or relaxation techniques if your psoriasis flares up under stress. They can help you deal with life's pressures.
- A vaccine for psoriasis is in the works in New Zealand. It contains organisms called Myobacterium vaccae that have been killed with heat treatment. They appear to 'turn off' immune system cells that attack the skin. In a preliminary test of 24 patients, psoriasis disappeared in 25% and improved in 50%, with benefits lasting as long as 18 months. Larger trials are now under way.
Most psoriasis requires medication. To begin, a topical formulation (cream, gel, ointment) can be very helpful. Try salicylic acid to dissolve scales or coal tar gels to slow skin growth. Prescription topical corticosteroids can reduce more severe inflammation. For more severe psoriasis, a common regimen is the daily use of a topical corticosteriod, such as I per cent hydrocortisone, until the patch clears up and then application just on the weekends. Or you can try the combination of weekend steroid use with weekday use of calcipotriol ointment (Daivonex), a form of vitamin D3.
For scalp psoriasis, try a medicated shampoo such as coal tar (Polytar, Ionil-T) or anthralin (Dithrasal). Be aware that both stain and anthralin can irritate normal skin so use them carefully.
For severe psoriasis, an oral immunosuppressant drug such as cycloporine or methrotrexate may be needed to clear up your outbreak. Once this drug begins working, an oral retinoid (vitamin A derivavative), usually acitretin (Neotigason), is added. The immunosuppressant will then be gradually
withdrawn and a low maintenance dose of Neotigason continued. Switch approaches after a couple of years to prevent serious of effects or drug resistance.
Procedures
With moderate to severe psoriasis, you'll need light therapy with ultraviolet B (UVB) rays, done at your dermatologist, a hospital or with a home unit. For more severe psoriasis, a special therapy called PUVA may be necessary; it combines the psoriasis drug psoralen with deeper-penetrating ultraviolet A (UVA) rays. Such treatments are very effective but can up your skin cancer risk.
Injecting plaques of psoriasis with corticosteroids can also be very effective, particularly for isolated small or moderate-sized lesions.
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