How Will Menopause Affect My Ability To Manage My Psoriasis How Should I Prepare
During menopause, hormone levels shift, resulting in lower levels of estrogen. We know that low estrogen levels in postmenopausal women is associated with dry skin, decreased collagen production with thinning of the skin, and loss of elasticity.
Theres no definitive data that menopause has a direct effect on psoriasis. But limited data suggests low estrogen levels may be associated with worsening of psoriasis.
Psoriasis may be harder to treat in people with weakened skin, so its important to do what you can to keep your skin healthy before menopause begins. Wearing sunscreen and practicing sun-protective behavior are the absolute most important things you can do to protect your skin when you are young.
Research And Statistics: Who Has Psoriasis
According to the National Psoriasis Foundation, about 7.5 million people in the United States have psoriasis. Most are white, but the skin disease also affects Black, Latino, and Asian Americans as well as Native Americans and Pacific Islanders.
The disease occurs about equally among men and women. According to the National Institutes of Health , it is more common in adults, and you are at a greater risk if someone in your family has it. A study published in September 2016 in the journal PLoS One concluded that interactions between particular genes as well as genetic and environmental factors play an important role in the diseases development.
People with psoriasis generally see their first symptoms between ages 15 and 30, although developing the disease between 50 and 60 years of age is also common.
The biggest factor for determining prognosis is the amount of disease someone has, says Michael P. Heffernan, MD, a dermatologist at the San Luis Dermatology and Laser Clinic in San Luis Obispo, California.
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Psoriasis And Psa Are Immune
Psoriasis is one of the most prevalent complex diseases worldwide and is characterized by a chronic autoimmune-mediated inflammation of the skin. In psoriasis, an unknown set of events induce T lymphocytes to chronically colonize the dermis and epidermis and promote inflammation. One of the consequences of the active immune infiltrate is an increase in the proliferation rate of keratinocytes, the cells that predominate in the epidermal skin layer, leading to red, raised and scaly plaque-like lesions. Psoriasis is considered a complex disease both etiologically and for its wide range of phenotypic manifestations. A combination of multiple genetic risk factors, triggering environmental agents and stochastic factors are thought to be responsible of its appearance . While little is known about the impact of environment on psoriasis, recent genome-wide association studies have markedly expanded the group of genomic loci that are associated with the susceptibility to develop this autoimmune disease . Although psoriasis is likely a multigenic disease, the PSORS1 locus on chromosome 6p21.3 is generally understood to confer the most risk for psoriasis . A specific allele of this locus, HLA-C*06, is also the only genetic variant repeatedly observed to associate with phenotypic features of psoriasis, such as the age at disease onset .
Map of the MHC region
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How Does Psoriasis Lead To Hair Loss
As well as being visibly noticeable, psoriasis can be unbearably itchy. The itching can get so bad it can interfere with sleep and your everyday interactions. And thats not all. Too much scratching can cause temporary hair loss over time as the hair follicles become damaged. The aim is to avoid scratching even though its really difficult. When the scale is shed, it tends to pull the hair out with it, said Bard. While the inflammation doesnt specifically affect the hair follicle, inflammation of the scalp can have a detrimental effect on hair growth and can lead to shedding.
Though psoriasis scales are upsetting to live with, you might also suffer from hair loss if you try to forcibly remove scales. The American Academy of Dermatology Association suggests avoiding scratching and picking at the scales to lessen the chance of aggravating the skin. They also recommended keeping fingernails short and filed down to reduce hair loss and limit the damage caused when scratching is the only option.
Its important to note that psoriatic alopecia also known as hair loss due to psoriasis can affect the entire scalp, and some data suggests that those living with psoriasis are also potentially at risk of developing alopecia areata over time. This is why, if youre living with severe psoriasis, you must check in with a dermatologist or health care professional to arrange an educated treatment plan.
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Will My Psoriasis Ever Go Away
For the majority of people, psoriasis doesnt go away on its own. Its caused by a combination of genetics and the environment.
In genetically predisposed people, an environmental factor acts as a trigger to unmask psoriasis. In rare cases, behavioral modification like weight loss or smoking cessation may be associated with improvements or complete clearing.
If your psoriasis is caused by a medication, then stopping that medication may improve your psoriasis. Certain high blood pressure and depression medications are strongly associated with triggering psoriasis. Speak to your doctor about any medications youre taking and whether they may contributing to your psoriasis.
Joshua Zeichner, MD, is the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. He actively lectures to international audiences and is involved in daily teaching to residents and medical students. His expert opinion is commonly called on by the media, and hes regularly quoted in national newspapers and magazines, such as The New York Times, Allure, Womens Health, Cosmopolitan, Marie Claire, and more. Dr. Zeichner has been consistently voted by his peers to the Castle Connolly list of New York Citys best doctors.
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Why Do People React So Hard To Being Diagnosed With Psoriasis
As mentioned, psoriasis can develop at any age, but it usually happens in the fourth or fifth decade of life. Metz said in the podcast that people react very badly to being diagnosed with this skin disease.
“Skin disease is something that is very bothersome, and a lot of times people come to me to calm down, she said.
Metz added that dermatologists must understand that even though they see a lot of people with psoriasis, and may not be excited about it, people must understand that the source of psoriasis isnt known, and that as you learn to understand the chronic nature of this disease, you start imagining all sorts of things. People open up Google and see the most horrible images.”
However, its important to remember that most psoriasis patients suffer from only a mild illness.
“There is a solution, most patients will not develop a terrible disease,” she said. “You can live with psoriasis. It isnt a contagious disease and we have a solution today for anyone who has psoriasis – mild to severe.
Talk To Your Doctor About Your Treatment Plan
If youâre 65 or older, you may need to adjust the types of medications you use. Some issues to consider:
Topical treatments can cause new side effects as you get older. Though topical psoriasis treatments like corticosteroids and topical vitamin D are usually considered safe for older adults, they may cause new issues. Tell your doctor if you notice purple spots on your skin, if your skin looks transparent, or if you notice signs of infection such as redness or areas that are inflamed or warm to the touch.
Topicals may be harder to apply as you age. You should also let your doctor know if you have joint swelling or flexibility issues that make it hard to apply topical medications to your psoriasis plaques.
Some oral or injected medications may be harder for your body to process. Your kidneys donât work as well as you age. That means they remove less waste from your body. Because of that, medications that work throughout your body, like methotrexate, can build up in your system and cause problems. If youâre taking these medications, your doctor will need to monitor you closely. They may recommend another treatment or ask you to work with a kidney specialist to make sure youâre staying safe.
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Skin Aging And Psoriasis
With age, skin loses its elasticity and becomes thinner and drier, increasing the appearance of wrinkles. Beyond genetics, the number one factor impacting skin aging is sun damage. Skin thats been chronically damaged by the sun may also be harder to treat during psoriasis flares.
While medical-grade ultraviolet B treatment can help psoriasis by targeting skin inflammation, tanning beds and chronic exposure to natural sunlight expose skin to a more powerful, full-spectrum UV light that damages skin and increases the risk of premature skin aging and cancer. Overexposure to this type of UV light can prevent us from appropriately treating areas with psoriasis, because the surrounding skin has been so heavily sun damaged, says Rashmi Unwala, MD, a dermatologist specializing in psoriasis at Cleveland Clinic in Ohio.
Its essential to use a broad-spectrum SPF 30 sunscreen on exposed skin every time you head outside. Sun exposure is a leading driver of skin thinning and damage with aging, so we recommend sun protection to allow people to use the medications that they will benefit from, says Dr. Unwala.
One of the most important factors of both psoriasis and skin aging is smoking. If you smoke, talk to your doctor for tips on quitting.
Are There Popular Skincare Products Or Ingredients To Avoid Ones To Use
Its important to take special care of your skin if you have psoriasis. I generally tell my patients to steer clear of products with drying alcohols, fragrances, and sulfates. All of these can cause skin irritation and dryness.
Trauma to the skin can lead to a psoriasis breakout, known as the Koebner phenomenon. So its important to avoid activities or products that can cause irritation.
I tell my patients to use gentle, hydrating, non-soap cleansers that wont disrupt the skin barrier. Shower with lukewarm water for 10 minutes or less, and moisturize the skin after patting dry.
If you have thick scales on your scalp or other parts of your body, skincare products that contain salicylic acid may be helpful. Salicylic acid is a beta hydroxy acid that exfoliates the skin to help remove the scale on psoriasis plaques.
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How To Tell Baby Psoriasis From Other Conditions
The only accurate way to tell if it is baby psoriasis or another skin condition is through careful observation.
A dermatologist or pediatrician can usually recognize the differences, so it is important for caregivers to seek medical attention for any rashes that do not clear up with time or treatment.
If a rash develops on a babys skin and remains for several days despite the use of over-the-counter creams and treatments, caregivers should seek consultation with a doctor so they can examine the rash.
There are for treating baby psoriasis. Doctors tend to rely on the results of case studies, guidelines for adult psoriasis, and expert opinion to treat the skin symptoms of psoriasis in babies.
However, some treatment options include:
- applying moisturizing creams and emollients to the skin
- keeping the affected areas clean and dry
- using specialized moisturizers for psoriatic skin symptoms
- trying phototherapy, which involves administering controlled doses of ultraviolet light to the affected areas
- avoiding exposure to extreme cold and heat
- taking oral medication
However, it is unlikely that a dermatologist or pediatrician will recommend a treatment more intensive than an emollient or moisturizer for a baby with mild psoriasis.
If symptoms are more severe than this, however, the doctor may suggest stronger treatment options.
Caring For Aging Skin
As you get older, there are many simple measures you can take to preserve the appearance of your skin and help prevent flares of arthritis.
Steer clear of skincare products that contain alcohol, fragrances, and sulfatesingredients that are known to cause irritation and dryness.
Try to avoid trauma to your skin. An injury can lead to a psoriasis breakout, and an injury-induced psoriasis breakout is described as a Koebner phenomenon.
Cleanse your skin with gentle, hydrating non-soap products that wont disrupt your skin’s barrier. Shower in lukewarm water for no longer than 10 minutes. Pat skin dry and moisturize.
If you have scales on your scalp or other places of your body, use skin care products containing salicylic acid., which can gently exfoliate skin and remove scales from psoriasis plaques.
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What Are The Best Psoriasis Treatments
It’s more than likely there will have to be a prescription involved. The good news is there are many medications that can help, ranging from topical steroids to oral immunosuppressants. As far as general things you can do at home, both doctors we spoke with agree that moisturization is the name of the game. “It’s a great way to improve symptoms, particularly itchiness and scale,” says Bhanusali. Markowitz adds that you want to opt for a super-thick, rich moisturizer or ointment, something very occlusive that will help seal and protect the skin barrier that’s been broken down due to the psoriasis. What you don’t want to do is try to scrub off excess scale and flaking. “Many psoriatic patients are tempted to use scrubs, but this will only further damage their already compromised skin and possibly cause further flare-ups,” warns Markowitz.
The bottom line: There’s no getting rid of psoriasis, but if you’re one of the millions of people who has it, there are plenty of different ways that you can manage it and keep it under control.
Cosmetic Products And Procedures For Aging
Retinol is one of the most common ingredients in skin aging treatments. Research shows it may indeed be effective at combating fine lines associated with natural aging, likely because it helps the skin retain water and boosts collagen production. Retinol is also used to treat psoriasis by slowing rapidly growing skin and decreasing scales.
A number of retinols, both topical and oral, are approved by the Food and Drug Administration for the treatment of psoriasis. Just be sure to talk to your doctor before using an over-the-counter retinol cream. Its a balance, because it might be a little irritating, says Unwala. Follow your doctors instructions for applying any new product or medication to your skin. You may need to test the product out a couple of times per day on a small patch of skin for four or five days first.
Avoid harsh exfoliating products, such as loofahs, body beads, and motorized brushes, to scrub off dead skin. That would be traumatizing for active areas of psoriasis, says Unwala. Instead, opt for gentle, fragrance-free, non-soap cleansers, which wont irritate sensitive skin. Cleansers and moisturizers with coal tar and salicylic acid, in particular, may help when youre having a psoriasis flare.
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Take A Whole Health Approach
When you think about psoriasis and your health, you might focus only on your skin. But you need to take a broader look at your health as you age. Psoriasis can make you more likely to get some kinds of cancer, such as lymphoma and non-melanoma skin cancer. It also can raise your risk of low bone density conditions like osteopenia and osteoporosis. And the same is true for type 2 diabetes and metabolic syndrome .
About 30% of people who have psoriasis also get psoriatic arthritis. Thatâs a condition that causes stiff and swollen joints and other issues like fatigue. Psoriatic arthritis often gets worse over time, especially if itâs not treated.
âIf you have psoriasis, itâs especially important to work closely with all your doctors,â says Shari Lipner, MD, PhD, a dermatologist at Weill Cornell Medicine and New York-Presbyterian Hospital in New York.
If a dermatologist or rheumatologist treats your psoriasis, make sure your primary care physician or family doctor knows what kinds of psoriasis treatments youâre getting and have gotten in the past. Some psoriasis medications may make you more likely to have health problems like infections or cancer. So your doctor may want to keep a closer watch on you. And some medications used to treat arthritis, heart disease, and other conditions may make psoriasis worse.
What Else Should I Ask My Healthcare Provider
If you have psoriasis, ask your healthcare provider:
- How can I prevent outbreaks and control symptoms?
- What medication will work best for me?
- What else should I do to improve symptoms?
- What are my options if creams dont work?
- Will psoriasis ever go away?
A note from Cleveland Clinic
Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.
References
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Is There A Cure For Psoriasis
There is no cure at the moment. However, as a consequence of current research, our understanding about what happens in psoriasis is growing and new drugs are being developed. In the meantime, there are a number of treatments that are effective in keeping psoriasis under control.
The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.
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Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
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