Psoriasis And Mental Health
Skin conditions that affect your appearance naturally can make you self-conscious. Add the misconception that psoriasis is contagious, and it’s no wonder those with psoriasis are often embarrassed to show their skin. Because of this misconception, psoriasis can be very isolating and wear on mental health. “Its a real problem. A condition thats visible like this is a disease that can change how people view you,” Dr. Cather says. “It can change how you present yourself and even what you wear.”
Beyond that, research has shown that psoriasis can contribute to or worsen various mental health conditions, including depression, anxiety, bipolar disorder, eating disorders, and more. For more information, check out SELFs reporting on the complex connection between psoriasis and mental health here.
What Is Cdc Doing About Psoriasis
In 2010, CDC worked with experts in psoriasis, psoriatic arthritis, and public health to develop a public health perspective that considers how these conditions affect the entire population. The resulting report is Developing and Addressing the Public Health Agenda for Psoriasis and Psoriatic Arthritis pdf icon. You can read a short article about the agendaexternal icon in The American Journal of Preventive Medicine.
CDCs National Health and Nutrition Examination Survey , an intermittent source of national psoriasis data, has included questions about psoriasis as late as the 2013-2014 cycle. A recent analysis of NHANES data estimates that 7.4 million adults had psoriasis in 2013external icon.
- Psoriasis causes patches of thick red skin and silvery scales. Patches are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places . The most common type of psoriasis is called plaque psoriasis.
- Psoriatic arthritis is an inflammatory type of arthritis that eventually occurs in 10% to 20% of people with psoriasis. It is different from more common types of arthritis and is thought to be related to the underlying problem of psoriasis.
- Psoriasis and psoriatic arthritis are sometimes considered together as psoriatic disease.
Who is at risk for psoriasis?
Anyone can get psoriasis. It occurs mostly in adults, but children can also get it. Men and women seem to have equal risk.
Can I get psoriasis from someone who has it?
Psoriasis Types And Locations
Psoriasis is a chronic inflammatory skin disease. The exact cause of psoriasis is unclear, but immune-system dysfunction plays a role in the inflammatory response that leads to psoriasis. Psoriasis is described as being an immune-mediated or autoimmune disease.
Psoriasis isnt a one size fits all condition. There are different types of psoriasis, which can affect different parts of the body. Psoriasis symptoms also vary from person-to-person and so do treatment options.
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Active Ingredients Wont Work On Psoriasis
All types of dandruff will visibly diminish after an active ingredient shampoo is used to remove the scaling almost immediately, Bridgette shares. Active ingredient shampooing does not immediately diminish psoriasis. Shampooing psoriasis sometimes removes the outer scabs and leaves the patches exposed to raw skin cells.
Only One Can Cause Your Scalp To Bleed
This is a fairly major difference between the two that many dont know how to interpret. Psoriasis is often accompanied by scalp bleeding and soreness, Bridgette says. Dandruff rarely is associated with bleeding. So if your scalp is bleeding, its more than likely psoriasis, not dandruff.
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How Do You Treat Psa
If you have this condition, youll want to see a rheumatologist, a doctor who specializes in arthritis. Treatments can range OTC non-steroidal anti-inflammatory drugs such as Advil to disease-modifying antirheumatic drugs , including methotrexate, that work by slowing your immune system and your bodys inflammatory response. If those dont work, biologics may be considered.
Plaque Psoriasis: Red Bumps And Silvery Scales
Plaque psoriasis is the most common form of the chronic skin condition, affecting about 80 percent of people with psoriasis. Usually starting as small red bumps on the skin, plaque psoriasis develops into red patches with a silvery, scaly coating these raised patches are called plaques. Plaques usually show up on elbows, knees, and the lower back, and they can last for months or even years without treatment.
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Prevention Of Psoriasis In Children
You cannot prevent psoriasis as it is an autoimmune disease, but you can minimize the flare-ups by eliminating the triggers. Identify what is causing the symptoms and try to eliminate them from your childs life. Stress is an important triggering factor. Stress of exams or tensions at home or other kids promote psoriasis.
A volunteer with The National Psoriasis Foundation, US, and a psoriasis patient expert Alisha M. Bridges recommends these tips to, minimize and manage psoriasis flare-ups:
- Staying on top of the treatment regimen and communicating with the doctor.
- Trying to get a head-start on flare-ups by paying attention to the childs body, and recognizing any new spots, or areas that feel itchier.
- Moisturizing the skin, especially in winter.
- Changing shower and bath water to cooler temperatures.
Eating healthy, exercising, and getting adequate sleep can also help your childs body cope with the symptoms of psoriasis. Also, keeping your childs skin clean and moisturized might reduce irritation and itching.
An Overview Of Psoriasis
Having a solid immune system is great. But an overactive immune system can trigger all sorts of unwanted changes in the body, including psoriasis.
Psoriasis is a chronic skin disease that is an autoimmune condition, which is when a persons immune system attacks the bodys own cells. In this case, psoriasis speeds up the life cycle of the skins cells, resulting in scaly red patches with thick, whitish or silvery buildup that flakes, peels, and often bleeds, and occasionally itches.
A dermatologist usually can diagnose the condition with a regular physical exam, however the physician may take a small skin biopsy to confirm the diagnosis, rule out other possible disorders, or classify the exact type of psoriasis. No cure exists for psoriasis, but it is possible to successfully manage the symptoms.
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How Do You Treat Scalp Psoriasis
Mild cases can be nipped in the bud or improved with salicylic-, coal-tar-, or clobestasol propionate-containing shampoos. More severe cases may require systemic or biologic drugs, oral treatments, light therapy, or a combination of treatments. Unfortunately, you may lose some hair with some of these treatments, which is usually temporary.
Heat Rash: Sweating That Leads To Bumpy Red Skin
Inverse psoriasis is a type of psoriasis that forms in the armpits and skin folds under breasts or in groin areas, making the skin red and shiny. Sweating makes this type of psoriasis worse. Heat rash also makes your skin red and forms in skin folds of the groin, breasts, and armpits. Heat rash occurs in hot, humid conditions. Sweating can cause your pores to get blocked and result in a bumpy, red skin rash that stings. Heat rash is more common in newborns, but can also affect older children and adults.
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What Is Psoriasis Again
Red, scaly, painful patches or bumps on your skin are the telltale signs of this inflammatory skin condition. It happens when your skin cells turn over at a way-too-fast rate , causing a pile up of cells on the skins surface that form those angry, red patches, or plaques. Why this happens isnt so clear, but researchers believe psoriasis is caused by a mix of genetics, an overactive immune system, and triggers such as bacterial infection, skin trauma, smoking, medications, and obesity, just to name a few.
As we mentioned above, there are seven different types of psoriasis:
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plaque psoriasis
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pustular psoriasis
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erythrodermic psoriasis
Theres also psoriatic arthritis, a combo of psoriasis and arthritis. Heres what you need to know about the causes and treatments for each one.
Can Psoriasis Affect Only My Nails
In some cases, psoriasis may involve only the fingernails and toenails, although more commonly, nail symptoms will accompany psoriasis and arthritis symptoms. The appearance of the nails may be altered, and affected nails may have small pinpoint pits or large yellow-colored separations on the nail plate called “oil spots.” Nail psoriasis can be hard to treat but may respond to medications taken for psoriasis or psoriatic arthritis. Treatments include topical steroids applied to the cuticle, steroid injections at the cuticle, or oral medications.
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How Is Psoriasis Diagnosed And Treated
Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.
Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .
Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.
What Is Scalp Psoriasis And What Causes It
Psoriasis can appear on any part of the skin, even the scalp. With scalp psoriasis, scalp plaques produce excess scales and can cause your scalp to itch.
Symptoms of scalp psoriasis appear as the following:
- A small bump, called a papule, with a scale on top.
- The plaque typically is covered by thick layers of horny scale. When the scale sheds, it can look like dandruff.
- Sometimes these plaques can itch.
- Scratching these plaques can worsen the condition and lead to what’s called the Koebner phenomenon, or isomorphic response, which can cause psoriasis to develop in areas where there’s inflammation and trauma.
The causes of scalp psoriasis, like all psoriasis, is related to genetic defects that affect the immune system. It is not known if stress causes or makes psoriasis worse.
In some severe cases, scalp psoriasis can cause alopecia, or a loss of hair, which is rare and may be controlled with treatment. Scalp psoriasis can be treated with topical medications, which can sometimes be difficult to apply when the scalp is covered with enough hair that can create a barrier.
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Types Of Psoriasis Rashes
Psoriasis is an umbrella term for multiple types of psoriasis, each defined by a specific kind of skin rash. Psoriasis rashes can range from small, localized teardrop-shaped lesions to a full-body rash with accompanying body-wide symptoms.
Below, we will describe how each of the different types of psoriasis rashes commonly appear on the body.
Intimacy Can Still Be Possible
If you are feeling anxious about sexual activity because of psoriasis, talk to your partner and educate them about psoriasis. Let them know that psoriasis isnt contagious and help to put them at ease. It is always a good idea to discuss psoriasis before you are intimate, so it is not a surprise.
To reduce friction and pain during sexual activity, use lubricants during sex. Choose products labeled cooling over warming lubricants. Warming lubricants often contain ingredients that inflame sensitive skin and might trigger psoriasis flares.
You can also make your own lubricant using olive oil, aloe vera, or coconut oil. However, oil-based lubricants should not be used with latex condoms, as they can degrade the latex and lead to condom failure.
The American Academy of Dermatology recommends the following ways to reduce irritation with sexual intercourse.
- Postpone sex when the skin around the genitals is raw or inflamed.
- Before sex, gently cleanse intimate areas using mild, fragrance-free cleansers.
- During sex, use lubricated condoms to reduce irritation in intimate areas affected by psoriasis.
- After sex, gently wash and dry intimate areas to reduce irritation.
- Reapply topical medications after sexual intercourse.
Following your treatment plan and taking your medications as prescribed can help to improve psoriasis symptoms regardless of where they are located on the body.
Medical Treatment Topical Agents
The first line of treatment for psoriasis includes topical medications applied to your skin. The main topical treatments are corticosteroids , vitamin D-3 derivatives, coal tar, anthralin, and retinoids. These drugs may lose potency over time, so often they are rotated or combined. Ask your doctor before combining medications, as some drugs should not be combined.
Causes And Risk Factors Of Psoriasis
Psoriasis, in general, is a genetic condition passed down through families. “It’s likely that multiple genes need to be affected to allow psoriasis to occur and that it’s frequently triggered by an external event, such as an infection,” says James W. Swan, MD, professor of dermatology at the Loyola University Stritch School of Medicine in Maywood, Illinois.
Certain risk factors, such as a family history or being obese, may increase your odds of developing psoriasis.
According to the National Psoriasis Foundation , at least 10 percent of people inherit genes that could lead to psoriasis, but only 3 percent or less actually develop the disease. For this reason, it is believed that the disease is caused by a combination of genetics and external factors or triggers.
A psoriasis outbreak may be provoked by:
What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
What You Should Know About Erythrodermic Psoriasis
The rarest of all psoriasis types, erythrodermic psoriasis affects only 2% of those with psoriasis. This type causes redness from head to toe, as if your skin has been burned. Even worse, its possible that your skin could peel off in sheets.
As with the pustular type, erythrodermic psoriasis severely compromises the skins protective barrier, so swift medical attention is a must. You can also develop fever, chills, swollen, painful joints, and rapid heart rate.
What Psoriasis Medications Can I Take
Systemic Medications
Biologics for Psoriasis
The following drugs are categorized under the term biologic because they are all proteins produced in the laboratory by industrial cell culture techniques and must be given either subcutaneously or intravenously. The frequency of treatment depends on the specific drug. All of these medications are very precise in that they block only one or two parts of the inflammatory reaction and are moderately immunosuppresive.
Biologics are expensive and do not cure psoriasis but as a group are quite effective and reasonably safe. If it is decided to start a patient on a biologic drug, the choice will depend on the particular physician’s expertise, as well as insurance coverage and payment issues.
Guttate Psoriasis: Small Red Spots
Guttate psoriasis the second most common type of psoriasis is characterized by multiple small, round red spots on the skin, usually widespread across the trunk and limbs. Often resulting from a bacterial or viral infection in children, such as strep throat, these spots come on suddenly and sometimes require oral medication or injections. Mild cases, however, may clear up without treatment.
Diagnosis Of Psoriasis In Children
In most cases, psoriasis can be diagnosed with a simple physical examination. Your doctor might enquire about your family history, medications, and infections. Diagnosis is mainly clinical. In very rare cases skin biopsy is done. If the symptoms are not clear and your doctor feels the need for further diagnosis, they may do a skin biopsy, wherein a sample of the skin is sent to the lab for examination under the microscope.
Psoriasis can also have an impact on your childs psychological well-being. When the condition flares up, it may result in rashes, skin scaling, itching, and burning sensation. So, children may become self-conscious and stop interacting with other children. How can you help your child? The next section covers the treatment options for psoriasis.
Volunteer mentor with the US National Psoriasis Foundation and psoriasis patient expert Sabrina Skiles says, It is important to talk to your child about how theyre feeling when they experience a flare-up.
Zara Enjoys Playing Sports But Sometimes Blisters And Oozing From The Psoriasis On Her Feet Stop Her From Playing Them
Okay.Right.And do you sort of know these different stages of your skin how it goes up and down and?Psoriasis subtype: scalp psoriasissymptoms body Tar-based shampoosspecial steroid ointmentsAnd did it help with what the dermatology department suggested of combing through your hair, did that help at all?Psoriasis subtype: nail psoriasisPsoriasis subtype: genital psoriasis
How To Treat Dry Dandruff
Bridgett recommends you use a shampoo that has active ingredients such as selenium sulfide, salicylic acid, sulfur, or zinc. When it comes to using the shampoo, she shares you can shampoo as often as needed yet alternate between dandruff fighting active ingredients and gentle daily shampoos to maintain the balance of the scalps microbiome. It is important to slow down the cellular turnover of the scalp when managing dandruff. It is the overactivity of the scalps cells that create the embarrassing flakiness. Even though you may feel the urge to shampoo often, dont. Doing so will only make things worse.
As far as a conditioner is concerned, Bridgette suggests using one based on hair type and texture. When you use the right products for your hair type, your strands will be better-taken care of. And who doesnt want that?