What Happens If My Gp Cannot Help
If you are referred for further treatment or advice it is likely to be to outpatients at your local hospital where a consultant dermatologist or a specialist dermatology nurse will assess you or it may be to another General Practitioner with enhanced role often referred to as GP with special interest .
It is likely that you may be offered the same treatment that your GP has already given you or other treatments that your GP is unable to prescribe.
How Does Psoriasis Affect Quality Of Life
It is widely accepted that psoriasis can severely affect an individuals quality of life although for many the condition is mild and a mere inconvenience. The severity of the disease does not always relate to the severity of anxiety that an individual will have. The area where the psoriasis is located such as the hands or face can severely affect an individuals ability to work or lead to discrimination due to ignorance.
When Time Is Of The Essence
Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor.
Speed is only one characteristic of a drug which may be of importancesafety, side effects, cost, and medical reasons why a certain drug can’t be used are just a few of the many others. But when time is of the essence, a faster drug may be just what the doctor ordered. Imagine that you’re a month away from a cruise and you want to relax by the pool, but feel uncomfortable due to a breakout of psoriasis. That’s just the type of situation when you want to get cleared up, fast. Here are a few medications with very rapid onset of action and clearing ability to consider.
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How To Treat The Toughest Psoriasis
Do you feel like youve tried every prescription, over-the-counter and alternative psoriasis remedy available but your plaques wont go away? Are you wondering whether there are any other options?
Join us as our expert guests discuss the most hard-to-treat psoriasis and what to do when stubborn psoriasis just wont go away. Youll learn about new combinations and approaches with existing treatment techniques, find out how to cope with low self-esteem and depression, which often accompany severe psoriasis, and hear why and when it might be a good idea to take a treatment break, at least for a little while.
As always, our expert guests answer questions from the audience.
Welcome to this HealthTalk webcast. Before we begin, we remind you that the opinions expressed on this webcast are solely the views of our guests. They are not necessarily the views of HealthTalk, our sponsors or any outside organization. And, as always, please consult your own physician for the medical advice most appropriate for you.
Now here’s your host, Heather Stark.
Dr. Miller, thank you for joining us.
Dr. Jami L. Miller:
Thank you for having me.
Dr. Miller, a lot of people think of psoriasis as a skin disorder and don’t understand why it’s so challenging to treat. Can you tell us what psoriasis is and how it manifests into the skin problems that we see?
Ways To Treat Psoriasis At Home
Even though it affects your skin, psoriasis actually begins deep inside your body in your immune system.
It comes from your T cells, a type of white blood cell. T cells are designed to protect the body from infection and disease. When these cells mistakenly become active and set off other immune responses, it can lead to psoriasis symptoms.
Even though theres no cure, many treatments exist to ease the symptoms of psoriasis. Here are 12 ways to manage mild symptoms at home.
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Treatments To Stop Psoriasis From Spreading
If you donât want your small skin patch to become larger, and you donât want more psoriasis patches to show up on your body, then you should start on a psoriasis treatment plan. This may include:
Topical steroids. Also known as corticosteroids, these are some of the most common medications for mild to moderate psoriasis. Topical means you apply the medication to your skin. Topical steroids are available as an ointment, cream, lotion, gel, foam, spray, solution, or shampoo.
Other topical therapies. Steroids arenât the only topical medications that can get your psoriasis patches under control. Others include:
Steroid shots. Doctors can treat stubborn psoriasis patches with a steroid shot directly into the inflamed skin.
Pills. There are a few types of pills that can lower your bodyâs production of skin cells:
- Methotrexate , which stops cell growth
- , a phosphodiesterase inhibitor that blocks cells that cause inflammation
- Acitretin , a retinoid, which may stop cells from growing as fast
- Cyclosporine, which suppresses your immune system
Cleveland Clinic: âItchy Rash? How to Tell If Itâs Eczema or Psoriasis.â
Mayo Clinic: âPsoriasis.â
I First Started Getting Psoriasis Around The Age Of 26
It was when I worked at a steakhouse as a cook. I was eating a lot of beef and white bread because it was free. Somebody would mess up a steak or burger at least twice a day, and boom, I had a free meal. I ate beef and white bread almost everyday for two years. Not a good choice.
Red spots starts showing up around my eyelashes and above my lip. Then they started flaking and getting gross, then it started in my hair, little crusty bumps. I didnt know what to do, I didnt have health care, so I couldnt go to the doctor. And it wasnt that bad.
During the next summer I played a lot of basketball outside with no shirt on and it went away. Getting a tan apparently makes psoriasis disappear. But I was also thinking, oh it goes away in the summer, who cares.
I went back to college and started drinking black coffee twice a morning and feeling stressed out. I think the black coffee and stress made the psoriasis return. During that winter it got really bad. The red dots became huge and dry, it felt like my skin was made of rocks. I kept putting lotions on it recommended by some of my female friends, all of which contained alcohol and fragrance, which actually made it worse. When I would reach up to grab things, the dots would crack and bleed.
I was really scared to eat differently like actually scared. How could I ever live without disgusting food and Pepsi on a daily basis?
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What Are The Trigger Factors
Although the underlying cause of psoriasis stems from your body’s immune system, the trigger factors that can make it worse or cause flare-ups include:
- Weather: Cold and dry weather can dry out your skin, which makes the chances of having a flare-up worse. In contrast, hot, sunny weather appears to help control the symptoms of psoriasis in most people
- Stress: Having psoriasis can cause stress itself and patients often report that outbreaks of symptoms come during particularly stressful times
- Some medications: Certain drugs, such as lithium , drugs for malaria, and some beta-blockers , can cause flare-ups of psoriasis. Some common painkillers — called non-steroidal anti-inflammatory drugs — may also aggravate psoriasis, although they are still used in some people with psoriatic arthritis
- Infections or disease: Certain infections, such as strep throat or tonsillitis, can result in guttate or other types of psoriasis. Psoriasis may worsen in people who have HIV
- Trauma to the skin: In some people with psoriasis, trauma to the skin — including cuts, bruises, burns, bumps, vaccinations, tattoos and other skin conditions — can cause a flare-up of psoriasis symptoms either at the site of the injury or elsewhere. This condition is called Koebner’s phenomenon
- Smoking: Some experts think that smoking can worsen psoriasis.
How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A can tell the doctor whether it’s psoriasis or another condition with similar symptoms.
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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 Is The Genetic Predisposition
Genetic predisposition means an inherited tendency to develop the disease. Recent research has greatly increased our knowledge about how and what we inherit from our parents and the role played by genes. As our knowledge increases so does our appreciation of the complexity of the process. While it was originally hoped that a specific disease might be associated with a specific gene, it now appears that for many diseases that have a genetic component, including psoriasis, there are probably multiple genes involved in producing the sequence of events that results in the expression of disease. This is further complicated by the way these genes interact.However, the evidence to support the belief that a genetic predisposition plays a major role in the cause of psoriasis can be summarised as follows:
- One third of people with psoriasis have a family member who is also affected
- There is an increased incidence of psoriasis in children when one or both parents have the disease
- In twins, psoriasis is more likely to appear in both identical twins than in both non-identical twins. This finding also confirms that more than one gene must be involved.
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Is Psoriasis The Same As Eczema
Psoriasis and eczema are two different skin conditions. They differ in where the disease appears on the body, how much it itches and how it looks. Eczema tends to appear more often behind the knees and inside the elbows. Eczema also causes more intense itching than psoriasis. Many people, especially children, can get both eczema and psoriasis.
Hydrocortisone Creams And Ointments
You can buy a mild corticosteroid like hydrocortisone without a prescription. For a few small patches of psoriasis, a mild hydrocortisone works well. If you have more than a few small patches, youll likely need a prescription corticosteroid to see results.
Whether OTC or prescription, this medicine works quickly to:
Reduce the itch
If you have cracked or bleeding skin, an ointment will likely feel better than a cream. Ointments tend to be more soothing and less irritating than creams.
MoisturizerThis may help anyone who has psoriasis because psoriasis makes the skin dry and scaly. Moisturizer helps to seal water in the skin, which can:
Help your skin heal
Dermatologists recommend applying moisturizer once a day, and more often when your skin is really dry. When shopping for a moisturizer, you want to select a:
Heavy cream, ointment, or oil rather than a lotion
Product that you like and will use
Oil can be especially healing, but its also messy. To reap the benefits of oil, try applying it before bedtime.
Moisturize before washing
For best results, you want to apply your moisturizer within 3 minutes of bathing and after washing your hands.
Scale softenersYoull find OTC products and prescription medicines that contain salicylic acid. This active ingredient helps to:
Remove and soften scale
Removing the scale helps other medicine that you apply to your skin to work better.
Psoralen Plus Ultraviolet A
For this treatment, you’ll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light.
Your skin is then exposed to a wavelength of light called ultraviolet A . This light penetrates your skin more deeply than ultraviolet B light.
This treatment may be used if you have severe psoriasis that has not responded to other treatment.
Side effects include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts.
Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer.
Safest Psoriatic Arthritis Treatment
Have you seen the commercials for prescription medications related to psoriasis or psoriatic arthritis? Pay attention to the list of possible side effects: hair loss, aggressive thoughts, changes in mood or behavior, liver damage, loss of vision, suicidal thoughts, trouble speaking, yellowing of your skin or whites of your eyes, just to name a few.
Yes you want to get rid of your psoriasis, but at what cost?!
Hiking, or extreme exercise, is the safest treatment for both psoriasis and psoriatic arthritis. I am basing this solely on personal experience, with no scientific or medical background.
If you consider my case along with what is known in the scientific literature , you can perhaps begin to realize that its not such a crazy proposition. After all, we evolved to walk and what a treat it is! Standing up on two legs and being able to walk for miles at a time is an evolutionary advantage and perhaps a biological necessity that most Americans dont put to use nearly enough.
I sincerely believe that if you rest, you rust. If you dont push your body, it will wither away. There is something about the simple act of walking albeit with a pack on for miles at a time that made my psoriasis and accompanying arthritis go into complete remission.
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Foods With Saturated Fats And Trans Fats
Fats in red meat, cheese, fried food, margarine, fast food and many processed snacks are known to trigger inflammation in the body. These fats increase the amount of low-density lipoprotein in your blood, also called bad cholesterol. Studies suggest there may be a link between excess fat in the body and development of psoriasis and worsening of psoriasis symptoms.
How Does This Information Affect The Management Of Psoriasis
The bottom line is that the lack of precise information on the cause of psoriasis severely hampers the search for a cure. However, the current state of information has resulted in the development of new effective treatments, all based on trying to correct the faults within the immune system. It is hoped that future more effective treatments will be developed as understanding of the complex problems within the immune system increases.
Meantime, more straightforward actions such as reducing alcohol intake, stopping smoking and trying to cope with stress can be recommended. The course of psoriasis is unpredictable. Whilst remission of symptoms can occur, it may take weeks, months or even years.
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What Else Should I Know
Making healthy choices can help with psoriasis. Here are some things you can do:
- If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
- Avoid alcohol. It can make psoriasis treatments less effective.
- Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
- Stay at a healthy weight. This decreases the risk of inverse psoriasis.
- Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.
People who have psoriasis may feel self-conscious about how it looks. That’s one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.
The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it so you don’t forget. Psoriasis is one of those things that you need to stay focused on treating, even when you’re feeling OK.
Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:
Is There A Cure For Psoriasis
Unfortunately, not at the moment. Much research is being done and in the last decade great strides have been made in understanding what goes wrong in psoriasis, so there is good cause for optimism. In the meantime there are a number of treatments that are effective in keeping the problem 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.
What is the history of psoriasis?
Psoriasis has a fascinating story, from ancient times, through to the modern scientific breakthroughs. Read more.
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