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.
Apple Cider Vinegar For Your Scalp
It’s more than just a salad dressing. Put some on your head a few times a week — either full strength or mixed with water. It’s a recipe for relief when your scalp calls out “scratch me.”
Rinse it off after it dries so you won’t get an irritation. And don’t try this when your scalp is bleeding or cracked. The vinegar will make it feel like it’s burning.
Genital And Anal Psoriasis
Plaque psoriasis at the genitals is sometimes called genital psoriasis. A study from 2017 in the journal Dermatology & Therapy reported the prevalence and effect on quality of life of people with plaque psoriasis who had genital involvement. Researchers found that 70% of the study participants had genital involvement.
Among these study participants, 100% reported itch and discomfort, 95% reported redness, burning, and stinging, 85% reported pain, and 75% reported scaling. Many of the study participants reported that itch, stinging, and burning were the most bothersome symptoms.
Inverse psoriasis is a rare form of psoriasis that affects between 3% and 7% of people with psoriasis. It often affects the genital and anal areas at areas where the skin folds or creases.
It can cause ongoing discomfort to the upper thighs, pubis, the folds between the thighs and groin, the vulva, penis, anus, and buttocks. Inverse psoriasis causes dry, red, inflamed patches on the skin of these sensitive areas.
Upper thighs: Inverse psoriasis can cause red, inflamed patches on the upper thighs. This can be especially irritating when the thighs rub together with walking or running.
Pubis: The pubis, also called the pubic bone, is located just above the genitals. In this area, the skin is very sensitive. Itching and scratching can make this area even more inflamed and sore.
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How Is Psoriasis Treated
Psoriasis is usually treated by a dermatologist . A rheumatologist may also help with treatment. Treatments can include:
- ultraviolet light from the sun or from home or office treatments. But in some people, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy for a while and then switch to another. Or a doctor may combine different therapies. It’s all about finding one that works for each person.
Sometimes what works for a while might stop working. This is one reason why it’s important to work closely with a doctor. Trying out new treatments can get a little frustrating, but most people eventually find one that works.
The Nitty Gritty Of Scalp Psoriasis
Its easy to think that patches of dry, itchy skin on the scalp are caused by some kind of lack of hygiene. But cleanliness has nothing to do with scalp psoriasis.
Psoriasis is actually a chronic inflammatory disorder caused when the immune system doesnt work quite right. Doctors arent sure why, but some people have an immune system that churns out too many skin cells. Since the body cant get rid of these excess cells fast enough, they pile on top of each other, forming flakey, silvery scales.
Psoriasis can pop up anywhere on the body, but when it shows up on your head, dry skin patches can appear under the hair, on the back of the neck, and behind the ears.
Its easy to confuse psoriasis with dandruff, and sometimes dermatologists arent so sure themselves. When it looks like a blend between psoriasis and dandruff, they call it sebopsoriasis a cute couples name for seborrheic dermatitis, aka dandruff, and psoriasis.
However, some clues that your scalp irritation might be psoriasis include more defined or patterned pink scale-like plaques.
Dandruff looks more like generalized greasy flaking with pink patches. Over-the-counter shampoos can typically knock out dandruff, but scalp psoriasis is a little harder to treat.
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Psoriatic Arthritis: What Is The Connection
Psoriatic arthritis : 1 in 4 of people with psoriasis may develop an associated arthritis called psoriatic arthropathy, which causes pain and swelling in the joints and connective tissue, accompanied by stiffness particularly in the mornings and when rising from a seat. Most commonly affected sites are the hands, feet, lower back, neck and knees, with movement in these areas becoming severely limited. Chronic fatigue is a common complaint linked with this condition. If you are experiencing mild aches and pains and have psoriasis, even very mildly, consult your dermatologist for further advice and if necessary a referral to a rheumatologist for further assessments. For more detailed information on psoriatic arthritis see What is Psoriatic Arthritis?
Do All Types Of Psoriasis Itch
Plaque psoriasis, a type that causes scaly, often gray-looking patches, is the most common type of psoriasis. It is also the most common cause of psoriatic itching, although other forms of psoriasis may also itch.
However, the severity of an itch may vary between one flare and the next. One psoriasis flare may only cause mild itching, while the following flare could result in severe itching sensations.
It is possible for one person to have multiple types of psoriasis at once and develop lesions that do not itch or only cause mild itching.
Many treatment options are available to help people who experience psoriatic itching.
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Can Psoriasis Cause Rashes Around The Anus
Inverse psoriasis generally causes lesions of smooth, shiny skin in the areas where the skin folds. It can cause red or purple itchy patches on the anus and the crease between the buttocks.
Skin plaques in these two areas can cause rectal bleeding and difficulty with passing stools. Fortunately, clear skin with inverse psoriasis is possible with appropriate treatment.
Soothe With Apple Cider Vinegar
Psoriasis lesions on your scalp can itch beyond belief. To find relief, mix equal amounts of apple cider vinegar and water. Dab the solution on your scalp two to three times a week. Rinse after a few minutes to keep your scalp from becoming irritated by the vinegar. One caution: Don’t try this if the skin on your scalp is cracked or bleeding.
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Wet Dressings And Warm Baths With Salts Or Oats
Baths and showers can be relaxing, but those that are too long or too hot can strip the skin of its oils, and this can make psoriasis worse.
Some people find that a warm bath containing colloidal oatmeal or Epsom salts is soothing and relieves symptoms.
According to , an oatmeal bath or a wet dressing can reduce itching, and a warm bath containing a suitable bath oil can help moisturize the skin.
In 2005, researchers found evidence that Dead Sea salts might help with dry skin. Volunteers immersed a forearm in water with a 5-percent concentration of magnesium salts, the most common minerals in the Dead Sea, for 15 minutes.
The participants skin barrier function improved, their skin hydration was better, and they had reduced roughness and inflammation compared with the control group who used tap water instead.
After bathing, applying an appropriate moisturizer while the skin is still damp can help prevent moisture loss.
Managing Psoriasis With Topical Treatments
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Maintain A Healthy Weight
When it comes to managing your psoriasis, Warycha says maintaining a healthy weight can help lower the levels of inflammation in the body. In addition to diet, engaging in physical activity can also help you manage your weight.
If youre finding it challenging to lose weight or maintain a healthy weight, talk to your doctor.
Is Psoriasis Hereditary
Although psoriasis is not contagious from person to person, there is a known hereditary tendency. Therefore, family history is very helpful in making the diagnosis.
There are many effective psoriasis treatment choices. The best treatment is individually determined by the treating doctor and depends, in part, on the type of disease, the severity, and amount of skin involved and the type of insurance coverage.
For mild disease that involves only small areas of the body , topical treatments , such as creams, lotions, and sprays, may be very effective and safe to use. Occasionally, a small local injection of steroids directly into a tough or resistant isolated psoriatic plaque may be helpful.
For moderate to severe psoriasis that involves much larger areas of the body , topical products may not be effective or practical to apply. This may require ultraviolet light treatments or systemic medicines. Internal medications usually have greater risks. Because topical therapy has no effect on psoriatic arthritis, systemic medications are generally required to stop the progression to permanent joint destruction.
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Cool Or Warm Compresses
Some people might experience temporary relief from the itching by using cold compresses and taking cool showers.
Others also find that warm compresses ease the pain, so alternating between warm and cold compresses may help with both itching and discomfort.
People should not take hot baths and try to avoid being in the shower for longer than 10 minutes, as this can increase irritation. Applying lotion after a cool bath can help a person retain moisture in the skin, reducing the risk of dryness and itching.
Tablets Capsules And Injections
If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments work throughout the entire body.
These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.
If you’re planning for a baby, become pregnant or are thinking of breastfeeding, you should also speak to your doctor first before taking any new medicine to check it’s suitable for use during pregnancy or breastfeeding.
There are 2 main types of systemic treatment, called non-biological and biological .
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What Can I Do To Help Treat My Psoriasis
There may not be a cure yet but there is much you can do to help maintain and control your psoriasis. Psoriasis, regardless of location or type, is often irritated by contact, particularly tight clothing such as elasticated waistbands, socks, tights, and underwear. It may be useful to wear looser clothing where psoriasis is likely to be irritated either when flaring or during periods of treatment. Identifying factors that may cause your psoriasis to flare, using a diary, can be helpful.
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:
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More Than Skin Troubles
A 2017 study from the Journal of the American Academy of Dermatology found that people with psoriasis that covers 10% of their body or more are 64% more likely than those without psoriasis to develop type 2 diabetes. “About 30% of people with psoriasis also might develop psoriatic arthritis, which causes destructive inflammation in your joints,” says dermatologist Dr. Gideon Smith. Psoriasis also may signal a higher risk for fatty liver disease and heart attacks.
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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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?
Make Time For Afternoon Tea
Tea tree oil isnt messing around. This strong antimicrobial, antifungal, and anti-inflammatory oil can treat scalp psoriasis when paired with a carrier oil .
Dont go nuts with this one. Start with just a drop or two and see how your skin reacts. Also, if youre pregnant, breastfeeding, have linear IgA disease, or are taking the antibiotic vancomycin, then this oil is not for you.
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