Why Do I Have Psoriasis

How Do I Know I Have Psoriasis

There are several skin conditions that cause the skin to itch, redden, or become inflamed, meaning you may think you have psoriasis, but you actually have another skin condition. While the treatment plans for most skin conditions are usually very similar, some conditions require very different treatment plans. For example, using an anti-fungal cream for an anti-bacterial infection may not be very useful, and the skin may even react negatively to it. It, therefore, becomes pertinent that one is sure of the skin condition he/she has before embarking on any sort of treatment.

How can you be sure you have psoriasis? The first pointer is the symptoms you observe. There are many symptoms of psoriasis. They differ from individual to individual, and also depends on the type of psoriasis the person has. Some of the common symptoms are:

• Elevated patches of skin, usually red and inflamed
• The occurrence of plaques or silvery scales on the patches of skin
• Joints may swell and hurt
• Patches may itch and burn
• The skin may become very dry, and break or bleed in some cases
• Patches may be sore

It is important to note that these symptoms are not generalized, as not everyone will have the symptoms. The symptoms some people experience may even be completely different from those listed above.

How Is The Psoriasis Itching And Burning Treated

The aim of treating itch caused by psoriasis is to break the cycle of itching and scratching. In people with psoriasis that causes frequent itching, scratching is a particular problem because it can damage the skin and cause new plaques to form in healthy areas of skin 1.

For people with milder psoriasis, itching can often be relieved by treating the underlying condition with the usual range of treatments . Other treatments that can help with itching and burning, include2:

• Over-the-counter antihistamines
• Moisturizers that contain colloidal oatmeal
• Aspirin
• Benzocaine
• Menthol

Some prescription medicines can be used specifically to treat itch. A medicine made with capsaicin is an ointment that can help with psoriatic itch when applied three or four times a day. Certain types of antidepressants can also have an itch-relieving effect, as can a medicine called gabapentin3.

Patients with moderate or severe psoriasis may need to treat the condition with medicines called biologic therapies, such as etanercept, adalimumab, infliximab, ustekinumab, secukinumab, and ixekizumab.

These are very powerful drugs that affect the immune system, unlike topical treatments that are applied directly to the skin. Biologic drugs can have the effect of disrupting the signal sent from the itch receptor to the brain4.

Researchers are currently developing new types of drugs specially designed to treat itching at its source in the brain.

How Is Psoriasis Diagnosed

There arent any special tests to help doctors diagnose psoriasis. Typically, a dermatologist will examine your skin and ask about your family history.

Youll likely be given a diagnosis based on this physical exam.

In some situations, doctors will remove a small sample of the skin and examine it under a microscope. This might allow them to get a better look at the affected area and make a more accurate diagnosis.

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How Does Psoriasis Occur

This chronic condition occurs as a result of the accelerated formation of skin cells. The formation of skin cells usually occurs deep down in the skin, and the cells created then gradually move to the surface. After a while, the cells drop off the surface. This process happens in everybody.

The difference between someone with psoriasis and someone without it is how fast the process occurs. The standard time for a skin cell to undergo this process, completing its life cycle, is thirty days. If you have psoriasis, it occurs in five to six days. The implication of this is that the time for the cells to drop off the surface is not sufficient, as the body cannot keep up with the accelerated formation of the cells.

So, instead of dropping off, the cells simply accumulate on the surface, and this makes the characteristic patches observed with psoriasis. The patches may also be inflamed and red and are often flaky with a silvery lining.

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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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 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.

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What Does My Psoriasis Flare Up

If youve been diagnosed with psoriasis, it doesnt mean youll always have active psoriasis plaques. Sometimes people can go years without symptoms before something causes a psoriasis flare-up. This period is called remission.

Everyones autoimmune system works a little differently, so what causes a flare-up in one person may not cause your psoriasis to flare. But there are some common triggers, including:

• Stress
• Smoking
• Drinking alcohol

Researchers also believe that different foods, like gluten, red meat, and dairy, may trigger inflammation and, therefore, psoriasis flare-ups in some people. Keep note of your food, and if you notice your skin reacts after eating certain foods, avoid them.

At the same time, anti-inflammatory foods like fruits and vegetables, leafy greens, nuts, seeds, legumes, and spices and herbs high in antioxidants may help you control your psoriasis.

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.

Announcer:

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.

Heather Stark:

Dr. Miller, thank you for joining us.

Dr. Jami L. Miller:

Thank you for having me.

Heather:

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?

Dr. Miller:

Heather:

Dr. Miller:

Heather:

Heather:

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Is It Scalp Psoriasis Or Dandruff

More than half of all psoriasis patients have scalp psoriasis, according to the NPF. Itchy plaques can extend beyond the hairline onto the forehead, neck, and around the ears.

“Most people with scalp psoriasis have it on other parts of their body as well,” says Dina D. Strachan, MD, a dermatologist and assistant clinical professor of dermatology at NYU Langone Medical Center in New York City.

Scalp psoriasis is sometimes confused with seborrheic dermatitis, or dandruff. According to Dr. Strachan, dandruff which causes a flaky, itchy scalp without signs of inflammation tends to itch more than scalp psoriasis. It has a greasy-appearing yellow scale, Strachan says. In contrast, psoriasis whether it’s on your scalp or any other body part tends to have a thick, silvery scale.”

Surgery And The Psoriatic Foot

Orthopaedic surgery to correct deformed joints is only justified in the presence of long-standing deformity where pain is preventing adequate mobility and all alternative medical treatments have failed. The advancement of newer techniques in recent years has seen better results in small joint replacement, but such procedures still need careful consideration and discussion with advice from an appropriate surgeon.

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Clinical Trials For Psoriasis

Before a new treatment can be registered in Australia it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis. The regulations governing clinical trials in Australia make the process as safe as possible for clinical trial participants. People with psoriasis may consider volunteering to participate in a clinical trial. Participation provides volunteers with access to cutting edge treatments that are not otherwise available. General information about being part of a clinical trial can be found here. Internationally, ClinicalTrials.gov provides patients, their family members, and the public with easy and free access to information on clinical studies for a wide range of diseases and conditions. If you are interested in participating in a clinical trial, talk to your doctor.

Psoriasis Causes And Triggers

The exact cause of psoriasis is unclear.1 It is thought to be caused by a combination of your genetic makeup and environmental factors .2,3 Not everyone who inherits genes for psoriasis will develop the condition. If one of your parents has psoriasis you have a 1 in 10 chance of getting it yourself. If both your parents have psoriasis, this increases to a 1 in 2 chance.4

Having psoriasis genes and being exposed to certain triggers in your daily life may cause psoriasis to develop.3

Psoriasis triggers are not the same for everyone. What causes one person’s psoriasis to flare up may not affect another.1 You may also find your triggers change over time.1 Knowing your triggers makes them easier to avoid and helps you take control of your skin.

Triggers are different for each person what sets off psoriasis in one person may not have any affect in another. 1

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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.

Psoriasis: More Than Skin Deep

The first accurate medical discussion of psoriasis dates back to 1801, but the disease itself is much older. In fact, its very name is borrowed from an ancient Greek word meaning an itchy or scaly condition. About 7 million Americans are plagued by this itching and scaling, and many of them have serious complications involving other organs. Although psoriasis is classified as a dermatologic disease, it doesn’t start in the skin, and its damage may be more than skin deep.

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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

Things To Avoid If You Have Scalp Psoriasis

Scalp psoriasis can be very uncomfortable, but find the right treatment and avoid these 6 pitfalls, and you can keep your scalp inthe best condition possible.

1. Dry skinKeep your scalp hydrated by using a moisturizing shampoo every time you wash your hair.

2. Itching and scratchingNever pick at scales or sore patches of skin Ââ this will make the condition worse!

3. Dry, cold weatherThe weather can have a big effect on psoriasis. Cold, dry weather can make the symptoms appear worse, so make sure to wrap up warm in winter and consider getting a humidifier to take the edge off the dry air.

4. Certain medicationTell your doctor about any medication you take and ask whether it might affect your psoriasis.

5. StressStress is often linked with flare-ups, so try to reduce stress and anxiety. Meditation and yoga are a good place to start.

6. AlcoholItâs thought that excessive alcohol consumption may worsen psoriasis symptoms, so drink in moderation. If youâre taking psoriasis medication, check whether itâs okay to drink alcohol while taking them.

How should you treat scalp psoriasis?Scalp psoriasis is a somewhat rare skin disorder, affecting about 3% of the population. If you havenât yet been diagnosed with the condition, itâs worthwhile to check to see if your symptoms are the result of a more common scalp flaking disorder like seborrheic dermatitis.

Try using Clinical Strength Shampoo for seborrheic dermatitis.

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What Is Genital Psoriasis

Psoriasis is an inflammatory autoimmune condition that can affect the skin anywhere on your body. Genital psoriasis develops around your genital area. It can flare up on the vulva or the penis. It can also appear on your upper thighs, the folds of skin between your thigh and groin, or between your buttocks. It rarely affects the inside of the vagina.

Anyone can get psoriasis, but researchers dont know the precise cause. Its not clear why some people with psoriasis get it around their genitals.

If you have psoriasis, you might go a long time without a problem and then have a flare-up. Flare-ups may be triggered by factors such as stress or illness, but it can be hard to determine those factors and avoid them.

Psoriasis tends to run in families, but it isnt contagious. The condition can be managed effectively, but theres currently no cure.

Problems With The Immune System

Your immune system is your body’s defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell.

T-cells normally travel through the body to detect and fight invading germs, such as bacteria. But in people with psoriasis, they start to attack healthy skin cells by mistake.

This causes the deepest layer of skin to produce new skin cells more quickly than usual, triggering the immune system to produce more T-cells.

It’s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.

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What Is The Treatment For Palmoplantar Psoriasis

Improvement in general health can lead to an improvement in palmoplantar psoriasis.

• Weight loss, if overweight
• Investigation and management of associated health conditions

Mild psoriasis of the palms and soles may be treated with topical treatments:

• Emollients: thick, greasy barrier creams applied thinly and frequently to moisturise the dry, scaly skin and help prevent painful cracking.
• Keratolytic agents such as urea or salicylic acid to thin down the thick scaling skin. Several companies market effective heel balms containing these and other agents.
• Coal tar: to improve the scale and inflammation. Because of the mess, coal tar is often applied at night under cotton gloves or socks.
• Topical steroids: ultrapotent ointment applied initially daily for two to four weeks, if necessary under occlusion, to reduce inflammation, itch and scaling. Maintenance use should be confined to 2 days each week to avoid thinning the skin and causing psoriasis to become more extensive.

Calcipotriol ointment is not very successful for palmoplantar psoriasis. It may also cause an irritant contact dermatitis on the face if a treated area inadvertently touches it. Dithranol is too messy and irritating for routine use on hands and feet.

More severe palmoplantar psoriasis usually requires or systemic agents, most often: