Psoriasis is a chronic and inflammatory illness that causes hyperproliferation and shedding of skin cells in the epidermis of the affected area. This results in build-ups of dead skin cells, which forms the irritation associated with the disease. The disease can affect almost anybody area and can spread if not treated properly.
Surface involvement, affected body sites, arthritis, and plaque/scale thickness all factor into the treatment plan for this condition, and treatment is often relative to case peculiarity.
Causes
The specific cause of psoriasis has yet to be discovered. However, experts suggest a combination of immunological, genetic, and environmental variables often leads to the disease’s development. Here’s a quick explanation of how these factors lead to the disease:
Immunological
Understanding how the immune system affects psoriasis’s skin changes is crucial. For those with psoriasis, understanding the natural process of skin development might explain why skin changes occur.
The skin consists of several layers. Cells in the epidermis (top layer) divide and eventually die, which creates a layer of dead cells on top of the skin, known as the stratum corneum. The middle layer of the skin is known as the dermis, and it consists of Collagen and blood vessels. And lastly is the inner layer, otherwise known as the subcutaneous, a fatty layer found beneath the skin. Usually, the epidermal cells die and decompose into the stratum corneum, and then the stratum corneum also sheds its topmost dead cells daily as well. This balance prevents the skin from growing excessively thick.
However, in some disorders, such as psoriasis, immune cells infiltrate the skin through blood cells, changing the normal skin cycle by causing the epidermis to develop fast and lose cells rapidly. This causes thicker skin and a scaly buildup of dead skin cells. The red skin color in this condition is caused by dilated blood vessels in the dermis feeding the rapidly developing epidermis.
Gene
A person’s genetic makeup also plays a massive role in influencing their tendency to acquire psoriasis. As many as 40 percent of those with psoriatic arthritis or psoriatic rheumatoid arthritis (a kind of arthritis closely connected to psoriasis) have relatives with the condition. Psoriasis susceptibility genes have been found, but no genetic test exists that can definitively predict whether a person would acquire the disease.
Environmental variables
Environmental and behavioral factors appear to play a role in developing and exacerbating the disease. Psoriasis can be aggravated or worsened by infections from bacteria and viruses, alcohol consumption, and even by using some medications (such as lithium, antimalarials, etc.). People who smoke are also more susceptible to contracting and increasing the severity of psoriasis, especially for pustular psoriasis (on their hands and feet).
Symptoms
There are physical signs that suggest the presence of psoriasis, and these signs may worsen with time if they are not treated. Also, note that there are different types of psoriasis, and they each come with specific distinguishing symptoms- however, there are general symptoms of this disease, and we’ve outlined them below;
- Itching that may cause bleeding on the affected area
- Burning sensation on the affected area
- Thickened and flaky skin on the affected area
- The affected area is red and swollen, and often pains
Treatment
While psoriasis cannot be cured, there are symptoms alleviating treatment options for psoriasis and come in different forms. Continuous usage of treatment is necessary to maintain progress in the treatment of psoriasis, and patients must follow the prescribed therapy regimen to get the greatest results. Also, if the diagnosis of psoriasis is unclear, if the initial treatment fails to alleviate symptoms, or if the disease is widespread or severe, consulting a dermatologist may be necessary. A rheumatologist should also be consulted for those with Psoriatic Arthritis.
Here are a few recommended treatment options:
Corticosteroids
Topical corticosteroids (often referred to as “steroids,” but separate from anabolic steroids) work by decreasing inflammation. At the beginning of treatment, this may be done twice a day. In some cases, doctors may propose reducing the frequency of treatment as the patient’s condition improves.
Skin emollients
Skin emollients can help alleviate itching and discomfort by keeping the skin smooth and moist. You may be advised to use over-the-counter moisturizing products such as petroleum jelly or heavy creams soon after washing or showering.
Formulations of these drugs, such as gel, lotion, liquid, shampoo foam, and spray, which some patients prefer over creams and ointments.
Tar
Patients with psoriasis have relied on tar products to alleviate their symptoms for many years. Inflammation in psoriasis is inhibited by tar; however, how exactly it does this is unknown. Preparations of tar products are accessible OTC and are commonly administered to the affected area once or twice a day in the form of shampoos, creams, oils, and lotions. Using tar products won’t thin your skin, but they’ll leave an odor and stain your skin and clothes- this is why many do not like using them. However, they are very effective. Corticosteroids and UV light therapies are common adjuncts when using tar products.
Calcipotriene or calcitriol
Both Calcipotriene (brands include: Dovonex, Sorilux) and calcitriol (brand include: Vectical) are related to vitamin D and work by inhibiting the proliferation of skin cells in the epidermis- this is why they are commonly used to treat psoriasis. It is possible to use these drugs in place of or in addition to topical steroids, and when used alone, they should be administered twice a day. There are few, if any, adverse effects, with the most prevalent one being skin irritation.
UV light
Psoriasis can be treated by exposure to UV light. For instance, people with psoriasis may find that their condition improves in the summer- hence Psoriasis may be treated using ultraviolet light from a dermatologist. Before starting any treatment plan, there should be a thorough discussion about the UV light therapy’s potential dangers and advantages. After bathing and carefully scrubbing the affected regions, you may be instructed to apply mineral oil to the skin, which helps the light permeate the skin more quickly.
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