Psoriasis is a common skin condition that speeds up the life cycle of skin cells according to Mayoclinic. It causes cells to build up rapidly on the surface of the skin. The extra skin cells form scales and red patches that are itchy and sometimes painful. Psoriasis is a chronic disease that often comes and goes. The main goal of treatment is to stop the skin cells from growing so quickly. (1)
The psoriasis signs, symptoms and treatments will vary depending on the individual. Some people have very severe psoriasis, meaning that it has a significant negative impact on their overall quality of life. Others, on the other hand, only experience mild irritation. Either way, the condition is chronic, and usually presents with periods of remission followed by a flare up.
The Causes of Psoriasis:
Before looking at the various psoriasis signs, symptoms and treatments, it is important to have some understanding of the different causes of the condition. What is known is that people with psoriasis produce too many skin cells. Normally, these cells replace every four weeks or so, but those who have the condition replace their cells every three to seven days. The patches, therefore, are a buildup of skin.
It is not well-understood how the process works. However, medical scientists believe that the issue lies in the immune system. Essentially, immune cells attack skin cells, believing them to be foreign invaders. It is also quite common for psoriasis to run in the family, although a linking gene has not yet been discovered.
Often, people also experience “trigger” events. This means that they have a flare up after a certain situation happens. This could be exposure to medication, a throat infection, or a skin injury. Before looking into the psoriasis signs, symptoms and treatments further, it is important to understand that the condition is not contagious, which means it won’t spread to someone else.
Psoriasis Signs and Symptoms:
Typically, the most prominent of the signs and symptoms of psoriasis is the development of red, dry, patches of skin with silvery scales. Sometimes, these can be sore or itchy. Scientists now understand that there are different forms of psoriasis, with the majority of people having only one type at the same time, although they can switch between types. They are:
1. Psoriasis vulgaris or plaque psoriasis, which is the most common. Around 80% of patients have this form. The typical psoriasis patches are very clear here, appearing on the lower back, scalp, knees, and elbows. They can also appear on other parts of the body. Often, the plaque is itchy and/or sore.
2. Scalp psoriasis, which presents only on the scalp. It seems that people either experience no discomfort with this or extreme itchiness. Sometimes, hair loss can occur, although this is temporary.
3. Nail psoriasis, which occurs in around 50% of people who have psoriasis. It means that the nails develop tiny pits or dents, making them grow abnormally. It is common for the nail to completely separate or crumble.
4. Guttate psoriasis, which leads to very small sores on the scalp, legs, arms, and chest. These sores look like drops. Usually, they disappear completely after a few weeks, although they can lead to plaque psoriasis. It is most common in the young up to teenage years and often follows a streptococcal throat infection.
5. Flexural (inverse) psoriasis, which appears in skin creases and folds, like under the breasts, between the buttocks, or in the groin or armpits. Patches are often large and smooth, and they can become irritated due to sweating and friction.
6. Pustular psoriasis, which is quite rare. Pustules (pus-filled blisters) appear, with their location determining the type of pustular psoriasis. They include Von Zumbusch (generalized), which means the pustules can be anywhere; palmoplantar, which means the pustules are on the palms and soles; and acropustulosis, whereby the pustules are found on the toes and fingers.
7. Erythrodermic psoriasis, which happens all over the body. Patients report extreme burning sensation or itching. The body often loses fluids and protein, which means other significant problems can arise, including malnutrition, hypothermia, heart failure, dehydration, and infections.
Is Psoriasis Contagious?
According to Healthline, Psoriasis isn’t contagious. You can’t pass the skin condition from one person to another. Touching a psoriatic lesion on another person won’t cause you to develop the condition. (2)
Generally speaking, the treatment for psoriasis is very effective. That said, the condition is chronic, which means treatment only helps to control outbreaks and sometimes to prevent more. Most of the time, general physicians would be able to offer treatment to manage the symptoms, although they may want to refer you to a dermatologist for more specialized help.
The type of treatment you will be provided with will depend on which type of psoriasis you have, how bad it is, where it is found, and how often you have flare ups. Usually, a mild treatment is offered first until the most effective one is identified. This can be an exhausting and frustrating time, unfortunately.
There are three main categories of treatment for psoriasis:
1. Topical treatments. With these, you apply ointments and creams to the skin. It is common for patients to find tremendous relief with topical treatments and to not require any further treatment. For those with scalp psoriasis, there are even shampoos available to help improve the condition. Topical options include:
– Emollients, which moisturize
– Steroid creams, which reduce inflammation
– Vitamin D analogues, which slow down the growth of new skin cells, while also being anti-inflammatory
– Calcineurin inhibitors, which slow down the immune system
– Coal tar, which can help reduce itchiness, inflammation, and scales
– Dithranol, which has been a treatment option for half a century
2. Photo-therapy, whereby the skin is exposed to UV (ultraviolet) lights. Both artificial and natural light can be provided for this. Options include:
– UVB photo-therapy, which slows down skin cell production.
– PUVA (psoralen plus ultraviolet A), which penetrates deeper than UVB treatment.
– Combination light therapy, which combines UVB with other treatment methods.
3. Systemic treatments, which is prescribed when all other forms of treatment have failed. According to Healthline, people with moderate to severe psoriasis, and those who haven’t responded well to other treatment types, may need to use oral or injected medications. Many of these medications have severe side effects. Doctors usually prescribe them for short periods of time. (3)
Lastly, there is no cure for psoriasis according to Mayoclinic, but you can manage symptoms. Lifestyle measures, such as moisturizing, quitting smoking and managing stress, may help. (1)