Psoriasis is an inflammatory skin condition that affects one in fifty people and up to 100 million people worldwide. It gets its name from the Greek word ‘psora’, which means ‘to itch’ and results in raised, red patches on the skin that burn and sting. Psoriasis can be a debilitating condition for sufferers and often leads to significant distress, embarrassment and self-esteem issues. It is a poorly understood but common skin condition, so we have put together an overview of what the condition is, why it happens and what you can do.
WHAT IS IT, EXACTLY?
Psoriasis is an autoimmune condition that causes cells to develop rapidly on the skin, which leads to distinctive scaly plaques that are often itchy, uncomfortable and in some cases, crack and bleed. Scientists believe that in people with psoriasis, white blood cells become overactive and produce excessive amounts of cytokines (proteins secreted by cells of the immune system that act as chemical messengers), which trigger inflammation in the skin and other organs. In the skin, this leads to widened blood vessels, an accumulation of white blood cells and rapid multiplication of keratinocytes (the main cells that make up the outer layer of healthy skin). When the skin is healthy, keratinocytes take roughly a month to divide, mature, and migrate to the skin’s surface and slough off. However, in the case of psoriasis, this process is sped up and takes around three to five days.
WHAT CAUSES IT?
Researchers are still unsure what exactly causes psoriasis, but they believe that both genetic and environmental factors can contribute. It occurs equally in males and females and can start at any age, but it is most common amongst 15–35-year-olds with the average age of onset being 28. Psoriasis frequently runs in families and about one in three people with a close relative who has it, will also develop the condition. However, symptoms of the disease may not develop unless there is an environmental trigger. Risk factors include psychological stress, smoking and some viral infections.
Symptoms can vary from person to person, but common signs of psoriasis include:
» Red, flaky, scaly patches or plaques of skin
» Dry skin that may crack and bleed
» Soreness, itching and burning sensations around patches
» Thick, pitted nails
» Painful, swollen joints Most people experience cycles of symptoms where the severity is greater for periods of time and are unnoticeable at other times.
Psoriasis frequently manifests as small patches on the elbows, knees, lower back and scalp. However, there are several different types to be aware of:
» Plaque psoriasis: present in up to 80-90% of cases. Characteristic of raised, inflamed, red lesions that are covered in silvery white scales.
» Inverse psoriasis: red lesions that develop in the armpit, groin, under the breasts or in other skin folds.
» Erythrodermic psoriasis: a rare form of psoriasis that is particularly inflammatory that leads to redness across the body. This can be life threatening and requires immediate medical attention.
» Guttate psoriasis: small, red or pink, individual spots on the skin. Spots are rarely thick or raised.
» Pustular psoriasis: characterised by pus-filled blisters with areas of red, inflamed skin.
If you have psoriasis, flare ups can be worsened by a number of factors such as:
» Stress: Psoriasis often flares up in times of stress. When you are stressed, your body releases chemicals that can trigger the body’s inflammatory response, which can in turn worsen the condition. Managing your stress plays an important role in minimising the severity of flare ups.
» Cold weather: Psoriasis is often worse in winter, so a trip to your favourite beach destination can help. How? The sun’s ultraviolet light can essentially turn off the skin’s immune system which can ease psoriasis by slowing the rapid rate of skin growth and shedding. However, don’t forget to wear sunscreen.
» Alcohol use: Scientists believe that alcohol might affect the immune system and increase the production of inflammatory cytokines, leading to psoriasis flare ups.
» Diet: Research is still ongoing in this area; however, some people have noticed improvements with their psoriasis when cutting out foods such as gluten and nightshade vegetables such as tomatoes, potatoes and eggplant.
IS IT CONTAGIOUS?
Absolutely not! It is impossible to catch psoriasis from another person as the condition is related to the immune system. There is often stigma attached to psoriasis so openly debunking inaccurate information can help sufferers. If a person has psoriasis, they didn’t get it from someone else, and they cannot infect others.
WHAT CAN HELP Psoriasis is a lifelong condition but there are ways that you can reduce the severity of flares. Topical creams such as corticosteroids, retinoids, salicylic acid and moisturises are often used to soothe symptoms. Light therapy is useful for some people as ultraviolet (UV) light can kill overactive white blood cells that are leading to rapid skin cell growth. Immunosuppressant drugs are used in severe cases.
To reduce symptoms, doctors also often advise:
» Losing weight
» Avoiding processed foods and alcohol
» Using a good moisturiser
» Cutting down on alcohol and smoking
» Eating a healthy diet rich in lean proteins and omega-3 fatty acids, such as salmon. New research suggests that following the Mediterranean diet (a diet rich in fruits and vegetables, legumes, whole grains, fish, fruit, nuts, and extra-virgin olive oil, can be helpful for reducing flare ups.