Psoriasis is a common skin condition characterised by red, raised patches and silvery-white scales on the surface of the skin. These patches are often concentrated around the elbows, knees, hands, upper body and scalp. The patches can cause irritation and itching. Sometimes the nails can be affected becoming uneven and loose. Psoriasis can also cause emotional problems such as embarrassment, lack of confidence, low self-esteem and even depression. Some psoriasis sufferers also develop inflamed and painful joints known as psoriatic arthritis.There are many different types of psoriasis. They have different symptoms which vary in severity. The most widespread form of psoriasis is 'plaque psoriasis' also known as 'psoriasis vulgaris' or 'discoid psoriasis'.

Psoriasis can affect people of all ages but often it first develops in early adulthood. It is not contagious.

Causes

The human body constantly produces new skin cells. Psoriasis occurs when new cells are produced faster than old ones are shed. This causes a build up of dead cells on the surface of the skin which is known as psoriasis. It is not fully understood what causes this abnormal pattern of cell growth although it is known that psoriasis can be passed down from generation to generation. Stress, infection, certain medicines and damage to the skin such as sunburn or scratching can all cause psoriasis to flare up.

Helping To Control Psoriasis

  • A healthy diet will help to improve the condition of the skin. Cut down on saturated fats and eat plenty of green leafy vegetables, carrots and oily fish (pilchards, herring, mackerel, sardines, kippers, salmon, trout and tuna). Research has shown that oily fish contains toxic chemicals as a result of polluted waters. The Department of Health therefore advises us not to eat more than one portion of oily fish per week (130g). The pollutants are stored in the fat content of fish so if you grill or bake your fish and remove any skin and visible fat, this will reduce the amount of pollutants that you consume. Fish oil supplements also contain pollutants so it is a good idea not to eat oily fish as well as taking fish oil capsulesDo not smoke and avoid excessive alcohol consumptionProtect your hands from strong soaps and detergents. Wear gloves when washing upAvoid stressful situationsDo not scratch. Scratching can cause further irritation, bleeding and infection
  • Spending 15-30 minutes out in the sunshine each day can help to improve the skin's condition. Take care to avoid sunburn

Treatment

There is no cure for psoriasis but the condition can be controlled with medication. Some treatments can be bought over the counter but others are only available on prescription. Controlling psoriasis can be time-consuming but to be successful it should be carried out correctly. Here follows a list of psoriasis treatments:

Topical preparations (applied directly to the skin such as ointments, creams, lotions, sprays, gels, washes, shampoos, shower gels and bath additives.)

  • Emollients soften, soothe and hydrate the skinSalicylic acid causes dead skin to peel awayTar products reduce inflammation, cause dead skin to peel away and slow down the production of new skin cells. They are effective but they are smelly and they can stain skin, hair and clothingDithranol causes dead skin to peel awayTopical steroids help to suppress inflammation and redness, stop any itching and cause dead skin to peel away. They are available in four different strengths. Some mild forms are available over the counter from pharmacies but these must not be applied to the face. Others are available on prescriptionCalcipotriol and tacalcitol resemble vitamin D. They cause dead skin to peel away
  • Tazarotene resembles vitamin A. It causes dead skin to peel away and helps to reduce inflammation

Oral preparation (stronger medications taken by mouth under medical supervision)

  • Methotrexate and ciclosporin can be taken orally to treat psoriasis. They work by suppressing the body's defence or immune systemAcitretin resembles vitamin A. It causes dead skin to peel away and helps to reduce inflammation
  • Oral steroids can also be prescribed in severe cases of psoriasis

Ultraviolet treatment ( exposure to ultraviolet light using specially designed light cabinets containing fluorescent tubes)

  • PUVA (photochemotherapy) can be used to treat psoriasis. This treatment combines the use of a light sensitive medicine with exposure to ultraviolet A light
  • UVB phototherapy can also be used. Exposure to ultraviolet B light can be used on its own or after a coal tar bath

When To See A Doctor

Anyone who develops psoriasis should go and see a doctor. Those who do not respond to treatment and those who develop joint pain should also see a doctor.

Additional Information

For more information about psoriasis, contact:The Psoriatic Arthropathy Alliance (PAA), PO Box 111, St Albans, Hertfordshire AL2 3JQ, tel/fax: 01923 672837, e-mail: info@paalliance.org

The Psoriasis Association, Milton House, 7 Milton Street, Northampton NN2 7JG, tel: 01604 711129, fax: 01604 792894.