Psoriasis is one of the most common chronic skin diseases. It affects between 1 % and 3 % of the world’s population and causes as much medical disability as other major medical diseases.
The condition is caused by abnormal activity of the immune system, resulting in the cells, blood vessels and nerves in the skin growing faster than usual. Unlike normal skin, where the cells take about a month to mature and are shed unnoticed, in patients with psoriasis cells mature within five days, causing them to heap up into characteristic patches or ‘plaques’ of thick, red skin, covered with white or silvery scales.
What is psoriasis and what are the symptoms?
The skin lesions can cause significant discomfort, including itching, burning, bleeding and pain from irritation. There may also be messy flaking of the scalp and involvement of the finger and toenails, which may be discoloured, pitted, and lift from the nail bed.2 Up to 50% of patients with psoriasis will demonstrate nail changes.
“Psoriasis is an autoimmune disease,” says dermatologist Dr Lushen Pillay. “Your body thinks its own tissues are foreign invaders that must be attacked. There’s no cure for psoriasis and the disease is chronic and relapsing, which means that symptoms may come and go, but you’ll have it for the long-term. Genes play a significant role too, and you may be more likely to get psoriasis if someone in your family has it.”
“Environmental factors can also set off psoriasis flares,” says Dr Pillay. “It is best to avoid alcohol, smoking, and certain foods like red meat. Adopting a healthy lifestyle can help to manage psoriasis symptoms and flare-ups. It’s also advisable to reduce stress and avoid excessive exposure to cold, dry weather. People with psoriasis also have a greater risk of developing other chronic and serious health conditions, known as ‘comorbidities’. These include obesity, hypertension, diabetes, heart attacks and strokes.”
The psychological effects
Psoriasis results in unsightly lesions and bleeding, often causing embarrassment, shame and reduced self-esteem. Patients might avoid going out and exclude themselves from social gatherings. Psoriasis is commonly associated with depression, and there is a lot of ignorance and misinformation about the disease, causing patients to feel isolated, excluded and stigmatised. They may stay home from work and school. Other people are often afraid that the condition is contagious and avoid getting too close to someone with psoriasis. In some communities, psoriasis may be regarded as a ‘curse’ or sign of evil.
It is important to understand that psoriasis is a systemic condition that does not only affect the skin but may also involve the scalp and the joints.
Help is available
“The good news is that there are medications to treat psoriasis, and they’re better than ever,” says Dr Pillay. “Studies have shown that a dual-combination topical treatment containing calcipotriene, a synthetic form of vitamin D, and betamethasone, a steroid with anti-inflammatory and immunosuppressive abilities, can provide effective relief for patients and long-term sustained control.”
Research into the development of new topical treatments in scalp psoriasis is needed because many current topical treatments are disliked by patients and associated with poor compliance. Studies on the formulation of calcipotriene plus betamethasone showed that patients achieved ‘‘absent’’ or ‘‘very mild’’ symptoms after prolonged use, indicating that the formulation is more effective than either of the components on their own, and improving the mental and physical functioning of patients.
“The combination of the two active ingredients in one is available as an ointment for body psoriasis and as a gel, recently launched to treat scalp and body psoriasis, letting the patient choose which they prefer,” says Dr Pillay.
“The new gel for scalp and body comes in an easy to use, compact, portable bottle and is less messy compared to ointments. It need only be applied once a day, a convenience that also helps to ensure patient compliance which is very necessary in achieving long-term sustained control.”
Dr Pillay stresses that it is important to see a doctor right away if you suspect you have psoriasis. “The earlier you seek help, the better the long-term outcome. We encourage people to take control of their health and speak to a dermatologist if they are experiencing symptoms of psoriasis so they can get them under control and improve their quality of life. Don’t become complacent. Understand what you might be doing to trigger a flare-up of your condition. Rather than relying on treatment alone, adjust your lifestyle habits accordingly.”
treating psoriasis from #TopToToe
information, visit www.UbetonPsoriasis.co.za