January 30, 2022 6 min read
Psoriasis is a common, yet vastly misunderstood skin condition. Despite advancements in medicine, there are a lot of unknowns, and treatment requires a systematic and person-centred approach. Knowledge is power! Take back control and read on to find out everything you need to know about the most common type of psoriasis - plaque psoriasis.
Fig 1: example of plaque psoriasis
Psoriasis is a chronic, inflammatory skin condition which according to the National Psoriasis Foundation affects 125 million people worldwide (National Psoriasis Foundation, n.d). Plaque psoriasis is the most common type, making up 80-90% of cases.
Plaque psoriasis is a long-term, recurring condition which is characterised by the build-up of large (1 to >10cm), demarcated ‘plaques’ with a whitish scaling of dead skin cells. The most affected areas are the elbows, knees, scalp and back.
Common signs of plaque psoriasis may include:
Plaque psoriasis may appear different for different body areas, skin types and colours, so it is important to get input from a doctor/dermatologist to properly diagnose you.
Guttae and plaque psoriasis are both types of psoriasis which may occur concurrently. Where plaque psoriasis causes the formation of large plaques, guttae psoriasis manifests as ‘drop-like’ (<1cm) papules usually on the arms and abdomen . It often occurs in children or young adults with no known history of psoriasis and can be triggered by conditions such as strep throat.
Plaque psoriasis tends to be chronic in nature, and varies over time, where guttae psoriasis can suddenly remit, recur and progress into plaque psoriasis.
The aetiology of psoriasis is incredibly complex, and develops due to a combination of immune, genetic and environmental factors.
In plaque psoriasis, a fault in the immune system causes the body to attack otherwise healthy skin cells. A hyperactive immune system causes the top layer of skin to multiply rapidly. As skin cells proliferate and fail to shed from the surface, raised plaques form. They are red in colour due to the dilated blood vessels supplying the top layer of skin and are covered with layers or white, dead skin cells.
Psoriasis is not contagious. That is - you cannot get it from contact with someone who has psoriasis. However, there is a large genetic component. This means that if a family member has psoriasis, you are at a greater risk of developing it (although can still develop plaque psoriasis without a family history). There is no genetic test that can tell you whether you will develop plaque psoriasis.
There is also an environmental and behavioural component to developing plaque psoriasis. You may find certain triggers such as stress, alcohol, smoking, certain medications, or infections may trigger a ‘flare-up’.
Plaque psoriasis is a lifelong, variable condition. Although there is no cure, there are options out there to help improve the appearance of and reduce troublesome symptoms associated with plaque psoriasis. Find a regime that works for your plaque psoriasis!
Here are some of the conventional treatments used for plaque psoriasis:Apremilast
Oral medication used to reduce inflammation for psoriasis and psoriatic arthritis. Improvements are seen in a few weeks, however side effects may include stomach upset, nausea, headache, respiratory infections, and mood changes.
Injectable medications which target the hyperactive immune system in moderate to severe plaque psoriasis. These medications are generally used when other treatments have failed and are effective within a few weeks of use. Biologics can be costly and may not be covered by health insurance.
Oral or injectable medication used to suppress the immune system for moderate to severe plaque psoriasis. Improvements are seen in 3 months, however it is recommended to avoid alcohol during use as this medication can cause liver damage. Careful monitoring is required and it is not safe to use while pregnant.
Oral medications which suppress the immune system, which is overactive in plaque psoriasis. These are only appropriate for short-term use only.
Topical ointments/creams which act to reduce inflammation seen in plaque psoriasis. These can be purchased over-the-counter, however prescriptions are required for strong formulations. While they are great to use in sensitive areas, they can cause skin thinning and stretch marks.
Topical ointment/cream used to reduce the proliferation of skin cells seen in plaque psoriasis. While it does not cause skin thinning like corticosteroids, it may irritate the skin.
Topical treatments which inhibit inflammatory mediators overactive in plaque psoriasis. This treatment is good for use in skin folds/sensitive areas.
Topical treatment with unclear mechanism of action on plaque psoriasis. There are a variety of types available including shampoos, lotions and oils, however it can stain clothing and has an unpleasant odour. Tar is often used with other treatments.
Topical treatment derived from vitamin A which acts to decrease skin cell proliferation and reduce inflammation seen in plaque psoriasis. Improvements are generally seen in 8 weeks, and it is often combined with other plaque psoriasis treatments.
UVB radiation penetrates the skin and improves the appearance of plaque psoriasis. It is delivered by a dermatologist, however can be expensive and may not be covered by health insurance. Theer is also a risk of developing skin cancer with this treatment.
Managing your plaque psoriasis often requires lifestyle changes in addition to a solid treatment regime. Here are some natural ways you can prevent and manage flare-ups:
Enjoying a healthy and balanced diet has clear benefits for the body and mind. Enjoying a diet high in vegetables and fruit, low GI carbohydrates and limiting bad fats can reduce overall levels of inflammation in the body and reduce your risk of chronic disease. Additionally, try to minimise or avoid alcohol or smoking where possible.
Regularly using a moisturiser can help protect your sensitive plaques, as well as soften the skin, improve moisture, reduce dryness and itching. Apply regularly and after showering or bathing.
Abundant Natural Health’s Ocean Soothe Lotion and Gel can help to protect your plaques, hydrate, and heal the skin from the inside out. With 160% higher concentration of salts than the Dead Sea, our all-natural Ocean Soothe® Range calms inflammation and promotes skin healing. These natural formulations contain Magnesium infused with olive oil and aloe vera to hydrate, soothe, and soften the skin as well as reduce symptoms such as including itching, peeling, scaling and crusting, inflammation, irritation and dryness.
Cheap and accessible, UVB rays helps to slow the rapid rate of skin growth & shedding. Natural sunlight also helps with the production of Vitamin D in the body, a natural anti-inflammatory, a known precursor for psoriasis flares.
Whether you are soaking in a magnesium salt bath or applying a topical magnesium to your skin, magnesium is a natural anti-inflammatory. Magnesium aids skin barrier function, and prevents bacteria growing in psoriatic plaques and lesions.
Furthermore, Magnesium is a proven stress-reliever, and with stress being a key contributor to flare-ups, it is a must-have.
Ocean water has significantly higher amounts of minerals like sodium, magnesium, potassium, and calcium. This high mineral salt content is why it provides so much relief for people with skin conditions like plaque psoriasis. Bathing in natural mineral-rich water, called balneotherapy, has been used since ancient times to treat psoriasis.
The Dead Sea is one such body of water that is used for the treatment of skin conditions due to its high mineral salt profile. These mineral salts have anti-inflammatory, anti-microbial and antiseptic effects, help to absorb toxins in the body and promote the healing process of the skin.
Abundant Natural Health’s Ocean Soothe Flare Relief Bath Soak harnesses the power of the ocean for effective relief from symptoms from mild psoriasis and problematic skin. Highly concentrated with salt, magnesium, and infused with lavender oil, this natural soak decreases flare-up effects, hydrates the skin and helps you wind-down after a long day.
Stress is one of the most common triggers for plaque psoriasis flare-ups. With so many things going on, it may be difficult to find time to look after yourself. Try yoga, meditation, or mindfulness. If that’s not your style- go for a walk, listen to music, or talk to someone about it. Most importantly- be kind to yourself!