Psoriasis

What is psoriasis?

Psoriasis is a chronic, immune-mediated skin condition which according to the National Psoriasis Foundation (NPF) affects 125 million people worldwide. The condition is typically characterised by plaques or lesions which form due to the rapid proliferation of skin cells. With increased blood flow and inflammation, these areas become red, itchy, and inflamed. Many people with the psoriasis notice it varies over time. A ‘flare-up’ is a sudden worsening of the condition, often brought on by a ‘trigger’ such as environmental changes, consumption of alcohol, smoking, stress, illness, or infection.

Psoriasis symptoms

Common signs of psoriasis may include [1]:

Psoriasis may look different for different people, body areas and skin tones, so if you think you might have psoriasis, get input from your doctor or dermatologist. Read the section ‘What does psoriasis look like’ to find out about each clinical subtype of psoriasis.

Is psoriasis itchy?

Yes, one of the most bothersome symptoms of psoriasis is persistent skin itchiness. This is due to chemicals called pruritogens (or itch mediators) which are released by the body as part of the inflammatory response. The temptation to scratch, while it may provide temporary relief, breaks the skin’s protective layer, leaving the skin susceptible to micro-organisms which may be sitting on the skin’s surface and under the nails. The colonisation of bacteria and other microorganisms leads to more inflammation and itchiness (and so the cycle continues). Breaking the cycle of itchiness and scratching is therefore essential to restoring skin integrity and preventing future flare-ups.

What does psoriasis look like?

Psoriasis may look different for each person that has it. There are different types of psoriasis including plaque, guttae, pustular, erythrodermic, inverse, nail, and palmoplantar psoriasis. If you believe you have one of these types, it is important to consult with your doctor or dermatologist for a more specific diagnosis. Continue reading for a brief rundown of each type of psoriasis: 

Chronic plaque psoriasis

Plaque psoriasis is the most common form of psoriasis characterised by the build-up of large distinctive ‘plaques’ with a whitish scaling of dead skin cells [2]. This type most commonly occurs on the elbows, knees, scalp and back [2]. Plaque psoriasis is chronic in nature but can vary over time.

Guttae psoriasis

Guttae psoriasis manifests as ‘drop-like’ papules usually present on the arms and abdomen. Guttae psoriasis can remit, recur, and progress into more severe forms of psoriasis. It can occur in young people with no known history of psoriasis and can be triggered by conditions such as strep throat [3].

Pustular psoriasis

Pustular psoriasis is characterised by the formation of pustules, widespread redness, and scaling [3]. Depending on the subtype, this form of psoriasis can have severe complications. Causes may include pregnancy, infection, or withdrawal from certain medications called glucocorticoids [3]. 

Erythrodermic psoriasis

Erythrodermic psoriasis is a relatively uncommon type of psoriasis which is characterised by generalised redness and scaling of the skin. Breaking of the skin barrier can leave patients at risk of infection and loss of electrolytes and fluids [3].

Inverse psoriasis

Inverse psoriasis occurs in the folds of the skin, including the genitals, around and in the buttocks, under the arms and/or breasts [3]. Plaques tend to be smooth and shiny, with minimal scaling [3].

Nail psoriasis

Nail psoriasis can emerge with or before plaques are seen on other areas of the body [3]. Nails become weak, and patients may also notice pitting (tiny holes), as well as red lines (called splinter haemorrhages) and/or a colour change of the nail [3].

Palmoplantar psoriasis

Palmoplantar psoriasis occurs on the hands and feet. The plaques are red, raised and may have fissures or splits through the skin (which can be very painful) [3] Due to the location of these plaques, this type can affect a person’s ability to walk and perform activities of daily living.

A note on psoriatic arthritis

Psoriatic arthritis is an inflammatory musculoskeletal condition associated with psoriasis which affects the joints of the body [4]. It is thought to affect up to 30% of patients with psoriasis [5], where psoriasis generally comes before the arthritis [4]. It is clinically distinct from rheumatoid arthritis and more commonly affects people with severe psoriasis.

If you have psoriatic arthritis, you may experience joint pain, stiffness, and generalised fatigue. It may be difficult to get moving in the mornings, which can take 30 minutes or so to subside. 

Psoriatic arthritis can affect multiple joints in the body and can change presentation over time. The common ways psoriatic arthritis can present include [6]:

  • Asymmetric oligoarthritis – where fewer than five joints are involved, and the corresponding joint on the other side of the body is not affected.
  • Symmetric polyarthritis – more joints are involved, and corresponding joints on the other side of the body are also affected. 
  • Distal arthritis – involves the joints near the tips of the fingers and toes.
  • Arthritis mutilans – arthritis which deforms and destroys the joints.
  • Spondyloarthritis – arthritis that affects the spine and can cause the fusion of the vertebrae across the joint.

It is unknown what causes psoriatic arthritis and there are treatments available to help ease symptoms you may experience. Engaging in regular exercise, although difficult due to the pain, is important to help keep your joints mobile and maintain your muscle strength.

Psoriasis causes

The aetiology of psoriasis is incredibly complex, and develops due to a combination of immune, genetic, and environmental factors. These can vary from individual to individual. That is, what might trigger someone else’s psoriasis, may not trigger yours. Some people with psoriasis can easily identify the causes of their flare-ups, however for others this can be more complex. In either case, it is worth exploring the triggers with your doctor so that you can make appropriate lifestyle and medication changes to keep your psoriasis under control.

Is psoriasis an autoimmune disease?

Psoriasis is likely to be an autoimmune disease, which is where the body attacks its own skin cells. In psoriasis, the immune system infiltrates the skin, causing the top layer to multiply at a rapid rate.  As these skin cells proliferate and fail to shed from the surface, the characteristic lesions of psoriasis form. Chronic inflammation means greater blood flow, causing localised redness. This inflammation also increases the chemicals which cause itching (or pruritogens), which make you want to scratch. Read section ‘Is psoriasis itchy?’ for more information about the causes of skin itchiness in psoriasis.

Is psoriasis contagious?

Psoriasis is not contagious. This means you cannot get it from direct or indirect physical contact with someone who has psoriasis. However, there is a large genetic component, which means if a family member has psoriasis, you are at a greater risk of developing it. That being said, you can still get psoriasis even without a family history. 

What are the environmental causes of psoriasis?

There are large environmental and behavioural components to developing psoriasis. You may find certain triggers such as stress, alcohol, smoking, certain medications, infections, even the season may trigger a ‘flare-up’ [1].

How to cure psoriasis permanently

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 psoriasis and/or psoriatic arthritis. Read the section ‘Psoriasis treatment’ for a detailed overview of psoriasis treatment options.

Psoriasis treatment

How to treat psoriasis

The treatment of psoriasis varies from individual to individual, and what may work on someone else, may not work on you. It is important to take a holistic approach and discuss the options available to you with your doctor. The process to treatment may be trial-and-error. You may also need to make some lifestyle changes such as diet, exercise, and stress management to help your symptoms.

Medical treatments for psoriasis [1]

Here is a list of some conventional medical treatments used for the management of psoriasis (it is by no means exhaustive). Although there is no cure, keeping your symptoms under control can make a significant difference to your quality of life.

Apremilast

This is an oral medication which reduces inflammation for psoriasis and psoriatic arthritis. You may notice improvements in a few weeks, however side effects may include stomach upset, nausea, headache, respiratory infections, and mood changes.

Biologics

These are injectable medications which target the immune system response in moderate to severe psoriasis. Biologics are generally used when other treatments have not worked. They are effective within a few weeks of use, however may not be covered by health insurance.

Methotrexate

This is an oral or injectable medication used to suppress the immune system for moderate to severe psoriasis. You may notice improvements in 3 months however it can damage your liver. It is recommended to avoid alcohol while taking this medication. Careful monitoring of liver function is required and methotrexate is not safe to use while pregnant.

Immunosuppressants

There are a variety of oral immunosuppressants like prednisolone and which suppress the overactive immune system in psoriasis. These are only appropriate for short-term use only.

Corticosteroids

Corticosteroids are topical ointments or creams which have anti-inflammatory effects to counteract the hyperactive immune system seen in 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.

Calcipotreine or calcitrol

Calcipotreine or calcitrol are topical ointments or creams used to suppress the hyperproliferation of skin cells seen in psoriasis. While it does not cause skin thinning like corticosteroids, it may irritate the skin.

Calcineurin inhibitors

Calcineurin inhibitors are topical treatments which block inflammatory mediators which are overactive in psoriasis. This treatment is good for use in skin folds or sensitive areas.

Tar

Tar is applied to the skin, however it is unclear the mechanism of action it uses to control psoriasis. It is often used in conjunction with other treatments and there are a variety of types available including shampoos, lotions, and oils. One drawback is that tar can stain clothing and has an unpleasant odour.

Tazarotene

Tazarotene is a topical treatment derived from vitamin A which acts to decrease skin cell division and reduce inflammation seen in psoriasis. Improvements are generally seen in 8 weeks, and it is often combined with other psoriasis treatments.

Ultraviolet therapy

UVB radiation penetrates the skin and improves the appearance of psoriasis. It is delivered by a dermatologist, however can be expensive and may not be covered by health insurance. There is also a risk of developing skin cancer with this treatment.

Natural psoriasis remedy – The Ocean Soothe® Range

Looking for a natural solution to mild psoriasis and problematic skin? 

The ocean, rich in minerals and electrolytes, has natural healing properties. In fact, people with skin conditions such as psoriasis and eczema bathe in the Dead Sea for the benefits of the mineral-rich ocean water. While the high concentration of salt cleanses and sloughs off layers of dead skin, the mineral magnesium, a natural anti-inflammatory, helps to calm the skin and provide flare-up relief. 

Abundant Natural Health’s 100% natural Ocean Soothe® Range, highly concentrated with salt and magnesium, harnesses the healing properties of the ocean for effective relief from symptoms of mild psoriasis, problematic, dry, and flaky skin. We bring the benefits of the Ocean to you, no matter where you are.

Our Ocean Soothe® Range includes a family of products for optimal management of problematic skin, wherever it may be. From scalp serums, sprays, skin gels, lotions, to body washes, bath soaks and a shampoo and conditioner, Abundant Natural Health is your one-stop shop for all things problematic skin.

In fact, our Ocean Soothe Lotion and Gel have received the ‘Seal of Recognition’ from the Natural Psoriasis Foundation. Find out how these products became recognised by the NPF.

A company founded by a psoriasis sufferer

Why is psoriasis so important to us at Abundant Natural Health?

Abundant Natural Health’s CEO, Tony Crimmins, is a sufferer of chronic psoriasis. Trying everything for medicine to natural remedies, Tony became frustrated by the lack of improvement in his condition, and even more so by the side effects of the multiple medications and treatments he was undergoing. He never gave up hope of finding something safe to help relieve the pain and itchiness.

Tony launched Abundant Natural Health in 2016 to fulfill his dream of developing topical solutions to many debilitating pain conditions, including psoriasis. Six years on, Abundant Natural Health has over 20 natural products specifically formulated to improve human health and wellbeing, with many more in development. 

Abundant Natural Health has complete product traceability, and we vouch for the quality, purity, and effectiveness of our all-natural formulations.

References

  1. Feldman, S. R. (2020). Patient education: Psoriasis (Beyond the Basics). UpToDate. Retrieved from : https://www. uptodate.com Accessed, 13 Jan 2021. 
  2. Mason, A. R., Mason, J., Cork, M., Dooley, G., & Hancock, H. (2013). Topical treatments for chronic plaque psoriasis. Cochrane Database of Systematic Reviews, (3).
  3. Feldman, S. R., & Duffin, K. C. (2019). Psoriasis: epidemiology, clinical manifestations, and diagnosis. UpToDate. Waltham, MA: UpToDate Inc. Retrieved from: https://www. uptodate. com Accessed, 13 Jan 2021.
  4. Brockbank, J., & Gladman, D. (2002). Diagnosis and management of psoriatic arthritis. Drugs, 62(17), 2447-2457.
  5. Ritchlin, C. T., Colbert, R. A., & Gladman, D. D. (2017). Psoriatic arthritis. New England Journal of Medicine, 376(10), 957-970.
  6. Gladman, D. D., & Ritchlin, C. (2010). Clinical manifestations and diagnosis of psoriatic arthritis. UpToDate. com, v18.


Disclaimer: This site does not provide medical advice. The author is not a medical professional, dietician, or nutritionist. This website is intended for informational purposes only and it is not a substitute for professional medical advice, diagnosis, or treatment. By providing the information contained herein we are not diagnosing, treating, curing, mitigating, or preventing any type of disease of medical condition. Patients should not use the information contained on this website to self-diagnose or self-treat any health-related condition. Never ignore professional medical advice in seeking treatment because of something you have read on this website. Before beginning any type of natural, integrative, or conventional treatment regimen, it is advisable to seek the advice of a licensed healthcare professional. Information is gathered and shared from reputable sources; however, Abundant Natural Health is not responsible for errors or omissions in reporting or explanation.