Psoriasis: The Top 10 Questions
- According to the National Psoriasis Foundation (NPF), nearly 90% of all psoriatic patients say they itch. Most of these patients describe the itchy feeling as burning and painful.
- About 30% of patients with psoriasis have a mother, father, or sibling with the same condition, and this gives us the idea that psoriasis has a genetic component.
- Psoriasis is not a contagious disease. It does not spread from one person to another through physical or even sexual contact.
Is psoriasis itchy?
Yes, psoriasis is itchy. According to the National Psoriasis Foundation (NPF), nearly 90% of all psoriatic patients say they itch. Most of these patients describe the itchy feeling as burning and painful. The itching can be so severe that it ruins one’s sleep. In psoriasis, dysfunction in your immune system causes the skin cells to divide rapidly. Too many skin cells are produced so that the dead cells move to the surface of the skin and give it a silver scaly appearance. The skin also appears to be red and inflamed. This scaly and inflamed skin makes you itch.
Itchiness makes you want to scratch that area. Yet scratching will only increase the inflammation and make the condition worse. It could also lead to bleeding. As it worsens, it makes you want to itch more. The itchiness of psoriasis may also be triggered by stress. Stress leads to psoriasis flare-ups and therefore will eventually lead to bouts of itching.
Is psoriasis genetic?
About 30% of patients with psoriasis have a mother, father, or sibling with the same condition, and this gives us the idea that psoriasis has a genetic component. However, genes alone do not decide whether a person will develop psoriasis or not. Environment factors also play a big role here. Some people are at a high risk of developing psoriasis and this is mainly because these people carry a particular gene that predisposes them to psoriasis.
Not just one gene is involved in psoriasis. It is not that simple. Scientists have identified that there are nearly 25 genes that contribute to the pathogenesis of the disease. A few of these genes have been identified and out of the few, some of these genes belong to a family known as interleukins. Interleukins play an important role in the immune system. Our immune system aims to destroy all the foreign invaders that enter our body. Communication between the cells of our immune system is done by the interleukins. Researchers have found that in a person with psoriasis, these genes work more than necessary, thus resulting in increased communication and therefore an exaggerated immune response. This gives rise to the signs and symptoms of psoriasis. Apart from that, the immune cells mistakenly start to attack our own cells and contribute to the clinical features of psoriasis. Because of this reason, psoriasis is called an autoimmune disease.
So yes, psoriasis is a genetic condition that can be passed down to succeeding generations, but it is complex to understand.
Does psoriasis spread from one person to another?
Psoriasis is not a contagious disease. It does not spread from one person to another through physical or even sexual contact. However, psoriasis can spread throughout the body.
Other factors that may increase the spread of the infection are the use of harsh medications, very dry skin, and an unhealthy diet.
You can prevent the spread of the disease to other areas by avoiding the triggering factors mentioned above. Maintaining a healthy diet, keeping the skin clean and moist, avoiding harsh medications, and avoiding scratching the lesions will help you prevent infection and therefore the spread of the disease from one area of the skin to another.
Is psoriasis an autoimmune disease?
Yes, psoriasis is an autoimmune disease. This means that psoriasis is due to the overactivity of our immune system. But how does the immune system that is normally designed to destroy the foreign invaders damage our own body? The word autoimmunity itself gives the answer. Autoimmunity is when the immune system starts attacking our normal cells, hence giving rise to signs and symptoms. It is similar to an allergic reaction.
In psoriasis, the immune system is overactive and therefore starts to attack the body's own cells, especially those of the skin and joints. Much research has been carried out to identify the factors that make the immune system mistakenly identify self-antigens. One of the explanations that researchers found was that bacteria such as streptococci can trigger the onset of guttate psoriasis. Antimicrobial peptides may also trigger an autoimmune response and give rise to the features of psoriasis. Moreover, genes that belong to the interleukin family will also make your immune system overly active and lead to autoimmunity as a result.
Is psoriasis curable?
No, psoriasis is not a curable condition. However, people can go into periods of remission every now and then, and during these periods, they will not show any signs and symptoms of psoriasis. Although it cannot be completely cured, the disease can be controlled with the help of medication and lifestyle modification. There are many different treatment options available that are effective in controlling the disease. The treatment that best suits you will depend on the type of psoriasis you have, the severity of the disease, and the amount of skin involved.
For mild cases where only less than 10% of the body surface area is involved, your dermatologist may advise topical treatments only. Occasionally, a steroid injection to the areas of resistant plaques may be needed.
For moderate and severe cases, where more than 10% of the body surface area is involved, topical treatment might not be considered practical. In this case, oral medications and injections could be required. However, oral drugs and injections have more side effects compared with topical treatments. Moderate to severe cases of psoriasis are can also be managed with light therapy.
In a nutshell, treatment for psoriasis can be classified into topical drugs, light therapy, and systemic medications, and depend on severity.
Topical treatment
These are medications that are available in the form of creams or lotions. The topical treatment for psoriasis includes topical corticosteroids, vitamin D analogues, calcineurin inhibitors, salicylic acid, coal tar, and moisturizers.
Light therapy or phototherapy
As you can tell from its name, this type of therapy uses natural or artificial UV light. The simplest and easiest form of light therapy is exposure to sunlight. Other forms of light therapy are ultraviolet B phototherapy, narrowband ultraviolet B therapy, Goeckerman therapy, and excimer laser.
Oral or injected drugs
Oral or injected drugs are recommended if your condition is very severe and does not respond to other types of medications. Some commonly used oral medications are retinoids, methotrexate, and cycloporins.
What is the cause of psoriasis?
The exact cause of psoriasis is not known. However, what we know is that psoriasis is a result of two main factors. They are genetics and the immune system.
The immune system – What happens in psoriasis is that T cells, cells of a special type that are involved in the immune response, begin to mistakenly attack the skin cells. This leads to the production of new skin cells at a much faster rate. This results in the formation of plaques on the surface of your skin.
Genetics – Some people may inherit certain genes that make them more susceptible to developing psoriasis. If you have a close family member with psoriasis, an immediate family member especially, the risk of developing it is higher.
What are some natural remedies for psoriasis?
Before you use the following natural remedies, speak with your doctor as some of these remedies may cause dangerous interactions with the medications you are using.
- Aloe vera – This gel can be applied on the affected areas up to 3 times a day. Research has shown that applying aloe vera reduces the redness and scaling of skin associated with psoriasis.
- Oats – Although there is no scientific evidence to show that oats help in alleviating the signs and symptoms of psoriasis, many people who have tried applying oat paste or bathing in water with oats have found that they provide some relief from the itchiness and redness associated with psoriasis.
- Dead sea salt or Epsom salts – Soaking yourself in a warm tub of water mixed with Dead Sea salt or Epsom salts for about 15 minutes helps reduce the scaling and itchiness associated with psoriasis.
- Turmeric – Turmeric is a well-known natural ingredient that possesses powerful anti-inflammatory and antioxidant properties. Also, turmeric has the ability to alter the expression of TNF cytokine which is the most likely reason why turmeric helps reduce the flare-ups of psoriasis and psoriatic arthritis in some patients.
- Tea tree oil – Tea tree oil possesses antiseptic properties that help with psoriasis. Some patients with scalp psoriasis have reported that they benefit from shampoos that have tea tree oil as an ingredient.
What is psoriasis of the scalp?
Psoriasis of the scalp is a common psoriatic skin condition that is characterized by raised, erythematous, scaly patches on your scalp. It may appear as just a single patch or several patches that may affect the entire scalp. These lesions may also spread to the forehead, back of the neck, or behind the ears.
Just like any other type of psoriasis, scalp psoriasis is not a contagious disease. It is not something you can catch from an infected person through contact or sexual intercourse.
The severity of psoriasis of the scalp may vary from mild to severe. The mildest cases may even be unnoticeable, whereas the severe cases of scalp psoriasis may produce thick sores and lesions that may last for a long time. Scalp psoriasis is also very itchy and therefore can disrupt your sleep, and the intense scratching may lead to skin infections and loss of hair.
What is plaque psoriasis?
Plaque psoriasis is the most common type of psoriasis. It presents as raised, erythematous patches that are covered with silvery scales. It is also associated with pain and intense itchiness. If you scratch these lesions, they can crack and lead to bleeding, and at the same time, scratching will increase the risk of these lesions getting infected. The scalp, knees, elbows, and lower back are the areas commonly affected by this condition. Topical treatments with or without steroids is the first-line therapy for plaque psoriasis. These slow down the production of skin cells and reduce the inflammation. Phototherapy and systemic drugs are the other treatment options available for plaque psoriasis. The treatment that suits you best will depend on the severity of your condition and the surface area affected by the disease. Your dermatologist will decide on the treatment that will work for you.
What is guttate psoriasis?
Guttate psoriasis is different from plaque psoriasis. This type of psoriasis appears as small, salmon pink dots on the surface of the skin. These lesions are also itchy. Just like plaque psoriasis, guttate psoriasis is not contagious, which means that you cannot catch it from someone else. The trunk, arms, and legs are usually the parts affected by guttate psoriasis.
Unlike plaque psoriasis, guttate psoriasis is very uncommon. Guttate psoriasis is seen in only less than 2% of psoriatic patients. As far as age groups is concerned, children and adults who are less than 30 years old are more likely than other age groups to develop this type of psoriasis. Both males and females are equally affected.
Guttate psoriasis is also due to an immune reaction and may be triggered by a past streptococcal or other type of infection. Although the triggering factors are different, the cause behind guttate psoriasis is similar to that of plaque psoriasis.
