Psoriasis is a common condition that appears as a lasting and scaly rash. Psoriasis on the skin can manifest as just a few spots of dandruff-like scaling, or there may be major eruptions that cover large areas. There is no cure for psoriasis but treatments can make the disease easier to live with. Our dermatologists’ aim is to manage the disease so that there is as little discomfort as possible.
Causes of Psoriasis
The cause of psoriasis is not certain, but it is thought to be related to an immune system problem. More specifically, the altered life cycle of one key cell in the body - a type of white blood cell called a T lymphocyte. These T cells normally travel throughout the body detecting and fighting off foreign substances, such as viruses or bacteria. These T-cells produce cytokines that cause the skin to regenerate faster than it can shed itself. These form a thick, scaly layer which can be itchy or painful.
Research has shown that psoriasis can be hereditary, but environmental factors are also linked to the development of the disease. Triggers that can worsen psoriasis include infections, stress, heavy alcohol consumption and certain medications.
Types of Psoriasis
There are several types of psoriasis which affect different parts of the body and have varying symptoms. Common types of psoriasis that we treat include:
This is the most common form of the disease. It causes red, dry, raised skin lesions, which are covered with silvery scaling. These may itch or be painful and can occur anywhere on the body, including inside the mouth.
This appears as red, itchy patches on the scalp, with silvery scales. The affected skin can extend beyond the hairline, and flakes of skin are often found in the hair.
This form of psoriasis mainly affects young adults and children. It is usually triggered by a bacterial infection and manifests as small, droplet-shaped sores on the trunk, arms, legs and scalp. The scaling that covers the sores is quite fine. Guttate psoriasis can sometimes go away on its own, although repeated episodes are often experienced.
Psoriasis is regularly found on fingernails and toenails. It affects the nails by causing pitting, discolouration, abnormal nail growth, and sometimes causing them to separate from the nail bed (onyccholysis).
This mainly affects the skin in the armpits, under the breasts and around the genitals. Smooth patches of red, inflamed skin are apparent, which are worsened by friction and sweating. This form of the disease can be triggered by fungal infections.
This less common form of psoriasis can manifest in widespread patches or smaller areas on your hands, fingertips or feet. Pus-filled blisters are present, which generally develop quickly. Pustular psoriasis can also cause fever, chills and diarrhoea.
This least common type of psoriasis can cover your entire body with a red rash that can burn or itch severely.
This condition not only causes inflamed, scaly skin, but also pitted, discoloured nails and swollen, painful joints. Symptoms range from mild to severe, and in serious cases can lead to deformity.
If you are experiencing symptoms of psoriasis and suspect that you have the condition, we advise that you visit a dermatologist. Often, psoriasis can cause regular discomfort and get in the way of performing routine tasks. A dermatologist can confirm whether you have the disease and can help you to manage symptoms.
Treatment of Psoriasis
The primary goal of psoriasis treatment is to stop the skin cells from building up so quickly on the skin’s surface, and to reduce scaliness. While there isn't a cure, psoriasis skin treatment can offer significant relief from symptoms including itchiness, soreness and flaking skin. Most types of psoriasis go through cycles where they flare up for a few weeks and then subside. With treatment, they can even go into complete remission.
We offer three main types of psoriasis skin treatment: topical treatments, light therapy and systemic medications.
Creams and topical ointments alone can effectively treat mild to moderate psoriasis. Treatments our skin doctors offer include:
- Topical corticosteroids;
- Vitamin D analogues;
- Topical retinoids;
- Calcineurin inhibitors;
- Salicylic acid;
- Coal tar; and
Psoriasis phototherapy uses natural or artificial ultraviolet light to reduce symptoms. It may be used alone or in combination with medications. Light therapy options include:
- UVB phototherapy;
- Narrow band UVB therapy;
- Goeckerman therapy;
- Photochemotherapy or psoralen plus ultraviolet A (PUVA); and
Oral or Injected Medication
Severe psoriasis, or cases that are resistant to other forms of treatment, may respond to oral or injected medications. They are usually used for only brief periods and alternated with other treatments. Your dermatologist may prescribe:
- Cyclosporine. Drugs that alter the immune system (biologics); and
- Other medications, such as Thioguanine and hydroxyurea