What Is Psoriasis & Treatment Options


What Is Psoriasis & Treatment Options…

Source: Dept. of Veteran Affairs


Psoriasis is a chronic inflammatory skin disease that is characterized by thick, raised, bright red and pink plaques with a silvery scale. The most common form is plaque psoriasis, which typically involves the scalp, elbows, knees, and back. It is estimated to affect between 1% and 8.5% of adults worldwide and becomes more common with increased distance from the equator. In the United Sates, it affects about 2% of the population. Psoriasis is much less commonly seen in children. The onset of psoriasis peaks in the fourth decade and again between the ages of 50 and 69.


Psoriasis is generally regarded as a disorder of the immune system that leads to the production of proinflammatory cytokines and overproduction and abnormal maturation of the outer layer of skin cells. While genetics plays a big role in the development of psoriasis, behavioral and environmental factors clearly influence the course of the disease. Infections, stress, trauma, and certain medications are known to initiate or worsen flares in people who have a genetic predisposition to developing psoriasis.


Additionally, smoking is clearly implicated in the onset and severity of psoriasis, with the incidence of psoriasis decreasing after successful smoking cessation. Psoriasis has been linked with higher body mass index and increased alcohol intake as well. Finally, some medications are known to worsen psoriasis. These include lithium, beta-blockers, antimalarials, interferon, and rapid tapers of systemic corticosteroids.

Psoriasis is associated with several comorbidities including arthritis (psoriatic arthritis), cardiovascular disease, depression, diabetes, and metabolic syndrome, and nonmelanoma skin cancer. It is important to screen for these and address them when present.


Skin Care

Gentle skin care can help minimize itching and limit trauma-induced flares. Bathing in lukewarm water using non-detergent-based cleansers such as soap less cleansers or glycerin-based soaps is an important first step. Abrasive cleansing devices should be avoided because these can be traumatic to the skin and worsen psoriasis.

Finally, applying thick moisturizing creams or ointments especially while the skin is still damp will help keep psoriatic skin soft and less vulnerable to itching and trauma. Natural oils such as avocado, coconut, almond, or olive can be very helpful. Colloidal oatmeal in the form of an emollient or bath powder (such as Aveeno) can also help soothe itching and irritation from psoriasis.

Food & Drink

Healthy dietary choices are important for overall health. Anti-inflammatory or Mediterranean-style dietary approaches have been found to enhance many aspects of health especially in the setting of inflammatory diseases.

Psoriasis is an inflammatory condition and will likely improve when dietary choices better align with foods that inhibit rather than promote inflammation. Dietary studies in psoriasis are limited, but there are a few that indicate an anti-inflammatory diet contributes to less-severe disease Additionally, a plant based, anti-inflammatory approach to diet will help with the comorbidities associated with psoriasis. More information about these dietary approaches can be found in the Whole Health tool Choosing a Diet.

Diets that promote weight loss (e.g., low-calorie diets) have been found to be beneficial in overweight and obese patients with psoriasis. It is important to make sure that the specific diet followed ensures adequate nutritional intake. Involving the aid of a dietician may be helpful.

Additionally, some patients with psoriasis have experienced improvement on a gluten-free diet. Elevated markers for celiac disease (tissue transglutaminase antibodies and endomysial antibodies) have been found in some patients with psoriasis as well, and in these patients, disease severity appears to correlate with circulating levels of these markers.

Asking about family history of gluten sensitivity and about gastrointestinal symptoms of flatulence, diarrhea, and iron deficiency anemia may suggest sensitivity to gluten. Testing for these markers may help identify those patients who are most likely to benefit from a gluten-free diet. Find more information about how to eliminate gluten refers to the Whole Health tool Elimination Diets.

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