Psoriasis is a skin condition many may have heard about from TV ads promoting prescription drugs. However, there are several ways to treat the disease, and the medications that are typically advertised are often the last in a line of treatments used by those with the condition.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, psoriasis is a skin disease that results in scaling and inflammation. It’s often associated with pain, swelling, heat and redness.
It’s a condition that affects about 2 percent of the population, according to Dr. Mona Mofid, a dermatologist at Sharp Grossmont Hospital in La Mesa, and there are many forms of the disease. The condition is chronic, and while she said there’s no cure, it’s something patients and doctors work to keep under control.
The most common form, she said, is plaque psoriasis, which generally affects the skin around joints such as the elbows and knees. It’s often marked by large, scaly, silvery patches that itch.
Other forms, such as inverse psoriasis, often target the folds of the skin, including the groin, armpits and under the breasts. Some forms of psoriasis are found on the face and scalp, creating a form of “dandruff on the face,” while other types affect the whole body and can be life-threatening.
While the cause of the disease is unknown, Mofid said different genes are being examined to pinpoint its origin. She likens the skin cells of those with psoriasis to being “on overdrive basically.” According to WebMD.com, the cells mature about five times faster than cells in normal skin.
“And unlike normal skin cells, which naturally slough off, these cells pile up on the skin’s surface almost faster than snow on a snowdrift,” according to the website.
Although the cause of the disease is unclear, Mofid said there are known triggers for psoriasis, mainly stress. She said stress that causes the disease to flare up can come in many forms. There’s emotional stress — everything from work or money issues to life-altering events such as death or divorce — and there’s also physical stress, She said something that physically taxes the body, like getting the flu, breaking a leg, even banging an elbow into a desk at work, can cause the disease to make its presence known.
“There’s often a trigger for psoriasis,” she said. “Something turns it on. Psoriasis loves elbows, knees and shins. It will flare with trauma.”
She added that alcohol use, smoking and obesity have been shown to inflame psoriasis.
Just as there are many forms of the disease, there are also many options for controlling it. Mofid said many patients try topical vitamin D ointments that are helpful. If those don’t provide relief, there are oral medications, but she said those run the risk of affecting the immune system or liver. Treatment is also available with ultraviolet light, she said, but the light can increase the risk of skin cancer and the treatment is time-consuming.
If and when other treatments fail — or if there’s joint involvement — medications such as Enbrel and Humira can be prescribed. But Mofid said the treatment can be costly and insurance typically won’t cover it unless other treatments have been exhausted first.
In addition to traditional treatment, she said some patients have success coupling what their doctor gives them with over-the-counter lotions containing ceramides, which she said helps “make better skin.” And she said those who use pure coconut or olive oils on their skin or adhere to diets rich in fruits and vegetables are better able to control the disease.
For the most part, she said, those who “make certain lifestyle changes and are diligent with topical treatment,” are able to live normally with psoriasis.
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