Psoriasis – What is it and how can I treat it?

Today’s blog about psoriasis has been written by Gillian Kiely our pharmacy pre-registration student in Knocklyon.

We all know someone with psoriasis, even if we don’t know we do. It is a common disease of the skin that affects over 2% of the population. That means that nearly 75,000 people in this country alone suffer with it and yet many of us know so little about it and how it affects those who have it.

Psoriasis is an auto immune disease that is caused by the outer skin cells (the epidermal cells) dividing at a rate twenty times faster than they should. As a result, a build-up of cells that occurs which creates the characteristic red, scaly and itchy plaques that are associated with psoriasis.

There are a number of different types of psoriasis, plaque psoriasis is the most common and usually affects areas such as the elbows and the knees. Other types of psoriasis include guttate psoriasis, which usually appears as small red dots on the trunk of the body and the upper thighs.

It is not known exactly what causes psoriasis although there are a number of trigger factors which have been proven to set off or exacerbate the condition. These triggers include;

•Skin trauma (i.e after an operation)
•Seasonal changes (some people might only get psoriasis in the winter)
•A strep throat (this is linked to guttate psoriasis)
•Alcohol and smoking
•Stress
•Some medications (such as antimalarial tablets)
•In a small amount of people sunlight can make psoriasis worse

How is Psoriasis treated?

Unfortunately there is no cure for psoriasis, it is a chronic disease that most people will have to live with and manage for the rest of their lives. However there are cases of patients getting a bout of psoriasis once and never again.
Although there is no cure there is a number of extremely effective treatment options that are chosen based on the severity of each individual patient’s condition.

The treatments:

•Topical corticosteroids– These come as creams, ointments or lotions. They work by having an anti- inflammatory effect on the skin and also regulate the division of cells. These topical preparations are extremely useful as they have a rapid effect on the psoriasis and reduce the scaling. However they can have local side effects and cause thinning of the skin.
•Vitamin D analogues – Also come as a cream or an ointment and works by interfering with the cell division process. Dovonex – a vitamin D analogue ointment is now available without prescription for the treatment of plaque psoriasis. This will allow patients who have been previously diagnosed with plaque psoriasis to be able to treat their chronic condition without the need for frequent doctor’s visits. Also Dovonex has none of the side effects that are associated with topical steroids which is another plus.
•Light therapy – Most people with psoriasis find that their condition will improve when they have been out in the sun. This is often why many people suffer worse in the winter. However we all know the sunny days in Ireland can be few and far between so there are hospitals which provide phototherapy to patients who have been prescribed it by their dermatologist. This involves exposing your skin to controlled amounts of natural sunlight.
•Antimetabloites – in severe cases of psoriasis that is resistant to other treatment options there are oral tablets or injections that can be administered to treat the condition.

Top tips for managing your psoriasis:

I myself have suffered with psoriasis for the past five years, I have plaque psoriasis all year round and have had two moderately severe flare ups of guttate psoriasis. So here are a few of my best tips for managing psoriasis year round:
•MOISTURISE, MOISTURISE, MOISTURISE! I cannot stress this enough, even when I am wrecked and just want to climb into bed I always make time to moisturise day and night. I use greasy emollients such as silcocks base or paraffin gel on the areas which are prone to psoriasis such as my elbows and knees, then use less greasy water based moisturisers like e45 everywhere else.
•Manage your stress – This is not always possible but I know for a fact that my skin gets far worse when I’m stressed and feel rundown. So mind yourself and your skin will thank you for it!
•Eat well and exercise regularly -I know it seems obvious but psoriasis has recently been linked to obesity.
•Get as much sun as you can! If the sun is out make an effort to spend some time outside, for me the sun is best way to clear up psoriasis because there is the added bonus of getting a great tan! Of course you still need to wear a high factor sun cream; the UV rays will still have their beneficial effect.

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