An Introduction to Psoriasis
Psoriasis is a skin disease that causes scaling and swelling.
Skin cells grow deep in the skin and slowly rise to the surface. This process is called cell turnover, and it takes about a month. With psoriasis, it can happen in just a few days because the cells rise too fast and pile up on the surface.
This disease affects 2 percent to 2.6 percent of the United States population, or between 5.8 and 7.5 million people. Anyone can get psoriasis, but it occurs more often in adults. Sometimes there is a family history of the disease. Certain genes have been linked to it, and men and women get psoriasis at about the same rate.
This condition begins in the immune system, mainly with a type of white blood cell called a T cell. T cells help protect the body against infection and disease. With psoriasis, T cells are put into action by mistake. They become so active that they set off other immune responses. This leads to swelling and fast turnover of skin cells.
People with this condition may notice that sometimes the skin gets better and sometimes it gets worse. Things that can cause your symptoms to worsen include:
- Infections
- Stress
- Changes in weather that dry the skin
- Certain medicines.
(Click Psoriasis Causes for more information about the causes of this condition.)
Most psoriasis results in patches of thick, red skin with silvery scales. These patches can itch or feel sore. They are often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. However, symptoms can also show up on other places such as fingernails, toenails, genitals, and inside the mouth.
A diagnosis is usually made by examining the area of skin that is affected. Psoriasis can be hard to diagnose because it can look like other skin diseases. The doctor might need to look at a small skin sample under a microscope.
Treatment options depend on:
- How serious the psoriasis is
- The size of the psoriasis patches
- The type of psoriasis
- How the patient reacts to certain treatments.
Treatment is sometimes administered in the "1-2-3" approach:
- Step 1 uses medication applied to the skin (topical psoriasis treatment)
- Step 2 uses light treatments (see Light Therapy for Psoriasis)
- Step 3 involves taking medication (by mouth or injection) that treats the whole immune system (called systemic therapy).
Not all treatments will work the same for everyone. Doctors may switch treatments if one doesn't work, if there is a bad reaction, or if the treatment stops working.
Topical Treatment
Psoriasis treatments (such as creams and ointments) applied right on the skin may help. Treatments can:
- Help reduce swelling and skin cell turnover
- Suppress the immune system
- Help the skin peel and unclog pores
- Reduce cell turnover and swelling.
Bath solutions and lotions may feel good, but they rarely make the skin better. They are often used along with stronger treatments.
Light Therapy
Natural ultraviolet light from the sun and artificial ultraviolet light are used to treat psoriasis. One treatment, called PUVA, uses a combination of a medication that makes skin more sensitive to light and ultraviolet A light.
Systemic Therapy
If the psoriasis is severe, doctors might prescribe medications or give it through a shot. This is called systemic treatment. Antibiotics are not used to treat psoriasis unless bacteria make the psoriasis worse.
Combination Therapy
If you choose to combine topical, light, and systemic treatments, you can often lower the doses of each. Combination therapy can also lead to better results.
(Click Psoriasis Treatment for more information about the treatment options for this condition.)
Doctors are currently learning more about psoriasis by studying:
- Genes
- New treatments that help skin not react to the immune system
- Laser light treatment on thick patches.
