Psoriasis affects everyone differently and can come in many shapes, sizes, forms and types. Treatments which help some can be ineffective for others. Not only this but when you search online, the advice can be so contrasting and difficult to navigate that you can be left feeling confused and alone.
We understand how you feel. It can be an emotionally and physically draining time. Not only this but the stressors involved in coming to terms with your condition can cause flare ups.
So, take a deep breath, and let us help clear the air with unbiased information about your condition and guidance on the different treatment options available to you.
WHAT IS PSORIASIS?
Psoriasis is a chronic skin condition which causes patches of your skin to become red and inflamed which can also cause dried skin patches (or scales) to flake and peel off1. It’s an autoimmune disease which means that it’s caused by your immune system mistakenly attacking the body – in this case your immune system attacks healthy skin cells2.
In a non-psoriasis sufferer, skin cells will grow and shed when they’re no longer needed. Psoriasis causes a person’s skin cells to multiply too quickly. This is where the inflamed red patches come from, it’s where these extra cells have built up2.
Around 2% of all people in the UK suffer from psoriasis in some form and it usually develops before the age of 35.
Although anyone can develop psoriasis, psoriasis runs in families as genetics plays a role in whether you’re more susceptible to the condition. Having said this, psoriasis doesn’t necessarily affect everyone within a family and scientists are unsure on how exactly genetics impacts the condition1.
Psoriasis is most commonly found around the elbows, knees and scalp, however the extent of the condition varies greatly from person to person and it’s not uncommon for patches of psoriasis to form anywhere on the body – including face, genitals, hands and feet1.
TYPES OF PSORIASIS
There are numerous different types of psoriasis and the severity of each varies from person to person. Here, we explain each type to help you understand more about your skin condition.
Plaque psoriasis, also known as psoriasis vulgaris, is the most common type with about 80% – 90% of all sufferers being diagnosed with this form of the autoimmune disease3.
Those diagnosed with plaque psoriasis usually notice thick patches of red skin with a white scaly layer above. These often appear on the knees, elbows, lower back or scalp, though these can appear anywhere on the body. The patches can itch and burn but it’s commonly accepted that scratching affected areas can worsen your symptoms3.
Guttate psoriasis is the second most common form of the skin condition, with about 8% of all sufferers diagnosed with this type of the disease3. Guttate psoriasis is defined by small red spots on the skin which usually form during childhood or young adulthood.
These spots are often small, circular in shape and separate from each other, often forming on the torso and limbs. These can also form on the face and scalp. The spots aren’t usually as thick as plaque psoriasis but over time guttate psoriasis can develop into plaque psoriasis3.
There are a number of triggers associated with guttate psoriasis, these include strep throat, stress, skin lesions or injuries, infection or even medication3.
FLEXURAL OR INVERSE PSORIASIS
Flexural or inverse psoriasis is red, shiny and smooth patches of skin which forms in skin folds, including under the breasts, armpits or groin area3.
The smoothness associated with this type of psoriasis is caused by the sweat and moisture in the skinfolds preventing the scales from appearing3. This does however make the condition very uncomfortable as skin often rubs together and aggravates the affected area. This type of psoriasis has been known to be misdiagnosed as a fungal or bacterial infection.
It’s worth noting that those who are affected by flexural or inverse psoriasis often have different forms of the condition on other areas of their body.
Pustular psoriasis is relatively rare, but can be a very uncomfortable form of the condition. This is diagnosed by pus-filled blisters appearing on the skin4. There are sub-types of this condition which affect different areas of the body.
At times, the condition can appear cyclical in nature where pustules appear and then heal. While the pustules are non-infectious, the body can display flu-like symptoms.
Erythrodermic psoriasis, or sometimes called exfoliative psoriasis, is another rare condition that is visibly comparative to severe burns. This can be a serious condition and depending on severity you may need to be hospitalised as it can lead to difficulties in the regulation of body temperature3.
The condition often affects large areas of the body and can develop from a number of conditions including:
- Large areas of uncontrolled plaque psoriasis
- Pustular psoriasis
- Alchoholism or drug abuse
- Intense stress
Nail psoriasis is not a condition on its own, but is in turn an extension of an existing psoriasis condition. This is when psoriasis affects the nails of the individual. Nails can become pitted, grooved, loose, crumbly and discoloured3. It’s not uncommon for nails to fall off when the condition is severe.
Nail psoriasis is often confused for a fungal infection however if you notice any of the above symptoms on your nails, it’s worth speaking to a dermatologist or GP about your condition so you’re not misdiagnosed. Unfortunately, there isn’t a cure for nail psoriasis but some treatments such as light therapy or oral medication can help alleviate symptoms3.
Around 30% of all sufferers of psoriasis will suffer from a condition called psoriatic arthritis. This is when the body’s immune system attacks the joints as well as the skin leading to arthritis – a painful and debilitating condition where the joints become inflamed and stiff.
There isn’t a cure for psoriasis, however there are a number of treatments which can help to alleviate your symptoms. There isn’t a one-size-fits-all treatment for psoriasis. You should take the time to talk to your GP or dermatologist about the different treatment options available for you and monitor how the different treatment options impact your skin. It may take a bit of trial and error before you settle on a treatment right for you. Here, we’ll explain a little more about the different treatments available to help you stay informed when discussing your condition5.
Topical treatments are often the first option for psoriasis sufferers. These are creams, ointments and moisturisers which can be applied to affected areas. These can come in many different forms from over-the-counter products to prescription only products.
Different types of topical treatments include:
- Emollients – reduces water loss and offers a protective cover to the affected skin
- Steroid cream and ointments – reduces inflammation and slows the production of skin cells
- Vitamin D analogues – help to slow the production of skin cells and reduces inflammation
- Calcineurin inhibitors – reduces the activity of the immune system and reduces inflammation
- Coal tar – reduces scales, inflammation and itchiness
- Dithranol – reduces the production in skin cells
Phototherapy, or light therapy, combines both natural and artificial light to help treat psoriasis. The concept is similar to sunbeds, though the light source is far healthier for your body than traditional sunbeds. Additionally, all treatment is done through the close monitoring of healthcare professionals.
Forms of light therapy include:
- Ultraviolet B (UVB) phototherapy – slows down the production of skin cells
- Psoralen plus ultraviolet A (PUVA) – slows down the production of skin cells
- Combination light therapy – a combination of the above with other treatment options
TABLETS, CAPSULES & INJECTIONS
Tablets, capsules and injections are usually used on severe psoriasis or when the condition hasn’t reacted to other treatments5. These work throughout the body and can be highly effective. The only concern with these options are the side effects involved which are worth discussing at length with your healthcare professional. Some of these treatments are not recommended if you’re planning to have a baby, are pregnant or breastfeeding.
These come in two forms, biological (often tablets or capsules) and non-biological (often injections).
Non-biological systemic treatments include:
- Methotrexate – slows down the production of skin cells and reduces inflammation
- Ciclosporin – an immunosuppressant
- Acitretin – reduces skin cell production
Biological systemic treatments include:
- Etanercept – targets overactive cells in the immune system
- Adalmumab – targets overactive cells in the immune system
- Infliximab – targets overactive cells in the immune system
- Ustekinumab – targets overactive cells in the immune system
Remember to discuss all potential side effects with your GP as these can be nasty.
PSORIASIS IS TOUGH, BUT WE’RE HERE TO HELP YOU
Living with psoriasis is difficult and it can be a drain on your physical, emotional and mental health. This is why we’re offering a variety of help and advice to get you informed and most importantly, back to living comfortably again. Keep your eyes peeled on our blog for regular guidance on coping with your skin condition – written by people like you, those who have been through this before and understand how it feels.