What is Psoriasis and Treatment for Psoriasis

This affects about two per cent of the population. It can start as early as the age of seven, seems worst during early adulthood but can start at almost any time of adult life. A patient of mine once complained that she had dandruff of the elbow and her description was remarkably accurate: psoriasis does look like dandruff. The skin is usually white and flaky and small dusty scales come off the skin's surface at the slightest touch.

Just why psoriasis develops is still something of a mystery. Under normal circumstances the skin is continually producing new cells to replace old ones. In psoriasis the skin produces new cells far too quickly with the result that older cells are pushed off the surface at an unusually rapid rate, prematurely exposing the pink, still raw layer of newly formed, young replacement cells.

Although we don't know why psoriasis develops we do know that it can be triggered by severe accidents, general infections or stress. Someone who already has psoriasis will almost always find it worsens when they are worried.

Psoriasis is not contagious but it can be inherited, and the likelihood increases with the number of close relatives who have the disease. If one parent is a sufferer then the chances of a child having psoriasis are about one in ten. If both parents have psoriasis, the chances of a child becoming a sufferer are more likely to be fifty-fifty.

The patches of white scaly skin which make up psoriasis (known as psoriatic plaques) may be only the size of a small coin or larger than palm size. These patches can occur anywhere on the body but most commonly on the knees and elbows or on the scalp. (Incidentally, although there is a resemblance between dandruff and psoriasis the two conditions are not the same and there is no link between the two.)

It is possible to get psoriasis on the palms of the hands, on the soles of the feet and on the face. In about ten per cent of sufferers there is also some joint involvement, with sufferers complaining of a type of arthritis. Although officially called psoriatic arthritis this is very similar to rheumatoid arthritis, most commonly affecting the joints of the hands and feet.

About a third of all psoriasis sufferers show signs of it on their finger or toe nails - the precise symptoms vary but there can be pitting of the nails, discoloration and thickening. Sometimes the condition is mistaken for a fungal infection.


Treatment for Psoriasis

Because the cause of psoriasis is still something of a mystery the treatment is a bit of a problem too. It is known that psoriatic patches tend to improve when the sufferer relaxes or goes on holiday - and it is now also clear that, whereas psoriasis is made worse by extremes of heat and cold, it can be quite dramatically improved by some pleasant sunshine.

Among the most useful prescribed remedies are PUVA, dithranol (a synthetic substance available as a cream or ointment which inhibits the production of new cells in the outermost layer of skin), various tars (rather messy, unpleasant and unpopular) and a vitamin A deriva­tive. Steroid creams used to be popular for the treatment of psoriasis but most dermatologists now believe that they are not suitable for this purpose because psoriasis is an incurable disease and may go on for many years, and continued treatment with steroid creams can cause other severe skin problems. Nevertheless, steroids are used for short-term treatment where psoriasis has resisted other forms of treatment.

Psoriasis does not kill but it can cause great distress. There are, around the world, some excellent organizations for sufferers from the disease and I suggest that anyone with the problem join their nearest association. They will, in this way, obtain encouragement and support from fellow sufferers as well as new information about the disease as it becomes available. Your doctor will know the relevant address.