What is Psoriasis?
Psoriasis is an inflammatory skin disease characterised by an increased rate of skin cell turnover, resulting in thick scales appearing on the skin. The affected skin becomes dry and scaly. Itching is often experienced in our hot and humid climate.
As part of our skin, nails also show changes like “pitting” of their surface in up to 50% of people with psoriasis. Joint pain and swelling are seen in 5-40% of those with more extensive psoriasis.
What treatment modalities are available for Psoriasis?
Topical Creams/Ointments/Scalp Solutions
Most people with psoriasis have mild disease and get considerable relief with topical applications. These include topical steroids, coal tar and nonsteroidal vitamin D3 derivatives e.g. calcipotriol and calcitriol. For the face, hairline and groin areas, mild steroid or calcitriol creams can be used.
Phototherapy
Psoriasis responds to ultraviolet (UV) light treatment. Ultraviolet light, either UVB or UVA have been found to be effective in clearing psoriasis if used in gradually increasing doses over a period of several months. UVA is usually given with psoralens to enhance the effect of phototherapy (PUVA).
Oral Drugs
Your dermatologist may prescribe oral medications when psoriasis does not respond to topicals and phototherapy. Examples of such drugs include methotrexate, cyclosporin, acitretin and hydroxyurea. Unfortunately, these drugs can sometimes cause severe side effects. Patients who are taking such drugs will require regular blood tests to detect side effects e.g. liver damage, bone marrow damage, etc.
Biologics
These are drugs which help to control extensive disease when other treatments have failed. Biologics have to be administered via injection just under the skin or into a vein. They work by balancing the immune system in the skin. As these are powerful drugs, side effects can occur and patients need regular blood test monitoring.
Is there a quick cure for Psoriasis?
No, but your doctor should be able to help you control your psoriasis. Oral or injected steroid treatment is best avoided because although it helps to clear psoriasis fast, it may result in a quick and severe rebound of psoriasis. But remember, psoriasis can be controlled with appropriate treatment.
How we can handle Psoriasis?
Do's
- Do use treatments regularly as directed.
- Do keep skin well moisturised as this will help reduce itching and scaling.
- Do have healthy lifestyle habits, eat in moderation, exercise regularly and manage your stress levels.
- Do regular health screening as obesity, diabetes, high blood pressure and cholesterol problems are more common in psoriasis.
- Do remember that the sun may help psoriasis but be careful not to get sunburnt.
- Do monitor for any joint pain or swelling as a proportion of patients also have psoriasis involving the joints (psoriatic arthritis).
Don't's
- Don't scratch the plaques as this may damage the skin and actually worsen psoriasis.
- Don't give up treatments too soon as it may take a few weeks for some of them to work.
- Don't allow yourself to have too many thoughts of self-pity or sadness. Don't distance yourself from your loved ones. Learn to accept it as part and parcel of life.
