Understanding psoriasis: A guide to management
Written in association with:Psoriasis is a long-term skin condition characterised by red, scaly patches that can cause discomfort, itchiness, and emotional distress. It occurs when the immune system becomes persistently overactivated, speeding up the life cycle of skin cells, which then accumulate on the skin's surface. Although there is no cure, various management options can help control symptoms and improve quality of life. Dr Ramessur, a renowned consultant dermatologist with clinical and research interest in psoriasis, explores these options in this article.
What lifestyle changes can help manage psoriasis?
Making small adjustments to your daily habits can significantly reduce psoriasis flares. Keeping your skin well-moisturised is crucial to prevent dryness and cracking. Use thick creams or ointments and apply them regularly, especially after bathing.
Managing stress is another important aspect, as stress is a common trigger for psoriasis. Techniques like yoga, meditation, or regular walks can help. Additionally, avoid skin injuries such as cuts or scrapes and limit alcohol consumption to minimise flare-ups.
The role of obesity and exercise
Dr Ramessur’s research during his PhD highlighted obesity as a significant risk factor for psoriasis. Being overweight not only increases the severity of the condition but can also make treatments less effective. Losing weight through a healthy diet and regular exercise can reduce inflammation in the body and improve treatment outcomes. Exercise can also improve mental well-being, helping to manage the emotional toll of psoriasis.
How are topical treatments used?
Topical treatments, applied directly to the skin, are often the first option for mild to moderate psoriasis. These include:
- Corticosteroids: Anti-inflammatory creams that reduce redness and swelling.
- Vitamin D analogues: Calcipotriol and similar products slow excessive skin cell growth.
- Salicylic acid: Helps remove scales for smoother skin.
- Coal tar: A traditional remedy that reduces itching and inflammation.
These treatments are widely available, with stronger formulations often requiring a prescription.
Can light therapy help?
Light therapy, also known as phototherapy, involves exposing the skin to controlled doses of ultraviolet (UV) light. It slows down the rapid skin cell turnover associated with psoriasis. Two common types are:
- UVB light therapy: A common option for moderate to severe cases.
- PUVA therapy: Combines UVA light with a medication called psoralen.
Light therapy is conducted in clinical settings, typically requiring multiple weekly sessions. It’s highly effective for many but requires consistency to see results.
Are oral or injectable treatments an option?
For severe cases that don’t respond to topical treatments or light therapy, systemic treatments may be recommended:
- Oral medications:
- Methotrexate: Suppresses the immune system and reduces inflammation but requires regular monitoring.
- Acitretin: A vitamin A derivative often used for severe psoriasis affecting the hands and feet.
- JAK/ TYK inhibitors: New tablet medications that target inflammatory pathways involved in propagating.
- Biologic drugs:
Biologics such as tildrakizumab and ixekizumab are targeted treatments for immune pathways involved in psoriasis. Administered via injection or infusion, these are suitable for individuals with extensive or treatment-resistant psoriasis.
These treatments require close monitoring by a healthcare provider.
Other key considerations in psoriasis management
- Associated health risks: Psoriasis is linked to several other health conditions, including heart disease, diabetes, and depression. Maintaining a healthy lifestyle and seeking regular health screenings can help mitigate these risks.
- Psoriatic arthritis: About 1 in 4 people with psoriasis may develop psoriatic arthritis, which causes joint pain, swelling, and stiffness. Early diagnosis and management by a rheumatologist are crucial.
- Smoking and alcohol: Both smoking and excessive alcohol consumption can worsen psoriasis symptoms. Quitting smoking and moderating alcohol intake can improve overall health and potentially reduce flare-ups.
Taking control of your psoriasis
While psoriasis is a chronic condition, the combination of effective treatments and lifestyle changes can significantly improve symptoms and quality of life. If you experience new symptoms or find your current treatment is no longer effective, consult your dermatologist. Together, you can develop a personalised management plan to help you lead a fulfilling life.
If you would like to book a consultation with Dr Ramessur, do not hesitate to do so by visiting his Top Doctors profile today.
