Psoriasis is a noncontagious but persistent skin disorder that occurs when the normal cycle of skin cell growth and replacement is disrupted. Normally, new skin cells rise from the deepest layer of skin to the top layer—the epidermis—and replace dead skin cells, which are shed. This process ordinarily takes about 28 days. In areas marked by psoriasis, the process has been accelerated, taking place in only three or four days—and as a result excess cells accumulate, causing the characteristic scaly patches.
Eruptions of psoriasis tend to peak in two different age groups: people ages 30 to 39 and those between the ages of 50 and 69. The rashes can increase and decrease in severity, often for no apparent reason, although they are often more severe during the winter (perhaps because of drier air) and prolonged periods indoors. Psoriasis cannot be cured, and it can be painful and unpleasant to live with, especially in severe cases when skin can crack and blister and nails may become pitted and deformed.
Symptoms of psoriasis
- Distinct rash-like patches of dry, reddened, raised and inflamed skin with white flaking scales (usually appearing on the scalp, lower back, elbows, knees, or knuckles)
- In severe cases cracked and blistered skin, often painful and disfiguring
- In some severe cases pitted, crumbly, and loosened fingernails
- May be associated with arthritis
What causes psoriasis?
No one knows what causes psoriasis. Strong evidence points to a genetic component (40 percent of patients have a family history of the condition).There are several things that can increase the risk for psoriasis or make symptoms worse. These include alcohol, smoking, obesity, stress, a recent bacterial or viral infection, anxiety, certain medications, sunburn, and possibly vitamin D deficiency. There is, however, no conclusive link between diet and psoriasis.
Psoriasis also increases the risk for numerous conditions, including some types of arthritis, eye disorders, metabolic syndrome, and inflammatory bowel disease.
What if you do nothing?
There is no cure for psoriasis. Since this chronic ailment is often painful and unpleasant to live with, some medical treatment is generally necessary to relieve the symptoms.
Home remedies for psoriasis
Psoriasis is not curable, but it can be controlled. It’s best to consult a doctor initially. The following home remedies can complement any treatments your doctor recommends. Only trial and error will determine which treatments are most effective for you. Improvement can take a few weeks or as long as several months.
- Get some sun. Most people should guard against too much exposure to the sun. But to minimize the effects of psoriasis, regular sunbathing offers some benefit. Proceed cautiously, staying in direct sunlight for 15 to 30 minutes a day. About 80 percent of people with psoriasis will see improvement in three to six weeks. Since sunburn on healthy unaffected areas of skin can aggravate the psoriasis or make it resistant to future treatment, apply sunscreen to those areas a half hour before sunbathing. Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15.
- Moisturize your skin. Apply moisturizing skin creams liberally to your skin to keep it moist and less likely to crack. Avoid alcohol-based preparations, which can dry the skin; also avoid lanolin-based products if you are allergic to lanolin. When used regularly, petroleum jelly or thick emollient creamscan keep the skin from drying. In general, use fragrance-free products.
- Take a soak. Special bath solutions containing either oatmeal, various oils, or Epsom salts may offer symptomatic relief for psoriasis. Soak for 15 minutes in warm bathwater to soothe the skin and encourage healing. Moisturize when you get out.
- Remove skin scales. Nonprescription creams and ointments that contain salicylic acid, lactic acid, or urea can help to soften and remove scales. Coal tar gels, also available in the pharmacy without prescription, can slow down the rate at which skin cells are produced, thereby improving psoriasis. Some coal tar products can be irritating to the skin, so test it on a small area first. Also, coal tar can make your skin more sensitive to sunlight, so be sure to wash it off before going out in the sun.
- Get some scalp relief. For psoriasis plaques on the scalp, a special softening gel that contains salicylic acid is available over the counter. Apply it to the scalp at night according to directions, and wash it out in the morning with a medicated dandruff shampoo.
- Be careful with your hair. When combing your hair, don’t comb too vigorously. Any time you scratch or scrape your scalp with a comb or brush, you increase the risk of having psoriasis come back worse than before.
- Avoid scratching. If you have an itch and feel like scratching, reach for moisturizer instead.
- Consider an OTC topical corticosteroid, such as hydrocortisone, which may help relieve itching. But discuss it with your doctor first because frequent and long-term use may create other problems.
- Reduce stress in your life. If stress makes your psoriasis worse, take steps to reduce it. Stress reduction exercises such as yoga, biofeedback, or meditation may work well for you.
Can psoriasis be prevented?
There is no way to prevent psoriasis. However, avoiding alcoholic beverages and minimizing your exposure to cold temperatures, preventing skin injuries, and reducing stress may prevent any psoriasis flare-ups.
When to call your doctor
Psoriasis may be confused with seborrhea or atopic dermatitis. Certain types of skin cancer may also look like psoriasis. For this reason contact your physician, who will make the correct diagnosis and prescribe the proper course of treatment. Also contact your doctor if psoriasis symptoms fail to respond to self-treatment.
What your doctor will do
After taking a complete history and performing a skin examination, your physician may prescribe corticosteroids or other medications to control and alleviate your symptoms. Many new drugs are being developed for treating psoriasis; your dermatologist should know which ones might be of benefit to you. Note that psoriasis can cause or exacerbate depression and other mental health conditions. So you may want to discuss whether you could benefit from counseling or, if needed, antidepressant medications.
For more information
Also see Dry Skin: Causes and Treatments.