Despite being the subject of intensive research over the years, the cause of autoimmune diseases still proves elusive. One such disease is psoriasis. This autoimmune condition causes itchiness, scaliness and discomfort amongst other things. Read on to learn more about the causes, triggers, and possible treatments of psoriasis.
What is psoriasis?
Psoriasis is a chronic autoimmune disease condition characterized by itchy, discoloured, and scaly rash patches on the skin surface. According to the National Health Service (NHS), two in a hundred people have psoriasis in the UK.
Unfortunately, psoriasis has no cure, but there are medications to help attenuate the effects. The condition is considered autoimmune because part of the body’s immune system becomes overly active, fails to differentiate between self cells and foreign bodies, and then attacks the body’s normal tissues.
As a result of this chronic autoimmune reaction, the growth cycle of skin cells is sped up, resulting in thick and scaly skin regions. The typical life cycle of a skin cell is clocked at approximately a month.
However, in people with psoriasis, the time is shortened to a few days resulting in the buildup and accumulation of skin cell layers. Psoriasis is chronic which means it could cause a flare-up unexpectedly.
Unfortunately, research still hasn’t shed light on the cause of autoimmune diseases. However, it is speculated that genetics, infections, diets and exposure to chemicals might be some of the possible causes.
Common sites of psoriasis
The common sites for psoriasis are;
- Knees
- Trunk
- Elbows
- Scalp
The less commonly prone body regions are;
- Mouth
- Hand
- Feet
- Nails
- Neck
- Genital areas
Symptoms of psoriasis
Psoriasis-afflicted individuals find it hard to sleep, concentrate and wear certain outfits because of the inflammation and pain associated with the condition. Chronic disease tends to surface in cycles. For weeks or months, the condition flares before abating for a while. The scales appear grey, brown or purplish on darker skin tones, but typically as whitish, with red swollen patches. Occasionally, these patches might crack and bleed.
Types of psoriasis
Here are the different types of psoriasis;
Plaque psoriasis
This is the most common form of psoriasis, also called psoriasis Vulgaris. About eighty to ninety per cent (80-90%) of psoriasis-afflicted individuals have this type, as stated by the American academy of dermatology (AAD). Characteristically, this form causes dry, itchy, elevated patches covered with scales. These said patches appear red and swollen on lighter skin tones and as greyish, brown or purple discolourations on skin of colour.
This type of psoriasis commonly occurs in certain sites; elbows, lower back, knees, and scalp. This form is responsible for what is known as psoriasis on the scalp. There could either be a few of the patches or many. After possibly healing, the skin might show some temporary colour change, referred to as post-inflammatory hyperpigmentation. This change Is mainly observed in black and brown skin tones.
Guttate psoriasis
Guttate psoriasis is another type of psoriasis. This form majorly affects children and young adults. This type of psoriasis is characterized by small pink, red or violet spots. The common sites include the trunk/torso, arms and legs. Unlike plaque psoriasis, the spots in guttate psoriasis are rarely thickened or elevated.
Common triggers include; stress, bacterial infections like strep throat, tonsillitis, skin trauma via injury, and anti-malarial and beta-blocker medications.
Pustular psoriasis
Unlike Guttate psoriasis, this form is commonly observed in adults. Pustular psoriasis is characterized by pus-filled pustules and red or violet scaly skin with inflammations. When observed, this form is seen localized to sites like the palms and soles, but sometimes, it can also be observed in some other parts of the body.
Inverse psoriasis
The inverse psoriasis is seen as smooth lesions primarily affecting skin folds. These lesions sometimes worsen due to friction and sweating in these skinfold areas. Common sites of inverse psoriasis include the armpits, breasts, buttocks, and genital areas. Triggers include fungal infection of these skin folds.
Erythrodermic psoriasis
This form of psoriasis is very rare and the least common type. Erythrodermic psoriasis is characterized by a fiery, shedding rash that burns, itches, and hurts excruciatingly. When observed, the skin looks like it’s been sunburned, and the scales shed and fall off in sheets. Afflicted people may run a fever and eventually become sick with this form.
This psoriasis type is life-threatening, so it’s advised to seek medical help from a professional immediately. It is typically widespread on the skin- it can cover large body areas at once. Triggers include severe sunburns, use of specific meds, infections and halting some psoriasis treatment regimens.
How does one get psoriasis?
There are no scientific conclusions regarding the cause of psoriasis. However, researchers believe the two key factors are genetics and the immune system.
Genetics
Some people inherit genes that make them more susceptible to psoriasis. For instance, if one of the parents has psoriasis, the susceptibility rate is high. Likewise, if both parents have psoriasis, the susceptibility is even higher.
Immune system
An autoimmune effect results from the white blood cells known as “T cells” fighting skin cells. To compensate for dead skin cells, skin cell proliferation goes into overdrive, and more cells are produced at alarming rates. The growth cycle is also sped up, resulting in multiple layers of mature skin cells referred to as the plaques.
It’s important to note that psoriasis is not contagious. Many assume that contact with an afflicted person could cause infection, but the notion is wrong even with contact with a psoriatic lesion. Anyone from any race, age or gender can get the disease as it’s an autoimmune condition
Triggers of psoriasis
Certain factors trigger the condition in individuals with a latent propensity to psoriasis.
These factors vary from person to person and might even change for an individual. During periods when psoriasis subsides or hasn’t surfaced initially, these triggers could start new episodes of the condition. These trigger factors include the following;
- Skin injuries like cuts and scrapes
- Surgery
- Emotional stress
- Smoking
- Hormones
- Strep infections
- Alcohol
- Infections
- Cold and dry weather
- Excess sun
- Certain food and nutrients
- Obesity
- Medications, such as blood pressure meds, antibiotics, anti-malarial drugs, Non-steroidal anti-inflammatory drugs, NSAIDs
How to cure psoriasis permanently
Unfortunately, there is no cure for psoriasis. For some, the condition clears off after some time; for others, it could be lifelong. The best you can hope to do to prevent an outbreak is to learn about your psoriasis triggers and plan toward avoiding them.
Psoriasis treatment
There are numerous treatment methods to help manage psoriasis. These treatments depend on the type of psoriasis and the doctor’s diagnosis. You must seek professional medical consultation to assess the situation appropriately.
According to Dr Nina Bal of Facial Sculpting Clinic, certain things need to be examined. Considering the size and location of the rash, severity, age, and overall health condition of the person, among others, are crucial to an effective treatment.
Based on the consultation, a decision will be made on the type, combination if needed, and treatment time frame. The treatment aims to reduce inflammation, remove plaques, reduce scales and slow the growth of skin cells.
There are three categories of treatment that may be recommended ;
- Topical treatment
Topical treatment involves creams and ointments applied directly to the skin to reduce mild to moderate psoriasis. Examples of topical treatment include corticosteroids, retinoids, salicylic acid, moisturizer, anthralin, and vitamin D analogues.
Topical retinoid is a derivative of vitamin A. The function is to slow the proliferation of skin cells in psoriasis patients. To apply, dab each lesion with a bit of topical retinoid once every night before bed. This gel is often combined with steroid treatments.
- Salicylic acid
Salicylic acid is a very potent Beta Hydroxy Acid (BHA). This gel dissolves the scales on the skin, making them accessible and quick to brush or wash off. Salicylic acid makes absorption of other topical medications into the skin possible.
- Systemic
This category works best to treat cases of moderate to severe psoriasis. The systemic class involves oral and injectable medications when topical applications prove unresponsive. This treatment is done for a short period to avoid the side effects of systemic drugs. Examples of this include oral retinoids, cyclosporine, and methotrexate.
- Light therapy
Light therapy involves the use of ultraviolet rays or natural light. The aim is to kill the hyperactive white blood cells destroying the healthy skin cells and reducing rapid cell proliferation.
FAQs on psoriasis
Generally, psoriasis isn’t life-threatening. But the rare type, erythrodermic psoriasis, can lead to fever, shivering, fluid retention and illness. It can increase the risks of pneumonia, heart failure and comorbidities such as stroke.
No, psoriasis is not contagious by touch. The disease is an autoimmune or genetic disorder, so an uninfected person can’t contact it by touch. That being said, members of the same family could individually develop psoriasis, appearing as though it was contacted.
No, psoriasis is not sexually transmitted. Dry, itchy, scaly lesions caused by psoriasis result from the hyperactive proliferation of skin cells. Psoriasis isn’t a result of viruses, bacteria, or fungi. So, you can’t contact it via sex.
Psoriasis is not curable. But managing the triggers helps keep the condition in check. It would be best to find out what triggers affect you specifically and how to avoid them. While avoiding all triggers might not be possible, actively staying conscious of them is an excellent place to start. Avoiding the triggers will keep the next psoriasis flare-up at bay.
No, psoriasis isn’t contagious through kissing. The disease isn’t viral, fungal or bacterial.
Research has shown that genetics is a crucial factor contributing to the risk of having psoriasis. If one of your parents has psoriasis, you have a high chance of having the autoimmune disease. The disease’s risk is even higher when both parents have psoriasis. So yes, psoriasis could be genetic. Offsprings from parents who have had psoriasis are potentially susceptible.
No amount of touching can spread psoriasis. It’s an autoimmune condition. You’d have to have a skin disorder to get the disease.
No, psoriasis is not infectious.
Scratching a psoriasis rash or lesion does not cause it to spread across locations. However, it might slow the healing process, creating the appearance that psoriasis is flaring.
Conclusion
Psoriasis is a chronic autoimmune condition. This condition can only be transferred potentially via genetic inheritance. Psoriasis can’t be transmitted via contact or sex. Unfortunately, there is no cure for this condition, but proper management of the triggers will reduce psoriasis flare-ups to a minimum. Dr Nina Bal is an expert at helping patients to manage such conditions. Book a consultation with her to know your psoriasis triggers and management measures.
Read also: Sunburn Remedies and Rosacea Triggers and Prevention
