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Skin Health: Psoriasis: Understanding Psoriasis  Previous Next

Understanding Psoriasis

by: Amy Otis, RN

Understanding Psoriasis

Psoriasis is a chronic, non-contagious skin disorder characterized by sudden or gradual development of reddened, thick, itchy patches of silvery scales (raised layers of dead skin flakes) usually in the elbows, knees, scalp, hands, trunk and or nails.  The skin may blister or have pustules (small, raised, and pus-filled). The nails may show pitting (small punched-out areas) and the joints may be painful. The most common causes are immune system disorder and hereditary. Psoriasis affects over seven million people in the United States alone.
In a "normal" person, new skin cells gradually move from lower layers to the surface in about a month's time, but if you have psoriasis the process speeds up to a few days -- which results in piling up of dead skin cells (scales) in patches.
There is evidence of genetic factors which may cause a person to get psoriasis and a strong family history in psoriasis sufferers. Your doctor may consult with a dermatologist or send you to see one.
A dermatologist might scrape some small areas of your lesions and look at them under a microscope. A biopsy (taking a small piece) of the patch is rarely needed for diagnosis and is often done to rule out other possible causes. Psoriasis can occur at any age but is more common between the ages of 15 to 60.
Factors that can initiate a flare up of psoriasis include:
1. Local injury or irritation to the skin (sunburn, insect bites, burns, and rashes)
2. Hormonal changes
3. Certain medications
4. Stress -- emotional or physical
5. Alcohol abuse
6. Obesity
7. Infections -- e.g., strep throat infections or mononucleosis
8. Viral infections such as HIV
9. Weakened (e.g., in AIDS, cancer) or overactive immune system (as in autoimmune diseases like rheumatoid arthritis)
10. Cold climates
11. Lack of sunlight
12. Increased blood uric acid levels in some patients.

In addition to following your health care provider’s orders, there is a lot that you can do on your own to help control and prevent flare-ups of psoriasis.
Use moisturizing lotions. Psoriasis symptoms get worse when your skin is dry, so keep it moist with creams and lotions. Thick and oily moisturizers are often the best, since they're good at trapping moisture beneath the skin. Moisturizers are also useful for removing scales.
Take care of your skin and scalp. People with psoriasis should always be careful with their skin. Never pick at lesions or scales, since that can just make your psoriasis worse.
Avoid dry, cold weather. Climate can have a big effect on psoriasis. For a lot of people, cold and dry weather can make the symptoms of psoriasis worse. In general, hot weather is better for people with psoriasis, although some have worsening symptoms when the heat and humidity rise. The sun may actually help some cases of psoriasis.

Use a humidifier during the dry seasons or in the winter when the heat is on. Keeping your skin moist is important.

Avoid medications that cause flare-ups. Tell your doctor all the medications you take, and ask if any could affect your psoriasis.

Get some sun, but not too much. Because ultraviolet rays in sunlight slow the growth of skin cells, getting moderate doses of sun is a good idea. However, make sure they're brief -- about 20 minutes or so. Use sunscreen if you're out in the sun for any longer period of time. Remember that sunburn can make your psoriasis worse, and too much sun raises your risk of skin cancer. If you're on medication that makes your skin more sensitive to ultraviolet rays as part of your phototherapy, ask your doctor about whether you should always use sunscreen when outside.

Decrease stress. Easy to say, harder to do.

AVOID drinking alcohol. The connection between alcohol and psoriasis isn't completely clear, but many people and health care providers are convinced that alcohol can worsen psoriasis.

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