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Psoriasis symptoms and causes

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In this article

Types of psoriasis
What causes psoriasis
Treatment for psoriasis 
How to care for psoriasis

Psoriasis is a chronic autoimmune disease, which manifests as a skin condition and typically presents itself in the form of flaky, red patches of skin, sometimes with white scales on top. Although these patches can occur anywhere on the body, the most common locations are on the back, scalp, knees or elbows. Psoriasis affects men and women equally and most people with psoriasis develop the condition before the age of 35.
The disease is not yet fully understood, but it is widely believed to have a genetic component, meaning those with a family history of the condition are more susceptible. The severity of psoriasis can vary significantly, but most sufferers will experience long term symptoms. With that said, there may be periods where many of those symptoms subside or disappear. The condition is thought to affect somewhere in the region of two percent of the population.

Types of psoriasis

There are five main types of psoriasis, as outlined below. Plaque psoriasis is by far the most common of these types, accounting for somewhere in the region of 90 percent of all psoriasis cases.

Plaque psoriasis

The most common type, plaque psoriasis is characterised by raised areas of red skin, called plaques, which often have a white or silver scaly centre.

Guttate psoriasis

Sometimes referred to as 'eruptive psoriasis', this variety manifests as many small patches of red or pink skin, often in a 'droplet' shape, covering large chunks of the body.

Inverse psoriasis

A type of psoriasis which typically presents itself as inflamed but smooth patches of skin, usually situated in skin folds, such as in the groin or navel areas, or behind the ears.

Pustular psoriasis

As the name suggests, this variety appears as patches of pustules, which are filled with pus. It can be localised, meaning it is restricted to a specific part of the body, or generalised.

Erythrodermic psoriasis

Sometimes known as psoriatic erythroderma, this is the most severe variety. It manifests as patches of inflamed skin, which affect the majority of the body.

What causes psoriasis

Research suggest that psoriasis is caused by a problem with the immune system, resulting in an abnormal production of skin cells, with cells being replaced too quickly. It is not known exactly why this occurs, but various studies have demonstrated a strong genetic link, indicating that there is a hereditary element. However, while it is likely a genetic disease, the triggering of the condition is associated with environmental factors.

Among the various lifestyle factors believed to contribute towards a person developing psoriasis, or their symptoms worsening, are: stress, smoking, excessive alcohol consumption, obesity and changes in climate or temperature. Indeed, the condition is often worse in the winter months. A number of medications have also been associated with the onset of psoriasis, with beta blockers, anti-inflammatory drugs and lithium included in this list.

Treatment for psoriasis

While there is no established cure for psoriasis, a number of treatments have proved to be effective in managing the symptoms. For those with mild cases, a topical treatment will usually suffice and there are a number of creams and ointments available, with coal tar, dithranol and corticosteroids often recommended.

Light exposure or phototherapy is another established way to treat psoriasis and it is often utilised when topical treatment fails to generate the desired results. In the most severe cases, it may be necessary to combine topical treatments and/or light exposure with more comprehensive methods, such as oral medication or injections. Often, these more systematic treatments work by suppressing the immune system.

In most instances, psoriasis can be diagnosed and treated by a GP, without blood tests or skin biopsies. However, where there is doubt about how to treat the condition, or if the psoriasis does not respond to first-line treatments, patients may be referred to a dermatologist. Due to the fact that psoriasis is a chronic condition, long term treatment is necessary and patients should establish a continuous care plan with their doctor.

How to care for psoriasis

Those living with psoriasis can have drastically different experiences, depending on the severity of the disease and the extent of the symptoms, ranging from mild irritation, to extreme discomfort. Nevertheless, there are certain steps that all sufferers should take. Firstly, it is important that those with the condition consult regularly with a medical professional, follow the treatment plan provided, and review that plan when necessary.

In terms of self-treatment, topical creams and ointments can help to reduce symptoms and alleviate discomfort, while it is important to maintain good levels of personal hygiene. Scientists have established a link between stress and the onset or worsening of psoriasis, so regular exercise, mindfulness techniques and general stress management can be highly effective. All treatments should be continuous, rather than in response to flare ups. 

Hannah de Gruchy BSc(Hons)

About Author

Hannah de Gruchy is a freelancer writer who specialises in health and wellness. She has a keen interest in the biology of skin and loves using her words to help separate the real science of skincare from the pseudoscience of some skincare brands. Hannah has a degree in Human Biology and many years’ experience working in laboratories around London. Using this experience, Hannah enjoys turning complex science into interesting, engaging and easy to digest pieces to read. In her spare time, Hannah runs, practices yoga and loves cooking plant based foods.

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