Psoriasis is a skin disorder that appears as raised, reddish-pink areas covered with silvery scales and red borders. Psoriasis most commonly appears on the scalp, elbows, knees, groin, and lower back. It "comes and goes," and may appear as a few spots or involve large areas. It is not contagious, either to other body parts or other people. More than 6 million people in the United States have psoriasis, which is seen in both sexes and all age groups. It can be triggered by emotional stress and can run in families. Severe cases can be physically painful and emotionally traumatic due to its unsightly appearance. Approximately 10 percent of psoriasis sufferers develop psoriatic arthritis, a painful arthritic condition.
Signs and Symptoms
The following are symptoms of psoriasis.
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Raised skin lesions, deep pink with red borders and silvery surface scales; may be cracked and painful
- Blisters oozing with pus (usually occurs on the palms or soles)
- Pitted, discolored, and possibly thickened fingernails or toenails
- Itchy skin in some people
- Joint pain (psoriatic arthritis) in some people
What Causes It?
The cause of psoriasis is uncertain, but researchers do know that it involves a higher-than-normal rate of skin-cell production. Dead skin cells accumulate and form thick patches. Several underlying factors may trigger the disorder or flare-ups, including the following.
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Faulty immune system
- Genetics (hereditary)
- Emotional stress
- Obesity
- Skin injuries or sunburn
- Streptococcal (strep) infection (symptoms sometimes first appear two weeks after strep throat)
- Certain drugs (gold, lithium, beta-blockers)
- Acidic foods
- Alcohol
What to Expect at Your Provider's Office
Your health care provider will examine your skin and ask questions about your physical and emotional health. You may need a blood test to check levels of calcium, zinc, and certain other elements.
Treatment Options
Your provider may suggest one or several different treatment options.
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Topical creams and lotions
- Medications
- Light therapy
- Changes in your diet
- Vitamin or mineral supplements
- Exercise
- Elimination therapy (in which you discontinue taking certain medications or eating certain foods)
Drug Therapies
Prescription
Topical creams include the following.
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Corticosteroids—reduce inflammation and irritation; can only be used for a short period of time at the beginning of treatment
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Salicylic acid ointments—help the scales to shed
- Capsaicin ointment—blocks chemicals in the skin that cause inflammation; painful if used on open wounds
- Calcitriol ointment—may be as effective as corticosteroids with fewer side effects
- Etretinate—for severe cases that do not respond to other treatments
- Systemic drugs are taken orally and are used for more severe conditions.
- Methotrexate—an anti-cancer drug that reduces symptoms; serious side effects
- Psoralen—used with UV therapy; least toxic oral medication
- Tegison—inhibits rapid cell growth; more effective with UV therapy; numerous side effects
Over the Counter
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Nonsteroidal anti-inflammatory drugs (such as ibuprofen)—reduces inflammation and pain especially for psoriatic arthritis; various side effects
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Petroleum jelly—softens skin, helps it to retain moisture
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Coal tar ointments and shampoos—relieves symptoms; helps UV light therapy to work more effectively; possibly serious side effects
Nutrition
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Eliminate alcohol, simple sugars, inflammatory fats (meat, dairy). Avoid acidic foods (pineapple, oranges, coffee, tomato) and any allergic foods (wheat, citrus, milk, corn, eggs).
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Essential fatty acids: omega-3 (oily fish, flaxseed oil, 1,000 mg two times per day)
- Vitamins: B12 (100 to 1,000 mcg) may need to be intramuscular injections, folate (400 mcg per day), vitamin E (400 to 800 IU per day)
- Minerals: zinc (30 mg per day), selenium (200 mcg per day)
- Quercetin: 500 mg three times per day before meals
- Digestive enzymes taken with each meal help with proper protein digestion.
Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
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Milk thistle (Silybum marianum) stops breakdown of substances that contribute to psoriasis, protects the liver.
- Yellowdock (Rumex crispus), red clover (Trifolium pratense), and burdock (Arctium lappa) are alternatives.
- Sarsaparilla (Smilax sarsaparilla) can be effective in psoriasis.
- Coleus forskohlii (tincture, 1 ml three times a day) has been historically used for psoriasis.
Mix equal parts of the above herbs and use 1 cup tea three times per day or 30 to 60 drops tincture three times per day. This is especially effective if sipped. Take 5 to 15 minutes before meals to stimulate digestion.
Topical creams may relieve discomfort. Chickweed (Stellaria media) relieves itching, and marigold (Calendula officinalis) speeds healing of open lesions.
