If you experience raised, red and itchy areas of skin with painful silvery scales (plaques), you may have psoriasis. This chronic skin condition, which affects 8 million Americans, occurs after the immune system attacks healthy skin. In response, the body grows skin faster than normal, causing the cells to stack up and create psoriatic plaques.
Management of psoriasis
Psoriasis commonly appears on the elbows, knees, lower back and scalp. You may find that your condition worsens with:
- Alcohol consumption or smoking
- Cold weather and dry indoor air
- Illness or skin injury
- Medication use
- Stress
Mild to moderate psoriasis can often be controlled by:
- Softening skin: Loosen the scales by taking short baths in warm water. Use mild soaps with few additives. You can add oatmeal, apple cider vinegar or Epsom salts to the water to provide relief from itching and burning.
- Avoiding irritants: Use natural deodorants and soaps and avoid household products with chemical ingredients that may trigger a reaction.
- Watching your diet: Eating more omega-3 fatty acids may benefit dry skin. You can get omega-3s from fatty fish, flaxseed products, canola oil and soybean products. Also, avoid weight gain because psoriasis can flourish in skin folds.
- Avoiding triggers: Stop smoking and avoid alcohol; these can make the condition worse. Managing stress can also help prevent flare-ups.
When to seek treatment
Contact your health care provider if you experience:
- Hard-to-control bleeding from psoriatic plaques
- Joint stiffness or pain
- Redness, swelling, pus or fever — these could be signs of infection
- Worsening skin pain
Treating psoriasis
There is no cure for psoriasis. Instead, treatment focuses on managing the condition to prevent it from getting worse. Psoriasis treatment falls into three categories:
Topicals
Topicals are medical treatments applied to the skin. They fall into three categories:
- Over the counter (OTC): The Food and Drug Administration has approved salicylic acid and coal tar as OTC psoriasis treatments. You may also find that you get relief from OTC zinc pyrithione, capsaicin or mild steroid creams.
- Prescription steroid: You may get more substantial relief from prescription-strength steroid creams. These creams have an anti-inflammatory effect that reduces the redness, swelling and itching common with psoriasis.
- Prescription non-steroid: Your provider may use non-steroidal creams or ointments to help control plaques. Examples are anthralin, synthetic vitamin D3 and vitamin A.
Phototherapy
Also known as light therapy, phototherapy involves exposing skin to ultraviolet light. Some people see improvement from consistent light therapy, which penetrates the skin to slow cell growth. Phototherapy is administered in the clinic, and in some cases, at home.
Systemics
Systemics are good options for people who haven’t had success with topicals or phototherapy.
Depending on the severity of your disease, you may benefit from:
- Oral medications: Pills or liquids taken by mouth are sophisticated drugs that can target specific molecules within immune cells to correct the overactive immune response.
- Biologics: Drugs that are injected or given by IV infusion target and block the activity of immune cells known as T-cells. Other biologics block specific proteins that play a role in psoriasis.
Clinical trials offer leading-edge treatments
Psoriasis treatments are evolving thanks to clinical trials — research, involving human participants, to study disease prevention, diagnosis or treatment. UCLA Health is currently recruiting pediatric patients for one such clinical trial.
If you’re experiencing red, itchy, scaly skin and are concerned it might be psoriasis, contact your primary care physician.
