Psoriasis– Sensitive Skin, Part 5

What do Kim Kardashian, Leann Rimes and my neighbor Erica  have in common?  Like almost 8  million Americans they all   have psoriasis.  This  chronic skin condition is caused  by  a dramatically increased speed of  skin cell growth leading  to red splotches coverd with  silvery scales.  Itchy, dry and  painful it usually pops up on the torso, hands, elbows,  and legs.  Unlike eczema, its found on the outside rather than on the underside of  joints.

Like so  many health problems, doctors  don’t  really have a good handle on the causes of psoriasis. It seems to be genetically driven and  about 30%  of people with  psoriasis have at least one family member with the condition.  Psoriasis flare-ups  have been  linked to wheat, stress, weight gain, strep infection cold weather, smoking  and heavy drinking.  Psoriasis can also cause joint  pain and swelling and up to 30% of people with psoriasis experience  some degree of psoriatic arthritis.

A Bounty of Treatment Options 

The three top rules for psoriasis care  are moisturize, moisturize and  of course moisturize. Daily care starts with a lukewarm bath with a mild soap  like Dove or Aveeno Skin Relief Body Wash.  Adding a handful of colloidal oatmeal to the bath will also reduce  itching and inflammation.  After a nice soak, gently towel dry and  apply a simple but heavy moisturizer like Aquaphor.  Apply a light  layer, let it soak in then apply another layer.

Sunlight  which is usually viewed as  skin enemy #1 is actually helpful for psoriasis  But easy does it.  A daily 15 minute exposure will provide the benefits you want without increasing  skin cancer risks.

Stepping up Psoriasis Care

Lukewarm bath, ointments and a little sunlight are the first steps in managing  itchy, scaly  psoriasis skin care problems.  If you need more help ( and most  people do) doctors “step-up” care, progressively adding treatments:

1. Topical Medications

When more than simple moisturizers are needed, salicylic  acid cleansers and gels  can remove scales.  Steroids can also be prescribed  for flare-ups, but  should not usually be used  long term.   Tazorac ( similar  to Retin A) and coal tar  products can be very helpful  if psoriasis  affects less than 10-20% of the body.

2.  Light Therapy

You can crank up the benefits of UV rays by adding  a type of drug  called psoralens.  Either in a pill or cream, psoralens act by slowing down the turbo charged rate of cell growth that is driving psoriasis.  Psoralens have  problems  of their own.  They can cause nausea, headache and  over time have been linked with  an increased risk of skin cancer

3. Systematic Medications

If psoriasis still persists, doctors still have a number of powerful options in their tool  box.   Usually taken in  pill form,  methotrexate, cyclosporine, and retinoids ( like Accutane) all act  by slowing down skin cell growth.

4.  Biologics

The  newest  categories of care are injectables  that act on the molecular level to interrupt skin cell over production.  Given  in an injection or IV infusion,  biologics like Stelera or Enbrel can be life changing  if you have extensive psoriasis  and/or psoriatic  arthritis. Biologics are extremely powerful  and require close medical monitoring.  They have been  linked to increased risk of  infections and worsening of heart failure  and multiple sclerosis.  Effective  but with potential side effects  they are  usually prescribed when other remedies  have not been able to control   psoriasis.

Living with psoriasis can be frustrating.  All the treatments  from oatmeal baths  to  biologic injectables  need to be used in combination and it takes time and supportive  health care to come up with the most effective combo plan for  you.  Don’t  give up.  The best care is out there.

4 thoughts on “Psoriasis– Sensitive Skin, Part 5

  1. I started using MIKMAC for my psoriasis. I bought it off of amazon but the company site is dermabiologics.com. Its a topical gel. Its an all natural product. I am looking for an all natural acne product. Any suggestions?

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