The severity of psoriasis varies greatly from person to person. For some people, it is just a minor irritation, for others it has a major impact on their quality of life. Either way, it’s a disease that can be extremely challenging, both mentally and physically for as many as 2% of the UK population.
We reached out to leading Dermatologist, Dr Sam Bunting, to answer some much needed questions and gain a little clarity and understanding into the best ways to deal with this difficult disease.
GTG: What is psoriasis?
SB: Psoriasis is a chronic disease of the skin and it’s far more common than people realise – as many as 2% are affected. Essentially it’s a disorder of the immune system which results in faulty signals being sent to the skin, causing the cells to turn over too quickly, causing inflammation. As a result, the cells pile up and form scaly red plaques.
GTG: Why does it occur?
SB: We inherit the genetics for psoriasis and sometimes there are certain triggers that result in those genes being expressed, like certain medications or a throat infection. It typically develops in the late teens and then later in life during the 50s. It’s not contagious and it’s not due to allergies.
GTG: What does it look like / what are the symptoms?
SB: There are different patterns and Psoriasis can take shape in a number of different forms. The most common is Plaque Psoriasis and this typically affects the elbows, knees, and scalp. The classic and most frequent finding of this results in well-defined scaly red plaques, which are often itchy. Other patterns that are recognized are Guttate Psoriasis, which is often triggered by a throat infection; Inverse Psoriasis, which affects the skin folds and 2 serious forms which can require hospital admission called Pustular Psoriasis and Erythrodermic Psoriasis. Nail changes are a frequent feature and joints can also be affected – as many as 20-30% of those with psoriasis have associated arthritis.
GTG: How do you treat it and what are the best products to use?
SB: Unfortunately there is no cure for psoriasis but it can be managed. Treatment usually starts with topical therapy; in more severe or extensive cases it requires phototherapy using UV light or drugs that suppress the immune system.
A good skincare regime using a soap-free cleanser and moisturiser is also vital. It’s important to find textures that you like and are comfortable using generously due to the fact that a minimum of twice daily moisturiser is required. It’s also important to take good care of yourself and to have effective mechanisms for managing stress as this can contribute to disease flares.
Treatment creams include:
Vitamin D analogues – Silkis or Dovonex ointment are effective; mild-to-moderate potency steroids work well in combination with vitamin D analogues. Tar-based therapies are also effective. These treatment creams target the rapid cell turnover to reduce scaling and are anti-inflammatory, thus reducing redness.
A thorough assessment by a dermatologist is also strongly recommended, especially if the disease is having a major impact on quality your of life or affects a significant proportion of the skin.