Psoriasis: Symptoms, Causes, Triggers and Treatments

psoriasis cells on the skin

Psoriasis: Overview and Incidence

Psoriasis a chronic (which means long lasting) inflammatory disease of the immune system. It mostly affects the skin and joints, but different and rarer forms of the disease can affect the fingernails, the toenails, the soft tissues of the genitals and the inside of the mouth.

For most sufferers psoriasis is a disease of the skin. Cells in normal skin mature and replace dead skin every 28-30 days. Psoriasis causes skin cells to mature in less than a week. Because the body can’t shed old skin as rapidly as new cells are rising to the surface, raised patches of dead skin develop on the arms, back, chest, elbows, legs, nails, folds between the buttocks, and scalp.

This “plaque psoriasis” is by far the most common form of psoriasis (80-90% of patients) and is characterised by patches of raised, reddish skin covered with silvery-white scales. Plaques normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body. The plaques can be itchy, sore or both. They make the skin inflexible and in severe cases, the skin around joints and expanding muscles may crack and bleed.

Regrettably once the disease develops it is usually present for the life of the patient and treatment is more one of limitation and control rather than cure. It can involve periods when the patient has no or only mild symptoms followed by periods when symptoms are more severe.

Who is Affected?

Psoriasis isn’t contagious, so it can’t be spread from person to person

Race and skin colour is a factor in the number of  sufferers but in western countries 3-5% of people will develop the condition. It is slightly more common in women than in men.

The disease can develop at any time in life but it is primarily a disease of adults. 10-15% of all cases are diagnosed in children under 10, and the average age at the onset of symptoms is 28. Psoriasis is most common in fair-skinned people; cases in dark-skinned people are rare.

Approximately 80 percent of those affected with psoriasis have mild to moderate disease, while 20 percent have moderate to severe psoriasis affecting more than 5 percent of the body surface area. The disease is classified as severe if the disease affects more than 30% of the body surface.

As many as 40% of psoriasis sufferers experience joint inflammation that produces symptoms of arthritis know as psoriatic arthritis; patients experiencing this form can experience other arthritis symptoms.

Types of Psoriasis and their Symptoms

Dermatologists distinguish different forms of psoriasis according to what part of the body is affected, how severe symptoms are, how long they last, and the pattern formed by the scales.

Plaque Psoriasis (psoriasis vulgaris), the most common form of the disease. Small red bumps enlarge, become inflamed and form scales. The top scales flake off easily and often but those beneath the surface of the skin clump together and look inflamed and redden. Removing these scales exposes more tender skin which bleeds and causes the plaques (inflamed patches) to grow. Plaque psoriasis can develop on any part of the body, but most often occurs on the elbows, knees, scalp, and trunk.

At least 50% of people with any form of psoriasis have Scalp Psoriasis which comprises red patches of skin covered in thick silvery-white scales and can occur on parts of the scalp or on the whole scalp. Some people find scalp psoriasis extremely itchy, while others suffer no discomfort. In extreme cases it can cause hair loss, although this is rare and usually only temporary.

Guttate Psoriasis sufferers typically have small (less than 1cm or 1/3 inch) red, drop-shaped sores on your chest, arms, legs and scalp that enlarge rapidly and may be somewhat scaly. Often found on the arms, legs, and trunk and sometimes in the scalp, guttate psoriasis can clear up without treatment or disappear and resurface in the form of plaque psoriasis. Guttate psoria sometimes occurs after a streptococcal throat infection and is more common among children and teenagers.

Inverse (flexural) Psoriasis affects folds or creases in the skin including armpits, groin, between the buttocks and under the breasts. It can cause large, smooth red patches in some or all of these areas. Inverse psoriasis is made worse by friction and sweating and can be particularly discomforting in hot weather.

Nail Psoriasis affects 50% of psoriasis sufferers and first symptoms are usually pitting of the fingernails or toenails. Size, shape, and depth of the marks vary, and affected nails may thicken, yellow, crumble, become discoloured, or grow abnormally. The skin around an affected nail is sometimes inflamed, and the nail may peel away from the nail bed.

Pustular Psoriasis

Pustular Psoriasis usually occurs in adults and is characterised by blister-like lesions filled with non-infectious pus and surrounded by reddened skin. It can be localised or widespread and may be the first symptom of psoriasis or develop in a patient already suffering from chronic plaque psoriasis. Generalised Pustular Psoriasis is also known as Von Zumbusch Pustular Psoriasis. Widespread, acutely painful patches of inflamed skin develop suddenly. Pustules appear within a few hours, then dry and peel within two days. Generalised pustular psoriasis can make life-threatening demands on the heart and kidneys.

Palomar-Plantar Pustulosis (PPP) generally appears between the ages of 20 and 60. PPP causes large pustules to form at the base of the thumb or on the sides of the heel. In time, the pustules turn brown and peel. The disease usually becomes much less active for a while after peeling.

Acropustulosis causes pustules to appear on your fingers and toes. The pustules then burst, leaving bright red areas that may ooze become scaly. These may lead to painful nail deformities.

Erythrodermic Psoriasis

Erythrodermic Psoriasis is a rare form of psoriasis that affects nearly all the skin on the body. This can cause intense itching or burning. Erythrodermic psoriasis can cause your body to lose proteins and fluid, leading to further problems such as infection, dehydration, heart failure, hypothermia and malnutrition.

Causes of Psoriasis

We know Psoriasis occurs when skin cells are replaced more quickly than usual but nobody quite knows why. Research suggests it’s caused by a problem with the immune system.

The human body produces new skin cells in the deepest layer of skin. These skin cells gradually move up through the layers of skin until they reach the outermost level. Then they die and flake off. The cycle should take around three to four weeks in a healthy person but in people with psoriasis the process only takes between three and seven days. So cells that aren’t fully mature build up rapidly on the surface of the skin which cause red, flaky, crusty patches covered with silvery scales.

Immune System Factors

The human immune system defends against disease and fights infection and in doing so produces T-cells. T-cells normally travel through the body to detect and fight invading germs such as bacteria, but in people with psoriasis they start to attack healthy skin cells by mistake. This causes the deepest layer of skin to produce new skin cells more quickly than usual, which in turn triggers the immune system to produce more T-cells. It’s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.

Genetic Factors

Psoriasis runs in families and one in three people with psoriasis has a close relative with the condition but the role of genetics in causing psoriasis is unclear. Many different genes are involved and it is likely that different combinations of genes may make people more vulnerable to the condition, but having these genes doesn’t necessarily mean you’ll develop psoriasis.

Triggers for Psoriasis

As with many skin diseases psoriasis symptoms can start or become worse because of triggers. Triggers are things which occur in your life or in response to what you eat. Knowing your triggers may help you to avoid a flare-up.

Common Psoriasis triggers include:

  • a response to certain types or ‘families’ of foods — including the Nightshade Family;
  • drinking excessive amounts of alcohol
  • smoking;
  • an injury to your skin, such as a cut, scrape, insect bite or sunburn (known as the Koebner response);
  • stress;
  • exposure to cold temperatures;
  • hormonal changes, particularly in women (for example, during puberty and the menopause);
  • a reaction to certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, ACE inhibitors (used to treat high blood pressure) and beta blockers (used to treat congestive heart failure);
  • throat infections – in some people, usually children and young adults, a form of psoriasis called guttate psoriasis develops after a streptococcal throat infection (although most people who have streptococcal throat infections don’t develop psoriasis);
  • other immune disorders, such as HIV, which cause psoriasis to flare up or to appear for the first time;

Treating Psoriasis Naturally

Why Natural Treatment?

Conventional medical treatments for the types of Psoriasis most people experience can be so unpleasant that many enlightened doctors don’t recommend them. Typical treatments include steroid creams and vitamin D topical ointments containing calcitriol, but the former can only be used over limited areas which are affected, only for short periods (a few days), and should not be used on the face or hands because they cause thinning of the skin.

Many doctors prescribe synthetic emollients as the best treatment but these are expensive and patients often find natural versions both more effective and cheaper, especially when combined with minor diet and lifestyle changes to identify and eliminate your dietary triggers.

Natural Treatment How-To:

1. Identify and Eliminate Your Dietary Triggers

Several scientific studies have linked Psoriasis to dietary triggers. Psoriasis is an inflammatory disease and some foods are know to have inflammatory properties.

Not everyone has the same triggers. Your psoriasis may be eased if you can discover your own personal inflammatory triggers and eliminate them from your diet.

Inflammatory triggers “families” for Psoriasis can include:

  • Alcohol
  • The Nightshade Family (incudes potatoes, tomatoes, peppers and aubergine)
  • Gluten Related Products (grain based including wheat, barley and rye)
  • Red Meat
  • Dairy Products and Eggs
  • Refined Sugars
  • Citrus Fruits

Read how Puraglow’s Lesley Wall discovered Nightshades, particularly potatoes were her Personal Trigger.

How to Identify your Triggers

Cut all your suspected Trigger Family out for at least a week—and don’t change anything else.

  1. Be particularly wary to remove all incidences of it. The easiest way to do this is to this is to prepare your food from raw ingredients and don’t buy processed food. Many of the above list, particularly gluten-related, refined sugars and nightshades (potato starch and tomatoes) are contained in pre-cooked foods.
  2. If your condition improves, extend your experiment to last for 28 days.
  3. Once you have identified your trigger family you can experiment to discover if the entire trigger family causes a problem or only a specific member of it by bringing each food back one at a time to check for an adverse reaction. Again make sure you only do this to only one and don’t change anything else.

2. Eat Foods that Soothe and Heal

Include foods in your diet that have been shown to reduce inflammation:

  • Oily fish (Sardines, salmon, mackerel, herring, trout and anchovies are all types of oily fish).
  • Flaxseeds, olive oil, pumpkin seeds and walnuts. These are plant sources of omega-3 fatty acids.
  • Fresh fruits and vegetables from the following list
    • Carrots
    • Squash and sweet potatoes
    • Spinach
    • Kale and broccoli
    • Red cabbage
    • Blueberries
    • Mangoes
    • Strawberries and figs
    • Celery (for cleansing the kidneys)
    • Parsley
    • Lettuce and other leaves

3. Treat Your Skin

We are constantly adding to and improving our treatments for Psoriasis including proprietary preparations and DIY.

If something worked for you, contact Natasha Rhead via @natasha or email her at natasha@puraglow.com

See our Psoriasis section

 

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