Psoriasis: The Best Therapy Management

The best way to manage plaque psoriasis, as with many chronic skin problems, is primarily through information gathering and applications of the best therapies that work for you. Learn all you can about the disorder from expert sources, keep abreast of scientific breakthroughs, know its root cause, what triggers a flair-up and what makes the condition better. In this way, you are able to recognise and manage your unique cyclic response to the disease, which ultimately allows you to find real solutions that reduce symptoms.

Let’s start by declaring what psoriasis is not. It is not contagious, and it is not your typical, “run of the mill” skin surface disease either. Psoriasis is medically known as a multifaceted chronic inflammatory disease of the immune system. The exact cause is still unknown; however, scientists believe that heredity, environment, and the immune system all play a role in the disease.

Definition, Causes and the latest scientific facts

Plaque psoriasis is also scientifically known as psoriasis vulgaris (vulgaris in Latin means common), and is the most prevalent form of skin problem that affect more than 89 per cent of people with psoriasis.

Defined as a chronic multisystem skin disease, the condition shows up on the skin as inflamed lesions covered by layers of scaly, silvery, contours of dead skin.

The term, psoriasis, is a general description of different categories of skin problems and includes as many as 7 variations of the disease. Some are categorised as plaque, pustular, guttate, erythrodermic and light sensitive psoriasis, as well as those that are identified based on its location on the body. They may appear on the scalp, torso, palms of hands and soles, skin folds, elbows, and between the buttocks.

Of the more than 3000 different types of skin problems, plaque psoriasis is one of the most common. Approximately 180 million people in the world suffer from the disease with some of the most developed countries such as Scandinavia, Great Britain, Germany, the United States and Canada having the highest incidences of the disease. Rare occurrences are seen in Japan, China, Africa and South America.

Research has pointed to geographical location as a meaningful component in the development of psoriasis. For some patients, their symptoms improved in the summer and worsened in the winter. The result of the clinical trial established previous notions that environmental factors affect symptoms.

This skin disorder’s genetic influence is also a primary component. In several studies, family history determined the development of the disease in 40-60% of patients. If one parent had psoriasis the probability of the offspring developing the disorder was 25%. If both parents were affected, their children were likely to develop the condition at a much higher rate of 60-75%.

The plaque condition can develop at any age and affect both genders. The onset is mostly seen at puberty and some scientists associate this development with hormonal changes during this period.

Scientists have done several studies in an attempt to examine elements outside of genetics and the environment that contribute to the disorder. Lifestyle choices were analysed, such as smoking, drugs, alcohol, poor nutrition and sedentary living. Most outcomes were conflicting while some lifestyle factors such as smoking, obesity and poor immune health linked to nutrition provided a higher propensity toward the disorder.

Skin facts, symptoms & triggers

Your skin functions in cycles: new skin cells replace dead cells every 28 days but with psoriasis, skin renewal is sped up abnormally to every 3 or 4 days.

In people with psoriasis, the immune system is what activates a faster than normal skin cell cycle. The cells move from the deepest layer of your skin to the surface in 4 days. Since they migrate at such a rapid rate, they have no time to mature efficiently; instead the cells are fragile, immature layers. These rapidly forming skin cells accumulate at the surface, forming raised, red patches, often with silvery scales.

Plaque psoriasis is most typically characterised by circular to oval red plaques distributed over the arms, legs, and scalp. The plaques usually exhibit scaling due to hyper-proliferation. Some individuals will experience burning and itching as a result of the inflammation in the deep skin layer. This may be agonizing for many, with severe attacks not uncommon.

The severity and length of time of each inflammatory episode is highly variable from person to person. Acute relapses of the disorder can evolve into a more severe disease such as pustular, arthritic, or erythrodermic psoriasis.

Certain environmental triggers include pollution, smoking, strep throat infection, trauma to the skin (example, sunburn, surgery or scratching), certain types of drugs and alcohol. People with psoriasis are often said to develop psychological complexes because of the way the disease makes them feel.

Conventional Medical Methods

Not that long ago, traditional applications to psoriasis began with a trip to the dermatologist, allergy specialist or emergency room depending on your level of severity. Often the doctor would misdiagnose the condition and treat you for one of the many other types of skin problems.

If diagnosis was correct then the probability of the patient getting an ineffective steroidal cream to apply or complicated drug regimen to comply with was very high and difficult to manage.

Currently, the treatment of skin problems associated with psoriasis has undergone a revolution with the advent of newer pharmaceutical drug therapies. One of the breakthrough drug therapies that have shown promise, based on clinical trials, are medications designed to target specific components of the immune system. This is a major technological advancement over the conventional methods of suppressing the immune system at a general level, which creates a weaker immune system function.

Researchers, who reviewed these “target-specific drugs” earlier this year, have also projected the long term adverse side effects for different patient populations; these are potentially harmful side effects. For this reason, care of patients who undergo this type of regimen need to be monitored for a variety of serious and routine “opportunistic” infections, particularly tuberculosis.

In moderate to severe cases of plaque psoriasis, the use of ultraviolet therapy, vitamin D3 and retinoid drugs have been considered effective combinations in managing symptoms.

Although most established treatment regimens are reasonably effective as short term therapy, extended disease control is difficult to achieve because the safety profile of most therapy agents limit their long-term use.

Modern medical treatments using pharmaceutical drugs have potentially dangerous side effects and supervision over use of certain classes of drugs is critical to prevent long-term health complications. This is a big concern for many individual who are trying to cope with psoriasis.

Patients with psoriasis often become frustrated and anxious about the management of the disease and most will have had previous drug therapies with adverse side effects. Additionally, managing a drug therapy at home is usually not easy, since the applications of several drug agents available require self-administered injections. Therefore, compliance is usually a problem when trying to achieve maximum results.

What is worse, the perceived ineffectiveness of the drug action by patients only pushes them further into states of depression. Studies have indicated that the impairment of quality of life caused by psoriasis equals or exceeds that of other medical conditions such as diabetes and cancer.

Natural Treatments

Researchers who have used natural treatments to reduce painful, sore inflammations and lesions have enjoyed substantial success. In naturopathic studies thermal baths in water of very high sodium content followed by twice daily sun exposure for approximately 3 hours a day resulted in 88 per cent of patients reporting satisfying improvements in conditions. This has been further confirmed by Dead Sea mineral studies where the best results were obtained from spas and clinics that adapted their trial settings to mimic the very high salt content found in the Dead Sea in Israel.

In making recommendations for home applications, some naturopathic physicians believe a heavy concentration of sea salt in heated bath water should soothe irritations after several minutes of soaking. This bath therapy should be done regularly to promote rapid healing in combination with phototherapy.

Nutrition

Diet as always is very important for skin problems just like any other health condition. Along with physical activity, nutrition is one of the cornerstones to a disease-free body. In alternative or naturopathic medicine the skin is considered to be an indication of the cleanliness of the blood. Any build-up of toxins which the liver is unable to cope with will manifest as skin problems.

There is some evidence that removing gluten and diary products from the diet can improve symptoms for some people. However, there is no specific diet that has been rigidly tested for psoriasis patients.

The general consensus, based on several leading studies, is that a healthy, wholesome diet with limited processed foods or beverages will improve anyone’s overall health. If lactose intolerance or other food insensitivities are suspect in your diet, it is recommended that you temporarily remove the offending food from daily meals for several weeks and then assess any changes in the condition.

The following are specific recommendations about natural remedies that may help in managing the symptoms of psoriasis:

    Vitamin D and D3 supplements – considered an essential part of your “natural” home regime.
    Vitamin B12 – has a stabilising effect on the immune system.
    Zinc - improves helaing, cell function, anti-inflammatory and the immune system.
    Fish oil – since the disorder causes scaly dryness this supplement moisturises.
    Coconut oil – apply directly unto the skin.
    Neem oil and leaves – the oil and leaves are popular for skin calming.
    Aloe Vera gel - commonly used, the sap will seep into the skin, with its soothing and healing properties. This can also be used as a cleanser instead of soap.
    Epsom salt (magnesium sulphate) – absolutely beneficial to exfoliate and reduce any swelling.
    Apple cider vinegar – its antiseptic qualities and high levels of vitamin C make it an effective skin remedy for exfoliation and delivering antioxidant benefits.
    Drink plenty of water – as a natural course of cleaning the body from inside out; limit the intake of sodas, sweet beverages, tea and coffee.
    Essential Fatty Acids – Omega 3 and Omega 6 oils are required for healthy skin, and there are plenty of studies which prove its effectiveness. Flax Seed Oil is a combination of Omega 3 and 6 oils. Take Zinc alongside for complete effectiveness of E.F.A’s.
    Natural soaps without perfumes, preservatives and sodium laurel sulphate (SLS) should be used in preference to conventional cleansers.
    Natural creams without perfumes, SLS, parabens or mineral oils. Creams that leave the skin smooth and soft such as MSM Cream Light with shea butter, almond oil, vitamin E and aloe vera.

A daily management plan that incorporates natural healing benefits should therefore be considered a priority in reducing relapse and severe episodes.

Plaque psoriasis is a disease which can be controlled effectively with careful changes in diet and lifestyle.

Looking to the future

Over the years, emerging studies have connected psoriasis with more than just another common skin disorder; instead these views have since changed dramatically. Psoriasis is currently being considered as an autoimmune dysfunction, an inflammatory disease of the immune system. Researchers believe that the disease occurs when your natural ability to fight and protect against infections and foreign invaders become overactive. The result is an increase in the normal skin cell cycle. This in turn causes an accumulation of skin cells on the surface of the skin.

Recent research has suggested that patients’ with this disorder may be at greater risk of cardiovascular problems, especially if psoriasis is severe, as well as hypertension, obesity, and diabetes. Researchers are yet to ascertain the reasons for these correlations and how best to treat patients.

Because psoriasis has a tendency to wax and wane with flares associated with external environmental factors and internal systemic causes, this makes managing the disease that much harder.

All efforts therefore should be aimed at reducing these “pendulum-swing” tendencies by steadying the factors that are within our control. Diet, exercise, meditation, stress- management, thermal salt baths, sunlight, and regular personal check- ups of your skin can help to manage symptoms effectively.