A principal source of advice, support and information on psoriasis and psoriatic arthritis
A registered charity no: 1118192
A registered charity no: 1118192
Psoriasis (sor-i’ah-sis) is a long-term (chronic) scaling disease of the skin, which affects 1% to 3% of the UK population – up to 1.8 million people. IT IS NOT CONTAGIOUS. It appears as red, raised scaly patches known as plaques. Any part of the skin surface may be involved, but the plaques most commonly appear on the elbows, knees and scalp. It can be itchy, but is not usually painful. Nail changes, including pitting and ridging, are present in 40% to 50% of people with psoriasis and 10% to 20% of people with psoriasis will develop psoriatic arthritis.
Although the commonest form features red, raised, scaly plaques, there are a number of types of psoriasis. These look different and may require specific treatment.
Remember, although psoriasis is a chronic condition it can be controlled and go into remission (go away; often temporarily and sometimes permanently). Not all people will be affected in the same way and doctors will class the condition as mild, moderate or severe.
Mild psoriasis (80% of people affected) involves a few patches that may need treatment but are not likely to cause problems and can be easily controlled.
Moderate psoriasis (15% of people) affects more skin the condition is widespread but, again, can usually be controlled with self-management under the supervision of a GP or nurse.
Severe psoriasis (5% of people) results in large areas being covered with psoriasis ; the condition becomes difficult to self-manage or no longer responds to treatment. At this stage referral to secondary care at a local hospital outpatient department or in extreme cases an inpatient stay may be felt necessary in order to provide optimum care (best or most suitable) and monitoring.
Normally a skin cell matures in 21 to 28 days. During this time it travels to the surface of the skin, where it is lost in a constant, invisible shedding of dead cells. In patches of psoriasis the turnover of skin cells is much faster, around four to seven days, and this means that even live cells can reach the surface and accumulate with dead cells. It is thought cells in the immune system (T cells) become overactive, leading to rapid growth of skin cells and the formation of psoriatic plaques. The extent of psoriasis and how it affects an individual varies from person to person. Some may only be mildly affected with a tiny patch hidden away which does not bother them, while others may have large, visible areas of skin involved that significantly affect daily life and relationships. The process is the same wherever it occurs on the body.
It affects men, women and children alike. It can appear at any age in varying degrees but usually between the ages of 10 and 30. The severity of the disease varies enormously – from a minute patch to large patches covering most body areas. Psoriasis can also run in families and much research is being done into the genetics of this disease. It is known that the disease is multi-genetic (a condition where several genes may each have different roles, contributing to specific characteristics of disease) and therefore children may not necessarily inherit psoriasis. It is estimated that if one parent has psoriasis then there is a 15% chance that a child will develop the condition. If both parents have psoriasis this increases to about 75%. Interestingly, if a child develops psoriasis and neither parent is affected there is a 20% chance that a brother or sister will also get psoriasis. This is because the condition is known to skip generations, so somewhere there will be a familial link to a relative via either or both parents.
Unfortunately not at the moment. Much research is being done and in the last decade great strides have been made in understanding what goes wrong in psoriasis, so there is good cause for optimism.
In the meantime there are a number of treatments that are effective in keeping the problem under control. The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.
In the absence of a cure you will always have psoriasis, but this does not mean that the signs will always be visible. Normally, the rash tends to wax and wane (increasing and decreasing). There will be periods when your skin is good, with little or no sign of psoriasis. Equally, there will be times when it flares up. The length of time between clear skin and flare-ups differs for each individual and is unpredictable. It may be weeks, months or even years.
There may not be a cure yet but there is much you can do to help maintain and control your psoriasis. Psoriasis, regardless of location or type, is often irritated by contact, particularly tight clothing such as elasticated waistbands, socks, tights, and underwear. It may be useful to wear looser clothing where psoriasis is likely to be irritated either when flaring or during periods of treatment.
Finding out all you can about psoriasis and having a full working understanding can be very helpful in coping with the problem. Look out for any emerging patterns, stress levels and any event that may trigger flare-ups. It is useful to keep a diary.
Yes, there are many forms of treatment for psoriasis, which range from those you apply to the skin (topical) to tablets, and more recently injectable therapies, See Treatments for Psoriasis.
Many people who have psoriasis find that the sun and artificial ultraviolet light (UV) helps to improve their skin’s appearance. For some the change is dramatic. Be aware that exposure to the sun and artificial UV therapy can cause damage to the skin. For further information see Psoriasis and the Sun and Psoriasis and Phototherapy.
For some people, talking therapies such as cognitive behaviour therapy (CBT) can also help them understand the psychological impact of psoriasis and provide a safe therapy which may help them cope with psoriasis. See our free online CBT programme at www.etips.org.uk
Your general practitioner or dermatologist will be best placed to advise you and keep you informed of all current and new treatments available and to recommend the best treatment programme for you personally.
Remember: Your treatment can only be as good as you allow it to be - that means if the treatment takes six weeks, you have to follow it as instructed for six weeks and no ducking out! Adherence to treatment instructions is an essential part of managing your psoriasis.
A healthy diet is important for wellbeing and can reduce your risk of many long-term illnesses. However, there is no clear link between what you eat and the severity of psoriasis symptoms.
If you think you have psoriasis, go and see your GP. He or she may decide themselves to start treatment or refer you to a dermatologist for advice.
Don’t forget, if you are also experiencing aches and pains in any of your joints, have any other symptoms or if you have a family history of psoriasis, inform the doctor. This will assist with diagnosis and treatment.
Remember: All treatments may have unwanted side effects or require special precautions (for example, during pregnancy). Always make sure you have all the relevant information available before embarking on any course of therapy. This includes reading the patient information leaflets (PIL) provided with your medicines.
This article is adapted from the What is Psoriasis? leaflet.
Always consult your doctor or healthcare provider.
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