What is psoriasis and how to treat it?

31 October 2023

Psoriasis that affects the skin, whose treatment includes the use of ointments.

Psoriasis is a dermatological disease in which red spots with silvery scales appear on the skin.

Depending on the type, psoriasis affects the knees, elbows, torso, nails, face, or scalp.

What is psoriasis?

Psoriasis is an autoimmune disease that causes skin cells to grow too quickly, which build up and form inflamed red spots. The symptoms of psoriasis can vary depending on its type, stage and cause. General signs of psoriasis:

inflamed areas of the skin;
silvery-whitish scales or plaques on red spots;
pain and burning of the skin;
dry, cracked skin (may itch and bleed);
stiff and swollen joints;
thickened and ribbed nails.

Psoriasis in children usually affects the scalp and nails first and then spreads to the elbows, knees, and torso. In nail psoriasis in a child, depending on the type of psoriasis, thick nails without pits or with small ridges may be observed, as well as yellowing of the nails or their separation from the bed.

If you notice the first signs of psoriasis, you should see a doctor. A dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots or silvery scales appear on the skin in children, it is advisable to consult a pediatrician.

How does psoriasis start?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (on the outside they resemble a normal rash). As they increase in size, white or silver scales may appear. The scales on top may fall off. The remaining scales stick together and begin to hurt and itch. When scratching the resulting rash, the scales can break away from the skin and cause bleeding.

What does psoriasis look like?

With psoriasis, red spots appear on light skin and brown or purple spots appear on dark skin. In the initial stage of scalp psoriasis, the spots resemble dandruff (due to the white scales). Forms of psoriasis:

mild form of psoriasis (less than three percent of the body is affected, rashes are localized on the scalp or extremities);
moderate form of psoriasis (the rash covers three to ten percent of the body and affects the scalp, arms, legs and torso);
severe form of psoriasis (more than ten percent of the body is affected, rashes appear on the palms, soles and face).

Treatment for psoriasis is selected by a dermatologist based on the form and type of psoriasis, symptoms, and location of the rash. If the treatment is incorrect or untimely, large areas of lesions appear on the skin.

Where can psoriasis occur?

The location of psoriasis spots depends on their type. Types of psoriasis:

plaque psoriasis (vulgar). Plaque psoriasis causes dry, raised areas of skin covered in silvery scales. Psoriasis appears on the elbows, knees, lower back, and scalp;
erythrodermic psoriasis. The skin seems burned, chills appear and the temperature rises;
guttate psoriasis. Small flesh-colored scaly spots, similar to water droplets, form on the arms, legs, and torso;
pustular psoriasis. With pustular psoriasis, white pus-filled blisters and large swollen areas of skin form on the skin. Located in small areas of the skin, affecting legs or arms;
exudative psoriasis. Spots appear on the skin covered with yellow scabs;
inverse psoriasis. Soft red spots appear on the skin. The rash occurs in the folds of the skin (armpits, buttocks, genitals).

In nail psoriasis, skin builds up under the nails, causing them to lift and form indentations ("nail pits"). The skin under the nail turns white, yellow, or brown. Nails become rough, crumble and break quickly.

Dermatologists also distinguish palmoplantar psoriasis. Psoriasis skin on the palms and feet is dry and prone to cracking.

Eyelid psoriasis causes redness, peeling, and crusting around the eyelids. Other symptoms of psoriasis on the eyelids:

the formation of scales that break off and adhere to the eyelashes;
pain when moving the eyes;
irritation of the skin of the eyelids, accompanied by pain and itching.

The edges of the eyelids may rise or fall depending on the location of the spots, causing friction between the eyelashes and the eyeball. Possible consequences of eyelid psoriasis include uveitis (inflammation of the eyes) and vision loss.

Psoriasis can appear on the eyebrows, behind and around the ears, and in the ear canal. Sometimes, psoriasis affects the mouth, causing redness and burning in the lips, gums, tongue and cheeks. Oral psoriasis can cause difficulty chewing and swallowing food.

The manifestations of psoriasis depend on its type, symptoms and stage. In the photo you can see psoriasis.

Manifestations of psoriasis on the knees.

Reasons for the development of psoriasis

Psoriasis is caused by a malfunctioning immune system, in which white blood cells mistakenly begin to attack skin cells. Due to the action of leukocytes, the process of producing new skin cells is reduced from a month to several days. The cells formed in advance are pushed by the body to the surface of the skin, where they accumulate and transform into spots or plaques.

Genetic predisposition (family history of psoriasis) or triggers (environmental factors that increase the risk of psoriasis) can cause the immune system to malfunction. Factors that provoke the development of psoriasis:

infections (tonsillitis, herpes, lichen);
skin trauma (sunburn, insect bites, scratches, cuts);
tobacco or alcohol abuse;
uncontrolled use of medications;
habitual stressful situations (lead to the development of stress psoriasis);
climate (dry and cold conditions);
Abrupt discontinuation of systemic or oral corticosteroids.

These factors can lead to the development of psoriasis in people predisposed to it or cause an exacerbation. Psoriasis exacerbation can be avoided by identifying and eliminating the factors that contribute to it.

Exacerbation of psoriasis

Psoriasis on the face, limbs and head is characterized by periods of exacerbation (symptoms appear intensely) and remission (the rash decreases in size, the pain disappears). Remission periods last from one month to a year. Stages of psoriasis:

progressive stage(onset of psoriasis). Small nodular rashes appear on the skin, which are accompanied by itching. Areas of redness increase, forming plaques;
stationary stage. New nodules (papules) do not appear, the inflammation subsides after the formation of scales or crusts on the plaques;
regressive stage. The plaques decrease, the itching and peeling disappear.

Relieve an exacerbation of psoriasis will be helped by a dermatologist, who will identify the triggers and prescribe treatment. Following your doctor's recommendations will help reduce periods of exacerbations and increase periods of remission.

How to treat psoriasis?

Before starting treatment for psoriasis, the dermatologist takes a history (asking about symptoms, when they appeared, and whether there is a family history of psoriasis) and performs a visual examination of the rash. After making the diagnosis, the doctor selects a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

ointments, shampoos, creams and gels based on algae extracts and Dead Sea minerals;
phototherapy (by exposing the rash-affected skin to ultraviolet rays, the growth of skin cells is reduced, leading to the normalization of the condition).

For psoriasis, a dermatologist recommends taking vitamins. To produce healthy skin cells and reduce inflammation and symptoms, your doctor will prescribe vitamins A, D, E, K, B, and C.

Diet for psoriasis

For psoriasis, a dermatologist recommends dietary changes. Foods that reduce inflammation:

fatty fish (tuna, salmon);
flax and pumpkin seeds;
nuts (walnuts, almonds);
cabbage, spinach.

Following a psoriasis diet helps reduce symptoms and prevent the development of complications (high blood pressure, diabetes, heart disease). If you have psoriasis on your legs, arms, or face, you should limit your alcohol consumption.

Your diet should also include the consumption of foods that contain fatty acids (sardines, salmon, shrimp, flax seeds). It is recommended to minimize the consumption of foods that contain saturated fats (fatty meats, confectionery) and simple carbohydrates (dairy, grapes, pastries).

Psoriasis prevention

Preventative measures will help prevent the development and progression of psoriasis on the arms, legs and head. Psoriasis prevention includes:

changes in diet (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of foods containing fatty acids);
protect your head and body from the sun (using sunscreen and a hat);
give up smoking;
reduce the risk of skin injuries (use of insect repellent sprays, gloves, long sleeves);
moisturize the skin (dry skin is prone to damage).

To reduce the likelihood of a psoriasis flare, extreme temperatures should be avoided. Exposure to temperatures that are too cold or too hot can cause the skin to become dry or damaged. Minimizing stressful situations will help prevent the onset of nervousness psoriasis.

How to distinguish psoriasis from dermatitis?

Scalp psoriasis (seborrheic psoriasis) is similar to seborrheic dermatitis. Dermatitis can be distinguished from scalp psoriasis with the help of a dermatologist. Symptoms of seborrheic dermatitis:

redness of the skin, on which white or yellow greasy scales form (when pressed, sebum - sebum can be released);
dandruff (skin flakes) that accumulate near the hair shaft.

You can distinguish psoriasis from dermatitis by the location of the rash. Unlike seborrheic dermatitis, psoriasis not only forms on the head, but also spreads beyond the hairline and appears on other parts of the body (extremities, lower back, nails). With psoriasis, the areas of skin affected by the rash are painful and itchy, and with dermatitis, your scalp may feel slightly itchy.