Myth 1: Psoriasis is a temporary problem, like chapped lips, dry skin, or acne.
“I think of psoriasis as more of a disease than a skin condition because there’s no cure,” says Emmy Graber, MD, president of the Dermatology Institute of Boston and an affiliated clinical instructor at Northeastern University. This is not to downplay acne, which can certainly be uncomfortable and even embarrassing to the point of causing mental health issues. But in many cases, acne can be cleared up for good, while psoriasis can’t. Says Graber, “Doctors need to learn to manage it, and patients can learn to live with it.”
Myth 2: The plaques only affect fair skin.
Psoriasis doesn’t discriminate based on skin colour—anyone can become affected by this chronic skin condition, though it may look slightly different in those with darker skin tones. “In darker skin tones, psoriasis plaques can appear more purplish,” says Porcia Bradford Love, M.D., clinical assistant professor at the University of Alabama School of Medicine. “You don’t necessarily see that pink, silvery scale. It’s more of a purple colour with grey scales—the redness can be very hard to see.” And for patients with brown plaques, which can also happen, says Love, the diagnosis may be quite confusing.
But patients with darker skin may respond better to a certain treatment than their fair-skinned counterparts says Love. The treatment in question—phototherapy—involves exposing patients to controlled but consistent doses of UV light under a dermatologist’s care. “I have several patients with darker skin who get treated with phototherapy for their psoriasis,” says Love.
Myth 3: All psoriasis symptoms are topical.
The most common form of psoriasis causes dry, raised, red skin patches covered with silvery scales that usually appear on elbows, knees, lower back, and scalp. The plaques may feel much worse than they look: They can cause excruciating itching, burning, soreness, and even bleeding. Less familiar symptoms of psoriasis are thickened, pitted, or ridged nails, and, in some cases, swollen and stiff joints. “A quarter of patients with psoriasis in their skin also have it in their joints,” says Graber. “They often don’t realize that their back or finger aches can be related to the skin issues. A dermatologist can help them make that connection and diagnose psoriatic arthritis.”
But psoriasis is also more than skin deep: In addition to being associated with a higher risk for developing conditions like diabetes, stroke, and heart disease (more on that below), severe forms of psoriasis may also correlate with higher incidence of depression, says Evan Rieder, M.D., assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Langone Health in New York. “This is a condition that can affect patients in multiple ways, including the way they perceive themselves, their self-esteem, and how other people respond to them,” Rieder says. “Negative responses to plaques from the outside world can really impact how a patient interacts with others."
Myth 4: Psoriasis is caused by things you’re doing (or not doing) to your skin.
Graber sees many patients blaming themselves. “They think the inflammation is a result of not showering enough or using the wrong skincare product,” she says. In cases where psoriasis causes redness and flakiness of the scalp, patients tend to assume they’re shampooing too much—or not enough. But psoriasis is not a result of poor hygiene or using the wrong type of product. While the exact causes aren’t fully understood, it’s thought to be an immune system problem that causes the skin to regenerate at faster-than-normal rates, resulting in those scales and red patches.
“We know that patients have a biological predisposition to develop this condition, and environmental factors, like an infection or skin injury, may trigger a flare-up,” says Graber. “But psoriasis is absolutely not the patient’s fault.” Changing the bed sheets, trying new detergents, and switching up a skincare routine are unlikely to make much of a difference.
Myth 5: The plaques can be treated at home with a loofah and a good moisturizer.
While some lotions and creams may help with mild cases, no amount of exfoliating is going to help psoriasis—and often makes it worse, says Graber. “Many of my patients think they can get rid of the flakes themselves, but there just aren’t any good OTC remedies.”
Natural remedies, too, will likely be ineffective at treating even mild cases of the condition, says Rieder. “There’s a little bit of interesting research on green tea, and some innovations happening with cannabinoids, but right now the data just isn’t there,” he says. Effective treatment usually requires the help of a dermatologist. “Prescription treatments make the most significant difference,” Graber says.
Myth 6: There’s nothing you can do about this condition.
Psoriasis is highly manageable—and treatment options have recently exploded. “There have been a lot of advancements in recent years, including a class of medication known as biologics,” says Graber. “Those can change the way the immune system functions in the skin, which can have a big impact on calming the inflammation associated with psoriasis.” While treating this condition is part of the standard dermatological training for board certification, it’s important to ask if your derm is knowledgeable about recent research. “Someone who hasn’t been keeping up to date with the literature might not be aware of the range of options,” says Graber. “If the first line treatments aren’t working, you want your derm to be able to suggest alternatives that might help you.”
In addition to exploring the proper treatment for you with a board-certified dermatologist, there are some lifestyle tweaks you can make that may significantly affect your psoriasis, says Love. “There are certain comorbidities that are associated with psoriasis, like high blood pressure, high cholesterol, diabetes, and obesity, so getting those under control may help with your psoriasis. There’s also some research that shows decreasing your alcohol intake may help.”
Myth 7: The plaques and rashes can spread via skin-to-skin contact.
“People who don’t understand psoriasis and may have never seen it before can think it’s an infectious condition—and that’s simply untrue,” says Rieder. “Psoriasis can be very stigmatizing—when outsiders see pink, scaly, sometimes bleeding plaques, they may not understand what they’re looking it and it can be frightening. But it’s not something you can ‘catch.’”
Adds Graber: “I see patients who are afraid they’re going to pass this on by touching their kids or their spouse; patients with patches on their palms who will sometimes avoid shaking hands. It’s really important for patients to know that psoriasis is not contagious. They can absolutely go on interacting with people as they otherwise would.”
https://www.oprahmag.com/beauty/skin-makeup/a34896780/psoriasis-facts/
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