Can Psoriasis Spread? What Are the Causes and Triggers?

From healthline.com

If you have psoriasis, you may be concerned about it spreading, either to other people or onto other parts of your body. Read on for more on psoriasis and how it works.

Can psoriasis spread?

Psoriasis isn’t contagious, and you can’t contract it from someone else or transmit it to another person. Psoriasis can spread to other parts of your body if you already have it, but there are ways to prevent it from getting worse.

How does psoriasis develop?

Psoriasis is a very common, chronic skin condition. It’s caused by your immune system attacking the skin, which increases your production of skin cells.

As the production increases, your skin cells die and regrow more quickly. That causes a build-up of immature skin cells that don’t behave normally, which results in itchy patches on your skin. The patches can be red, very dry, and very thick and may have a silvery appearance.

Your immune system and your genetics play a major role in the development of psoriasis. These affect your whole body, so you can develop psoriasis in many places. Psoriasis is most common on the scalp, knees, and elbows, but it can appear anywhere.

The skin condition can also range from mild to severe. It’s possible for your psoriasis to become more or less severe over time. Psoriasis can also look and feel different depending on its location.

It may seem as though your psoriasis is spreading to other parts of your body if it becomes more severe. But in actuality, you’re having a flare-up.

What can trigger a flare-up?

Researchers believe that anyone can develop psoriasis, even with no family history of the condition. It’s thought that a combination of genetic and environmental triggers most likely need to be present for psoriasis to start.

That’s also likely an explanation for why psoriasis comes and goes, or gets better and worse over time.

Psoriasis flare-ups can be triggered by various factors, including:

• an infection in your body
• smoking
• skin injury, like friction, a cut, or burn
• stress
• dry air, either from the weather or from being in a heated room
• too much alcohol
• some medications
• vitamin D deficiency
• obesity

8 tips to prevent psoriasis from spreading

Treatment is focused on preventing you from producing skin cells too quickly, but there are also steps you can take to help prevent psoriasis flare-ups.

1. Eat a nutrient-dense diet

Eating a nutrient-dense diet is important for everyone, but it may also help reduce psoriasis flare-ups. Certain types of foods may be triggers.

In a 2017 surveyTrusted Source conducted in the United States, about half the subjects with psoriasis reported improved symptoms after reducing their alcohol, gluten, and nightshades intake. Nightshades include potatoes, tomatoes, and eggplants, among other things.

Improvement was also seen in those who added omega-3s and fish oil, vegetables, and vitamin D supplements to their diet.

StudiesTrusted Source have also linked higher body fat levels to more severe flare-ups ofTrusted Source of psoriasis, so talking with your doctor about your weight goals may be helpful.

There have been few scientific studies on the effects of diet on psoriasis, however. Talk with your doctor about an ideal diet for you.

2. Avoid smoking and alcohol

This one may be easier said than done but smoking and alcohol can aggravate psoriasis. Researchers hypothesize that it may be due to factors such as oxidative stress and vascular issues.

Try to limit your cigarette smoking and drinking alcohol as much as possible to prevent psoriasis from getting worse.

Talk with your doctor if you need help quitting. They can recommend smoking cessation programs and resources to help manage alcohol intake.

3. Protect your skin

Sunburn, cuts, infection, and even vaccinations can trigger psoriasis.

This kind of trauma to the skin can cause a response called the Koebner phenomenon. It can lead to psoriasis patches developing in areas where you don’t normally experience flare-ups, making it seem as if psoriasis has spread.

To avoid this, try these tips:

• Use a sunscreen if you’ll be in the sun for extended periods of time. While some ultraviolet light may help heal your psoriasis, too much exposure can damage your skin and may even lead to skin cancer.
• Take extra care to avoid friction, cuts, or scrapes. If you do get injured, take steps to avoid infection. If you experience any signs of infection (redness, warmth, swelling, a fever, etc.), contact your doctor.
• Keep a close eye on your skin following vaccinations. Vaccinations could lead to a psoriasis flare-up.

4. Decrease stress

It’s not always easy to manage stress, and it can be unavoidable at times. From a sudden life change, like a job transition or the loss of a loved one, everyday life’s ongoing stress is linked to an increase in psoriasis.

Here are some things you can do to try to reduce your stress:

• Keep your schedule manageable.
• Find time to do the activities you enjoy.
• Spend time with people who uplift you.
• Keep your body and mind healthy.
• Look into stress-reducing activities like mediation and yoga.
• Take a few moments each day just to breath and clear your mind.

5. Sleep

Getting enough sleep can support your immune system and may help you maintain a moderate body weight and manage stress. All of these are important for keeping your psoriasis at bay.

Adults are recommended to get 7 or more hoursTrusted Source of sleep a day. Speak with your doctor if you have any trouble getting enough sleep.

6. Reconsider certain medications

The following medications are associatedTrusted Source with psoriasis flares:

• lithium
• synthetic antimalarial medications
• beta-blockers such as propranolol
• quinidine, an antiarrhythmic
• tetracyclines
• non-steroidal anti-inflammatories (NSAIDs) such as indomethacin

Talk with your doctor if you think one of these medications might be affecting your psoriasis. And always talk with your doctor before quitting or changing any of your medications.

7. Use lotion

Overly dry skin can trigger psoriasis. Avoid overly hot showers, which can dry your skin. After bathing, pat your skin dry with a towel and apply an unscented lotion to help lock in moisture.

You may also want to use a humidifier in your home if the air is dry. That can help prevent dry skin as well.

Takeaway

Psoriasis isn’t contagious, meaning you can’t spread it to other people. Flare-ups can cause your psoriasis to get worse and cover larger amounts of your body.

Learn your triggers and avoid them, when possible, to help reduce your risk for flare-ups.

https://www.healthline.com/health/psoriasis/does-psoriasis-spread?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2022-11-29&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e

Things You Can Do To Improve Your Psoriasis Symptoms

From glam.com

It can be difficult to grasp the concept of autoimmune diseases if you don't have to contend with one of them yourself. An autoimmune condition means that your body's immune system attacks its own healthy tissue, according to the Centers for Disease Control and Prevention. Some common autoimmune disorders include Addison's disease, Graves' disease, multiple sclerosis, rheumatoid arthritis, and psoriasis (via MedlinePlus).

It's an unfortunate state of affairs that people who deal with psoriasis are often very good at explaining what makes their condition an autoimmune disease. With psoriasis, the body causes raised, flaky patches of red skin that form scales. And those scales can itch to absolute distraction. Psoriasis patches are most common on arms, elbows, palms, knees, the lower back, and feet, though they can break out anywhere on the body, per Cleveland Clinic. 

Every condition comes with a learning curve, and people with psoriasis often must take time to learn the many steps they can take to ease the intense dryness and soothe their itchy skin. If you are dealing with psoriasis, here are six tactics you can try that may help you find relief and feel like a new person.

Soften and break down scales

There's nothing like getting to the heart of a problem. And removing the patches and scales that form on your skin will remove the source of the itchiness, according to the American Academy of Dermatology Association. Applying salicylic acid — with the approval of your physician — will soften and break down the scales so that they can be brushed or sponged away, which ought to give you the upper hand over your symptoms.

Salicylic acid is used to treat many skin disorders and is available without a prescription (via Mayo Clinic). Using it to manage psoriasis symptoms is a far superior method to picking at the scales, which may only them worse.

Consider light therapy

People who have moderate to severe psoriasis often report good results from light therapy, which is meant to impede the growth of affected skin cells. Also called phototherapy, the Mayo Clinic says light therapy can be used by itself or in tandem with medication.

A healthcare provider is in the best position to recommend the best type of light therapy, which can range from regular but brief periods of exposure to sunlight or to artificial light sources. Like most other soothing tactics, light therapy stands the best chance of working when it's used consistently, according to the National Psoriasis Foundation. 

Try aloe vera

Aloe vera has been used for thousands of years to treat burns, scrapes, and other skin wounds. And this is good enough for many psoriasis sufferers to turn to the plant — or a product that includes the ingredient — for relief. It should provide a triple punch: soothing itchiness, tamping down inflammation, and moisturizing dehydrated skin cells (via Medical News Today). 

Slicing open a thick leaf, squeezing out the aloe gel, and applying it to your sore, itchy skin may help you appreciate the plant's vaunted reputation — and why the Egyptians referred to aloe as the "plant of immortality" and Alexander the Great used the plant to heal his soldiers' wounds (per Lily of the Desert).

Take an oatmeal bath

Psoriasis sufferers who love a good soak usually aren't happy campers about the restrictions they must endure for their own good. To refrain from further irritating their skin, the American Academy of Dermatology Association recommends limiting baths and showers to only one per day, setting the shower timer to five minutes and the bath timer to 15 minutes, and using lukewarm water.

This is why the advice to soak in oatmeal — known as colloidal oatmeal — may play like music to the ears and like a feather on the skin. The oatmeal's anti-inflammatory and antihistamine qualities will leave your skin with a silky, almost oily coating that is the antithesis of the dry, itchy, and flaky skin you may be cursing now.

Keep moisturizer with you, always

If you consider an oatmeal bath an at-home indulgence, you'd be smart to keep a moisturizer with you as an out-of-home necessity. As psoriasis sufferers often learn the hard way, flare-ups can strike out of nowhere, without warning, per WebMD. 

Somewhere along your psoriasis journey, a well-meaning person is certain to tell you to "fight the urge" to scratch, but you can one-up that advice by moisturizing instead of scratching, the American Academy of Dermatology Association says. It's a powerful antidote that will suppress a powerful urge.

Chill out with a cold compress

Since psoriasis doesn't usually burn, it can be easy to forget that it responds to cool influences. As the American Academy of Dermatology Association notes, nerves don't "send itch signals to the brain" quite as quickly or adeptly when they're chillin'.

Cold compresses and ice packs may keep the itch factor under control, but don't go too far and extrapolate. Using a cold, wet cloth will actually backfire because the water will eventually evaporate and, as it does, will leave your already dry skin even itchier, per Balcones Dermatology & Aesthetics. And with psoriasis, that's the last thing you need.

https://www.glam.com/1112755/things-you-can-do-to-improve-your-psoriasis-symptoms/ 

Can You Have Eczema and Psoriasis at the Same Time?

From self.com

The symptoms overlap quite a bit—but an accurate diagnosis is crucial 

If you have painful skin symptoms that just won’t quit—you know, dryness that leads to obvious cracks, inflammation that just feels awful, or intense itchiness—and you’ve travelled down a rabbit hole via Dr. Google, then you’ve probably come across information on either eczema or psoriasis.

These skin conditions are different and complex in unique ways, but their respective lists of symptoms can overlap quite a bit, making them difficult for the average person (read: anyone who’s not a trained dermatologist) to tell apart.

If you think that suspicious rash could be a sign of eczema, psoriasis, or maybe even both, here’s some information to help you navigate what you’re experiencing, straight from dermatologists.

First, a little bit about how psoriasis is defined…

At its core, psoriasis is an autoimmune condition, meaning it’s caused by a glitch in the immune system that causes the body to mistakenly attack healthy skin cells. Because of this immune malfunction, the body overproduces skin cells, which then accumulate and pile up on the skin’s surface, according to the American Academy of Dermatology (AAD).

Plaque psoriasis, the most common form of the condition, causes raised lesions—often with a scaly appearance with a silver-to-grey plaque, depending on your skin tone—that can manifest anywhere on the body and feel itchy, tender, or even painful.

There are various forms of psoriasis, so the symptoms can vary widely. But plaque psoriasis often appears on areas like the elbows, knees, trunk, and scalp, Esther Kim, MD, an assistant professor of dermatology at Columbia University Medical Center, tells SELF. You may even start to feel pain in your joints: When inflammatory arthritis occurs alongside psoriasis, it’s called psoriatic arthritis, Dr. Kim says.

Many people with psoriasis experience flare-ups, or periods of time when symptoms become more active. These flares can last anywhere from weeks to months, and there is a range of triggers that can set them off, from infections and illnesses to skin stressors (like cuts and scratches) to changes in weather and stress levels, per the AAD.

Like other autoimmune conditions, the root causes of psoriasis aren’t well understood, but researchers believe that both environmental and genetic factors are at play, Dr. Kim says.

…and here’s a little eczema 101.

Eczema is an umbrella term for a group of skin conditions in which the skin barrier (the outermost protective layer) is damaged, leading to itchy, dry, and inflamed skin, per the AAD. Eczema is broadly referred to as atopic dermatitis, the most common form of the condition, but there are various types of eczema that have different triggers. An eczema rash can look and feel different from person to person, but it may include small, raised bumps, dry or cracked skin, itchiness, and oozing or crusting, among other symptoms that generally signal irritation. 

“Intense itch is a hallmark of eczema,” Dr. Kim notes. “Because of the itch, patients often suffer from a persistent itch-scratch cycle that can lead to thickening of skin and scratches that render the skin prone to superficial skin infections.”

Like psoriasis, eczema is known to flare from time to time. Unlike psoriasis, though, it is associated with an increased risk of asthma and allergies, Dr. Kim says. Experts believe eczema is triggered by a combination of genetics, environmental factors, heightened stress, and immune system activation, as SELF previously reported—but, technically speaking, it’s not classified as an autoimmune condition like psoriasis.

Yes, you can technically have psoriasis and eczema at the same time.

Experts know that psoriasis affects around 3% of adults in the United States; eczema is a bit more common, affecting around 7% of adults. It’s possible to have eczema and psoriasis at the same time, but it’s pretty rare, according to Alexa B. Kimball, MD, MPH, a professor of dermatology and the president of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center. “They’re a little bit of a yin and yang, in terms of which parts of the immune system are being activated,” she tells SELF. “So they don’t usually occur in the same people, but they can.”

A 2021 paper published in the journal Skin Health and Disease reviewed the findings of 31 studies on these two conditions and found that the prevalence of them occurring together is approximately 2%. The researchers concluded that “clinicians should be aware of coexistence at diagnosis” and “when reviewing poor response to treatment.”

Even though psoriasis and eczema might look similar, they may require different medications and therapies, so it’s important to see a dermatologist who can diagnose you and figure out a treatment plan that’s most appropriate for your situation.

Getting an accurate diagnosis will help you start a treatment plan that actually helps your symptoms.

Usually, psoriasis and eczema aren’t that difficult for dermatologists to tell apart. One big giveaway is that the two conditions usually develop on different parts of the body. Eczema is more common in places like the insides of the elbows and the backs of the knees, whereas psoriasis plaques are more common on the outer parts of the elbows and the knees. When a doctor is examining your skin, the locations of your symptoms offer a huge clue in determining whether you have psoriasis, eczema, or both.

The rashes will likely look a bit different too, Dr. Kimball says. Psoriasis lesions tend to be thicker and more scaly, while eczema rashes are often flatter and itchier. The one place where it can be really hard to tell the two apart? The hands, she says.

Sometimes it can also be challenging to tell the two conditions apart if the lesion or rash has been scratched so much that it’s hard to identify. In these cases, Dr. Kim says if there’s a question about what skin condition you’re dealing with, your doctor will take a tissue sample (a.k.a. a biopsy) and send it to a lab for testing.

Treatments for mild cases of eczema and psoriasis overlap.

When we say “mild,” we mean just a small portion of the skin is affected, Dr. Kimball says. In these cases, treatment typically involves keeping the skin really moisturized and applying topical steroid creams and ointments as needed. “They’re very effective at calming down skin inflammation in general, no matter what causes it,” Dr. Kimball says. “So that’s why it works for both of them.”

And, as you may learn after your flare-ups, it’s helpful to avoid things that might trigger your symptoms. Both conditions can be exacerbated by heavy stress, long and hot showers, infections, allergens, and poor sleeping habits, among other factors, Dr. Kim says.

Treatments for severe cases are quite different, though.

For moderate to severe forms of psoriasis and eczema, the treatments tend to be specific to the condition. A few treatments are broad enough to be useful for both—such as UV light therapy and an oral medication called methotrexate, which works by suppressing inflammation throughout the body, Dr. Kimball explains.

But it’s not that common to use just one treatment for both conditions these days, because highly effective, targeted medications are available. “When we had fewer tools, we treated them more similarly,” Dr. Kimball says. “Now we have much better tools.” For example, biologics are an effective class of injectable medications that act on specific parts of the immune system that play a role in either psoriasis or eczema, Dr. Kim says. Because these medications are so specialized, they can be ineffective if used for the wrong diagnosis, she adds.

If someone happens to have both psoriasis and eczema, they may be prescribed a combination of treatments, which could include prescription-strength creams, light therapy, and oral or injected systemic medications. If someone has moderate-to-severe cases of both conditions, a dermatologist may prescribe two separate biologics as well, Dr. Kim notes.

According to the experts SELF spoke with, you don’t need to worry about a psoriasis medication causing an eczema flare, or vice versa—but it is really important to have an accurate diagnosis. The sooner you know what you’re actually dealing with, the sooner you can start treatment to get your skin feeling good again.

https://www.self.com/story/can-you-have-psoriasis-eczema-same-time

Psoriasis on the Hands and Feet: Types, Symptoms, Treatments

From everydayhealth.com

Psoriasis on the hands and feet can have a major impact on how you function and feel. Here’s what it looks like and how to get the treatment you need. 

From a young age, Steven Levy had an idea of how dramatically psoriasis can impact physical and mental health. “My dad had it,” recalls Levy, 33, a TV producer in Los Angeles. “Growing up, I watched him be very self-conscious about it.”

So, Levy wasn’t all that surprised when, in college, he was also diagnosed with psoriasis, an autoimmune disease with a strong genetic link. The worst flare-ups were on his scalp — “I think it would’ve been hard for people not to notice,” he says, referencing the flakes on his shirt — but he also developed psoriasis on his fingernails as well as his feet.

While flare-ups anywhere on his body were problematic, Levy found that those involving his hands and feet had a unique impact.

What Plaque Psoriasis on Hands Looks Like

Plaque psoriasis is the most common psoriasis type, usually appearing on the elbows, knees, lower back, and scalp. But it can show up on any part of the body, including the hands and feet.

This kind of psoriasis is characterized by thick, scaly patches of skin. “On white skin, you’ll see redness or salmon-pink patches. On darker skin, you may not see the red as much; instead, the skin can look hyperpigmented, appearing brown or purple in colour, depending on skin type and skin tone,” explains Jeffrey Cohen, MD, assistant professor of dermatology and director of the psoriasis treatment program at Yale Medical School in New Haven, Connecticut.

Nail Psoriasis Is Often an Issue

Another type of psoriasis that affects the hands and feet is nail psoriasis. “This can be challenging to treat since it’s difficult to get medications underneath the nails, to the matrix beneath the surface, where nails are made,” says Dr. Cohen.

Although nails take up a relatively small amount of the body’s surface area, they can create major discomfort. Per Cohen: “The nails can thicken, lift up, or get little divots.”

That’s what Levy experienced. “My fingernails became pitted, which I later learned is a warning sign for psoriatic arthritis,” he says. A study published in 2017 in Reumatologia found that almost 80 percent of people with psoriatic arthritis have nail symptoms.

Pustular Psoriasis Can Affect Palms and Soles

There are other rarer types of psoriasis that can affect the hands and feet. “Some people develop pinpoint-sized white bumps, or pustules, on the surface of the skin, which can appear on the palms of the hands or on the soles of the feet,” says Elisabeth Richard, MD, assistant professor of dermatology at the Johns Hopkins University School of Medicine in Baltimore.

As to why psoriasis develops on the hands and feet, Dr. Richard suggests, “It’s possible that it has to do with a process known as Koebnerization, which links trauma such as banging or frequently rubbing an area to flare-ups.”

Psoriasis Involving the Hands and Feet Can Interfere With Everyday Life

Psoriasis flare-ups on the hands and feet can be hard to live with, for some obvious and not-so-obvious reasons. “Often, there’s intense itching — that can be extremely debilitating,” says Cohen.

And because psoriasis can thicken the skin, a phenomenon known as hyperkeratosis, it’s easy for painful cuts or fissures (cracks) to develop, especially in cold weather.

These symptoms can pose obstacles that make everyday life stressful. With hand psoriasis, “Activities like typing can become difficult,” according to Cohen. Levy had flare-ups on the knuckles of his toes, which were initially itchy and eventually became raw and painful. “After I walked for a while, I would really start to feel it,” he says.

Anxiety and Depression Due to Hand and Foot Symptoms May Take Hold

Psoriasis flare-ups can lead to embarrassment — and worse. A study published in 2021 in Frontiers in Medicine involving more than 1,500 people with psoriasis found that people with psoriasis were more likely to experience depression than those without the skin condition. And a recent meta-analysis of studies found that 34 percent of patients with psoriasis had symptoms of anxiety. 

When psoriasis appears in a place as obvious as the hands, it causes a lot of social stress. “My patients with psoriasis on their hands tell me all the time that people are reluctant to give them a handshake,” says Richard, who emphasizes that psoriasis is definitely not contagious. 

“But it’s tough to go about your life if you don’t want people to see your hands,” Cohen acknowledges.

Finding the Right Psoriasis Treatment Can Help

The first-line treatment for psoriasis on the hands and feet (and other areas of the body) is typically topical steroids alternated with topical anti-inflammatories. “There are some very new nonsteroidal topical treatments that have been recently approved by the U.S. Food Drug Administration (FDA). The nonsteroidal topicals don’t thin the skin like steroids can do,” says Richard.

There is also a new nonsteroidal treatment in pill form, deucravacitinib (Sotyktu), which the FDA approved in September 2022 for moderate to severe psoriasis. “It works by blocking certain molecules that affect immune system signalling, helping to prevent inflammation,” explains Cohen.

Other treatments include light therapy, which can be a good option when psoriasis is localized as opposed to all over the body. “Light therapy is a well-established treatment that’s been in use for over 40 years. It’s a nice drug-free alternative that works well for some people,” says Richard.

Two more options for moderate to severe psoriasis are the chemotherapy drug methotrexate and a class of drugs known as biologics, which are either administered through injection or intravenously. These medications target underlying inflammation by suppressing the body’s immune response, but they can sometimes cause side effects. Patients and doctors need to work closely together to decide whether these medications are the right choice.

“Usually, we reserve biologics for people with moderate and severe psoriasis, when anywhere from 7 to 10 percent of the body is affected,” says Richard. “But the hands and feet can be a special case since they are so essential to a person’s quality of life, so we’ll often go to the more aggressive treatments sooner.”

Trial and Error Is Often Part of the Process in Psoriasis Treatment

Psoriasis patients often find they need to try a number of different treatments before settling on the most effective option. “That’s particularly true for psoriasis on the hands and feet — it’s common for people to go through many medications that don’t work before they find one that does,” acknowledges Cohen.

For Steven Levy, it took seven or eight years for him to find the right approach. He started with steroid creams: “For me, the impact wasn’t worth the amount of effort it took to apply them twice a day.” He then moved on to methotrexate and, finally, biologics. 

“I’d say my psoriasis is now 97 percent better — it’s amazing, and I barely feel the shot,” he says. “When I first got psoriasis, biologics were kind of the last resort, but it seems like there are so many safer options now.”

The Right Psoriasis Treatments Can Significantly Improve Your Quality of Life

The bottom line: It’s important to see a dermatologist for psoriasis and not to give up, even if the first few treatments don’t work for you.

“One thing I’d like patients to understand is that we have a lot of good options for psoriasis, and they are expanding all the time,” says Cohen. “I’ve seen it with so many patients — we can drastically improve the quality of a person’s life.”

https://www.everydayhealth.com/psoriasis/psoriasis-on-the-hands-and-feet-types-symptoms-treatments/

Catching Psoriasis Early Can Make a Big Difference — Here Are the Signs to Look Out For

From parade.com

Plus, recommendations for managing symptoms 

It would be nice to think that skin problems were confined to the teenage years. Unfortunately, not only can breakouts happen at any age, but new changes to the skin can occur too. One skin condition that can be particularly challenging to manage is psoriasis.

“Psoriasis is a lifelong condition where your body’s immune system creates skin and nail lesions,” says California board-certified dermatologist Dr. Cynthia Bailey, MD, founder of Dr. Bailey Skin Care. According to Dr. Bailey, an estimated 125 million people, or 2 to 3 percent of the population in the world, have psoriasis. “In the U.S., 3 percent, or about 8 million Americans, have psoriasis,” she says. Dr. Bailey says that symptoms can start at any age—often first appearing between someone’s 20s and their 60s.

The key to properly managing psoriasis starts with knowing what its early stages look like. Then, it can be helpful to work with a dermatologist to manage symptoms.

How to Spot Psoriasis as Soon as it Starts

San Francisco-based board-certified dermatologist Dr. Caren Campbell MD, FAAD, explains that psoriasis is a chronic inflammatory skin disease. She says that usually there is a genetic component to it. Dr. Bailey agrees, saying that an estimated 60 to 90 percent of people with psoriasis have inherited a psoriasis gene from one of their parents. “A number of different genes associated with psoriasis have been discovered,” Dr. Bailey says. “These genes are ones that regulate some of the complex aspects of the immune system and the skin’s barrier function. We don’t know exactly how these genes lead to the manifestations of psoriasis, and research is actively ongoing to better understand this condition.”

While genetics most certainly play a role, Dr. Campbell says that psoriasis can be triggered or made worse due to stress, illness, smoking, medications or medical issues such as obesity. Dr. Campbell and Dr. Bailey both say that there are some early signs of psoriasis to be aware of. 

Some of the symptoms are outlined below:

• Pink, thickened areas of skin with a silvery scale (most likely to be found on the elbows, knees and scalp).
• Symmetric lesions appearing on both sides of the body (such as the arms, legs, back and chest) at the same time. They are typically red, raised and covered with a crusty scale.
• Skin folds such as the groin, armpits, under the breasts and cleft in the buttocks. The rash may be red and moist with very little scale.
• Thick fingernails and toenails that are lifted off of the nail beds, with pitted dents on the surface.
• Joint pain that is worst in the mornings.

“Psoriasis, like so many health problems that are due to inflammation, gets worse with age,” Dr. Bailey says. “The condition often becomes more stubborn and difficult to treat over time. In the worst case, the entire skin can become red, which can put life-threatening strain on the heart and internal organs.”

Dr. Campbell emphasizes that psoriasis affects more than just the skin, especially as it worsens. “It can cause destructive arthritis that is permanent,” she says. Dr. Campbell adds that psoriasis can also increase the risk of cardiovascular disease, as the inflammation of the skin can also happen in your blood vessels and heart. “[For this reason], it's important to address this systemic inflammation as well to prevent long-term issues systematically,” she says.

While all of this may be discouraging to hear, both dermatologists say that there are ways to manage symptoms and Dr. Campbell says that with proper management, the symptoms can actually get better over time, not worse.

What Psoriasis Management Looks Like

If you notice any of these early stages of psoriasis, Dr. Campbell says it’s important to see a dermatologist so you can be properly diagnosed and discuss treatment together.

Since psoriasis is caused by inflammation, Dr. Campbell says an important first step to managing psoriasis is to do what you can to minimize inflammation through diet and lifestyle habits. This may look like adhering to an anti-inflammatory diet, which involves eating minimally processed foods and limiting sugar and alcohol. Doing what you can to manage stress, getting adequate sleep and exercising regularly are also ways to fight inflammation. 

In addition to doing what you can through diet and lifestyle to minimize inflammation, Dr. Bailey says that there are some topical and oral medications available that can help with symptoms. “The choice of treatment depends on the type of psoriasis and how extensive it is,” she says. Often, she says, doctors will recommend cortisone creams and ointments to treat psoriasis as topical vitamin D prescription medication. “Other topical treatments include tar and dithranol ointments,” Dr. Bailey says. Sometimes, Dr. Bailey says that UV light is used to treat psoriasis and she adds that there is an oral medication that can enhance its effects, called PUVA treatment.

No matter what medications someone with psoriasis may or may not take, Dr. Bailey says that a proper skincare routine is key. She explains that someone with psoriasis should focus on treating and preventing skin dryness because psoriasis can spread on really dry skin. “To treat and prevent dry skin you want to moisturize areas prone to psoriasis with a good, rich moisturizing cream after every bath or shower,” she says, adding to avoid bathing with harsh soaps and steamy, hot water—both of which will dry out skin.

As with any medical condition, early detection is key to managing psoriasis. That way, you can start working with a dermatologist quickly to manage symptoms before they impact your health more severely. 

While there’s no cure for psoriasis, there is a lot that can be done to make it more manageable to live with. “During my 35-year dermatology career, I’ve always emphasized to my psoriasis patients the importance of making lifestyle choices that help control inflammation,” Dr. Bailey says. “Psoriasis is easier to control when you get your body’s physiology helping instead of fuelling this otherwise capricious disease.”

Let this serve as a reminder to pay attention to what your body is telling you: often, the message is more than skin deep.

https://parade.com/health/early-stage-beginning-of-psoriasis

Psoriasis on the Knees and Elbows: What It Looks Like, How to Treat It

From everydayhealth.com

The knees and elbows are among the most common spots for psoriasis. Here, special concerns and treatments to try 

Ellen Pace’s journey with psoriasis has been a long one. “I’m 67, I’ve had psoriasis since I was 11 years old, and it’s been a challenge throughout,” says Pace, a psychotherapist who lives in Brooklyn, New York. “I’ve always gotten flares on my knees and elbows, and it’s really unsightly.”

She’s been mortified by these flares since childhood. “As a kid, I’d go to day camp wearing jeans and long-sleeved shirts — and I never, ever wore a bathing suit,” she recalls.

What Knee and Elbow Psoriasis Looks Like

The knees and elbows are the most common location for psoriasis flare-ups. “Those are the textbook cases,” says Elisabeth Richard, MD, an assistant professor of dermatology at the Johns Hopkins University School of Medicine in Baltimore.

Psoriasis on these body parts tends to have a distinctive appearance: “You’ll usually see a well-circumscribed plaque, bigger than a centimetre, with thickened skin and overlying white scales,” Dr. Richard explains. Plaques may appear red or salmon pink on white skin and purple or brown on Black or brown skin.

Psoriasis most often appears on the front of the knees and the elbows, known as extensor surfaces, says Jeffrey Cohen, MD, an assistant professor of dermatology and director of the psoriasis treatment program at Yale Medical School in New Haven, Connecticut.

The prevalence of psoriasis in these areas is likely no accident. “We lean on our knees and elbows frequently, or they are apt to rub against clothing. That can result in a process called Koebnerization, in which micro-traumas like rubbing or banging skin potentially lead to flare-ups,” Dr. Cohen explains.

What Knee and Elbow Psoriasis Feels Like

Typically, psoriasis on the knees and elbows isn’t itchy or painful, according to Richard, “unless the skin becomes very thick. Then small cuts, known as fissures, can develop.”

With knee psoriasis, there is some evidence that the condition can harm not just the skin but also the joint. In a 2021 study published in the journal Frontiers in Medicine of more than 10,000 people with psoriasis, women with psoriasis, in particular, were significantly more likely to end up having total knee replacement surgery than people of the same age without psoriasis.

Flare-ups on the knees and elbows can also cause emotional pain. “I see a lot of patients who don’t feel comfortable wearing shorts or short sleeves, even in summer, because they’re embarrassed,” Cohen says.

Pace says that even as a successful psychotherapist, she feels the same self-consciousness about her skin that she did as an insecure 11-year-old. “I still won’t wear a bathing suit — and even though I had a pool built, I won’t go in, because I don’t want anyone to see my flares,” she says.

Knowing that other people in her family have also dealt with psoriasis — the condition has a strong genetic link — hasn’t eased her distress. “I have it worse than my other relatives, and at times, I’ve thought, ‘Why me?’ It has definitely played a psychological game with me.”

Psoriasis flares might appear on the knees and elbows because of small traumas to those areas from leaning or rubbing against clothes.Natalia Serdyuk/iStock; Getty Images; Canva

Psoriasis Treatments Can Help the Knees and Elbows

The good news is that people with psoriasis on the knees and elbows have numerous treatment options that can make a significant difference.

Most dermatologists will typically start out by prescribing topical steroids. Non-steroidal topical treatments are another, relatively new alternative since the U.S. Food and Drug Administration (FDA) approved tapinarof (Vtama) and roflumilast (Zoryve) creams.

There is also a new non-steroidal oral treatment (in pill form) called deucravacitinib (Sotyktu), for people with moderate to severe psoriasis. Cohen explains that it helps minimize inflammation by blocking certain molecules that affect immune system signaling.

Other treatments include light therapy (also called phototherapy), which can be a good option when psoriasis is localized as opposed to all over the body. Pace purchased her own light box and used it for 10 years. “It helped,” she says, “but I eventually stopped because I was worried about developing skin cancer.” (Light therapy utilizes ultraviolet B — UVB — rays rather than the UVA kind to minimize skin cancer risk.)

Richard says that one alternative method for delivering phototherapy is the excimer laser. “You can use a handpiece to deliver the treatment in a very focused way,” she says.

Two more options for people with moderate to severe psoriasis are methotrexate, a chemotherapy drug also used to treat psoriasis and psoriatic arthritis, as well as a class of drugs known as biologics, which are administered via IV or injection. These medications target underlying inflammation by suppressing the body’s immune response but can cause side effects.

Pace has tried a number of biologics. “They worked wonderfully,” she says. Yet eventually, side effects got in her way. “It happened like clockwork — after taking them for three months, I’d start to experience joint pain and nausea,” she says.

Cohen and Richard emphasize that physicians and patients often need to explore a number of therapies before finding the one that works best at a given point in time.

Sunlight and Moisturizers Can Also Help With Psoriasis

For now, Pace is not using medication for her psoriasis, but she is spending more time at her home in Florida. “The one thing that really helps me is the sun,” she says. Keeping her knees, elbows, and other affected areas well moisturized helps, too. “Aquaphor is my friend,” she quips.

Richard agrees: “It’s really important to stay ahead of the dryness with moisturization, and hypoallergenic ointments are best.”

The most important thing to do, says Cohen, is to keep working with your dermatologist. “The main thing I want to impress on people who feel disheartened is that we have a lot of good treatments out there, and the options are expanding all the time.”

https://www.everydayhealth.com/psoriasis/psoriasis-on-the-knees-and-elbows-what-it-looks-like-how-to-treat-it/