Coping with Psoriasis

1. Psoriasis: More Than Skin Deep

Psoriasis keeps you thinking. Strategies of concealment ramify, and self-examination is endless. You are forced to the mirror, again and again; psoriasis compels your narcissism, if we suppose a Narcissus who did not like what he saw.

A chronic, complex condition. Psoriasis is a common, chronic skin disorder affecting millions worldwide. It's characterized by red, scaly patches caused by an overproduction of skin cells. The condition can appear anywhere on the body, but commonly affects the knees, elbows, scalp, and lower back.

Beyond the surface. Psoriasis is more than just a skin condition; it's a systemic disease that can affect overall health:

• Can lead to psoriatic arthritis in about 10% of cases
• May increase risk of cardiovascular disease and other health issues
• Often triggered or exacerbated by stress, injury, infections, and certain medications

Unpredictable and persistent. The disease follows an unpredictable course, varying in severity and location. While not curable, it is manageable with proper treatment and self-care strategies.

2. The Emotional Toll of Psoriasis

Psoriasis hurts—not just the body, but the psyche as well.

Psychological impact. The visible nature of psoriasis can profoundly affect a person's emotional well-being and quality of life. Common emotional responses include:

• Anxiety and depression
• Embarrassment and low self-esteem
• Social isolation and relationship difficulties
• Frustration with treatment and disease management

Coping strategies. Addressing the emotional aspects of psoriasis is crucial for overall well-being:

• Seek support from friends, family, or support groups
• Practice stress-reduction techniques like meditation or yoga
• Consider professional counseling if needed
• Focus on self-acceptance and educating others about the condition

3. Finding the Right Doctor: A Crucial Partnership

You are a valuable individual, your health is worth fighting for, and you deserve a physician who will enable your recovery in every way.

Choosing a dermatologist. Finding the right doctor is essential for effective psoriasis management. Look for a dermatologist who:

• Has experience treating psoriasis
• Takes time to listen and address your concerns
• Explains treatment options clearly
• Is willing to work with you as a partner in your care

Effective communication. Maximize your doctor visits by:

• Preparing a list of questions and concerns
• Being honest about your symptoms and treatment adherence
• Taking notes or bringing a trusted friend/family member
• Discussing both physical and emotional aspects of the disease

4. Self-Help Strategies: Empowering Yourself

Self-help does not mean you do everything by yourself. On the contrary, it is a method whereby you include those closest to you in taking on a fresh attitude and approaching your disease from a new perspective.

Taking control. Self-help strategies can significantly improve your quality of life and disease management:

• Educate yourself about psoriasis through reputable sources
• Maintain a positive attitude and practice stress management
• Follow treatment plans consistently
• Join support groups or connect with others who have psoriasis

Lifestyle factors. Healthy habits can help manage psoriasis:

• Get regular exercise
• Maintain a healthy weight
• Avoid smoking and limit alcohol consumption
• Use moisturizers to keep skin hydrated

5. Topical Treatments: First Line of Defense

Most patients start treatment with topical corticosteroids which are available in different strengths. They may reduce skin inflammation and slow skin cell turnover.

Common topical treatments. These are typically the first line of treatment for mild to moderate psoriasis:

• Corticosteroids: Reduce inflammation and slow cell turnover
• Vitamin D analogues (e.g., Dovonex): Slow skin cell growth
• Retinoids (e.g., Tazorac): Normalize skin cell development
• Coal tar and salicylic acid: Help remove scales and reduce inflammation

Application tips. For best results:

• Follow instructions carefully
• Be consistent with application
• Use as directed by your doctor
• Be patient, as it may take weeks to see improvement

6. Light Therapy: Harnessing the Power of UV

It is well known that most patients with psoriasis do better when exposed to ultraviolet light (UVL), which occurs naturally in sunshine.

Types of light therapy. Controlled exposure to UV light can effectively treat psoriasis:

• Natural sunlight: Carefully managed sun exposure
• UVB phototherapy: Artificial UVB light, can be done at home or in a clinical setting
• PUVA: Combines UVA light with a light-sensitizing medication (psoralen)

Considerations. While effective, light therapy requires careful management:

• Must be done under medical supervision to avoid overexposure
• May increase skin cancer risk with long-term use
• Can be combined with other treatments for enhanced effectiveness

7. Systemic Medications: When Topicals Aren't Enough

Currently, there are several internal medications that can be taken to help clear up psoriasis. Because these drugs enter the body, they are called systemic agents.

Types of systemic medications. For moderate to severe psoriasis, systemic drugs may be necessary:

• Methotrexate: Slows skin cell growth
• Cyclosporine: Suppresses the immune system
• Oral retinoids: Regulate skin cell production
• Biologics: Target specific parts of the immune system

Important considerations. Systemic medications can be highly effective but require careful monitoring:

• Regular blood tests to check for side effects
• May increase risk of infections or other health issues
• Often used in rotation or combination with other treatments
• Not suitable for everyone, especially pregnant women or those with certain health conditions

8. Diet and Supplements: Nutrition's Role in Management

If changing or supplementing your diet seems to make an improvement in your psoriasis and is not endangering your overall health, you should continue what you are doing.

Dietary considerations. While no specific diet cures psoriasis, some dietary changes may help:

• Maintain a healthy weight
• Eat a balanced diet rich in fruits, vegetables, and omega-3 fatty acids
• Limit alcohol consumption
• Consider reducing dairy and red meat intake

Supplements. Some people find certain supplements helpful, though scientific evidence is limited:

• Fish oil
• Vitamin D
• Aloe vera
• Probiotics

Always consult with your doctor before starting any new supplement regimen.

9. Alternative Therapies: Exploring Complementary Options

Alternative therapy costs less than conventional medical treatment after disease has set in. A combined approach may offer both good medicine and good economics.

Popular alternative approaches. Many people with psoriasis explore complementary therapies:

• Acupuncture
• Herbal medicine
• Homeopathy
• Meditation and stress reduction techniques

Integrative approach. While alternative therapies can be beneficial, they should complement, not replace, conventional treatments:

• Always inform your doctor about any alternative treatments you're using
• Be cautious of unproven "miracle cures"
• Look for evidence-based complementary therapies
• Consider a holistic approach that addresses both physical and emotional aspects of psoriasis

10. The Future of Psoriasis Treatment: Hope on the Horizon

People with psoriasis today should remain upbeat, with the knowledge that new and exciting treatments are on the way.

Ongoing research. Scientists are continually working to better understand and treat psoriasis:

• Genetic studies to identify psoriasis-related genes
• Immunological research to develop targeted therapies
• Investigation of new biologics and small molecule drugs

Promising developments. Future treatments may offer more targeted, effective, and personalized options:

• Gene therapy
• T-cell targeted treatments
• Oral medications with fewer side effects
• Combination therapies for enhanced efficacy

While a cure remains elusive, ongoing research offers hope for better management and potentially a cure in the future. Stay informed about new developments and work closely with your healthcare team to find the best treatment approach for you.

Last updated: August 10, 2024