Understanding Psoriasis: A Health Condition with Psychological Implications

Understanding Psoriasis:

A Health Condition with Psychological Implications

While psoriasis is a health problem, unlike other health problems like diabetes or blood pressure issues, psoriasis is very much visible and its impact can be on more than just the skin. Specialist Dermatologist Dr. Dhanya Rajkumar explains more.

OVERVIEW According to Dr. Rajkumar, psoriasis is a common, chronic, inflammatory and proliferative condition of the skin, associated with systemic manifestations in many organ systems. “Psoriasis is a non-communicable, disfiguring, and disabling disease that has a greatly negative impact on the quality of life for those with the disease,” she says. “The most common characteristic of the skin rash is red, scaly, sharply demarcated lesions that are seen particularly over the extensor surfaces and scalp.” It also affects the nails and joints. According to the International Association of Psoriasis Federations, approximately 125 million individuals across the globe are affected by psoriasis.

LINK TO THE IMMUNE SYSTEM In psoriasis, she points out that any infection that affects the immune system can trigger a certain type of psoriasis, which is why there can often be a flare up following an ear infection, bronchitis, tonsillitis, or even respiratory infection. “These kinds of infections should be treated immediately,” she advises.

LIFESTYLE MODIFICATION There are several dos and don’ts when it comes to psoriasis. “Special consideration should be given to lifestyle factors and behaviors that contribute to the overall health and treatment responsiveness,” she says, these include weight management and smoking cessation. She recommends using thick, nonfragranced moisturizers on a daily basis in conjunction with additional baths which can be infused with colloidal oatmeal, Epsom salts or coal tar to help alleviate inflammation, irritation, dryness, and redness.

SUN EXPOSURE While a majority of individuals avoid sunbathing in an attempt to decrease the risk of developing skin cancer, those who suffer from psoriasis may benefit from it. That said, Dr. Rajkumar advises only exposing the regions of the body affected by psoriasis. To avoid sunburn, cover the unaffected skin with clothing or make use of an SPF 30 sunscreen and limit your sun exposure to 15 minutes.

THE DIFFERENCE BETWEEN OTHER HEALTH PROBLEMS AND PSORIASIS As psoriasis is a health problem that is visibly apparent to others and because it’s chronic, it can often take a toll on the individual’s self-confidence, mood, and even relationships. And while millions of people across the world are affected by this disease, only a small percentage actually understands what it is. Dr. Rajkumar also explains that increased levels of depression, anxiety, and worry often results in flare ups of the disease, leading to moderate or sometimes even severe psoriasis. She also recommends reaching out to family members, friends and seeking medical advice as psoriasis is not simply a painful physical condition; it’s also emotionally draining, with depression, dissatisfaction, and loneliness commonly experienced by those who have the disease. “The best treatment for the mental health concerns listed is to consult a dermatologist, as they would be able to better explain the disease and advise on the best possible treatment, which in turn could reduce the mental health impact that it can have,” she explains.

TREATMENT It is also important to note that there are various treatment modalities, depending on the type and severity of the disease. “Mild plaque psoriasis without psoriatic arthritis can be treated with various topical treatments such as coal tar, potent topical corticosteroids, vitamin D analogues, followed by phototherapy as a second line of treatment,” she says. “In terms of moderate to severe plaque psoriasis treatment, phototherapy is the first line of treatment, followed by oral medications such as immunosuppressants and apremilast.” However, in case patients do not respond to the aforementioned treatment, the next step is biologicals, which can have a great promise for individuals with moderate to severe psoriasis, and they represent a significant step forward in the development of psoriasis medications that will improve the quality of life of patients. H