Psoriasis is a common, non-contagious and distressing skin complaint. Varying in severity it is caused when skin cells reproduce too quickly. Usually skin renews itself every 28 days but psoriasis sufferers have a much faster turnover of skin cells - around every four days. The condition is characterised by red, scaly, raised patches of dead skin known as 'plaques'. These patches, which vary in size from a few millimetres to several centimetres across, can fall off, often leaving small areas of skin bleeding. Some sufferers also experience itching.
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Where does it appear?
Plaque psoriasis, the most prevalent form, can appear almost anywhere on the body although most frequently on the elbows, knees and scalp. Most common amongst those with fair skin in Europe and the USA, around 2% of the population is affected by psoriasis at some stage. Men and women are troubled equally and although psoriasis can begin at any age it most often occurs between the years of 5-9 in girls and 15-19 in boys. However, adults between 57 and 60 years old can also experience their first attack (psoriasis is regularly mistaken for eczema in the elderly).
What triggers it?
Psoriasis has a tendency to run in families although the exact cause remains unknown for certain. Particular situations do seem more likely to trigger a flare-up including:
- Illness (especially a streptococcal infection - a familiar cause of sore throats and tonsillitis)
- Infection
- Emotional stress
- Side effects to some medication
- Hormonal factors such as puberty and menopause
- Sun exposure (although ultraviolet light can be very beneficial to the majority of sufferers)
How can it be treated?
For some, psoriasis will simply disappear on its own. For the rest of sufferers the good news is that treatments have vastly improved in the past few years and more help is therefore available to help slow down the rate of skin cell formation and ease some of the discomfort. The most popular treatments include emollients, vitamin D based creams, coal tar preparations, steroid ointments or creams and phytotherapy (UV light therapy). As psoriasis has also been linked to problems with the metabolism of essential fatty acids (EFAs), dietary changes and nutritional supplements can also help significantly. (See 'Dietary supplements' and 'Did You Know?')
Dietary supplements
Some sufferers experience significant relief from the main symptoms of psoriasis - itching, scaling and redness - by taking specific supplements:
- Omega-3 fish oils (a rich source of EFAs, which are essential for good skin health) can significantly help to reduce lesions. A daily dose of around 3000mg is recommended. Flax or linseed oil is a good alternative to fish oils for vegetarians.
- Evening primrose oil may also ease symptoms in some sufferers: try 2000mg over an 8 week period.
- Antioxidants including beta-carotene and vitamins C and E can help boost your immune system to prevent illness and help you fight infection better, two of the key triggers.
- Available as either a tincture or capsule, the herb echinacea is a proven anti-inflammatory and immune-stimulator and also has wound healing properties.
Complementary medicine
Studies have shown that specific combinations of Chinese herbs may significantly improve some types of psoriasis and eczema. When choosing a medical herbalist, see a reputable, well-qualified practitioner who is registered with one of the governing organisations (see 'Want to know more?'). It is advisable to tell your GP that you are going to try complementary medicine. Do not suddenly stop your prescribed treatment.
Skincare advice
Gentle, non-irritating skincare can greatly help to minimise the discomfort of psoriasis:
- As with any skin condition avoid using soap, perfumed shower gels or bubble baths. Although not a medicated product, our Orange Flower Botanical Body Wash is detergent-free and offers a gently cleansing alternative. You could also try bathing with a mild and non-drying emollient lotion; your pharmacist will be able to recommend a good one.
- Frequently apply a moisturising emollient cream. This will help to keep skin soft and supple and may also help disguise the appearance of flaking skin. Some sufferers find Nourishing Botanical Body Cream beneficial for this.
- For specific patches of irritation, our conditioning skin salve Superbalm may help to soothe and calm skin.
- There are also natural treatment creams containing specialised EFAs and other helpful oils that can be applied topically. A good one is Dermanova PS-98 which contains omega-3 fish oils, neem seed oils and cactus extracts.
Did you know?
Diet can play a major role in helping to control symptoms. Ideally, psoriasis sufferers should avoid 'trans' fats, artificial trans-fatty acids created by food processing that interfere with the way EFAs work within the body. It is therefore best to aim for a 'clean food' diet, which avoids processed foods wherever possible. It may also be useful to cut back on saturated fats found in red meats, dairy products (in particular cheese) and eggs, as well as refined sugars found in biscuits and cakes, plus wheat gluten. Instead, boost your intake of oily fish as they are an excellent source of omega-3. Some practitioners suggest taking milk thistle and artichoke extracts to help improve liver function too.
Want to know more?
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psoriasis-association.org.uk Providing support for sufferers as well as raising awareness into the condition and helping to fund research into its causes and treatment the charity's site contains good information about all the different forms of psoriasis.The Psoriasis AssociationMilton House 7 Milton StreetNorthampton NN2 7JGTel: 0845 676 0076
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papaa.org This charity offers a wide list of free publications including information leaflets on psoriasis and psoriatic arthritis.Psoriatic Arthropathy AlliancePO Box 111 St AlbansHertfordshire AL2 3JQTel: 0870 770 3212Fax: 0870 770 3213Email: info@thepaa.org
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An umbrella organisation representing the interests of everyone with skin diseases in the UK, this subsidiary of the National Eczema Society runs regional skin information days throughout the year.Skin Care CampaignHill House Highgate HillLondon N19 5NATel: 0207 281 3553Email: infoscc@eczema.org
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Dermanova Products
Available as a cream, shampoo and body lotion, this steroid-free moisturising cream contains fish oils and other natural ingredients. Available via mail order from Wellcene Health.
bad.org.uk This very informative site is put together by UK dermatologists to offer a wide range of information leaflets on many skin conditions including psoriasis, as well as details of how to get professional help and listings of patient support groups. -
rchm.co.uk This non-profit making organisation has an excellent website. A full list of registered practitioners in the UK can also be obtained by sending a S.A.E plus a cheque for £3.00.The Register of Chinese Herbal MedicineOffice 5 1 Exeter StreetNorwich NR2 4QTel: Tel:0160 362 3994Fax: 0160 366 7557
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nimh.org.uk The UK's leading professional organisation for herbal medicine practitioners offering a free register of members either by telephoning, or a precise search can also be made on the website.The National Institute of Medical HerbalistsElm House 54 Mary Arches StreetExeter EX4 3BATel: 0139 242 6022Fax: 0139 249 8963
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