The Challenge of Psoriasis

It’s not life-threatening, but certainly unsightly

Imagine your distress if thick, red, scaly patches began appearing on your skin, and you found out you’d have the condition for the rest of your life. Four to 5 million people in the United States are coping with just such a chronic skin problem—psoriasis.

“We’re not completely sure what causes psoriasis,” says dermatologist Marc Levin, M.D., of Lehigh Valley Hospital and Health Network. Some people seem to be genetically susceptible. If you’re one of them, an outbreak of psoriasis can be triggered by infection, injury to the skin, emotional stress or some other factor. A mistaken response from your immune system causes your skin to grow too rapidly.

Normally, your body replaces skin cells about every 30 days, but psoriasis speeds the process to three or four days. The most commonly affected areas are elbows and knees. “There are several different types of psoriasis, and some people think it’s more than one disease,” Levin says.

Treatment usually begins with creams or ointments, especially if not too much of the skin is affected. These topical treatments (some containing corticosteroids) often are used in combination to slow cell growth and reduce inflammation.

If creams aren’t effective, ultraviolet B (UVB) light treatments may help. UVB is present in natural sunlight, but dermatologists use an artificial narrow-band UVB light source in a series of timed treatments.

“Some people need a combination of drug and light therapy,” Levin says. After they take the drug psoralen orally or as a cream, ointment or bath, the psoriasis patch is exposed to a carefully measured amount of a special form of ultraviolet light (UVA). For people with severe psoriasis, there are other oral and injectable drugs that target the cells activating the immune response, but those medications may have serious side effects.

The itching and irritation of psoriasis can be extremely uncomfortable in severe cases. Up to a third of psoriasis sufferers develop a form of arthritis, or inflammation of the joints and connective tissue. (Like all autoimmune diseases, psoriasis raises the risk for developing other autoimmune disorders.)

People prone to psoriasis learn to avoid stress (which can trigger flare-ups) and to be careful not to irritate their skin. “For now, treatment is focused on relieving symptoms, but as researchers learn more about the disease, we hope to find a cure,” Levin says.

Want to Know More about coping with psoriasis or about skin care? Click here.

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