What is psoriasis and how to treat it

31 October 2023

Psoriasis affecting the skin, the treatment of which involves the use of ointments

Psoriasis is a dermatological disease in which red spots with silvery scales appear on the skin.

Depending on the type, psoriasis affects the knees, elbows, trunk, nails, face or scalp.

What is psoriasis?

Psoriasis is an autoimmune disease that causes skin cells to grow too quickly, which accumulate and form inflamed red patches. Symptoms of psoriasis can vary depending on its type, stage and cause. General signs of psoriasis:

inflamed skin areas;
whitish-silver scales or plaques on red spots;
pain and burning of the skin;
dry, cracked skin (may itch and bleed);
stiff and swollen joints;
thickened, ridged nails.

Psoriasis in children usually first affects the scalp and nails, then spreads to the elbows, knees and torso. In nail psoriasis in a child, depending on the type of psoriasis, thick nails without depressions or with small protrusions can be observed, as well as yellowing of the nails or their separation from the bed.

If you notice the first signs of psoriasis, consult a doctor. A dermatologist deals with the diagnosis and treatment of psoriasis in adults. If red spots on the skin or silvery scales appear in children, a pediatrician should be consulted.

How does psoriasis start?

Psoriasis begins with the formation of small red bumps that rise a few millimeters above the skin (externally resembling an ordinary rash). As they enlarge, white or silver scales may appear. The scales on top can fall off. The remaining scales become closed and start to hurt and itch. When scratching the resulting rash, the scales can detach from the skin, causing bleeding.

What does psoriasis look like?

In psoriasis, red patches appear on fair skin and brown or purple patches on dark skin. In the initial stage of scalp psoriasis, the spots resemble dandruff (due to white scales). Forms of psoriasis:

mild form of psoriasis (less than three percent of the body is affected, the rash is localized on the scalp or extremities);
moderate form of psoriasis (rash covers three to ten percent of the body, affecting the scalp, hands, legs and torso);
severe form of psoriasis (more than ten percent of the body is affected, rashes appear on the palms, soles and face).

Psoriasis treatment is chosen by a dermatologist depending on the form and type of psoriasis, symptoms and location of the rash. If the treatment is improper or untimely, large areas of lesions appear on the skin.

Where can psoriasis occur?

The localization of psoriasis spots depends on its type. Types of psoriasis:

plaque (vulgar) psoriasis. Plaque psoriasis causes dry, raised patches of skin covered with silvery scales. Psoriasis appears on the elbows, knees, lower back and scalp;
erythrodermic psoriasis. The skin looks burnt, chills appear, and the temperature rises;
guttate psoriasis. Small, flesh-colored, scaly spots, similar to water droplets, form on the arms, legs, and trunk;
pustular psoriasis. In pustular psoriasis, white blisters filled with pus and large inflamed areas of skin form on the skin. Localized on small areas of the skin, affecting the legs or arms;
exudative psoriasis. Spots covered with yellow crusts appear on the skin;
inverse psoriasis. Smooth red spots appear on the skin. The rash appears in skin folds (armpits, buttocks, genitals).

In nail psoriasis, the skin builds up under the nails, causing them to lift and form pits ("nail pits"). The skin under the nail plate turns white, yellow, or brown. Nails become rough, brittle, and break easily.

Dermatologists also distinguish between palmoplantar psoriasis. Skin with psoriasis of the palms and feet is dry and prone to cracking.

Psoriasis of the eyelids causes redness, flaking and crusting around the eyelids. Other symptoms of psoriasis on the eyelids:

the formation of scales that peel off and stick to the eyelashes;
pain when moving the eyes;
irritation of the skin of the eyelids, accompanied by pain and itching.

The edges of the lids can turn up or down depending on the location of the stain, which leads to friction between the eyelashes and the eyeball. Possible consequences of psoriasis of the eyelids are uveitis (inflammation of the eyes) and loss of vision.

Psoriasis can appear on the eyebrows, behind and around the ears, and in the ear canal. Sometimes psoriasis affects the mouth, causing redness and burning of the lips, gums, tongue and cheeks. Oral psoriasis can cause difficulty in chewing and swallowing food.

Manifestations of psoriasis depend on its type, symptoms and stage. Psoriasis can be seen in the photo.

Manifestations of psoriasis on the knees

Reasons for the development of psoriasis

Psoriasis is caused by a malfunction of the immune system, in which white blood cells mistakenly attack skin cells. Due to the action of leukocytes, the process of creating new skin cells is reduced from a month to a few days. Cells formed prematurely are pushed by the body to the surface of the skin, where they accumulate and turn into spots or plaques.

Genetic predisposition (family history of psoriasis) or triggers (environmental factors that increase the risk of psoriasis) can lead to a malfunction in the immune system. Factors that cause the development of psoriasis:

infections (tonsillitis, herpes, ringworm);
skin trauma (sunburn, insect bites, scratches, cuts);
smoking or alcohol abuse;
uncontrolled use of drugs;
regular stressful situations (leads to the development of stress psoriasis);
weather conditions (dry and cold conditions);
abrupt discontinuation of systemic or oral corticosteroids.

These factors can lead to the development of psoriasis in people with a predisposition to it, or cause it to worsen. Exacerbation of psoriasis can be avoided by identifying and eliminating factors that contribute to it.

Worsening of psoriasis

Psoriasis on the face, extremities and head is characterized by periods of exacerbation (symptoms appear intensively) and remission (rash decreases, pain disappears). Remission periods last from a month to a year. Stages of psoriasis:

progressive phase(beginning of psoriasis). Small nodular rashes appear on the skin, which are accompanied by itching. Areas of redness increase, forming plaques;
stationary phase. New nodes (papules) do not appear, the inflammation subsides after the formation of scales or crusts on the plaques;
regressive stage. Plaques are reduced, itching and peeling disappear.

A dermatologist will help alleviate the exacerbation of psoriasis, who will identify triggers and prescribe treatment. Following the recommendations of your doctor will help reduce the period of exacerbations and increase the period of remission.

How to treat psoriasis?

Before starting the treatment of psoriasis, the dermatologist collects the medical history (asks about the symptoms, when they appeared and whether there is a family history of psoriasis) and performs a visual examination of the rash. After establishing the diagnosis, the doctor chooses a comprehensive treatment for psoriasis. Treatment for psoriasis includes:

ointments, shampoos, creams and gels based on extracts of Dead Sea algae and minerals;
phototherapy (exposure of the skin affected by the rash to ultraviolet rays reduces the growth of skin cells, which leads to the normalization of the condition).

For psoriasis, the dermatologist recommends taking vitamins. To produce healthy skin cells and reduce inflammation and symptoms, your doctor will prescribe vitamins A, D, E, K, B and C.

Diet for psoriasis

For psoriasis, the dermatologist recommends dietary changes. Foods that reduce inflammation:

fatty fish (tuna, salmon);
flax and pumpkin seeds;
nuts (walnuts, almonds);
cabbage, spinach.

Adhering to a diet for psoriasis helps reduce symptoms and prevent the development of complications (high blood pressure, diabetes, heart disease). If you have psoriasis on your legs, arms or face, you should limit your alcohol intake.

Your diet should also include the consumption of foods that contain fatty acids (sardines, salmon, shrimp, flax seeds). It is recommended to minimize the consumption of foods containing saturated fats (fatty meat, confectionery products) and simple carbohydrates (dairy products, grapes, bakery products).

Prevention of psoriasis

Preventive measures will help prevent the development and progression of psoriasis on the hands, feet and head. Psoriasis prevention includes:

changes in diet (abstinence from alcohol, simple carbohydrates and saturated fats, consumption of food containing fatty acids);
protection of the head and body from the sun (using sunscreen and a hat);
stop smoking;
reducing the risk of skin injuries (use of insect repellent sprays, gloves, long sleeves);
moisturizing the skin (dry skin is prone to damage).

In order to reduce the likelihood of psoriasis outbreaks, extreme temperatures should be avoided. Exposure to temperatures that are too cold or too hot can dry out or damage your skin. Reducing stressful situations to a minimum will help prevent the appearance of psoriasis due to nervousness.

How to distinguish psoriasis from dermatitis?

Scalp psoriasis (seborrheic psoriasis) is similar to seborrheic dermatitis. Dermatitis can be distinguished from scalp psoriasis with the help of a dermatologist. Symptoms of seborrheic dermatitis:

redness of the skin, on which greasy white or yellow scales are formed (when pressed, sebum can be released);
dandruff (skin flakes) that accumulates near the hair.

You can distinguish psoriasis from dermatitis by the location of the rash. Unlike seborrheic dermatitis, psoriasis does not form only on the head, but spreads beyond the hairline and appears on other parts of the body (limbs, lower back, nails). In psoriasis, the areas of the skin affected by the rash are painful and itchy, and in dermatitis you may feel a slight itching of the scalp.