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Body

How to manage psoriasis

Psoriasis isn’t catching, and although one in 50 of us develops it at some point, it is often little more than a minor inconvenience for most people. That said, psoriasis isn’t something you have to put up with. If it causes you significant problems a lot can be done, even though there is no single cure.

The red, scaly patches of skin that are the main symptom of psoriasis are caused by chronic inflammation and a build-up of skin cells, because the body is producing them at a much quicker rate than usual. Dermatologists now know that this is because psoriasis is a response of the immune system.

“Psoriasis can start at any age, from childhood to later life, with recognised peaks of onset and a strong familial link,” says Dr Kurt Ayerst, consultant dermatologist at Benenden Hospital. “It can affect all body surfaces and can also be associated with general health issues including arthritis.”

Some people also have distinct triggers that cause their psoriasis to flare up, such as smoking, alcohol, hormonal changes, stress and infection.

So how can you make psoriasis easier to cope with?

Self-care

First off, moisturise and don’t scratch and pick the areas – even if you’re using a specific psoriasis treatment. Also try to:

  • Exercise. Cover up if you want to while you’re doing it, but there’s good evidence that exercise lowers the risk of psoriasis. This may be because it’s a good stress management tool, and it’s known that stress can cause psoriasis to flare up.

  • Steer off the beer. Other alcoholic drinks may raise your risk too, but at least one major study has shown a link between drinking beer and the flare up of psoriasis.

  • Get some sun. The sun’s ultraviolet rays can slow down the production of skin cells. However, keep it to 20 minutes maximum, stop when there’s any risk of burning – and never use a sunbed, which will just raise your risk of skin cancer instead.

Medical intervention

GPs and dermatologists have an array of topical treatments, tablets and injections they can recommend. When managing psoriasis, each area of the body needs to be assessed separately.

“Psoriasis management needs to be approached by assessing and managing each area of involvement in relation to the site, severity and extent. Working from head to toe is a useful approach,” says Dr Ayerst. “Treatment must also be individualised to account for preferences and experience.”

He explains that topical products can be used intermittently for either a few weeks or months at a time, stopping and starting with improvement and deterioration, and interspersed with supportive non-steroid products.

“Once controlled it may be possible to treat once or twice a week to maintain the improvement. Potent topical steroids should not be overused as it can cause skin thinning (atrophy) and tachyphylaxis, when the skin stops responding to treatment.” Emollients are also an important part of the treatment plan and are often overlooked, he adds.

Beyond topical therapy there is a range of options including phototherapy (ultraviolet radiation), tablets and injections. The risks and benefits of these need to be discussed and weighed up carefully.

There is a lot of research and funding into psoriasis treatments and new products are constantly being developed and approved for use. There are, however, restrictions and cautions to be aware of, so discuss options with a healthcare professional.

The Psoriasis Association and the British Association of Dermatologists provide useful advice and support service for patients in the UK.
 

If referred to see a dermatologist, Benenden Health members may be able to access consultations and any tests required to diagnose your condition. This may be at Benenden Hospital in Kent if you live within the catchment. Or, you could be offered diagnostic tests, with a financial limit of £1800 at a convenient hospital. Each case is assessed individually. Speak to Benenden Health member services on 0800 414 8100 for more information.