Psoriasis

Unpredictable, intractable, and unsightly, psoriasis is one of the most baffling and persistent of skin disorders. It is characterized by skin cells that multiply up to 10 times faster than normal, typically on the knees, elbows, and scalp. As underlying cells reach the skin's surface and die, their sheer volume causes raised, white-scaled patches. Palmar or plantar psoriasis, which affects only the hands or feet, tends to be much more painful and often blisters and oozes.

Though not contagious, psoriasis tends to run in families. Fair-skinned people aged 10 to 40 are particularly susceptible, especially those with a blood relative who suffers from the disorder.

Psoriasis is extremely rare among people with dark skin. Outbreaks are triggered by the immune system and can affect other parts of the body, particularly the joints, in which case the condition is called psoriatic arthritis.

Although psoriasis may be stressful and embarrassing, most outbreaks are relatively benign. With appropriate treatment, symptoms generally subside within weeks.

Causes

A variety of factors, ranging from emotional stress to a streptococcal infection, can precipitate an episode of psoriasis. As many as 80 per-cent of patients suffering a flareup report a recent emotional trauma, such as a new job or the death of a loved one. Many doctors believe such external strains serve as triggers for an inherited defect in skin-cell production.

Injured skin, obesity, and certain drugs - including the painkiller ibuprofen and the anti-malarial medication chloroquine - can aggravate psoriasis. The disease often appears two to three weeks after an infection such as strep throat. Alcohol consumption clearly makes psoriasis worse, as does a diet high in protein and low in fiber.

Treatment

Despite the fact that psoriasis is technically incurable, it responds well to most treatments for dermatitis. I n addition to the conventional therapies below, light therapy is accepted and practiced by conventional doctors.

Conventional Medicine

A standard treatment recommended by many doctors is to soak in a warm bath for 10 to 15 minutes, then immediately apply a topical ointment such as petroleum jelly, which helps your skin retain moisture. Some doctors recommend salicylic acid ointment, which smooths the skin by promoting the shedding of psoriatic scales. Steroid-based creams are effective; however, because they can have harmful side effects, psoriasis sufferers should be especially careful not to overuse them.

Treatment with capsaicin, a component of cayenne (Capsicum frutescens), may also be effective. Available as an over-the-counter ointment for treating shingles, it causes the body to block production of an inflammation-causing chemical found in psoriatic skin. It also prevents the body from building blood vessels to the affected area, thereby stemming the abnormal growth of psoriasis. Because capsaicin can burn and severely damage the skin if used incorrectly, try this only under a doctor's supervision.

A topical ointment containing calcitriol, which is related to vitamin D, has proved as effective as hydrocortisone creams for treating psoriasis and has fewer side effects. Coal-tar ointments and shampoos can alleviate symptoms, but many psoriasis patients seem vulnerable to the side effects-in particular folliculitis, a pimple-like rash affecting the hair follicles. Some studies also indicate that continued use of such coal-tar products may increase the risk of skin cancer.

Anthralin therapy is generally reserved for severe forms of psoriasis. Anthralin salve is carefully applied to the affected areas and removed after 30 to 60 minutes. All the white scales should be gone, revealing an underlying layer of fresh, normal skin. If not properly applied by a trained therapist, however, anthralin may irritate healthy skin and leave stains that can last several weeks. For persistent, difficult-to-treat cases of psoriasis, many medical doctors also recommend and prescribe light therapy.

Alternative Choices

If conventional treatments for psoriasis are not working for you, ask your doctor about the potential benefits of the following alternatives.

Aromatherapy

As an alternative to coal-tar shampoos for psoriasis on your scalp, mix together 4 drops of essential oil of cedarwood and 2 drops of juniper (Juniperus communis) or lemon in 1 tbsp almond or olive oil. Apply the mixture to your scalp and leave it on overnight under a shower cap. Shampoo and rinse thoroughly in the morning. Repeat three times a week until the symptoms clear. Since some people are sensitive to essential oils, place a drop on your skin for 30 minutes to be sure you have no adverse reactions.

Climatotherapy

Climatotherapy is based on the idea that specific climatic conditions can help or even heal certain diseases. For psoriasis, spending time in the sun can be beneficial. Special facilities at Israel's Dead Sea or other resort locations offer treatment designed for people suffering from psoriasis and other skin disorders. The combination of sunlight, relaxation, and mineral baths seems to have a therapeutic effect for many people.

Herbal Therapies

Burdock (Arctium lappa) root, dandelion (Taraxacum officinale) root, and Oregon grape (Mahonia aquifolium) are said to help reduce symptoms of psoriasis. Simmer 1 tbsp of any of these dried herbs in a cup of boiling water for 10 minutes; strain and drink hot, up to three cups a day. You may also take up to 1½ tsp fluidextract of bur-dock or dandelion root daily.

Evening primrose oil (Oenothera biennis) may soothe itching associated with psoriasis. Some doctors believe it's as effective as corticosteroids with fewer side effects, although people with liver disease or high cholesterol should use it only under medical supervision; pregnant women should not use it, because it can affect their hormone levels. The recommended dose of two 500-mg capsules a day can be costly; flaxseed and borage oils are less expensive alternatives.

Mix tinctures of burdock, skullcap (Scutellaria lateriflora), sourdock (Rumex crispus), and cleavers (Galium spp.) in equal parts; take 1 or 2 tsp a day. Or steep 1 tbsp of fresh nettles (Urtica dioica) and fresh cleavers in 1 cup boiling water for 10 minutes, strain, and drink two or three cups a day.

A rinse made of dried rosemary (Rosmarinus officinalis) and sage (Salvia officinalis) offers an alternative to tar-based shampoos. Pour a pint of boiling water over 1 oz of each of the herbs and let the mixture steep overnight. Strain and use daily as a hair rinse after each shampoo.

Homeopathy

Don't try to choose homeopathic remedies on your own to treat a chronic, systemic condition such as psoriasis. A homeopath assesses many variables, including the site of the inflammation, as well as the patient's family history and reaction to stress. Remedies homeopaths recommend for psoriasis include Sulphur, Graphites, Lycopodium, and Arsenicum album.

Light Therapy

Like other serious or chronic skin disorders, psoriasis may respond to light therapy, or photo-therapy. Patients receive timed exposure to ultra-violet radiation, in some cases after taking an oral medication called psoralen. The treatment is repeated several times a week for up to eight sessions per month. Although many doctors and patients report positive results, the treatments can have serious short- and long-term side effects; the drug psoralen is not recommended for pregnant women, because of the potential risk to the developing fetus. While light therapy may not be right for every psoriasis sufferer, it may be worth discussing with your doctor.

Mind/Body Medicine

The skin, the largest organ in the body, often mirrors turmoil within, so it's no surprise that many psoriasis patients have a history of high anxiety, low self-esteem, and stress-related problems. Many mind/body techniques help psoriasis patients by addressing the psychological roots and consequences of the disease. In particular, hypnotherapy, guided imagery, any of a number of relaxation techniques, biofeedback, and psycho-therapy may be effective.

You can train yourself to relax by trying anything from a brisk half-hour walk every day to self-hypnosis, in which you focus your attention to block out irritating stimuli. If you think internal stress contributes to your condition, make a relaxation technique part of your daily schedule.

Nutrition and Diet

Fish oil high in eicosapentaenoic acid (EPA), from such fish as mackerel, herring, and salmon, may help reduce inflammation and itching. Because you would have to eat up to two pounds of fish a day to get enough EPA, try a 1,000-mg fish-oil capsule containing EPA four times a day; or try 1 tbsp cod-liver oil, also high in vitamin A, once a day.

Vitamin A plays a vital role in the growth and maintenance of skin; when an outbreak of psoriasis occurs, take a megadose of up to 100,000 I U a day for a month under a doctor's supervision, then return to maintenance levels not exceeding 50,000 I U a day. A daily 400 to 1,000 IU of vita-min D may also help with healing. To avoid the risk of overdose, particularly of these fat-soluble vitamins, ask your doctor to monitor your progress. Always check dosages carefully before giving megasupplements to children.

Vitamin B complex containing vitamin BS and vitamin Bi may promote healthy skin; to help fight psoriasis, the suggested dosage is 50 mg three times a day. Rubbing concentrated vitamin E ointment into your scalp two or three times a week can deter skin damage.

Some research has suggested that eating too much citrus fruit can aggravate psoriasis, and that psoriasis patients, like eczema patients, can not metabolize fatty acids. To help prevent flare-ups, adopt a diet high in fish and raw vegetables, and low in fatty meats and acidic fruits.

At-Home Remedies

Source : The Medical Advisor

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