Something that looks like a rash might not seem like cause for alarm, but psoriasis is a chronic disease that needs to be diagnosed by a medical professional. Although there is currently no cure for psoriasis, there are a number of conventional and at-home psoriasis treatments out there that can make living with the disease a little easier. “Psoriasis is a genetic, autoimmune, inflammatory condition, in which your skin cells divide too quickly and do not shed quickly enough, creating inflamed, itchy, thick, white, scaly plaques, most classically on the scalp, elbows, and knees,” says Tsippora Shainhouse, MD, a board-certified dermatologist, fellow of the American Academy of Dermatology, and a clinical instructor at the University of Southern California. Psoriasis is a chronic disease, and while it can’t be cured, it can be managed. “Psoriasis is a lifelong disease that can wax and wane but usually does not resolve completely or forever,” says Shainhouse. “Many of our newer medications are able to achieve a 90 to 100 percent skin clearance while [the person is] on the medication, but it is not a cure.” Fortunately, thanks to a number of psoriasis treatments, the symptoms can be managed. Here’s what you need to know about treating psoriasis.
What causes psoriasis?
“The causes of psoriasis are not completely understood, but it is thought to be an autoimmune disease, which means that your body’s defense—your immune system—is overactive and actually working against itself,” says Jeanette Jacknin MD, a holistic dermatologist specializing in topical cannabinoids for skin disorders. “One-third of psoriasis patients have a family history of the disease, so there also appears to be a genetic component for the disease.” Even if you are genetically predisposed to carry psoriasis, you might or might not get it. There are often certain factors trigger the psoriasis, Shainhouse says. These triggers might cause the first outbreak or aggravate the existing symptoms of your psoriasis. Stress is another potential trigger, according to the scientific research. Jacknin mentions that severe stress often precedes the first emergence of psoriasis and 70 percent of flare-ups. Other potential triggers include skin infections and injuries to the skin, according to the National Psoriasis Foundation. Even a small pinprick can trigger or aggravate psoriasis, a reaction called the Koebner phenomenon. The Koebner phenomenon could also trigger psoriatic arthritis (more on that later). In addition to having a number of triggers, there are a number of different types of psoriasis, categorized by where and how they appear on the body.
Types of Psoriasis
Guttate psoriasis is characterized by a “sudden eruption of small, pink, scaly spots all over the trunk,” Shainhouse says, adding that the “trigger” for guttate psoriasis is often strep throat: “for some reason, the body recognizes strep antigen as psoriasis and turns it on.”
Also known as psoriasis vulgaris, plaque psoriasis is the most common type, accounting for 80 percent to 90 percent of psoriasis cases. The American Academy of Dermatologists (AAD) notes that plaque psoriasis is accompanied by a scaly, silver, thin layer covering the skin and a thick buildup of plaque, usually on the scalp, elbows, knees, and lower back.
Most commonly found in the underarms or groin, Shainhouse says, inverse psoriasis occurs where hair touches skin. Skin will appear raw and it will feel swollen and sensitive.
Commonly appearing on the hands and feet, pustular psoriasis includes the development of pus-filled bumps accompanied by red, swollen skin, according to the AAD. This type of psoriasis can be extremely painful.
A rare but serious and life-threatening form of psoriasis, erythrodermic psoriasis involves large patches of red, raw-looking skin covering the body. This is accompanied by chills, a fever, and flu-like symptoms. This is usually developed by people who have another kind of psoriasis.
Generalized Pustular Psoriasis
When pus-filled bumps and scales appear all over the body and not just on the hands and feet, it could be generalized pustular psoriasis. Again, this is a rare but life-threatening form of psoriasis. It’s often accompanied by flu-like symptoms.
Nail psoriasis is frequently accompanied by discoloration of the nails, tiny dents or pits in your nails, and blood or build-up in the nail bed, according to the AAD. The nails might come away from the skin.
Conventional Psoriasis Treatments
If you have psoriasis, it’s most likely plaque psoriasis, which is manageable. But it’s important to keep an eye out for any symptoms of the more serious forms of psoriasis described above. The psoriasis treatments prescribed by your healthcare provider will depend on the type of psoriasis you’re experiencing. [pullquote align=”center”]“Once you understand your skin disease and know which treatments work for you, you can treat flares at home as needed and see your dermatologist when you need help.” —Tsippora Shainhouse, MD, FAAD[/pullquote] If you have a flaky, itchy rash that doesn’t go away, contact a medical professional, says. “You should see a dermatologist to discuss treatment options and long-term management,” she advises. “Once you understand your skin disease and know which treatments work for you, you can treat flares at home as needed and see your dermatologist when you need help.” “Depending on the severity of your skin and whether or not you have systemic symptoms, including psoriatic arthritis, your doctor will prescribe topical treatments or even oral or injectable medications,” Shainhouse explains. Shainhouse says that there are a number of topical psoriasis treatments. You might be prescribed a vitamin D analogue topical cream, which slows down the production of new skin cells so that a thick scale won’t build up on your skin. Another option is a topical steroid or a topical tar, which helps to calm the inflammation, redness, and itch. A retinoid might also be prescribed; this helps to normalize cell division so that old cells can shed instead of building up. Oral medications are usually prescribed for moderate to severe cases of psoriasis. “Oral medications reduce inflammation, reduce the immune response, and/or regulate skin cell production,” Shainhouse notes. In the last decade, biologics (injectable medications) have become a popular psoriasis treatment. “A biologic is a protein-based drug that blocks the action of a specific type of immune cell (called a T cell) or blocks proteins in the immune system,” Jacknin says. “Patients on biologics have to be monitored closely for side effects.” Keep in mind that the psoriasis treatment that is prescribed for you depends on the nature and severity of your symptoms and that it’s best to see a dermatologist about psoriasis to receive the necessary medication. With that being said, certain natural or at-home remedies can help with your psoriasis treatment.
Natural Psoriasis Treatments and Lifestyle Changes
Get a little sun.
Soaking up the sun—in moderation—might help with your psoriasis symptoms. “UV light is generally a no-no in dermatology, since we know that too much can be associated with the development of skin cancer and melanoma,” Shainhouse says. “However, it has an anti-inflammatory effect in psoriatic skin and is a very useful option for reducing skin disease/symptoms.”
Keep your skin from drying out.
Dry skin can aggravate the symptoms and discomfort associated with psoriasis. You can prevent dry skin by staying hydrated, avoiding very hot showers or baths, and using an air humidifier. Dry air dries your skin out, and an air humidifier helps to counter that issue. Moisturizing regularly is also important—just ensure that your moisturizer is free of fragrance, as fragrance might irritate the skin more. Many people swear by using moisturizers containing Oregon grape for psoriasis. Also known as mahonia aquifolium, Oregon grape has been proven to be an effective and helpful moisturizer for people with psoriasis. Another great moisturizing agent is aloe vera, Jacknin says. “Research shows aloe vera can help reduce the redness and scaling of psoriasis,” she says. Moisturizers containing 0.5 percent aloe are your best bet.
Soak in a tub.
Although psoriasis is itchy, scratching is a bad idea, as it can exacerbate the problem. “Rubbing and picking at the skin will actually worsen the spots,” Shainhouse says. “Psoriasis tends to develop in sites of skin trauma, including cuts and scratches.” Instead, you’ll want to relieve the itchiness in another way. The National Psoriasis Foundation recommends a number of natural treatments for itchiness. This includes soaking in the tub with a natural remedy such as oats. If you’re not keen on letting the oats float in your bathwater, put some in a clean sock or a small sachet, tie it closed, and let it soak in your bath. A bath with Dead Sea salts or Epsom salts might also help relieve itchy skin, Jacknin says. It’s best to moisturize just after getting out of the tub to avoid drying your skin out, she adds. Rinsing with apple cider vinegar can help reduce itchiness on your scalp, but avoid it if you have any open wounds.
Invest in CBD oil.
Plants related to the cannabis genus—including hemp and what we refer to as cannabis—contain cannabinoids, which have a range of health benefits. “Recent studies have suggested that cannabinoids may treat psoriasis by interfering in many of the inflammatory and immune pathways that exacerbate or trigger psoriasis,” Jacknin notes. She points to research that suggests cannabinoids may slow the development of skin cells called keratinocytes, which lead to psoriasis symptoms. [pullquote align=”center”]“Based on the research, I believe that the anti-inflammatory properties of CBD can dramatically improve symptoms for many patients with psoriasis.” —Jeanette Jacknin MD[/pullquote] Cannabidiol (CBD), a type of cannabinoid, is particularly helpful for people with psoriasis, Jacknin says. This is because it has anti-inflammatory properties. “Based on the research, I believe that the anti-inflammatory properties of CBD can dramatically improve symptoms for many patients with psoriasis,” Jacknin says. CBD comes in the form of ingestible oils and tinctures, which can be consumed orally, or in topical treatments. Hemp-derived CBD is legal throughout the United States. Jacknin suggests using third party–tested CBD oil derived from U.S.-grown hemp, such as MedTerra CBD oil.
Avoid alcohol and smoking cigarettes.
Research shows that drinking alcohol and smoking cigarettes can aggravate psoriasis symptoms, so it’s best to avoid both alcohol and cigarettes.
Eat anti-inflammatory foods.
Certain foods have anti-inflammatory properties, and stocking up on these anti-inflammatory foods can help treat psoriasis. Anti-inflammatory foods include kale, ginger, sardines, and beets. Jacknin strongly recommends integrating turmeric into your diet: Eat it in your food or have some in pill form. Some people have an inflammatory reaction to dairy, so consider avoiding dairy products and monitor whether your symptoms improve. Remember that these remedies and lifestyle changes should complement your prescribed psoriasis treatment, not replace it. In other words, while there are measures you can take at home to reduce your psoriasis symptoms, it should primarily be treated by a healthcare professional.
Diseases Related to Psoriasis
Psoriasis is more than just skin deep—which is why you need to see a healthcare professional if you suspect you have it. According to the National Psoriasis Foundation, up to 30 percent of people with psoriasis are at risk for developing psoriatic arthritis, a kind of inflammatory arthritis that could cause permanent joint damage if left untreated for too long. If you have psoriasis, be on the lookout for sore, stiff, and swollen joints, as this symptom could be caused by psoriatic arthritis. After being diagnosed with psoriasis by a dermatologist, you might have to be tested for these related diseases. Shainhouse says that a rheumatologist could address issues with psoriatic arthritis. “There should be communication and joint patient care with the primary care practitioner, because there are medical conditions that must be screened for and monitored in patients with psoriasis,” she adds. If you have psoriasis or psoriatic arthritis, you’re at greater risk for certain diseases. Studies have suggested that people with psoriasis are more likely to develop cancer, cardiovascular diseases, depression and anxiety, metabolic syndrome, liver disease, and inflammatory bowel disease, among other conditions. The reason that psoriasis is linked to those diseases isn’t fully understood, although it’s thought to be because of the chronic inflammation and compromised immune system associated with autoimmune diseases such as psoriasis. Living with psoriasis isn’t easy, but a combination of the right medication and positive lifestyle changes can greatly improve the symptoms. Consult a dermatologist before pursuing any home remedies or natural psoriasis treatments, as psoriasis could be indicative of another serious disease or medical condition.