What is Psoriasis?
Psoriasis is an inflammatory skin disease characterized by an increased
rate of skin cell turnover resulting in thick scales appearing on the
skin. The affected skin becomes dry and unsightly. Itching is often
experienced in our hot and humid climate.
As part of our skin, nails also show changes like "pitting" of their
surface in up to half of people with psoriasis. Joint pains and swelling
are associated in 5% to as much as 40% in more extensive psoriasis.
How do you know if you have Psoriasis?
Psoriasis usually presents with red scaly patches on
the scalp, body and limbs. The scaly patches on the scalp are usually
thicker and more extensive than ordinary dandruff. Common sites of the
body affected are the elbows, the knees and the back.
Why does Psoriasis happen?
The cause of psoriasis is unknown. Studies point to a genetic
predisposition, although complex interaction with environmental factors
are necessary to trigger off the appearance of psoriasis. Once
psoriasis starts, there will be periods of remission alternating with
periods of active psoriasis.
What makes Psoriasis worse?
What's the natural history of Psoriasis?
Psoriasis usually starts in the 20's but has been described at birth
and in old age. Like diabetes and other chronic diseases, psoriasis has a
delayed onset and seldom remits permanently. However, unlike other chronic
illnesses, it rarely shortens life expectancy.
What treatments are available for Psoriasis?
Topical Creams I Ointments I Lotions I Shampoos & Scalp
Most people with psoriasis have mild disease and get considerable relief with moisturizing creams/ointments. These
include coal tar, anthralins, steroids and vitamin D3 derivatives (eg alcipotriol) ointment/cream. For the face, hairline
and groin areas, mild steroid creams are usually used.
1. For psoriasis on the scalp.
Tar shampoos and steroidal lotions/gels
are commonly used to control it. Others include coal tar ointment &
vitamin D3 derivatives (eg calcipotriol) scalp solution.
2. Photo therapy
Psoriasis responds to
ultraviolet (UV) light treatment. Ultraviolet light, either UVB or UVA
have been found to be effective in clearing psoriasis if used in gradually
increasing doses over a period of one to several months. UVA is usually
given with tablets called psoralens to enhance the effect of phototherapy
Your dermatologist may prescribe oral medications when
psoriasis does not respond to topicals and phototherapy. Examples of such
drugs are methotrexate, cyclosporin, acitretin and sulphasalazine.
Unfortunately, these drugs cause side-effects. Patients who are taking
such drugs will require regular blood tests to detect side-effects eg.
liver damage, bone marrow damage,
How we can handle Psoriasis
- Do use treatments regularly as directed.
- Do keep skin moist as this will help reduce
itching and scaling.
- Do protect the skin against scratches and cuts
as this may cause the psoriasis to flare up at the site of
- Do remember that the sun may help the psoriasis
but be careful not to burn.
- Don't scratch the plaques as this may damage the
skin and actually worsen psoriasis.
- Don't give up treatments too soon as it may take
a few weeks for some of them to work.
- Don't indulge in self-pity and avoid people.
Psoriasis is not evil. Learn to accept it as a part and parcel of
Is Psoriasis contagious?
Will I pass my Psoriasis on to my children?
Not necessarily. Psoriasis is a
hereditary disorder but only about 10% of people with psoriasis have a
family member affected by psoriasis. The cause of psoriasis is
multifactorial and inherited genes do not always express disease without
the appropriate environmental triggers.
Is Psoriasis a rare skin disease?
No, psoriasis is not an uncommon skin disease. It is
estimated that 1 - 2% of the population in Singapore have
Are there any foods to avoid, or supplements to help my Psoriasis?
No. But it is wise to
consume a nutritious, balanced diet containing more green vegetables and
less meats. Alcohol abuse is best avoided because of its associated
malnutrition and liver disease.
Is there a quick cure for Psoriasis?
No, but your doctor should be able to help you
control your psoriasis. Oral steroid treatment is best avoided because
although it helps to clear psoriasis fast, it invariably results in a
quick and severe rebound of psoriasis. But remember, psoriasis can be
controlled with appropriate treatment.