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Why Not Treating Your Psoriasis Goes Beyond Your Skin

By EmpowHER
 
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You might assume that psoriasis only affects your skin. After all, you see it appear on your skin as scales, bumps, and pustules. But psoriasis affects other parts of your body too.

Management of psoriasis is critical in preventing it from getting worse or affecting other parts of your body. Most doctors use a combination of treatments to help psoriasis. New medications are targeting the condition in more effective ways than before.

The importance of treatment

Psoriasis is a chronic autoimmune condition that can’t be cured. It begins when your immune system essentially fights against your own body. This results in skin cells that grow too quickly, causing flares on your skin.

The effects of this condition include more than just skin lesions. Other medical consequences can result such as psoriatic arthritis (PsA) or other comorbidities.

PsA is a disease that affects the joints. Symptoms include pain, inflammation, and stiffness in your joints. It affects up to 30 percent of those with psoriasis.

Comorbidities are other health conditions that may arise with psoriasis. You may be at risk for several serious health conditions, such as:

  • cardiovascular conditions
  • cancers, such as lymphoma
  • diabetes
  • inflammatory bowel disease
  • liver conditions
  • kidney disease
  • metabolic diseases
  • mental health conditions like depression
  • obesity
  • erectile dysfunction
  • alcoholism

These wide-ranging health implications require you to manage your psoriasis effectively. Most likely, this will involve a variety of treatments. Delaying treatment or ignoring symptoms puts you at risk for the condition to get worse. It’s imperative that you talk to your doctor when symptoms develop. Your doctor will work with you to create an effective treatment plan.

Managing psoriasis

Psoriasis is a condition that requires individual treatment plans because the causes of it are unknown. Research suggests that this condition could be caused by:

  • your immune system
  • your genes
  • environmental factors

This lack of understanding about the cause of psoriasis means that there is no one-size-fits-all treatment for it at this time.

Treatment plans are evolving as researchers discover more about the condition. Traditional treatments from many years ago mainly targeted the skin. Now treatment plans for moderate to severe psoriasis target many areas of the body. The newest drugs for psoriasis can even target specific parts of the immune system, rather than the entire immune system. This evolution of psoriasis treatment is helping researchers better understand psoriasis.

It’s now recommended that doctors approach psoriasis treatment at many levels. Doctors should look at a variety of factors when managing psoriasis, including:

  • screening for comorbidities
  • screening for PsA
  • screening for current medications you take
  • screening for triggers, such as stress, infections, obesity, and smoking
  • using a combination of treatment methods

This treatment approach reflects how complicated psoriasis is and how many factors lie beyond your skin.

Combination therapy is typical for psoriasis. This approach incorporates a variety of treatment methods to manage your psoriasis. Your doctor may utilize several approaches, such as:

  • topical treatments
  • oral medications
  • light therapy
  • biologic therapy

Some believe complementary and alternative therapies can help psoriasis. Many of these options lack scientific backing. Methods thought to improve psoriasis include:

  • maintaining a healthy diet
  • exercising regularly
  • using stress-reduction techniques
  • adding supplements

Talk to your doctor before trying alternative therapies because they may impact your management plan.

Treatments for mild psoriasis

Your doctor may decide your mild psoriasis only needs first-line treatments. Several options exist.

You may start with an over-the-counter topical like:

  • fragrance-free moisturizers
  • shampoos or body creams that contain salicylic acid or coal tar

A prescription topical may be better for your psoriasis. Prescription topicals have a higher concentration of active ingredients. Some contain steroids.

Light therapy can be administered at your doctor’s office or even your house with the right equipment. Ultraviolet light therapy can improve psoriasis but should be done with guidance from your doctor.

Mild psoriasis still requires careful monitoring by you and your doctor. Schedule regular appointments to review your treatment plan.

Treatments for moderate to severe psoriasis

More widespread psoriasis will require medications that treat your immune system and other parts of your body to keep the condition from getting worse or causing other health issues.

Systemic medications should be used for people with moderate to severe psoriasis.

Some systemic medications have been available for decades. You can take them orally or through an injection or intravenously. They target your entire body and suppress your immune system. You’ll likely need regular bloodwork to avoid side effects.

Biologics are the most recent treatment developed for psoriasis. They are made from living cells and target specific parts of your immune system, like T cells and proteins known to trigger psoriasis. These drugs are administered via injection or intravenously. Using this treatment method is thought to improve and control psoriasis, as well as decreasing risk for other comorbid conditions, giving you a higher quality of life.

The takeaway

It’s imperative that your doctor consider many factors when treating psoriasis. On the surface, it seems like just a skin condition. There are more serious implications if you fail to treat it.

Unmanaged or undermanaged psoriasis can lead to the condition getting worse. It can also lead to development or worsening of PsA and other comorbidities.

Here are ways you can manage your psoriasis:

  • Make sure your doctor creates a management plan that works for you.
  • Follow the treatment plan.
  • Update your doctor frequently on how the treatments work and suggest modifying them if needed.
  • Contact your doctor when you experience a psoriasis flare.
Read more in Psoriasis Resources

About psoriasis. (n.d.). Retrieved from https://www.psoriasis.org/about-psoriasis#psa Comorbidities associated with psoriatic disease. (n.d.). Retrieved from https://www.psoriasis.org/about-psoriasis/related-conditions

Garret, N. (2016, February 29). Subclinical inflammation predicts progression from psoriasis to PsA. Retrieved from http://www.mdedge.com/rheumatologynews/article/106933/psoriatic-arthritis/subclinical-inflammation-predicts-progression

Koutnik-Fotopoulos, E. (2014, July). Biologics: Changing the treatment scope for psoriasis and PsA. The Dermatologist, 22(7). Retrieved from http://www.the-dermatologist.com/content/biologics-changing-treatment-scope-psoriasis-and-psa

Mayo Clinic Staff. (2015, July 17). Psoriasis: Definition. Retrieved from http://www.mayoclinic.org/diseases-conditions/psoriasis/basics/definition/con-20030838 Moderate to severe psoriasis and psoriatic arthritis: Biologic drugs. (n.d.). Retrieved from https://www.psoriasis.org/about-psoriasis/treatments/biologics

Mrowietz, U. (2012, March). Implementing treatment goals for successful long-term management of psoriasis [Abstract]. Journal of the European Academy of Dermatology and Venereology, supplement 2, 12-20. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22356631

Mrowietz, U., de Jong, E. M. G. J., Kragballe, K., Langley, R., Nast, A., Puid, L., … Warren, R. B. (2013, February 26). A consensus report on appropriate treatment optimization and transitioning in the management of moderate-to-severe plaque psoriasis. Journal of the European Academy of Dermatology and Venereology, 28(4), 438-453. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/jdv.12118/full

National Psoriasis Foundation. (n.d.). Systemic medications. Retrieved from https://www.psoriasis.org/sites/default/files/systemics_booklet.pdf

Psoriasis. (n.d.). Retrieved from https://www.aad.org/public/diseases/scaly-skin/psoriasis#causes Traditional systemic medications. (n.d.). Retrieved from https://www.psoriasis.org/about-psoriasis/treatments/systemics

Up to 30 percent of people with psoriasis develop psoriatic arthritis, an inflammatory form of arthritis. (n.d.). Retrieved from https://www.psoriasis.org/about-psoriatic-arthritis

World Health Organization. (2016). Global report on psoriasis. Retrieved from http://apps.who.int/iris/bitstream/10665/204417/1/9789241565189_eng.pdf

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