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What Is Psoriasis?

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I have had Psoriasis since I was about 3 years old. I was dressed up as a grape for Halloween and when I got home my mom took the makeup off my face. She found that I had Chicken Pox under my makeup. After my Chicken Pox went away I ended up with Psoriasis. I have tried everything under the sun.... so much so that I don't remember all the names of the meds that I have tried. I started out with the creams and the body wash. I even tried the blue star over the counter ointment and wrapped myself in plastic wrap. That made it worse! I have tried oils in my hair and put a plastic cap on. Nothing cleared my spots but somethings made them feel better. It was embarrassing and I always looked like I had a bad case of Dandruff. My scalp was always bright red. I have endured many taunts and have learned to stop wearing anything but pants. I mostly had it on my scalp, legs, elbows, knees and most recently on my back. I always had a breakout but sometimes it would get worse with stress or if I got sick. I learned soaking in the tub and putting on lots of lotion helped but I was still spotted. I have 2 kids and during both pregnancy's I had clear skin. I heard they are doing research into why pregnancy affects Psoriasis. Right now I am on Humira (adalimumab) and I have to say that it is the best thing I have EVER used. It started working right away and withing a couple months it was almost all gone. It does hurt though cause you have to inject it and you have to go into the hospital for regular blood tests but I love it anyway. It is also very expensive so being an army wife really helps. After my skin cleared up I personally still saw the spots that nobody else could. I still don't like to show my legs. I guess it's all in my head but I can't seem to help it. Here is some info on Psoriasis and I will put a note by the things I remember trying... Remeber, things don't work the same for everybody so it is a process of elimination!

What Is Psoriasis?

Psoriasis is a chronic immune
system-related disease that causes inflammation and damage to involved
tissues, primarily the skin. Though it can affect skin anywhere on the
body, psoriasis most often appears on the scalp, elbows, knees, lower
back, and the palms and soles of the feet. It can also affect
fingernails and toenails, the soft tissues of the genitalia and inside
the mouth.

The five forms of psoriasis are:

  • Plaque psoriasis, which accounts for about 80
    percent of cases. Patches of skin, often on the elbows, knees, scalp
    and lower back, are raised, red and covered with silvery scales that
    shed; they are usually very dry, and may itch, burn or crack.
  • Guttate psoriasis,
    which occurs in less than 2 percent of patients, often starts in
    childhood, and can be triggered by bacterial or viral infection, such
    as strep throat, chicken pox, tonsillitis or even a cold. Patients
    develop spots of red skin on the abdomen, chest, back, arms, legs and
  • Pustular psoriasis, which occurs in
    less than 3 percent of patients. It appears as blisters on the skin,
    which become reddened and may appear in specific spots, mainly on the
    hands and feet or on the tips of the fingers, or in widespread patches
    on the body.
  • Erythrodermic psoriasis, which
    also occurs in less than 3 percent of patients and usually covers most
    of the body’s surface. The skin becomes fiery red and may be extremely
    itchy and painful. This form can be very serious and may occur suddenly
    or, in people with plaque psoriasis, come on more gradually.
  • Inverse psoriasis,
    another rare form of psoriasis, which produces smooth, dry areas of
    skin, mainly in the armpits, groin, under the breasts, and in skin
    folds around the genitals and buttocks. Affected areas become very red
    and inflamed. Rubbing and sweating can irritate these patches, which
    can become painful and itchy.


What Causes Psoriasis and How Is It Diagnosed?

psoriasis, skin cells move up from below the surface and pile up on the
outer layer before they have a chance to mature normally. Usually, it
takes about a month for cells to move to the surface. But in psoriasis,
it may occur in only a few days, leading to the characteristic plaques.
Psoriasis is an inflammatory disorder in which a certain type of cell
called a T lymphocyte becomes overactive and initiates a series of
biochemical events leading to inflammation.

About a third of those who develop psoriasis have a family history of
the disease. While it can develop at any age, psoriasis often first
appears between ages 15 and 35. Only about 10 to 15 percent of people
with psoriasis get it before age 10, and occasionally it appears in
infants. The severity of psoriasis varies for each individual. Some
people may have such mild cases that they escape notice. In others, the
flare-ups are disabling. Mild cases are those that involve less than 2
percent of the body. Moderate cases affect between 3 percent and 10
percent, and severe cases involve more than 10 percent of the body.

Doctors rely on two methods to make a diagnosis of psoriasis:

  • Physical examination, which involves a careful examination of the skin and taking a medical history.
  • Biopsy, which involves taking a small sample of skin and submitting it for examination under a microscope.


Will My Psoriasis Go Away?

Psoriasis is a
disease that lasts a lifetime. In some people, psoriasis completely
clears up for months or even years at a time. This is called remission.
For others, the disease is active in cyclical patterns. In one common
pattern, psoriasis is better in the summer and worse in the winter.
Psoriasis can be uncomfortable both physically and emotionally, and
severe cases can be disabling. But the disease does not affect a
person’s life expectancy, and most people who have psoriasis are able
to lead active lives.

Usually, psoriasis flares up after people experience what’s called a “trigger,” such as:

  • Stress
  • An injury to the skin, such as severe sunburn, scratches or a reaction at a vaccine injection site
  • Medications,
    most notably beta-blockers, which are used to treat high blood
    pressure, and lithium, which is used to treat depression
  • Change in climate or weather
  • Infections, such as streptococcus infection


How Is Psoriasis Treated?

There is no cure for
psoriasis, but there are treatments to help relieve symptoms. Doctors
usually treat psoriasis in a series of steps, depending upon the
severity and type of psoriasis a patient has. This is sometimes called
the "1-2-3" approach, where:

Step 1 includes topical treatment – patients apply medicines to their skin.
Step 2 includes phototherapy – patients use exposure to light.
Step 3 includes systemic treatment - patients take medication.

psoriasis is chronic and unpredictable, patients often experiment
before they find a treatment – or combination of treatments – that
works for them.

What Are Topical Treatments for Psoriasis?

people can clear up psoriasis by applying medications to their skin.
The most commonly used topical treatments include:

  • Steroids, which slow the growth of excess
    skin cells and decrease inflammation, though they rarely clear
    psoriasis for long periods of time. Doctors may prescribe short-term
    treatment with high-potency steroid ointments, such as Diprolene
    (betamethasone topical) or Temovate (clobetasol) for use on thicker
    areas of skin, such as the knees, elbows and feet. Patients often use
    medium and low-potency ointments on more delicate skin areas. (I deffinatly tried that!)
  • Dovonex (calcipotriene),
    a synthetic form of vitamin D3 that can control excessive growth of
    skin cells and is most often prescribed for patients with mild to
    moderate psoriasis. (This stuff didn't do anything.)
  • Coal tar, available both
    with a prescription and over the counter, coal tar preparations have
    been used to treat mild to moderate plaque psoriasis for centuries.
    They have fewer side effects than steroids, but are messy and less
    effective. (This stuff smells.)
  • Anthralin, one of the older
    medications for psoriasis, it is derived from Goa powder from the bark
    of the araroba tree. Anthralin can be effective on mild to moderate
    plaque psoriasis and has no known long-term side effects, but it can
    irritate the skin, and stain skin, clothing and even sinks and tubs.
  • Tazorac (tazarotene),
    a topical retinoid; a medication derived from vitamin A, for people
    with mild or moderate plaque psoriasis; in some patients, it can
    produce long-term remissions.
  • Salicylic acid, a
    chemical that helps remove scales, which allows topical medications to
    penetrate the skin more successfully. Patients often use it in
    combination with anthralin, coal tar or topical steroids. (Good for Acne but not much else.)
  • Bath solutions,
    such as oil, tar solution, oiled oatmeal, Epsom salts or Dead Sea salts
    that are added to bath water to reduce itching and removes scales. (Felt good but didn't clear anything up.)
  • Moisturizers,
    usually thick, greasy varieties, which work best to soothe psoriasis
    because they hold water in the skin and reduce scales and itching.(My best friend!!!)


What Is Phototherapy Treatment for Psoriasis?

light kills T cells in the skin, which reduces inflammation and excess
skin cell growth. Phototherapy can be in the form of sunlight or
controlled treatments with artificial light administered in a doctor's
office or in a psoriasis day clinic. Phototherapy treatments include:

  • Sunlight: Short doses of sunlight help clear psoriasis, but sunburn can worsen it, so patients must monitor their time outdoors closely.
  • UVB phototherapy:
    In this treatment, patients expose their skin to ultraviolet light B. A
    newer source of the light, called narrow-band UVB, emits the part of
    the ultraviolet spectrum that may be most helpful for psoriasis. It
    often takes at least two or three months of regular exposure before
    psoriasis clears up. Doctors may prescribe UVB phototherapy in
    combination with topical treatments. (This would make me ill afterwards.)
  • PUVA:
    This treatment combines a medication called psoralen with exposure to
    ultraviolet light A, or UVA, which makes the skin more sensitive and
    responsive to UVA. According to the National Psoriasis Foundation,
    about 75 percent of people using the treatment find that their
    psoriasis clears up for as long as a year. On average, it takes about
    25 treatments to clear the skin. PUVA has more short-term side effects
    than UVB, including nausea, headache, fatigue, burning and itching.
    Long-term treatment may increase risk of skin cancer.
  • Lasers:
    The FDA recently approved laser treatment for psoriasis. The laser
    emits a high-intensity beam of light similar to narrow-band UVB. The
    treatment is usually used by people with mild to moderate psoriasis
    that affects less than 10 percent of the body. Evidence suggests that
    it takes eight to 10 laser sessions for psoriasis to clear up. These
    treatments also reduce exposure to potentially harmful UV radiation.


What Systemic Medications Are Available for Psoriasis?

Doctors may prescribe the following systemic drugs for people who have moderate to severe psoriasis or psoriatic arthritis:

  • MTX or Rheumatrex (methotrexate), oral or
    injectable drugs that slow down the production of skin cells by
    suppressing the immune system. It's prescribed for psoriatic arthritis
    and severe psoriasis, especially for serious cases of pustular or
    erythrodermic psoriasis. More than 80 percent of patients see some
    change within two to three months. Methotrexate can cause liver damage,
    however, and it can also inhibit the production of red and white blood
    cells and platelets. (It didn't do anything.)
  • Neoral, Sandimmune (Cyclosporine),
    an oral drug that works by suppressing the immune system in a way that
    slows skin cell growth. It's usually prescribed for patients with
    severe psoriasis who aren't responding to other treatments or can't use
    them. It usually clears up psoriasis within six weeks, but is generally
    only effective while patients take it. Side effects include impaired
    kidney function and high blood pressure.
  • Soriatane (acitretin),
    a retinoid, which is a class of compounds related to vitamin A that
    affect how quickly cells grow. They are used to treat plaque,
    erythrodermic and pustular psoriasis, especially if patients don't
    respond to other therapies. Patients usually see improvement within two
    to four months. Retinoids can clear up psoriasis for a few weeks to
    more than a year, but they can also cause birth defects, so women of
    child-bearing age must use contraception while taking the drug.


What Biologic Treatments Are Available for Psoriasis?

therapies are systemic medications that target specific proteins in the
body. Traditional drugs affect all the cells in the body, but biologics
target only specific cells or specific proteins and therefore may be
more effective and cause fewer side effects. Biologics used for
psoriasis include:

  • Amevive (alefacept): Amevive blocks the
    action of overactive immune cells (T cells) that eventually cause
    excessive growth of skin cells. Amevive is indicated for adults with
    moderate to severe chronic plaque psoriasis who are candidates for
    systemic therapy or phototherapy. It is injected into the muscle once a
  • Enbrel (etanercept): Enbrel blocks the
    action of a protein that causes inflammation (TNF). It has been
    approved for treatment of adults with chronic moderate to severe plaque
    psoriasis who are candidates for systemic therapy or phototherapy.
    Enbrel is also indicated in psoriatic arthritis. It is injected under
    the skin once a week. (This made the enjection site extreamly itchy, swollen, hot, red.... it was basically a welt. I think I may have been allergic to this.)
  • Humira (adalimumab):
    Humira blocks the action of a protein called TNF that causes
    inflammation. Humira is indicated for the treatment of adult patients
    with moderate to severe plaque psoriasis who are candidates for
    systemic therapy or phototherapy, and when other systemic therapies are
    medically less appropriate. Humira is also indicated for the treatment
    of psoriatic arthritis. It is injected under the skin once every two
    weeks. (Best thing on earth! Who ever invented this needs to be kissed! It worked for me!!!)
  • Raptiva (efalizumab): Raptiva is
    indicated for the treatment of adult patients (18 or older) with
    chronic moderate to severe plaque psoriasis who are candidates for
    systemic therapy or phototherapy. Raptiva works under the skin and
    prevents the T cells that cause psoriasis from becoming activated and
    entering the skin. It is injected under the skin.
  • Remicade (infliximab):
    Remicade is indicated for the treatment of adult patients with chronic
    severe (i.e., extensive and/or disabling) plaque psoriasis who are
    candidates for systemic therapy and when other systemic therapies are
    medically less appropriate. It is also approved for the treatment of
    psoriatic arthritis. Remicade blocks the action of a protein that
    causes inflammation (TNF). It is given by intravenous infusion either
    in a doctor’s office or in an infusion center.

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I had psoriasis for over 45years. I've colored my hair, use special shampoo and conditioner for colored hair and it all cleared up. It used to be on my back, way down in both ears.  I'd try to scratch but my fingernails wouldn't go down that far in the ear. I used to have to use an ear syringe to squeegie out the loose scabs. I get this shampoo  at the hairdresser's.  Hope this helps. My psoriasis started in my hair.

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