“Psoriasis is a lifelong condition where your body’s immune system creates skin and nail lesions,” says California board-certified dermatologist Dr. Cynthia Bailey, MD, founder of Dr. Bailey Skin Care. According to Dr. Bailey, an estimated 125 million people, or 2 to 3 percent of the population in the world, have psoriasis. “In the U.S., 3 percent, or about 8 million Americans, have psoriasis,” she says. Dr. Bailey says that symptoms can start at any age—often first appearing between someone’s 20s and their 60s. The key to properly managing psoriasis starts with knowing what its early stages look like. Then, it can be helpful to work with a dermatologist to manage symptoms.
How to Spot Psoriasis as Soon as it Starts
San Francisco-based board-certified dermatologist Dr. Caren Campbell MD, FAAD, explains that psoriasis is a chronic inflammatory skin disease. She says that usually there is a genetic component to it. Dr. Bailey agrees, saying that an estimated 60 to 90 percent of people with psoriasis have inherited a psoriasis gene from one of their parents. “A number of different genes associated with psoriasis have been discovered,” Dr. Bailey says. “These genes are ones that regulate some of the complex aspects of the immune system and the skin’s barrier function. We don’t know exactly how these genes lead to the manifestations of psoriasis, and research is actively ongoing to better understand this condition.” While genetics most certainly play a role, Dr. Campbell says that psoriasis can be triggered or made worse due to stress, illness, smoking, medications or medical issues such as obesity. Dr. Campbell and Dr. Bailey both say that there are some early signs of psoriasis to be aware of. Some of the symptoms are outlined below:
Pink, thickened areas of skin with a silvery scale (most likely to be found on the elbows, knees and scalp).Symmetric lesions appearing on both sides of the body (such as the arms, legs, back and chest) at the same time. They are typically red, raised and covered with a crusty scale.Skin folds such as the groin, armpits, under the breasts and cleft in the buttocks. The rash may be red and moist with very little scale.Thick fingernails and toenails that are lifted off of the nail beds, with pitted dents on the surface.Joint pain that is worst in the mornings.
“Psoriasis, like so many health problems that are due to inflammation, gets worse with age,” Dr. Bailey says. “The condition often becomes more stubborn and difficult to treat over time. In the worst case, the entire skin can become red, which can put life-threatening strain on the heart and internal organs.” Dr. Campbell emphasizes that psoriasis affects more than just the skin, especially as it worsens. “It can cause destructive arthritis that is permanent,” she says. Dr. Campbell adds that psoriasis can also increase the risk of cardiovascular disease, as the inflammation of the skin can also happen in your blood vessels and heart. “[For this reason], it’s important to address this systemic inflammation as well to prevent long-term issues systematically,” she says. While all of this may be discouraging to hear, both dermatologists say that there are ways to manage symptoms and Dr. Campbell says that with proper management, the symptoms can actually get better over time, not worse.
What Psoriasis Management Looks Like
If you notice any of these early stages of psoriasis, Dr. Campbell says it’s important to see a dermatologist so you can be properly diagnosed and discuss treatment together. Since psoriasis is caused by inflammation, Dr. Campbell says an important first step to managing psoriasis is to do what you can to minimize inflammation through diet and lifestyle habits. This may look like adhering to an anti-inflammatory diet, which involves eating minimally processed foods and limiting sugar and alcohol. Doing what you can to manage stress, getting adequate sleep and exercising regularly are also all ways to fight inflammation. In addition to doing what you can through diet and lifestyle to minimize inflammation, Dr. Bailey says that there are some topical and oral medications available that can help with symptoms. “The choice of treatment depends on the type of psoriasis and how extensive it is,” she says. Often, she says, doctors will recommend cortisone creams and ointments to treat psoriasis as topical vitamin D prescription medication. “Other topical treatments include tar and dithranol ointments,” Dr. Bailey says. Sometimes, Dr. Bailey says that UV light is used to treat psoriasis and she adds that there is an oral medication that can enhance its effects, called PUVA treatment. No matter what medications someone with psoriasis may or may not take, Dr. Bailey says that a proper skincare routine is key. She explains that someone with psoriasis should focus on treating and preventing skin dryness because psoriasis can spread on really dry skin. “To treat and prevent dry skin you want to moisturize areas prone to psoriasis with a good, rich moisturizing cream after every bath or shower,” she says, adding to avoid bathing with harsh soaps and steamy, hot water—both of which will dry out skin. As with any medical condition, early detection is key to managing psoriasis. That way, you can start working with a dermatologist quickly to manage symptoms before they impact your health more severely. While there’s no cure for psoriasis, there is a lot that can be done to make it more manageable to live with. “During my 35-year dermatology career, I’ve always emphasized to my psoriasis patients the importance of making lifestyle choices that help control inflammation,” Dr. Bailey says. “Psoriasis is easier to control when you get your body’s physiology helping instead of fueling this otherwise capricious disease.” Let this serve as a reminder to pay attention to what your body is telling you: often, the message is more than skin deep. Next up, here’s a step-by-step guide for dealing with dry skin.
Sources
Dr. Cynthia Bailey, MD, California board certified dermatologist and founder of Dr. Bailey Skin CareDr. Caren Campbell MD, FAAD, San Francisco-based board certified dermatologist
