About Psoriasis

What is Psoriasis

Psoriasis is one of the most common skin complaints. There are many different types, but it usually appears as clearly defined red patches covered in fine silvery scales. These patches can affect small or large areas of the body, and can be very distressing - not only because they are sore and itchy but also because they can make you feel very self-conscious.

Psoriasis is not infectious, and it may be helpful to point this out to anyone who is afraid they might catch it from you. Apart from causing you physical discomfort and loss of self-confidence, psoriasis doesn't actually make you feel unwell.

In the UK, about 2 per cent of the population gets psoriasis - that's more than a million people. It affects women and men equally and it can come on at any age. There appears to be family links to psoriasis as about one-third of sufferers have relatives with the condition.

What causes Psoriasis

Types of Psoriasis	Areas it Affects	Typical Symptoms
Chronic plaque psoriasis	Scalp, knees, elbows or other body crevices	This is the most common type. It causes scaly red patches which can be very or cover large areas
Flexural psoriasis	Body crease such as elbows,armpits and under the breasts	Reddening of the skin but no scales
Guttate psoriasis	All over the body except for palms and soles	This usually follows about a week after a throat infection. It causes teardrop shaped scaly patches it can be completely eradicated if treatedearly or go on to become chronic plaque psoriasis
Pustular psoriasis	All over the body	Painful pustules which can be Accompanied by fever and may come on in response to Over use of strong steroids
Erythrodermic psoriasis	All over the body	Very rare; Much of the skin is red, scaly affects body fluid balance and temperature

One research study in Denmark found during post mortems that people with psoriasis had overgrown cells which produce the Human Growth Hormone in their pituitary glands. The researchers therefore proposed that psoriasis could be caused by this. In fact, the reason why psoriasis happens at all is not known but there are many ways in which it can be helped.

Treating Psoriasis

A key factor in dealing with psoriasis does appear to be managing the way you react to stressful or irritating situations.

Evaluating stress levels and looking for ways to reduce these or to cope with them better is important in any case, but particularly in a chronic condition such as psoriasis. This may take the form of dealing with an issue directly, talking to a therapist, doing a personal development or stress management course, or taking up t'ai chi or yoga whichever course of action feels most appropriate for you. Other therapies such as reflexology or aromatherapy, when carried out by a qualified practitioner, can also be very relaxing.

From the outside

Traditional medical treatment usually involves using emollients to moisturize the skin, or coal tar preparations which are messy and smelly. Harsher chemicals such as dithranol are relatively effective. But they are also messy, can stain the skin and harm normal skin, and are too strong to be used on the face, groin or armpits. Other treatments include salicylic acid, retinoids, steroids and vitamin D. While these can all be very helpful, they are not without side-effects, such as severe skin irritation; and ultimately, they do not get to the cause of the problem. More radical treatments, using powerful drugs such as methotrexate, help stop cell growth, but these are quite toxic and affect all cells in the body.

Ultraviolet light therapy is a very useful treatment for people with psoriasis (although in a very few cases it can make it worse). Substances such as psoralens, which increase the skin's sensitivity to light, are often used in conjunction with light therapy. Because of the risk of skin cancer with ultraviolet exposure, this only tends to be used as a last resort and has to be carefully monitored.

Natural sunlight and bathing in the sea can be very helpful. Indeed, visiting the sunny shores and waters of the Dead Sea is a popular therapy for people with psoriasis, if rather expensive. A cheaper alternative is to put a kilogram of Epsom salts and 500 g of salt in a warm bath, or even one of the Dead Sea products which are available in health food shops. You may also want to look in your local health food shop for alternatives to cortisone creams such as glycyrrhetinic acid (made from licorice) which can be just as effective, or camomile or cayenne pepper extract (capsaicin)

From the inside

As with many skin problems, there seems to be a significant link between gut health and psoriasis. External treatments will never cure the condition until the internal cause is dealt with balancing the mechanisms which control skin cell division appears to be vital, and these mechanisms can only function properly when the digestive tract is working well. If the lining of the intestines is not healthy - due to constipation, poor digestion, food allergies or whatever - toxins can get into the body and affect the skin.

Enzymes

One of the main gut problems in people with psoriasis appears to be faulty digestion of protein; this, in turn, creates excessive toxicity in the bowel, which weakens the gut lining and allows substances to intoxicate the rest of the body. This can lead to skin problems including psoriasis and other forms of inflammation.

And a digestive enzyme supplement taken with each main meal should also help. The body naturally produces proteolytic enzymes (which digest protein) but may not be producing enough, so taking a source of these may help.-Look out for a formula containing protease - the broad name for enzymes which digest protein. Bromelain is an extract from pineapple, available in supplement form, which does this.

Herbs

Toxins produced in the body by undesirable bacteria or yeasts such as Candida albicans in the intestines can affect the compounds which control cell division. However, the herb sarsparilla can bind to toxins and clinical studies have shown it to help people with psoriasis.

Other herbs which can help cleanse the digestive tract are oregano grape, which was traditionally used in chronic skin conditions such as psoriasis (or goldenseal which has some similar properties), and oregano, which is also a powerful detoxifier. You may, with the help of a herbal practitioner, want to follow a bowel-cleansing program of specific herbs and fibers such as pectin or psyllium.

Any build-up of toxins also has the knock-on effect of burdening the liver, the body's main detoxification organ. The liver usually filters' out toxins from the gut before they get out around the body, but if it is overloaded it becomes less efficient at this. The herb milk thistle (Silybum marianum) helps support the liver, as does the mineral sulphur. This can be increased in the diet by eating more eggs, onions and garlic and can be taken in the form of MSM supplements - 1000mg, three times a day.

Diet and supplements

It is therefore important to have a diet which supports good digestive and liver health - high in whole foods that are naturally high in fiber such as whole grains, root vegetables, lentils, fresh fruits, fresh vegetables (especially green ones) and beans. You should also avoid foods that have a negative effect on the gut and liver, such as fats, alcohol and sugars in particular, as well as any foods that may be acting as irritants (most commonly wheat and dairy products). Eliminating these two food groups from your diet should only be done with the guidance of an experienced health practitioner.

In addition to eating a healthy diet and checking for food sensitivities, people with psoriasis can benefit from supplementing particular nutrients to promote the health of the skin and calm inflammation. Vitamin A (up to 20,000 IU daily) and the mineral zinc (up to 30mg daily) are essential for good skin health. Quercetin is a plant bioflavonoid which has powerful antioxidant properties and can help soothe inflammation take 400mg three times a day. Large doses of vitamin C (i.e. more than 500mg a day) should be avoided. There are many essential nutrient supplements that may be beneficial, but taking those above and a multivitamin is a good way to start, in addition to some essential fats.

It's important to limit animal fats from meat and dairy products because they can promote inflammation, as can commercially processed foods (e.g. margarine or foods containing hydrogenated fats) and fried fats which also interfere with the way the body processes essential fats. Conversely, fish oils and other essential fats can help control inflammation. Eat fish such as salmon, mackerel or herring at least three times a week; and have fresh pumpkin and other seeds daily. If you can get hemp seeds or linseeds, grind them in a coffee grinder and sprinkle them on cereals, soups or salads; use cold-pressed pumpkin, safflower, sunflower and other oils on salads or on food after it has been cooked (heating these oils damages them). Also, each day take either a dessertspoon of flax seed oil, or a fish oil supplement which provides at least 1000mg of EPA. Sprinkling lecithin granules on food can also be beneficial, as it helps with the body's use of fats.

Interestingly, one clinical study found that psoriasis patients tended to be deficient in protein and folic acid due to the extremely rapid growth of their skin cells, which created extra demand for these nutrients. While it is not necessarily recommended that people with psoriasis dramatically increase either of these nutrients, this does underline the need for a good diet. Unfortunately, finding out what best keeps your psoriasis at bay is often a question of trial and error. Go for those methods which do not involve large financial outlay first, as what works for some may be of little use to others.