Causes Of Psoriasis
The causes of psoriasis aren’t fully understood. It’s thought the skin condition is caused by a problem with the person’s immune system, specifically the T cells and certain white blood cells called neutrophils. T cells usually course through the body looking for viruses and bacteria to attack, but with psoriasis, the T cells attack healthy skin cells by mistake. This causes inflammation.
A secondary aspect to this is these overactive T cells encourage the body to increase the production of skin cells, T cells, and neutrophil white blood cells. The neutrophils travel into the skin causing inflammation and at times creating pustular lesions. The areas affected become warm and red, due to dilated blood vessels. These processes trigger the body to produce more skin cells and they are moved to the outermost layer of the skin much more quickly than normal. This makes the skin thick and scaly in the affected areas.
The reason a person’s T cells perform abnormally isn’t fully understood. It’s thought that both genetics and environmental factors play a role. There are various ways a person can, in effect, trigger an outbreak. These are some potential triggers:
- Infections, such as strep and skin infections
- Skin injury, such as a bug bite, cut, or a severe sunburn
- Heavy alcohol consumption
- Vitamin D deficiency
- Certain medications, such as lithium, blood pressure medications, anti-malarial drugs, and iodides
Who is most likely to develop psoriasis?
Psoriasis is common, affecting about two percent of the United States population. Psoriasis is about twice as likely to affect whites as it is people of color. It is not contagious, despite rumors to that effect, and it cannot be acquired from swimming in a pool, touching a person with the condition, or sexual contact.
Psoriasis usually develops between the ages of 15 and 35, although 10-15 percent of people get it before age 10. There is a definite genetic predisposition to developing psoriasis.
These are the risk factors for developing psoriasis:
- Family history — If you have at least one parent with psoriasis, your odds of developing the disease are elevated, even more so with both parents.
- Viral and bacterial infections — People with compromised immune systems are more likely to develop psoriasis. This occurs with HIV and repeated strep throat infections, and even the common cold.
- Stress — High levels of stress impact your immune system, making it more likely you’ll develop the skin disease.
- Obesity — Excess weight increases risk. Plaques associated with all types of psoriasis often develop in skin folds.
- Smoking — Smoking seems to impact the chances of developing psoriasis, and it increases the severity.
Forms Of Psoriasis
Psoriasis in a common skin condition, and it can show itself in different forms.
- Plaque psoriasis — This is the most common form of psoriasis, where dry, raised, red skin lesions (plaques) covered with silvery scales form. Areas may be small or large, and they can occur anywhere on the body, even inside the mouth or on the genitals.
- Nail psoriasis — Psoriasis can affect the fingernails and toenails, causing abnormal nail growth and discoloration, pitting, and even causing the nail to loosen from the nail bed or crumble.
- Guttate psoriasis — This type of psoriasis is usually triggered by a bacterial infection such as strep throat, most often affecting children and teens. Small water-drop-shaped, scaly lesions form on the trunk, arms, legs, and scalp. These lesions aren’t as thick as most other plaques. This type may occur just a single time, or it may have repeated episodes.
- Inverse psoriasis — It’s thought that fungal infections trigger this type of psoriasis. It mainly affects the skin in the armpits, groin, under the breasts, and around the genitals. Smooth patches of red, inflamed skin form, without the isolated plaques of other types. These patches worsen with friction and perspiration.
- Pustular psoriasis — This is a rare form that affects the hands, feet, or fingertips. Pus-filled blisters develop quickly, appearing just hours after the skin first becomes red and tender.
- Erthrodermic psoriasis — This is the least common form of psoriasis. The entire body is covered with a red, peeling rash that can itch and burn intensely.
Living With Psoriasis
Psoriasis is a chronic skin disease, and there is no cure. The symptoms come and go in cycles. It can flare up for a few weeks or even months, but it can then calm down or go away for a period. It can even go into complete remission. The goal is to stop the skin cells from growing so quickly. Managing the symptoms becomes paramount to living with psoriasis.
How psoriasis impacts your daily life can depend, in part, on the type of psoriasis you’re dealing with. For instance, nail psoriasis won’t have the same impact on life as a plaque psoriasis outbreak on exposed skin or the genitals.
Why does psoriasis seem to change throughout the year?
For many people with psoriasis, their skin seems to improve in the spring and summer, but then it relapses in the fall and winter. It is thought this is due mainly to the sun. Psoriasis often responds well to exposure to both natural and artificial ultraviolet light. In the summer we wear less clothing, so more of our skin receives the sun’s UV rays. This shouldn’t be overdone, however, as sunburns can trigger flare-ups.
In the winter our skin is covered, the sun is lower and less strong, the temperatures are colder, and indoor heated air is dry. Plus, it’s more likely your immune system is taxed by colds and the flu, which can trigger flare-ups.
How long after I start treatment will my psoriasis heal?
There are a wide variety of treatments, just as there are a variety of types of psoriasis. The disease varies in individuals. Although it is usually worse during the cold weather months, the frequency and severity of a person’s outbreaks are quite haphazard.
At Dermatology Institute & Skin Care Center, we employ a number of different treatment methods. Often we use a degree of trial and error because different patients respond to the same treatment in different ways. We usually start patients on the mildest treatments, usually ultraviolet light therapy combined with topical creams. From there we ramp up the strength as necessary.
Although there is no cure for psoriasis, we are very successful helping our patients overcome or manage their symptoms.