Psoriasis

Psoriasis in Dallas, TX

This condition develops when the body makes skin cells too quickly, causing skin cells to pile up and form visible patches or spots on the skin, called plaques. They can appear anywhere on the skin, but you’re most likely to find them on your knees, elbows, lower back or scalp.

Plaques tend to vary in size. They may appear on the skin as a single patch or join together to cover a large area of skin. No matter the size, plaques tend to be itchy. Without treatment, the itch can become intense. Some people notice that their skin stings, burns, or feels painful and tight. While there is no cure for psoriasis, there are more treatment choices than ever before to help ease discomfort from your symptoms.

Because psoriasis tends to be a life-long disease, it helps to learn about it and see a dermatologist. A bit of knowledge and help from a board-certified dermatologist can give you some control over the psoriasis. By gaining control, you can see clearer (or clear) skin. Gaining control can also help you to feel better, improve your overall health, and prevent the psoriasis from worsening.

Gaining control often involves:

• Learning (and avoiding) what triggers your psoriasis
• Sticking to a good psoriasis skin care routine

• Living a healthy lifestyle
• Using medication when necessary

Seeing a board-certified dermatologist has another benefit. Psoriasis can increase your risk of developing certain diseases, such as psoriatic arthritis or diabetes. Your dermatologist can watch for early signs of disease. If you do develop another disease, early treatment helps to prevent the disease from worsening. When you see a board-certified dermatologist about psoriasis, your dermatologist may talk about the type(s) of psoriasis you have. It’s possible to have more than one type.

While patches of thickened, dry skin are common, psoriasis can cause many signs and symptoms. What you see and feel tends to vary with the: 

• Type of psoriasis you have
• Places psoriasis appears on your body

• Amount of psoriasis you have

Psoriasis is not contagious. Unlike chickenpox or a cold, you cannot catch psoriasis from someone. You also CANNOT get psoriasis by: 

• Swimming in a pool with someone who has psoriasis
• Touching someone who has psoriasis

• Having sex with someone who has psoriasis

While we know that psoriasis isn’t contagious, scientists are still trying to determine exactly how psoriasis develops. For some, psoriasis runs in families: If a parent, grandparent, brother, or sister has psoriasis, you have a higher risk of getting it. But for other everyday things can act as a trigger, causing psoriasis to appear for the first time.

These triggers can also cause psoriasis flare-ups. Different people have different triggers. For example, periods of intense stress may trigger your psoriasis, but cold weather may not. That’s why it’s so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.

Psoriasis tends to come and go unexpectedly. People often have periods when psoriasis calms down. Some may see clear or nearly clear skin during these periods. Psoriasis can also flare unpredictably. 

Treating psoriasis can keep it under control, helping you avoid serious flares and preventing the psoriasis from becoming more severe. 

If you think you have psoriasis, it’s important to find out by speaking with a board-certified dermatologist, as they can help you manage your psoriasis and find a course of treatment to relieve your discomfort and lead to clearer (or clear) skin. Visit our office and let us put together a proper treatment plan that can give you relief and restoration.

TREATMENT

When it comes to treating psoriasis, many people find that working with a doctor who has experience treating psoriasis helps. Dermatologists have this experience, so they understand the risks and benefits of the different treatments. They know which treatments can be safely combined and when a treatment is unacceptable for a patient.

Treating psoriasis has benefits for both your body and mind.  Treatment can:

• Help you see clearer skin
• Slow the psoriasis, reducing your risk of getting more severe (and sometimes disabling) psoriasis

• Reduce symptoms such as itch and pain
• Lessen the effects of related health conditions such as heart disease

Research also shows that keeping psoriasis under control with treatment can help you get a good night’s sleep and improve your self-confidence.

Keeping your psoriasis under control tends to be an ongoing process. It requires appointments with your dermatologist. You’ll also need to follow your treatment plan and learn what triggers your psoriasis. Once you know your triggers, you can avoid them. 

While treatment may be ongoing, the type of treatment you need may change. Different treatment may be necessary to keep your psoriasis stable, nearly clear, or clear; and/or to control a flare-up. At times, treatment can lead to clear skin and no psoriasis symptoms. The medical term for this is “remission.” A remission can last for months or years; however, most last from 1 to 12 months.

Psoriasis is notoriously unpredictable, so it’s impossible to know who will have a remission and how long it will last. Even when psoriasis clears, it’s likely to return. When it does, treatment can help control it so that your psoriasis doesn’t worsen. One of three things happens when you stop treatment:

• You may stay clear and have no psoriasis symptoms (remission).
• Your psoriasis may return, looking and feeling much like it did before (relapse).

• The psoriasis may return and be worse than before (rebound).
• What happens often depends on the medication you were using when you stopped, how well you manage your psoriasis triggers, and your medical history. 

Before stopping psoriasis treatment, talk with your dermatologist

Because psoriasis is a lifelong disease, it’s understandable that you may want to stop treatment at some point. Always talk with your dermatologist before you stop treatment.

Some treatments can be stopped immediately. Others need to be discontinued slowly to prevent psoriasis from worsening (rebound). When psoriasis rebounds, it may become a more serious type of psoriasis. A person who had plaque psoriasis may suddenly have pustular psoriasis or erythrodermic psoriasis. 

The best way to prevent a rebound is to talk with your dermatologist. Your dermatologist can tell you whether you can stop the treatment abruptly or slowly. Sometimes, the best approach is to gradually switch to another treatment. 

Tell your dermatologist why you want to stop treatment

When you talk with your dermatologist, it’s important to explain why you want to stop treatment. This may play a key role in determining next steps. This talk is especially important for both men and women who want to start a family

TYPES

Plaque

patches of thick raised skin covered with silvery scale form. These patches usually appear on the scalp, elbows, knees, or lower back- but they can develop anywhere on the skin.

Scalp

on the scalp the psoriasis may be thin or thick. Very thick patches can lead to hair loss, whether thick or thin the patches can extend beyond the scalp to the forehead, neck or ears.

Nail

this can develop with any type of psoriasis, signs include yellow-brown spots on the nails, pitted nails, crumbling nails, and nails separating from fingers or toes.

Guttate

this type often develops in children who get it after they’ve had an infection, such as strep throat. Guttate psoriasis tens to cause lots of small, scaly spots.

Inverse

found where skin touches skin, such as the armpit or groin area. This tyoe causes shiny smooth patches instead of scaly ones. This psoriasis often bright red and the skin may be sore.

Pustular

on their hands and feet, people develop painful pus-filled blisters and thick scaly skin that cracks easily

Generalize pustular

Rare and very serious, this type of psoriasis requires emergency medical care. It begins with dry, red, and tender skin. Within hours, widespread pus-filled blister appear.

Erythrodermic

this type of psoriasis causes large areas of skin to look burnt. Anyone who has skin that looks burnt should see a doctor immediately because this type of psoriasis can be life threatening.

FLARE-UP TRIGGERS

If your psoriasis seems to flare for no reason, one or more triggers could be to blame. Everyday things like stress, a bug bite, and cold temperatures can trigger psoriasis.

Triggers vary from person to person. By finding your triggers and learning how to manage them, you can gain better control of your psoriasis and have fewer flares.

To find yours, you’ll have to do a bit of detective work. A good place to start is by looking at this chart of the common triggers, which also gives you signs that that it could be a trigger for you.

Stress

Do you get flare-ups when you're feeling overwhelmed or stressed? Stress is a common trigger.

Reduce the risk of flare-ups from stress:

• Find a way to manage your stress and practice- even when you're feeling okay. Common stress busters include yoga, meditation, and support groups.
• Before going to sleep, write down 3 things that you're grateful for. Do this daily.  

• When you start to feel stressed, take a deep breath, hold it, and exhale slowly

Skin Injury

If this triggers your psoriasis, you’ll get a flare-up near (or in the same spot as) the injury or bite. This happens about 10 to 14 days after you injure your skin. Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.

Reduce the risk of flare-ups from a skin injury/;

• If you injure your skin, treat it quickly.
• If your skin itches, calm the itch. 

• Avoid scratching, which can trigger a flare.
• Try to avoid getting bug bites by using insect repellent and staying indoors when bugs are most active. Bugs are most active at dusk and dawn.

Drinking frequently or in excess

If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect. Even treatment that could be effective for you may not work and you’ll continue to have flare-ups.

Reduce the risk of flare-ups from drinking:

• Quit drinking.
• If you continue to drink, limit how much you drink in a day. Women should stop after 1 drink. Men should limit themselves to 2 drinks per day. 

• Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate.

Smoking

Does your psoriasis flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause. 

Reduce the risk of flare-ups from smoking

• Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.
• Before trying a nicotine patch, ask your dermatologist whether using it could trigger your psoriasis.

• Avoid being around people who are smoking.

Dry, cold weather 

If your psoriasis worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.

Reduce the risk of flare-ups from dry, cold weather

• Treat your psoriasis.
• Limit showers and baths to 10 minutes and use warm rather than hot water.

• Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.
• Use a gentle, moisturizing cleanser instead of soap.

• Apply moisturizer throughout the day when your skin feels dry. 
• Plug in a humidifier when the air in your home feels dry.

• Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.
• Sit far enough away from a fireplace, radiator, or other heat source so that you cannot feel the heat on your skin.

• Remove wet clothes and footwear when you come in from the cold.

If your psoriasis continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.

Sunshine, warm weather

During warm weather, psoriasis can flare if you Sunburn and/or spend time in air conditioning

Reduce the risk of flare-ups during warm weather:

• If you spend time in air conditioning, apply moisturizer immediately after showering or getting out of a bath.
• If your skin still feels dry from spending time in air conditioning, apply moisturizer throughout the day.

• Avoid sunburn by wearing sunscreen. You want to apply sunscreen to skin that clothing doesn’t cover and is free of psoriasis. To get the protection you need, use sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.

Infection

Psoriasis can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.

Reduce the risk of flare-ups due to infection:

• Treat the infection. This can lessen or clear the psoriasis.
• Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some psoriasis treatments risky.

Medication

Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning a medication.

Reduce the risk of flare-ups from medication:

• If you think a medication is causing your psoriasis to flare, DON’T stop taking it. Ask the doctor who prescribed it whether the medicine could be causing your psoriasis to flare. If it could, ask if you could take another medication. 
• Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause psoriasis to flare. Medicines that commonly trigger psoriasis include lithium, drugs taken to prevent malaria, strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down), medicine that treats high blood pressure and problems with your heartbeat, some arthritis medications.

Tattoos and Piercings

When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, psoriasis can flare. 

Reduce the risk of flare-ups from tattoos and piercings:

• Avoid tattoos and other types of body art if you have psoriasis.
• If you want to get any type of body art, talk with your dermatologist first. Your dermatologist may be able to offer some tips that can reduce flare-ups.

Shaving

If you cut yourself while shaving, you may notice new psoriasis about 10 to 14 days later where you cut yourself.

Reduce your risk of flare-ups from shaving

• Take care to avoid cutting yourself while shaving.
• Dermatologists’ tip: To reduce cuts and nicks, try applying moisturizer and then shaving gel before you shave.

PSORIASIS AND PREGNANCY

Psoriasis can change during pregnancy: Many women find they have less psoriasis during pregnancy. Psoriasis may also stay the same or worsen. Yes, it’s possible to treat psoriasis while pregnant or breastfeeding. A woman must avoid some treatments because they can harm her baby. Others can be prescribed.

Psoriasis treatment a woman can use while pregnant

If you need to treat your psoriasis while pregnant, your dermatologist will think carefully about how best to control your psoriasis without affecting your baby. Treatment options considered the safest for pregnant women include the following.

Moisturizers and emollients

These cannot clear psoriasis, but they can:

• Protect your skin from chaffing
• Reduce your risk of a flare-up if you injure or irritate your skin

There are no known risks to using moisturizers and emollients while pregnant. 

Corticosteroids that you apply to your skin

When a woman needs to treat psoriasis while pregnant, a low- to mid-strength corticosteroid is often the first medicine prescribed.  These do not appear to increase the risk of birth defects or to cause a baby to be born early. This medicine may increase the risk of a woman developing stretch marks.  If a strong corticosteroid is needed, it should be used for the shortest time possible. 

Phototherapy

If a woman needs stronger psoriasis treatment, a type of light treatment called narrowband UVB phototherapy is often prescribed. Two types of phototherapies are considered safe for pregnant women to use:

• Narrowband UVB
• Broadband UVB