Psoriasis

How to get psoriasis under control

Psoriasis can be treated well today.

(Bild: stock.adobe.com/Ban Orsolic)

It's hard to imagine how much psoriasis affects patients' quality of life - especially if you are not affected yourself. But those affected should not despair, because the chronic skin disease and the associated symptoms can now be treated effectively.

There are many sad stories of fathers whose children are reluctant to hug them or of people who don't invite anyone home spontaneously because they can't vacuum up the flakes of skin scattered around their home so quickly. "Suffering from psoriasis is a huge burden on life," confirms Dr. Katharina Wippel-Slupetzky, a dermatology specialist in Vienna. "So it's all the more important to know that you don't have to put up with it. Although there is no cure for the skin condition, with the right treatment it is now possible to be symptom-free - and not have to be satisfied with a slight improvement in symptoms."

However, there is still a lack of knowledge about this non-contagious skin disease - even among young patients, the expert is surprised to learn. At first, they often know little about the unpleasant, itchy, rough and scaly patches on their bodies. These are often found on mechanically stressed areas such as the knees and elbows, but also on the scalp and sometimes on the palms of the hands, soles of the feet and in so-called inverse areas such as the genital area, armpits and anal folds. The joints are involved in up to 30% of cases.

Various triggers trigger the condition
"There is often a genetic background, even if only distant relatives are affected. This mainly affects psoriasis that occurs before the age of 40; in a third of cases, the disease develops before the age of 16. There is a second peak from the age of 40, usually in the 5th to 6th decade of life," explains the expert. Infections such as streptococci, but also smoking, alcohol, stress or some medications (certain drugs for high blood pressure) can trigger the outbreak of psoriasis.

The appropriate treatment for this unpleasant skin condition is discussed with the doctor.

(Bild: stock.adobe.com/B. BOISSONNET)

Sometimes very emotional or stressful phases of life also cause the condition. "A great deal has improved in terms of treatment in recent years," says Dr. Wippel-Slupetzky. "There are now various good local therapies such as creams and sprays. Irradiation with UV light, some immunosuppressive tablets such as methotrexate and those that block inflammatory messengers also help. However, drugs called biologics have revolutionized therapy. These inhibit inflammatory messengers in the body."

The way these drugs are administered is also advantageous, explains the expert: "Depending on the active ingredient, injections or infusions are administered. The frequency ranges from every few days to several times a year. This makes everyday life easier, as the application takes less time. However, basic skin care should be maintained." Of course, the doctors discuss which therapy would be best together with those affected.

"The rough rule of thumb is that if more than 10 percent of the skin is affected, systemic therapy is recommended, i.e. the entire organism is treated, be it with UV radiation, tablets, injections or infusions. If so-called 'upgrade criteria' are present, such as the infestation of visible areas such as the face, hands, severe nail infestation, but also involvement of the genital area, these therapies are also used for skin involvement of less than 10 percent." It is also important to consider the patient's individual circumstances in order to select the most suitable therapy for them.

Psoriasis often affects more than just the skin
Psoriasis is much more than just a skin disease, as it affects the entire body. Those affected have a higher risk of cardiovascular disease, for example. Sometimes the joints are also affected, which is referred to as psoriatic arthritis. "30 percent of psoriasis patients develop this disease, but the skin does not necessarily have to be affected first," says Dr. Wippel-Slupetzky. "In general, nail, scalp and intimate areas are strong warning signs for the possible development of psoriatic arthritis. Skin symptoms and joint complaints that occur together should therefore always be linked and shown to a specialist."

According to the expert, patients should: "Take care of your health: go for a check-up, don't smoke and ideally don't drink alcohol or only drink a little. It is also important to aim for a normal weight, as abdominal fat in particular produces inflammatory messengers that fuel psoriasis. You should eat a Mediterranean diet with fish, olive oil and lots of vegetables."