Psoriasis: treatment

Cure psoriasis (has psoriasis ) to this day. However, doctors can usually significantly alleviate the symptoms with individually tailored therapy. Treating the disease consistently is important for two reasons: On the one hand, to prevent concomitant diseases and the resulting consequences on the joints or eyes. On the other hand, because psoriasis often has a massive impact on life.

In particular, when the skin is changed in visible areas such as the face or hands, many patients feel disfigured, which affects their self-confidence and social contacts. Psoriasis on the vagina, penis or other parts of the genital and genital area can be so uncomfortable and annoying for women and men that they avoid any sexual relationship.

The aim of psoriasis therapy is always to suppress the symptoms as far as possible, to shorten the acute phases of the disease and to prevent new relapses. Various treatment options are available today that can be combined with one another. The choice of therapeutic measures depends on the patient's individual condition and personal wishes. In the case of psoriasis, doctors basically differentiate between topical, external or local therapies, UV therapy and systemic treatment that affects the entire body.

External therapy

The basis of every treatment for psoriasis is that the patients carefully and regularly care for their skin and especially the changed areas with moisturizing ointments, creams or lotions. This keeps the skin supple, protects it from injuries and relieves itching. There are also special shampoos, washing lotions and bath additives for psoriasis patients. Commercially available products for skin cleansing and care usually contain preservatives and fragrances, which can additionally irritate the inflamed skin of those affected.

Externally applicable active ingredients that are suitable for acute psoriasis vulgaris:

• Care preparations containing salicylic acid, urea or lactic acid
  These have a keratolytic effect. That is, they soften the thickened skin and loosen the horny cells from the top layer.
• Corticoids (cortisone)
  The derivatives of the body's own hormone cortisol contained in cortisone preparations have a dampening effect on the immune system. They have an anti-inflammatory effect and at the same time reduce the excessive proliferation of horny cells. Possible side effects of topical cortisone therapy include hair root inflammation, pigmentation disorders and thinning of the skin. If the remedies, which are available in different strengths, are correctly dosed and not used for too long, these undesirable effects are rare.
• Vitamin D-like substances
  These active substances, which are chemically derived from vitamin D3, also slow down inflammation and slow down the growth of specific skin cells that produce horny substance. Since the vitamin D analogues only cause slight skin irritation as a side effect, patients with psoriasis can use them over a longer period of time.
• Dithranol
  This drug, synthetically produced from tar, which was previously often used in psoriasis, also inhibits the multiplication of horny cells. Since the active ingredient can cause skin irritation and can discolour skin, clothing and bedclothes brown, it is mainly used today in the (partial) inpatient treatment of psoriasis

Phototherapy: With UV light against psoriasis

An important treatment method for psoriasis is phototherapy. Dermatologists make use of the fact that exposure to light in the ultraviolet range (UV-A and UV-B light) reduces inflammation and slows down accelerated cell growth. In the so-called PUVA, which is used in more severe cases, the patient receives a photosensitizer before phototherapy, which makes the UV rays in the skin stronger.

UV therapy belongs in the hands of a specialist. He has the right lighting equipment and individually adapts the treatment to the skin type and the current condition of the psoriasis for each session. Because of the risk of sunburn and other skin damage, experts advise against self-treatment in the solarium.

Internal therapy: tablets and injections against psoriasis

In the case of moderate to severe psoriasis, purely external therapy does not always enable the patient to lead a completely or at least largely symptom-free life. Then treatment with drugs that are given as tablets, syringes, or infusions can help those affected. Since these drugs work throughout the body, doctors speak of systemic or internal therapy.

The active ingredients methotrexate, ciclosporin and fumaric acid ester have long proven themselves here . They dampen the immune system and thus the inflammatory process that causes the symptoms of psoriasis. Doctors also use methotrexate with good success when psoriasis has spread to the joints.

For a number of years there has been a new, highly effective group of drugs for the systemic treatment of psoriasis, the biologics . The active ingredients called etanercept, adalimumab, infliximab, secukinumab and ustekinumab are genetically engineered proteins that specifically trap and switch off certain inflammatory substances in the body or occupy their binding sites and block them in this way. All of these drugs are approved for the treatment of common psoriasis and psoriasis with joint involvement (psoriatic arthritis ).

Since all drugs used for internal treatment suppress the body's defenses, they can make patients more susceptible to infections. In addition, the individual active ingredients have specific side effects such as a disorder of kidney or liver function. Because of the risk of such undesirable effects, systemic therapy for psoriasis should be the last option and, if possible, only be carried out temporarily.

Psoriasis: Homeopathy and Home Remedies

Many psoriasis patients are interested in alternative medical methods such as acupuncture or homeopathy. However, research has not yet been able to prove that these procedures really help with psoriasis. Ultimately, the same applies to home remedies, although baths with sea salt are considered to be relatively tried and tested. The risk that homeopathy and home remedies will have a negative effect on psoriasis is low, but to be on the safe side, patients should discuss these measures with the treating doctor.

Diet for psoriasis

A healthy, balance diet with plenty of fruit and fresh vegetables, meat only in moderation and plenty of unsaturated fatty acids, which are contained in sea fish, olive, linseed or rapeseed oil - these general advice also apply to patients with psoriasis. There is no scientific evidence for more specific nutrition tips or even a special psoriasis diet. Alcohol, and especially smoking, has been shown to make psoriasis symptoms worse. Therefore, those affected should avoid these luxury foods as much as possible.

 

 

Psoriasis: causes

Despite intensive efforts, researchers have not yet been able to conclusively clarify the exact causes of psoriasis. According to the current state of knowledge, the disease is one of the autoimmune diseases in which the immune system falsely targets the body's own tissue and causes inflammation there. Accordingly, psoriasis is not contagious. Like many other autoimmune diseases, psoriasis is not completely curable.

Psoriasis patients are constantly producing too many skin cells. In particular, the so-called keratinocytes, which make up the top layer of skin, multiply excessively as a result of the autoimmune reaction. A healthy epidermis usually takes four weeks to renew itself. It only takes four days for people with psoriasis. Since the keratinocytes do not die off as quickly as they are reproduced, the skin thickens in the affected areas and flakes much more than in healthy people.

Inheritance of psoriasis

Experts believe that hereditary predisposition plays an important role as the cause of psoriasis. This is supported by the fact that relatives are also affected in 30 to 40 percent of patients. If both parents have psoriasis, the likelihood that their children will also develop psoriasis is around 30 to 40 percent. Conversely, this means that around two thirds of these children remain healthy despite their genetic makeup.

Hereditary predisposition alone does not necessarily make you sick, but only increases susceptibility. However, if there are certain personal or environmental triggers, psoriasis can break out.

Psoriasis: possible triggers

The triggering factors that can cause psoriasis or a disease flare-up include:

• Infections, mainly caused by the bacterial genus Streptococcus
• hormonal fluctuations, for example due to puberty, menopause, menstruation or pregnancy
• certain medications such as beta blockers, lithium salts, antihypertensive ACE inhibitors, or the anti-malarial drug chloroquine
• Local skin irritation, e.g. from sunburn , irritating substances from the environment such as chemicals, tight-fitting clothing or severe scratching of the skin
• Stress and other mental stress
• Smoking and increased alcohol consumption
• Skin injuries and burns
• climatic influences, especially dry, cold air

Psoriasis: symptoms

Psoriasis is a multi-faceted disease. There are several manifestations that appear both alone and in combination and differ in their symptoms. It is typical that psoriasis usually comes on in flares. This means that the patients alternate periods of time in which they have no or only very mild symptoms and acute phases of illness with noticeable and visible symptoms.

Psoriasis vulgaris

By far the most common form of disease is what doctors call psoriasis vulgaris. Eight out of ten patients suffer from such “common” psoriasis. In those affected, the skin turns red and forms silvery, shiny, slightly raised changes that are clearly delimited, heavily flaky and often itchy. Doctors refer to these typical skin conditions as plaques.

Initially, the foci of inflammation measure only one or two centimeters, but often enlarge in the course of the disease and can flow together. In principle, psoriasis vulgaris can occur anywhere on the body. The scalp, elbows and knees on the extensor sides of the arms and legs and the back are particularly often affected. Plaques also often form behind and in the ears, on the eyebrows, on the hands, feet and in the area of ​​the navel.