Topicals: Psoriasis

Overview

Psoriasis is classified as an autoimmune condition that causes red, raised, and scaly patches on the skin. In the United States, it is estimated that 7.5 million individuals have some degree of psoriasis. Typically, this skin condition occurs on the outside of the elbows, knees, and scalp, but it can also occur anywhere on the body.

In general, this condition often appears on individuals aged 15 to 25 years, but it can develop at any age. There may be times when psoriasis symptoms get better and times when the symptoms flare up. There are several types of psoriasis. Some people with psoriasis may also develop psoriatic arthritis.

Signs and Symptoms

Psoriasis affects people in varying degrees. Common signs and symptoms often include:

• Red patches of skin with silvery scales
• Itching, burning, and soreness
• Dry, cracked skin
• Swollen and stiff joints
• Thickened, pitted, or ridged nails

Causes and Common Triggers

While the exact cause of psoriasis is unknown, it is thought to be due to a problem with an individual’s immune system. Various triggers of psoriasis include:

• Stress
• Infections
• Injury to the skin
• Smoking
• Exposure to cold temperature
• Use of certain medications such as beta-blockers, antimalarial drugs, nonsteroidal anti-inflammatory drugs, and lithium
• Having a family history of psoriasis

Testing and Diagnosis

Your doctor will conduct a thorough physical exam, examining your skin, scalp, and nails, and will ask you questions about your medical history and symptoms. Your doctor may also perform a skin biopsy to determine what type of psoriasis you have.

Prevention and Management

The most effective way to prevent psoriasis flare-ups is to adhere to the prescribed treatment plan. Measures to manage psoriases include:

• Avoid triggers when possible
• Bathe daily, and moisturize the skin
• Take Epsom salt or oatmeal baths to calm redness and remove scales
• Get an adequate amount of sunlight when possible
• Practice relaxation techniques to reduce stress
• Eat a balanced and healthy diet
• Maintain a healthy weight
• Avoid alcohol consumption

Treatment and Care

Treatment of psoriasis is based on the type and severity of the psoriasis and the areas of skin involved. Treatment may include:

• Topical corticosteroid medications
• Oral and injectable medications
• Vitamin D analogues
• Moisturizers (use fragrance-free products)
• Light therapy (known as phototherapy)
• Topical salicylic acid or coal tar

Homeopathic and Alternative Remedies

Many patients with psoriasis may elect to use alternative remedies. While scientific data are limited, some herbal remedies, homeopathic remedies, or other forms of therapy include:

• Aloe vera
• Omega-3 fatty acid supplements
• Apple cider vinegar
• Vitamin D
• Turmeric
• Topical Oregon grape
• Acupuncture
• Gluten-free diet
• Olive leaf extract

If you are considering the use of supplements or alternative therapies to manage your psoriasis, you should consult your doctor or pharmacist prior to using them.

Self-Care

To prevent potential drug interactions or contraindications, it is very important to discuss the use of OTC products with your doctor or pharmacist before using these products. A pharmacist can make recommendations about possible treatments.

Resources for Patients

• Nemours Foundation
• Medline Plus
• National Psoriasis Foundation

Resources for Pharmacists

• American Academy of Dermatology
• The Psoriasis Association
• National Psoriasis Foundation