Psoriasis, a chronic skin condition that affects millions of people worldwide, has a tendency of making those suffering from this skin condition feel like they are navigating in unchartered waters. Characterized by red, itchy patches of skin covered with silvery scales, psoriasis can significantly impact a person’s quality of life. The good news is that there are various treatments available to manage and control this troublesome skin condition. In this blog post we will discuss different treatment approaches recommended by the National Psoriasis Foundation to help you better understand these options so can make informed decisions regarding management of this condition.

Understanding Psoriasis

Imagine your skin as a beautifully woven fabric designed to protect your body from external threats. Now, imagine that fabric starting to fray and lose its strength. This is similar to what happens when a person experiences psoriasis. Psoriasis is an autoimmune disease where your body’s immune system mistakenly attacks healthy skin cells, leading to an acceleration of the skin cell regeneration process.

Normally, your skin cells go through a cycle whereby old skin cells shed off gradually, making way for new ones. When it comes to psoriasis sufferers, their cycle is disrupted resulting in new skin cells starting to rapidly form before the old ones have had a chance to shed. As a result, the skin cells pile up on the skin surface leading to the formation of thick, red, and scaly patches known as psoriatic plaques. [1]

The Skin Barrier and Psoriasis

Your skin barrier is like a protective shield that guards your body against outside invaders. It consists of several layers, with the outermost layer called the epidermis. Within the epidermis there are specialized cells called keratinocytes that play a crucial role in forming this barrier.

With psoriasis, the excessive growth of new skin cells disrupts the normal function of the skin barrier. The rapid turnover leads to an accumulation of immature skin cells on the surface, making the barrier less effective in keeping moisture locked in and harmful substances blocked out. Consequently, your skin becomes more susceptible to dryness, irritation, and infections. [2]

Impact on Inflammation

Now, let’s talk about inflammation. Think of inflammation as your body’s way of fighting off intruders and healing wounds. When you get a cut or a scrape, your body triggers an inflammatory response to repair the damaged tissues. [3]

In psoriasis, the immune system goes into overdrive, activating an inflammatory cascade even without any real threat. The immune cells, especially T-cells, release inflammatory proteins known as cytokines. These cytokines signal other immune cells to join the fight, creating an ongoing cycle of inflammation.

This chronic inflammation then affects the skin, leading to redness, swelling, and discomfort often associated with psoriasis. The inflammatory process also contributes to the increased production of skin cells, further aggravating the buildup of psoriatic plaques.

Triggers and Factors

Psoriasis is a complex condition with various triggers and contributing factors. Stress, for instance, can act as a catalyst, exacerbating psoriasis symptoms. When you’re stressed, your body releases stress hormones that can influence your immune system, potentially triggering psoriasis flare-ups.

Additionally, genetics play a significant role in psoriasis. If you have a family history of the condition, you may have a higher risk of developing it yourself. Other factors such as infections, injuries to the skin, and certain medications, can also play a role in psoriasis development. [4]

 

Exploring the Treatment Landscape

Now, let’s begin our journey through the diverse terrain of psoriasis treatment options. And who better to take along as a guide on this journey than The National Psoriasis Foundation, a bona fide expert in the field. The National Psoriasis Foundation has identified various treatment options for managing psoriasis, each tailored to the severity of the condition and the patient’s individual needs. Think of these treatment options as tools in your psoriasis toolbox, each designed to help you regain control you’re your skin’s health and harmony. [5] These treatment options fall into several categories: topical treatments, phototherapy, systemic medications, and emerging therapies. Let’s explore each category in greater detail:

Topical Treatments: Nurturing Your Skin’s Garden

Think of your skin as a garden that needs tender care to thrive. Topical treatments are like specialized fertilizers nurturing your skin back to health. These treatments come in the form of creams, ointments, and lotions which can be applied directly onto the skin and oftentimes represent the first line of defense for mild to moderate cases of psoriasis. They work by reducing inflammation, slowing down the growth of skin cells, and relieving itching. Common types of topical treatments include:

• Corticosteroids: These are anti-inflammatory medications that help reduce redness, swelling, and itching. They come in various strengths and formulations. Imagine these as quick-fix caretakers. They swoop in to reduce inflammation and itching. But just like pruning too much from a plant can be problematic, their prolonged use can lead to thinning skin.
• Calcineurin Inhibitors: These are like gentle gardeners for sensitive spots. They also soothe inflammation but without the potential risks of corticosteroids. These medications reduce inflammation and can be especially useful for sensitive areas like the face and genitals.
• Coal Tar: Think of coal tar as a natural pest repellant for your garden. Coal tar products help slow down the growth of skin cells and can alleviate itching. They are available in various forms including shampoos, creams, and ointments.
• Salicylic Acid: Similar to pruning shears, this ingredient helps remove scales and can be found in shampoos, lotions, and creams.
• Moisturizers: Just as plants need water, your skin needs hydration. Regular use of moisturizers helps keep skin hydrated, thereby reducing itching and scaling.
• Prescription Vitamin D Analogues: These creams or ointments are like targeted plant food, slowing down skin cell growth and easing inflammation. They can be especially effective when combined with other treatments.

 

Phototherapy: Basking in the Sunshine

Let’s bring sunlight into the equation which is like a natural remedy for your skin garden. Phototherapy involves exposing the skin to controlled amounts of natural or artificial UV light to slow down cell growth and reduce inflammation. Common types of phototherapies include:

• UVB Phototherapy: Imagine UVB light as the prefect amount of sunlight. It penetrates your skin, slowing cell growth. But like sunburn from too much exposure, moderation is key. It involves exposing the skin to UVB light, which helps control psoriasis symptoms. It can be done in a healthcare provider’s office or at home with a prescribed UVB light unit.
• PUVA Therapy: This is like a carefully curated sunlight session. PUVA combines the use of a photosensitizing medication (Psoralen) with UVA light exposure to slow down cell growth. This treatment is usually done under medical supervision.

 

Systemic Medications: Tending to Your Skin’s Inner Core

Now let’s dig deeper into the soil. They work from within, tackling psoriasis at its root, like nourishing your garden from the roots up. Systemic medications are taken orally or through injections and work throughout the body to target the underlying causes of psoriasis. They are typically used for more severe cases of psoriasis or when other treatments have failed to prove effective. Common types of systemic medications include:

• Biologics: Like precision garden tools, these are genetically engineered medications that target specific proteins in the immune system that contribute to psoriasis. They are administered through injections or infusions.
• Oral Retinoids: Like slow-release fertilizers, these oral medications help reduce cell production and inflammation. They are usually reserved for severe cases due to potential side effects.
• Methotrexate: This medication suppresses the immune system and slows down cell growth. It’s often used for severe psoriasis or psoriatic arthritis.
• Cyclosporine: Cyclosporine suppresses the immune system and can provide rapid relief. It’s typically sued for short-term treatment due to potential side effects.

 

Emerging Therapies: The Seeds of Innovation

Just as gardeners experiment with new gardening techniques, researchers are working on innovative treatments. Ongoing research has led to the development of new treatments for psoriasis. While these treatments may not yet be widely available, they hold promise for the future. Some emerging therapies include:

 

• Janus Kinase (JAK) Inhibitors: Think of these as new garden tools. These oral medications target specific immune responses involved in psoriasis development. They are still under investigation but offer a potential alternative.
• Small Molecule Inhibitors: Like precision tools for your skin garden, these medications target specific molecules in the immune system to control inflammation and cell growth. They are also being studied for psoriasis treatment.

Creating Your Psoriasis Treatment Plan

Just as a gardener customizes care for each plant, your psoriasis treatment plan should be tailored to your unique needs.

• Personalized Treatment Plans: Your psoriasis treatment journey should be as unique as your garden. Tailoring treatment options ensures the best possible outcome.
• Consulting Healthcare Providers: Just as you would seek advice from expert gardeners, consulting dermatologists is essential for effective treatment.
• Combining Treatment Options: Mixing and matching treatments can create a comprehensive strategy for managing psoriasis.

Lifestyle Strategies for Managing Psoriasis

Your lifestyle can significantly impact your skin, much like the environment affects your garden’s growth.

• Healthy Habits: Cultivate good habits to support treatment effectiveness.
• Stress Management: Stress can be like harsh weather for your skin garden. Learn techniques to minimize its impact.
• Dietary Considerations: Nourishing your body with the right nutrients is like providing rich soil for your garden.
• Skincare Routines: Gently skincare routines can minimize irritation, just like tending to delicate plants.

Emotional Well-being and Support

Remember, your emotional well-being is crucial, much like a gardener’s bond with their garden.

• Addressing Emotional Impact: Just as a garden brings joy, it can also be frustrating. Addressing emotional impacts is essential.
• Connecting with Support Groups: Like a community of gardeners sharing tips, connecting with support groups can provide valuable insights.
• Seeking Professional Help: If your emotional well-being is affected, seeking help is like calling in an expert landscaper.

Monitoring and Adapting Your Treatment Plan

Gardens require ongoing care and adjustments, much like your psoriasis treatment plan.

• Tracking Progress: Like monitoring plant growth, track your plan’s progress to ensure it’s working.
• Recognizing Signs: Just as a gardener recognizes signs of plant health, be vigilant about your skin’s progress.
• Regular Check-ins: Visiting your healthcare provider regularly is like consulting with a seasoned gardener for advice.

Inverse Psoriasis: Understanding the Hidden Side of Psoriasis

Inverse psoriasis, also known as intertriginous or flexural psoriasis, a lesser-known type of psoriasis, behaves a bit differently than traditional psoriasis, as it targets areas where the skin folds and touches. Picture the folds of your skin as flowerbeds nestled under the shade of trees. Inverse psoriasis takes root in these warm, moist nooks such as the armpits, groin, under the breasts, and in skin folds around the genitals and buttocks. Much like plants in the shade, this form of psoriasis prefers the hidden, snug areas of your skin where its warm and moist. [6]

The Silent Irritation: Symptoms and Challenges of Inverse Psoriasis

Similar to how hidden plants require careful attention, inverse psoriasis brings its own set of challenges. The redness and moisture in these skin folds can create an environment ideal for fungal or bacterial infections. This means that individuals with inverse psoriasis might experience discomfort, itching, or soreness in these sensitive areas. Think of it as dealing with two guests at once: psoriasis and potential infections. Additionally, the affected areas might feel raw and painful due to constant friction and moisture.

The Role of Genetic Testing in Psoriasis Treatment

While those suffering from psoriasis are typically quite familiar with the symptoms associated with this skin disorder, some might not know or fully appreciate the role a person’s genetic makeup plays in determining who is more likely to develop psoriasis and how they might respond to treatments.

Imagine your DNA as a vast library of instructions that guide your body’s functions, like the chapters of a book. Psoriasis has a strong genetic component and researchers have identified several genes linked to its development. One of the key players is the HLA-C gene. Think of this gene as a code that helps your immune system differentiate between your body’s own cells and potential invaders. When it comes to psoriasis, certain variations of the HLA-C gene can cause the immune system to mistakenly target healthy skin cells, triggering the characteristic rapid cell growth and inflammation seen in psoriasis. To understand this better, imagine your immune system as a security guard whose job is to protect a museum. The HLA-C gene is like the guard’s ID card which recognizes who belongs in the museum and who doesn’t. Psoriasis is like a glitch in the ID card’s code which causes the guard (immune system) to become a bit jumpy and suspicious, causing the guard to perceive the innocent museum visitors (skin cells) as threats requiring an alarm (inflammation) to be triggered. [7]

Now, let’s talk about individual genetic testing and how it can revolutionize psoriasis treatment. Genetic testing involves analyzing your DNA to identify specific variations in genes that might influence your risk of developing certain conditions, like psoriasis. By understanding your genetic makeup, doctors can tailor treatments to your unique needs, kind of like crafting a personalized roadmap to guide you on your journey towards healthier skin.

Genetic testing helps doctors pinpoint genetic variations that might affect how you respond to different treatments. For example, certain variations might indicate that you’re more likely to benefit from biologic drugs – medications that target specific parts of the immune system. Others might show that you could have an increased risk of side effects from certain treatments, prompting your healthcare provider to opt for alternative options.

Genetic testing, however, is not only useful when it comes to predicting treatment options. It can also be used to understand triggers. Just like being familiar with road conditions can help you plan a more enjoyable trip, understanding your genetic predisposition can guide lifestyle choices that might prevent psoriasis flare-ups. If your genetic test suggests a sensitivity to stress, your might prioritize stress-reduction techniques like meditation and yoga. [8]

Picture genetic testing as a kind of treasure map. X marks the spot where you can find personalized treatments, and along the way, you can encounter signposts that warn of potential roadblocks. Genetic testing doesn’t provide all the answers, but it provides you with valuable insights on how to navigate the complex terrain of psoriasis management.

Tending to the Inverse Psoriasis Garden: Management and Care

Just as a gardener takes care of both plants and the soil they grow in, managing inverse psoriasis involves nurturing the affected areas while addressing potential complications.

• Selecting the Right Tools (Treatments): Inverse psoriasis demands a tailored approach. Much like using specific tools for delicate plants, your healthcare provider might recommend topical steroids or calcineurin inhibitors to soothe the inflammation.
• Protecting from Pests (Infections): Just as gardeners protect their plants from pests, using antifungal or antibacterial creams shield these areas from potential infections that thrive in warm, moist environments.
• Water and Sunlight (Hygiene and Dryness): Like maintaining optimal conditions for plant growth, keeping these areas dry and clean is critically important. Think of it as ensuring your garden isn’t overwatered to prevent mold.
• Choosing the Right Environment (Lifestyle Adjustments): Just as plants thrive in the right conditions, wearing breathable clothing and managing weight can reduce friction and moisture, thereby promoting comfort.

Codex Labs Treatment Tools for Psoriasis

For more mild to moderate cases of psoriasis, there is a psoriasis treatment gardening tool set offered by Codex that can be used to effectively manage this skin condition, namely, the ANTU® SKIN BARRIER REPAIR SET. Psoriasis flare-ups are known to wreak havoc on the skin barrier primarily due to the onset of inflammation and the loss of hydration triggered by the condition. The set contains our patented AntuComplex® comprised of highly potent plant-based, biotech-derived antioxidants from the Patagonia region of Chile and hyaluronic acid, this set was scientifically designed for sensitive and psoriasis-prone skin to restore integrity, calm irritation, and deeply hydrate a compromised skin barrier. The set contains a soothing gel for gently cleansing irritated skin, an antioxidant-rich serum to help repair and re-densify the skin barrier, and a deeply hydrating and nourishing moisturizer to draw and lock-in moisture in the skin. 

Conclusion: Nurturing Your Skin Garden

Just as a skilled gardener adapts their methods to suit the changing seasons and conditions, individuals with psoriasis must adapt their treatment plans over time. Understanding the array of treatment options available, from topical treatments to emerging therapies empowers you to make informed decisions about your psoriasis management. Just remember, managing psoriasis is like tending to a garden – it requires patience, care, and the right tools to achieve the best results and enjoy clearer, healthier skin. Always consult with your healthcare provider to determine the best treatment plan for your unique needs.

 

References:

1. https://www.psoriasis.org/about-psoriasis/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509518/
3. https://www.psoriasis.org/advance/understanding-inflammation/?gclid=CjwKCAjww7KmBhAyEiwA5-PUSmEqf5l9t4h5zh8JlbVmrYqJcdf1EmCVWeGmRgJlKbnvOk5ylgbwdhoCa4wQAvD_BwE
4. https://www.psoriasis.org/causes/
5. https://www.psoriasis.org/treatments-for-psoriatic-disease/
6. https://www.psoriasis.org/inverse-psoriasis/
7. https://www.mdpi.com/1422-0067/24/12/9850
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181835/