Everything you wanted to know about psoriasis but were afraid to ask

I was sick Monday, the shawl and I arent getting along too well, I got nothing else, Hawkeye has psoriasis (he was diagnosed when he was eight) and we lived together for 7 years, so here we go:

Psoriasis is an autoimmune disease that causes your skin cells to divide faster than normal.  Skin is the largest organ (dont get any naughty ideas) which is why psoriasis can be found all over your body.  Usually your skin cells take about month or so to divide and come to the surface.  With psoriasis, it takes 3-5 days.  Because the skin cells divide and come to the surface so quickly it causes plaques to form on the body.  Plaques can form around joints or all over the body.  Psoriasis can cause pitting of finger and toenails.

The quick division of skin cells is what causes scaley plaques  to form on the skin.

Plaques can form on the scalp.  This is particularly annoying if you have dark hair because it looks like you have really bad dandruff and it makes wearing dark clothes nearly impossible.  Plaques on the palms or feet can inhibit everyday functions and can be very painful.

A little Q&A

Q.Is psoriasis contagious? A. Nope.  Psoriasis is thought to be passed along genetically.  If there is a family history of psoriasis there is a chance you could develop psoriasis.  Most cases develop in childhood through the early teen years.

Q. Is psoriasis related to leprosy?  Um . . . not just no, but hell no.  Even though this was once common thinking a hundred or more years ago, this is no longer the case.  Psoriasis is not going to make your nose or feet fall off.

Q. Do you develop psoriasis from being unclean?  Again, no.  It’s an autoimmune disorder.  An autoimmune disorder is where your own body’s immune system goes a bit haywire and starts attacking you.  In the case of psoriasis, the immune system starts attacking the skin.

Q. Is there a cure?  A.  Frustratingly, no.  There are several treatments, everything from lotions and creams for the most mild cases all the way to injections for the most severe.  There is a new laser treatment coming to market that can treat large plaques.  No idea exactly how effective it is yet. (treatments will be followed up on later)

Severity of psoriasis varies dramatically although, according to Wikipedia at least, over half of people diagnosed with psoriasis have a mild to moderate case.   If more than 10% of your body is covered in psoriasis plaques, then it’s considered severe. 

Psoriasis can be life threatening in one instance: if you have severe psoriasis, are not treating it, and it gets out of control you can develop a condition called  Erythrodermic psoriasisWhen this happens, the immune reaction goes completely ape shit and makes it nearly impossible for your body to regulate it’s temperature.  The skin, instead of coming off in small flakes, comes off in sheets, and it opens the body for secondary infection.  Hawkeye developed this condition (he wasnt taking care of himself) and spent 2 weeks in the hospital once he got back to Iowa.

 Generally though, psoriasis is not life threatening but is a complete pain in the ass.  It affects not just the body, but the psyche as well.  Think about it for a minute.  You have silvery, scaley patches on your arms, knees, hands, and maybe face, of course you’re going to feel extremely self-conscious.  It’s not a well known condition, and we all know how some people can be when they’re confronted with something they dont understand.  You can face a lot of judgement.  It effects your self esteem, the kinds of clothes you wear, the colours you wear, and your dating/sex life.  Psoriasis may go into remission, but it will never go away.  There is no cure.  Cuts and scrapes can take longer to heal and can cause your psoriasis to flare up.  It effects what kinds of activities you participate in (you may not go swimming because you feel self conscious about your skin) it effects how attractive you feel.  The psychological effects of the disease is worse than the disease itself, at least imho.

Treatment: There are several treatments of varying effectiveness for psoriasis and treatment depends on how severe your case is.  If you case is mild, you might only have to use over the counter lotions and creams on your plaques.  Lubrederm, A&D Ointment, Vitamin E oil, Nutrogena Coal Tar Shampoo, (this is good for scalp psoriasis although it’s not clearly understood why coal tar has a positive effect on psoriasis), Dead Sea Salts, etc.  Exposure to sunlight is good too because the UV rays shrink psoriasis spots. 

If your case is more severe there are other more dramatic treatments you can pursue:

Photo therapy:  This usually involves some type of light box.  I’ve only ever seen Hawkeye’s and can tell you it’s about 5 feet tall with lights that look like big fluorescent bulbs.  There are two types of light that can be used: UVA and UVB.  Sometimes creams and coal tar are used in combination to achieve greater effectiveness.  Hawkeye even had little goggles (the kind you get in a tanning salon) to wear.  This is how it works: you turn the light on (make sure to wear your little goggles.  Safety first!)  and stand in front of it for a couple of minutes.  Over time you stand in front of the light for longer periods.  Because it’s UVA or UVB you can get burned which is why you have to build up a tolerance.

There are systemic treatments too involving drugs and/or injections.  Methotrexate is commonly prescribed because it slows cellular growth.  It’s also prescribed if you have an ectopic pregnancy.  Methotrexate can effect liver functions so it’s important to have monthly blood tests.  Liver biopsies are recommended, but having your liver bored into is not the most pleasant experience.

Cyclosporine (which I thought was an antibiotic but isnt) is an immunosuppressant  that is usually given to transplant patients but is also used to treat psoriasis. 

There are a few other drugs that can be used to treat psoriasis, but we’re going to talk about the big guns now.  IV and injections.

Remicade is given through IV injection in a Dr. office.  Imagine how much fun it is to sit in your Dr’s office with an IV drip for 4 hours.  What a way to spend an afternoon.

Humira and Enbrel are administered through self injection.  I dont know much about Humira, but Enbrel is an immunosuppressant.  It helps stop the body from attacking itself, but can leave the body open to other infection.  It’s also used to treat psoriatic arthritis.  It’s very expensive, but also very effective.

Psoriatic Arthritis is a specific form of arthritis associated with guess what? Psoriasis.  It’s similar to rhumetoid (yes, it’s a product of an over active immune system), can be very severe, and left to it’s own devices will destroy the joints.  It seems to effect the joints in the fingers the most but like any arthritis, can effect joints all over the body.

There are other treatments other than drugs.  Stress plays a big role in outbreaks and techniques to reduce stress are helpful in treatment (yoga, meditation, biofeedback, massage, etc)  Food allergies can play a role in flare ups.  Two common food allergies that play a role are wheat and dairy.  Weather can also play a role in flare ups of psoriasis and psoriatic arthritis. 

The most important thing to remember is that someone with this condition is the same as you are.  Their brains are just as big, their minds are just as clever, and they have the same feelings as you do.  Hawkeye doesnt mind questions, even if they seem dumb.  I lived with him for 7 years, talk to him a few times a week, and still have questions about his disease process.  Practice tact.  Dont be a dumb ass and say things like “Eww yuck! How do you live like that”  You can ask things like: How long have you had this disease?  How do you treat it?  How do you take care of yourself?  Do you have a hard time with people staring?  Yes, btw, people do stare, it’s not nice, but it happens.  Just like anyone with diabetes or arthritis, practice respect and kindness.

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4 Responses to Everything you wanted to know about psoriasis but were afraid to ask

  1. Victoria says:

    For Hawkeye and Walter Knitty:

    Hi there. My name is Victoria… and I’m 23 years old. First of all, I want to say that I too have psoriasis. I was dignosed with it a couple of months ago, but I’ve had it for over a year. It started on one elbow… and then all of a sudden I had it on both elbows. I was prescribed 2 ointments. Salicylate Vaseline and Clobetasol Propionate. I was also diagnosed with Alopecia Areata… and Morphea (localized Schleroderma). I was given shots of something on the back of my head… for the Alopecia Areata… although that was only supposed to be a month’s treatment. I don’t care much about the Morphea spot… since it’s on my ankle and it doesn’t bother me as much as the Psoriasis. After a while with this treatment, the plaque on my elbows was going away. I was surprised… and happy. BUT… all of a sudden… it started coming up everywhere. I have plaques everywhere. I’d say about 30 or so. They’re small… the biggest is about the size of a dime. They’re all over my body though. Just resently, I got some on my scalp. It’s not enough that I’m going bald. I feel so depressed at times. I’m a cashier… and people give me weird looks. They probably think I have mange… or some std. I don’t know… but it’s very embarrassing. I just wanted to share my story though. Nobody here wants to listen to me moan about it. They say it’s all in my head… and not to think about it. How can they tell me not to think about it when I’m reminded every 10 minutes because of either the itch or the fact that someone is staring.

    I guess I’ll just have to keep trying. Hoping they’ll soon go away… at least for a while. I still can’t believe… and accept that I’ll probably… most likely have to live with this for the rest of my life.

    Thank you for sharing your knowledge… and I had a few questions.

    Have you heard about these prescriptions?
    Salicylate Vaseline and Clobetasol Propionate. It’s what I started with. Now I’m using Psoriasin (still hoping it will work) and MG217 Coal Tar Shampoo for my head.

    Since you’ve lived with Psoriasis for a long time, do you find it better in the long run to pull off the dead skin or is it better to just let it fall off with the ointment? It’s so itchy… and annoying. I don’t want to worsen it though.

    Thank you in advance for your advice.

    • Gabriele says:

      i had psiorasis since i was a baby and i’m 13 now and i use Dermovate but you only have to use it a small bit and the cream i use is called Dermatological E45 and the shamppo i use is called Nizoral it really helps i practicly dont have on my scalp anymore and thank god

  2. I’ve had psoriasis since I was a kid and started using vaseline to make it go away. Didn’t work. 10 years ago, I contracted psoriatic arthritis and my dermatologist got me a rheumotologist and he put me on methotrexate for 4 years. Didn’t work. I am now ready to start working on detoxing my body after reading TONS of information. I’ve heard great things about deniplant tea and kangen water and I actually know a woman who drinks kangen water and her plaque is completely GONE after 4 months of using it.

  3. Dana Barnett says:

    Ive had psoriasis for about 12 years now and its mainly on my arms and legs. But i have no health insurance. Its frustrating that theres nothing over the counter that works for this annoying skin disease. and yes people stare like i have something that there going to catch Ive had medicine prescribed to me before and they might work for a while and then they stop working. Ive tried anything and everything imaginable if anyone knows of any good home remedies that may help please tell me….thanks…

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