Browse Medications by Medical Condition: Psoriasis

Psoriasis is a chronic autoimmune condition that causes rapid skin cell turnover, leading to the build-up of thick, scaly patches on the skin. These patches are often red, inflamed, and covered with silvery scales, and they can appear anywhere on the body, although they are most commonly found on the scalp, elbows, knees, and lower back. Psoriasis affects both men and women and can develop at any age, but it is most often diagnosed in people between 15 and 35 years old. The condition is significant because it not only affects appearance but can also lead to physical discomfort, emotional distress, and an increased risk of other health conditions like cardiovascular disease and arthritis.

Psoriasis has been documented for thousands of years, with early references appearing in ancient Greek and Egyptian texts. The term "psoriasis" itself was coined in the 19th century, derived from the Greek word "psora," meaning itch. Over time, the understanding of psoriasis evolved from a misunderstood skin disorder to a recognized autoimmune disease. In the 20th century, advancements in dermatology and immunology provided a clearer understanding of the mechanisms behind psoriasis, leading to better treatment options. Today, psoriasis is acknowledged as a complex condition influenced by genetic, environmental, and immune system factors.

Psoriasis is caused by an overactive immune system that accelerates the production of skin cells. Normally, skin cells regenerate every 28-30 days, but in people with psoriasis, this process occurs much faster, leading to the accumulation of skin cells on the surface. While the exact cause is not fully understood, genetic factors play a significant role, as psoriasis tends to run in families. Environmental triggers, such as infections, stress, injury to the skin, or certain medications, can also precipitate flare-ups. Inflammatory processes within the immune system, particularly involving T-cells, contribute to the development and worsening of the condition.

Key risk factors for developing psoriasis include a family history of the disease, a previous history of strep throat or other infections, obesity, smoking, and excessive alcohol consumption. Stress and skin injuries like cuts or burns can also trigger or exacerbate psoriasis. Certain medications, including lithium, antimalarials, and beta-blockers, are known to increase the risk of flare-ups.

While there is no cure for psoriasis, certain lifestyle changes can help prevent or manage flare-ups. These include moisturizing the skin regularly to prevent dryness and cracking, avoiding triggers such as stress and skin injuries, and maintaining a healthy lifestyle with a balanced diet and regular exercise. Quitting smoking and reducing alcohol intake can also significantly improve psoriasis symptoms. Regular use of prescribed topical treatments or phototherapy, as recommended by a healthcare provider, can help reduce the severity of flare-ups.

The most common symptoms of psoriasis include red, inflamed patches of skin covered with silvery-white scales, which may be itchy or painful. These patches can vary in size and are typically found on the scalp, elbows, knees, and lower back. Other symptoms include cracked or bleeding skin, thickened or ridged nails, and a burning or stinging sensation in affected areas. In severe cases, psoriasis can lead to joint pain or swelling, a condition known as psoriatic arthritis.

Psoriasis is typically diagnosed through a physical examination by a healthcare provider, who will examine the skin for characteristic patches and scales. In some cases, a skin biopsy may be performed to rule out other conditions. Blood tests are not typically needed unless there is suspicion of an underlying issue like psoriatic arthritis or an infection.

There is no cure for psoriasis, but various treatment options can help manage symptoms. These include topical treatments like corticosteroids, vitamin D analogs, and retinoids, which reduce inflammation and slow down skin cell turnover. Phototherapy, which involves exposure to ultraviolet light, is another common treatment. In more severe cases, systemic treatments such as oral medications or biologics that target specific immune system components may be prescribed

Common medications for psoriasis include topical corticosteroids, which reduce inflammation and relieve itching, and topical vitamin D analogs, which help slow down the rapid turnover of skin cells. For moderate to severe cases, systemic treatments like methotrexate, cyclosporine, or biologics such as adalimumab (Humira) and etanercept (Enbrel) may be used to suppress the overactive immune response.

Managing psoriasis involves regular moisturizing to keep the skin hydrated and prevent flare-ups, using gentle skin care products to avoid irritation, and avoiding known triggers such as stress or skin injuries. Stress management techniques like meditation, yoga, and regular physical activity can also help reduce flare-ups. A healthy diet and avoiding alcohol and smoking are important lifestyle changes that can improve symptoms over time.

The direct costs of psoriasis include medical expenses for doctor visits, medications, treatments, and potential hospitalizations for severe cases. The indirect costs can be significant, including lost productivity due to symptoms, especially when flare-ups cause discomfort or difficulty working. People with psoriasis may also experience social or psychological costs due to the visible nature of the condition, potentially affecting their self-esteem and leading to issues like anxiety or depression.

Living with psoriasis requires ongoing management to reduce flare-ups and maintain skin health. People with psoriasis can often lead normal, active lives by working with healthcare providers to develop personalized treatment plans. Emotional support from friends, family, and support groups can help individuals cope with the psychological challenges of the condition. Regular check-ups and adherence to prescribed treatments are important to managing psoriasis effectively.

Support resources for people living with psoriasis include organizations such as the National Psoriasis Foundation, which provides educational materials, online forums, and information about treatments and coping strategies. Local support groups and online communities can also offer emotional support and practical advice for living with the condition.

Research into psoriasis is focused on understanding the genetic and immune factors that contribute to the disease, as well as developing new therapies to improve the effectiveness of treatments. Clinical trials are exploring biologics and targeted therapies that could offer better outcomes with fewer side effects.

Advancements in psoriasis care include the development of new biologic treatments that target specific immune cells involved in the disease, providing more effective and personalized treatment options. The use of precision medicine, where treatments are tailored based on genetic and environmental factors, is a promising area of research. Additionally, improvements in light therapy and topical treatments are helping to manage symptoms more effectively.