What is Psoriasis? Is there a cure?

What is Psoriasis? What causes Psoriasis?

Psoriasis, scientifically known as psoriases, is a chronic, inflammatory, and autoimmune disease. This disease, which affects the skin, our body's largest and heaviest organ, affects approximately 2-3% of the world's population. Psoriasis gets its name from the pearly color of the lesions that appear on the skin.

The most common type of psoriasis is plaque psoriasis. The scientific names for plaque psoriasis are psoriasis vulgaris. This type of psoriasis forms thickened, red, scaly, and often itchy lesions on the skin.

The underlying mechanism of psoriasis is an abnormal activation of the patient's immune system. In other words, the person's immune system gives an abnormal response to its own cells. In medical terms, this is also called an autoimmune disease. This abnormal response leads to the abnormal proliferation and inflammation of keratinocytes, the cells that produce keratin in our skin.

Is Psoriasis genetic?

The root cause of psoriasis is still not fully understood. However, the significant role of genetic factors should not be forgotten. For example, it has been observed that in individuals carrying certain specific genes, the disease starts at an earlier age and is more severe.

What triggers Psoriasis?

Some environmental triggers can exacerbate psoriasis:

1. Stress: Psychological stress can affect the immune system, leading to an increase and worsening of disease symptoms.

2. Infections: Infections can cause psoriasis flare-ups due to their effect on the immune system. Additionally, infections such as Streptococcus pyogenes can lead to the appearance of guttate psoriasis.

3. Traumas: After physical trauma, symptoms of the disease may begin to appear on the skin (in medical terms, this can also be seen as the Koebner phenomenon).

4. Smoking and Alcohol: Due to their effects on the immune system, they can cause psoriasis flare-ups.

5. Medications: Some medications can cause psoriasis flare-ups. Therefore, if you suspect you have psoriasis, you should make a list of all medications you are currently using and have recently stopped and show this list to your doctor.
   
   

Stress can trigger psoriasis.

Does psoriasis go away? Does psoriasis recur?

Due to its chronic and relapsing nature, psoriasis can unfortunately recur periodically. While there is currently no definitive cure for psoriasis, the severity and frequency of flare-ups can be significantly reduced through complementary and symptomatic treatments. Therefore, it is possible to control psoriasis and lead a good quality of life.

Psoriasis treatment may vary depending on the severity and extent of the disease. Topical treatments (such as creams) and systemic treatments (such as pills) can be used as prescribed by your doctor.

Are topical steroids (cortisone cream) harmful?

The first line of treatment for psoriasis usually involves topical products containing cortisone. While these treatments provide relief to the patient by reducing inflammation in the short term, their long-term use can be harmful. Long-term and uncontrolled steroid use can lead to consequences such as skin thinning, stretch mark formation, increased visibility of blood vessels, and a decrease or complete loss of the medication's effectiveness. For this reason, cortisone creams should be used for short-term treatment, and other agents should be preferred for long-term comfort.

At this point, non-cortisone supportive treatments are drawing attention. Antibacterial and anti-inflammatory substances like piroctone olamine help re-establish microbial balance and reduce signs of inflammation.

Is psoriasis contagious?

No, psoriasis is not contagious. Psoriasis cannot be transmitted to you from someone else through contact or any other means.

What helps psoriasis? Which supplements should be used?

In addition to main treatment methods for psoriasis, some supplements that can be used are as follows:

• Moisturizing creams

• Shampoos/creams containing piroctone olamine

• Omega-3 fatty acids

• Vitamin D

• Probiotics

Proper care can reduce flare-ups and improve quality of life.

Especially in the most stubborn and common type of plaque psoriasis, the use of shampoos and creams containing piroctone olamine plays a major role in reducing secondary infections and controlling itching.

How does psoriasis start? What are the symptoms of psoriasis?

Psoriasis, which generally has an insidious onset, manifests after a significant triggering event in most patients, while in others, it may remain silent for years and suddenly show symptoms.

The initial symptoms are as follows:

• Small, red spots and bumps

• These bumps rapidly turning into thick, scaly, and itchy plaques

The first symptoms usually appear on the elbows, knees, lower back, and scalp (like the head).

The onset usually involves a few localized plaques in a specific area.

Initially, the lesions are slightly scaly and pink-red, but over time, these plaques thicken, spread over a larger area, and become covered with silvery-white scales.

Symptoms depend on many factors such as the patient's age, the type of disease, and environmental factors. Most of the main symptoms are seen in plaque psoriasis, which is the most common type.

The main symptoms are as follows:

• Red-pink bumps with silver-white scales

• Thick, dry, and peeling scales

• Itching

• Burning and stinging sensation

• Cracking and bleeding

The most common areas where these symptoms appear are as follows:

• Elbows, knees

• Lower back, upper buttocks

• Scalp

• Behind the ears

• Palms and soles

Psoriasis lesions usually develop slowly and thicken over weeks.

Is psoriasis genetic?

Yes, psoriasis is associated with genetic predisposition. However, genetic predisposition alone is not enough for the disease to appear; environmental factors also play a significant role. Factors such as infections, stress, trauma, and medications, when combined with genetic factors, increase the likelihood of the disease appearing.

Plaque psoriasis is considered the type of psoriasis that most strongly demonstrates genetic predisposition.

Does psoriasis cause itching?

Yes, psoriasis often causes itching. Patients with plaque psoriasis, in particular, may experience a very strong sensation of itching. Itching significantly reduces the quality of life for patients.

Moisturizers, topical steroids, and products containing piroctone olamine can be used to control itching and reduce symptoms. However, it is very important to consult your doctor or pharmacist before using topical steroids (i.e., cortisone creams).

Psoriasis can appear on the scalp.

Is psoriasis dangerous?

Psoriasis does not directly threaten life. However, it significantly reduces the quality of life due to the itching and similar symptoms it causes. Moreover, unfortunately, due to misconceptions about the disease (such as it being contagious, etc.), psoriasis patients also experience significant psychosocial pressure.

What causes scalp psoriasis?

Scalp psoriasis is usually caused by plaque psoriasis, and treating scalp psoriasis can be quite challenging. Hard and adherent scales cling tightly to the scalp. Itching and even pain may occur along with it. Lesions can extend to the hairline and behind the ears.

Does psoriasis cause hair loss?

Scalp psoriasis does not directly cause hair loss. However, temporary hair loss may occur due to reasons such as severe itching and intense inflammation. For this reason, treatment is very important.

Which doctor should be consulted for psoriasis?

You can consult your family doctor or a dermatology specialist for psoriasis. Please remember that cortisone creams used without consulting your doctor or pharmacist may cause more harm than good. You can try active ingredients like piroctone olamine, which aim for treatment without containing cortisone.

For product recommendations based on symptoms, click here.

Frequently Asked Questions

Is psoriasis contagious?

No, psoriasis is not contagious; it does not spread through contact or any other means.

Is there a definitive cure for psoriasis?

No, there is currently no definitive cure. However, with appropriate topical and systemic treatments, the frequency and severity of flare-ups can be reduced, improving the quality of life.

What are the harms of long-term use of cortisone creams (topical steroids) in psoriasis treatment?

Long-term and uncontrolled use can lead to harmful consequences such as skin thinning, stretch mark formation, increased visibility of blood vessels, and reduced effectiveness of the medication.

This article was written by Pharmacist Nil Eker from the Primum Pharma team.