If you’re anything like Melbourne’s other 100,000 psoriasis sufferers, you know all too well the daily impact the skin condition can have on your life.

Besides the physical irritation and discomfort, psoriasis can affect your self-esteem and confidence. Leaving the house can be a nerve-racking experience – especially in summer when you typically wear less clothing.

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ON THIS PAGE

• What is psoriasis?
• Known causes
• Living with symptoms and recognising triggers
• Treatment options
• Clinical trials
• About Dr Nicholas Hudson

We’re learning more about the disease each day, with current psoriasis treatments being very effective. Patients I’ve treated have had excellent results with topical treatments, UV light therapy, and medications.

What is Psoriasis?

Psoriasis is a chronic, non-contagious, inflammatory autoimmune skin disease. It’s relatively common in Australia, with 1 in 50 people affected to some extent.

The condition is characterised by overactive skin cell reproduction. Psoriasis-prone areas of the body can produce the same amount of skin cells over a few days that normal skin might make in a month.

This rapid growth typically results in silvery scales on your skin. Scaling can become red and inflamed.

Prone areas of the body include:

• knees and elbows;
• joints;
• scalp;
• hands and feet, and
• neck.

There are a few different types of psoriasis, the most common being plaque psoriasis. Your GP or dermatologist will diagnose if your condition is another rarer subset of the condition.

People often mistake eczema (atopic dermatitis) for psoriasis and vice versa. Two key differences are:

• Eczema usually occurs in babies and toddlers, with symptoms generally improving with age. It’s rare for young children to have psoriasis. Eczema is more common than psoriasis in all age groups.
• Itchy skin and scratching are usually much more intense with eczema.

What Causes the Skin Disease?

To the best of our knowledge, psoriasis is mostly genetically inherited. Unfortunately, having the condition is just bad luck.

It’s not to say you’ll develop psoriasis if one or both of your parents have the condition. Some researchers theorise that a genetically prone person will develop psoriasis symptoms only when exposed to specific triggers.

These triggers essentially turbo-charge your immune system into rapidly producing skin cells and fighting off any perceived ‘invaders’.

Living With Psoriasis

Physical symptoms and minimising triggers are only part of the challenge people face when living with psoriasis. Many find the condition also has a significant impact on their mental health.

PHYSICAL SYMPTOMS

From a physical point of view, people with psoriasis may experience the following:

• Scaly, red patches of skin in prone areas
• Itching
• Dry, cracked, and sometimes bleeding lesions
• Excessive skin shedding
• Thickened, discoloured, and painful finger or toenails

Around 10-20% of patients also complain of swollen, stiff, and sore joints due to psoriatic arthritis. Psoriatic arthritis can lead to significant disability, so it’s important to talk with your doctor if you have psoriasis and aching joints.

PSORIATIC TRIGGERS

Factors seemingly unrelated to psoriasis are known to set off the condition and cause flare-ups. The list of triggers is long, with different ones affecting different people.

Some of these triggers include:

• Skin injuries and infections
• Stress
• Cold weather
• Smoking and drinking
• Certain medications
• Hormones

Understanding what triggers cause flare-ups or worsen your psoriasis is essential to self-management.

PSYCHOLOGICAL SYMPTOMS

Many people living with psoriasis are troubled by the stigma associated with how their skin looks to others. Going out in public knowing that people might fear catching your ‘skin disease’ can take a considerable toll on your mental health.

In fact, those with psoriasis are twice as likely to experience anxiety and depression than those without.

A vicious cycle occurs when psoriasis leads to poor mental health, which can further compromise your immune system. With psoriasis being an autoimmune disease, this situation isn’t ideal.

I’ve seen patients tackle the problem with everything from wearing light-coloured clothes to hide skin shedding to speaking with psychologists and using stress management techniques (including exercise).

Plaque Psoriasis Treatment Options

Though psoriasis isn’t yet curable, the available treatment options are pretty effective in reducing its severity.

We’ll tailor treatment plans to your individual circumstances, helping you work out the most effective approach to minimising symptoms. We may refer you to a dermatologist if your psoriasis is severe or requires specialist care.

We tell people that a good dose of patience is required when treating psoriasis. It can take a couple of weeks to notice changes, so hang in there.

TOPICAL OINTMENTS AND CREAMS

We’ve seen great results with topical treatments, especially in patients with mild psoriasis. Steroid creams, vitamin D products, and coal tar ointments are a few examples.

When rubbed into your skin, these products reduce redness, inflammation, and skin shedding. Many products are available over the counter at your local pharmacy.

UV LIGHT THERAPY (PHOTOTHERAPY)

Ultra-violet therapy aims to minimise inflammation by slowing down the rapid production of skin cells.

Conducted by your dermatologist, patients strip off and stand in a unit that surrounds them with special UVB-emitting lights. Sessions are usually relatively short to minimise skin damage, and numerous sessions are often required.

Due to Australia’s high rate of skin cancer, we suggest patients avoid prolonged sun exposure. It should be noted that sunscreens block UVB rays.

ORAL MEDICATIONS

For more severe cases, your GP will refer you to a dermatologist who’ll discuss a range of oral prescription medications.

Most psoriasis medications work by interacting with your immune system.

LIFESTYLE CHOICES

When combining the above options, improved lifestyle choices may enhance treatment results.

Stopping smoking, limiting alcohol intake and upping your exercise should be considered.

We also recommend looking at your diet and taking note of foods that potentially inflame your psoriasis.

Such lifestyle changes won’t do your mental health any harm either. 

Clinical Trials

Research continues to pursue improved treatment options, and ultimately a cure. These lofty goals are contributed to by willing participants engaging in safe clinical trials.

If you’re living with psoriasis and are interested in contributing to a clinical trial, regularly check the Australian New Zealand Clinical Trials Registry.

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Dr Nicholas Hudson is a local GP at Doctors of South Melbourne.

He has a special interest in chronic and complex health needs.

You can make an appointment online with Nick or call us on (03) 8579 6838.

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