Psoriasis

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Psoriasis

If there ever was a medical condition that could convince Sherlock Holmes to get out of the business, it's psoriasis. The clues are obvious--after all, it's hard not to notice that maddening itch, the inflammation and those bothersome silvery scales that usually occur on the elbows, knees, trunk and scalp. But when it comes to finding its cause or cure, that's even more of a mystery than Watson's first name.

What is known about psoriasis is that it causes skin cells to go hyper. A normal skin cell takes about a month to mature, but in those with psoriasis, this process takes only three or four days. These skin cells are poorly developed, and they can't shed fast enough. Instead, they pile up--forming raised, scaly "plaques" that itch and leave skin below red and inflamed.

Psoriasis isn't contagious, but beyond that, researchers can't speak about the condition's causes with any degree of certainty. There may be a genetic link, however: In one in three cases, the disorder can be traced through the family, although it sometimes skips a generation. Also, doctors have observed that stress can spark new outbreaks (or make existing cases worse). Other suspected triggers include damage to the skin from injury, dryness or chafing and reaction to certain drugs and infections (such as strep throat).

But instead of the proverbial heartbreak, there is reason to take heart. While there's no cure as yet, you can control psoriasis and lessen its impact on your life. Your doctor has probably told you about tar shampoos and ultraviolet light treatments, but here are some other ways to keep those plaques from giving you flak.

Look for lactic. All our experts agree that the most important step in controlling psoriasis is to keep skin well moisturized. "A big problem with psoriasis is scale buildup, and moisturizers are extremely effective at preventing this," says Nicholas J. Lowe, M.D., clinical professor of dermatology at the University of California, Los Angeles, School of Medicine and director of the Skin Research Foundation of California in Santa Monica. "Plain petroleum jelly is a very effective moisturizer. But if you're buying a commercial moisturizer, those that contain lactic acid, such as LactiCare, seem to work better. Also, Eucerin cream works well as a moisturizer for those with psoriasis."

Moisturize after bathing. To get the most from your moisturizer, "apply it within three minutes after leaving the shower or bathtub," advises Glennis McNeal, public information director at the National Psoriasis Foundation headquarters in Portland, Oregon. "We recommend that you pat yourself dry and apply the moisturizer liberally all over your body--not just on plaques. That's because even 'clear' skin in people with psoriasis is drier than in people who don't have psoriasis. It's thought that little cracks on dry skin might encourage more psoriasis."

Soak up the sun. Many psoriasis patients are prescribed a specific regimen of ultraviolet light treatments. Getting artificial sunlight from a special lamp or tanning booth can help. An easier and less expensive method is simply to hit the Great Outdoors. "We know that exposure to sunlight is extremely helpful for treating psoriasis," says David Kalin, M.D., a family practitioner in Largo, Florida. A moderate amount of sunlight enhances the production of vitamin D, which may be effective in controlling psoriasis.

But don't soak up the booze. Doctors are still trying to find out for sure why alcohol exacerbates psoriasis. They suspect that alcohol increases activity of a certain kind of white blood cell that's found in psoriasis patients but not in other people. (But it's also possible that drinkers are just more highly stressed and therefore more prone to psoriasis.)

"Alcohol is a definite problem," according to Stephen M. Purcell, D.O., chairman of the Department of Dermatology at Philadelphia College of Osteopathic Medicine and assistant clinical professor at Hahnemann University School of Medicine in Philadelphia. "It's best to not drink at all if you have psoriasis."

Spice up your bath. Bathing is often a catch-22 for those with psoriasis. That's because soaking in warm water helps soften psoriasis plaques, but it sometimes dries skin and worsens itching. "One way to get the benefits of a bath without the dryness is to add a couple of capfuls of vegetable oil to your bath," says McNeal. "The best way to do it is to get in the tub first, so your body soaks up the water, and then add the oil." Another alternative suggested by McNeal: Mix two teaspoons of olive oil in a large glass of milk and add that to your bath.

Be extra careful stepping out of the tub, since oils can make surfaces very slippery. (Be sure to scrub the tub afterward.)

Head to the kitchen to soothe that itchin'. To soothe itching caused by dry skin and psoriasis, dissolve 1/3 cup of baking soda in a gallon of water. Soak a washcloth in the solution, wring it out, and then it apply to the itchy area. Or add a cup of apple cider kitchen vinegar to the water and apply that to the skin.

Cover the cracks with cow cream. If your skin is cracked because of psoriasis--which can cause itching and more plaques--do what dairymen do. "They found that Bag Balm, a product originally used to relieve cracking in cow udders, worked just as well on their cracked hands," says McNeal. "Then people with psoriasis found it worked great on their dry or cracked skin." Bag Balm is available at most feed stores; some drugstores may be able to order it.

Take care of mind and body. Stress is a known trigger of psoriasis, so managing your mental state--through exercise, relaxation techniques or whatever mellows you out--is one way to keep your condition under control.

Guard against infection and injury. "Infection may lead to an outbreak or worsen your condition, so it's important to try to avoid infectious disease," says Dr. Kalin. New lesions may also appear on injured skin, so try to avoid cuts and scrapes.

Watch what you eat. "Although there are no specific links that have been proven, it appears a diet high in oily fish--such as tuna, mackerel, sardines and salmon--helps reduce the itching and inflammation of psoriasis," says Dr. Lowe.

Avoid certain foods. "Some anecdotal reports suggest patients do better when they reduce or eliminate tomatoes and tomato-based dishes--possibly because of high acidity levels," says Dr. Kalin. "Also, some of my patients with psoriasis have noticed a decrease in plaques by avoiding or limiting their intake of pork products and other fatty meats as well as caffeine."

Go electric. If you have plaques on your face, neck, legs or other areas that require shaving, use an electric razor instead of a blade. "An electric razor won't cut skin as easily, and every time you cut yourself, you risk new lesions," says dermatologist John F. Romano, M.D., clinical assistant professor of medicine at The New York Hospital-Cornel Medical Center in New York City.