Psoriasis – how to cope and what to expect

Psoriasis is one of the commonest skin complaints, affecting about 2% of the UK population.  It can start at any age, but usually develops in late teens or mid-life.

There has been a lot of progress in our understanding of psoriasis, for example, several genes have been discovered which are linked with the tendency to get psoriasis and explain why the complaint often runs in families. Other discoveries about the inflammatory processes taking place in psoriasis skin have led to new groups of drugs which can balance out these changes.

However, we do not yet have a cure, so treatment needs to be used long-term. The incurable and visible nature of psoriasis can make sufferers feel depressed and affects many aspects of their life, causing them to avoid physical contact, and restricting their choice of clothing and hobbies such as swimming. 

A scaly scalp is often the first sign of psoriasis, and sometimes, this is the most troublesome body area affected. Unlike dandruff, where fine, dry flakes are shed easily, scalp psoriasis causes a build up of thick layers of skin that stick together and bleed when scratched off.

Both complaints cause problems when wearing dark clothing, with noticeable skin flakes, which can cause embarrassment and affect self-esteem.

The build up of skin in scalp psoriasis also stops any applied medication from working properly as it acts as a barrier and prevents the medication getting into the skin.

A descaling treatment is needed to loosen and lift the thickened skin, allowing it to be washed away when the hair is shampooed. By using a descaling treatment regularly, the scalp can be kept comfortable, flaking reduced, and prescribed scalp lotions will work more effectively in controlling the psoriasis.

This can avoid the need to use stronger drugs, which in turn have potentially serious side effects.

Psychological impact

Psychological studies have shown that psoriasis sufferers can feel a heightened sense of shame or even disgust, and tend to judge themselves harshly. 

Supportive friends and family can help psoriasis sufferers cope more easily with their skin problem.

Offering a non-judgmental sympathetic ear is something that a friend or family member can aim to do, and not staring or making tactless comments is a good starting point for strangers. Psoriasis is not contagious and can’t be caught.

It helps if sufferers and their families have a positive yet realistic outlook, as in my experience those who are in endless quest for a miracle cure get frustrated and disappointed. That said, for people with very severe psoriasis, newer biological drugs are offering the possibility of almost clearing psoriasis as long as treatment is continued.

From a general health point of view, it is important for psoriasis sufferers to lead a healthy lifestyle – avoiding getting overweight, smoking and alcohol excess.

For generic advice about how to cope with a disfiguring complaint/visual skin complaint, it might be helpful to look up Changing Faces or the Psoriasis Alliance.

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