By Dr. Mercola
More than a superficial skin condition, psoriasis is a chronic condition of your immune system that triggers cells to build up on the surface of your skin. This leads to thick, scaly and red patches that itch and are sometimes painful.
Approximately 7.5 million Americans suffer with psoriasis, which also has a surprising economic impact.1
The combined annual cost of psoriasis reached nearly $112 billion in 2013.2 Although it commonly affects the skin, it may also affect your joints (psoriatic arthritis), and has been associated with diabetes, asthma, cardiovascular disease and depression.3
Psoriasis can also have significant emotional and mental impact on patients, with the prevalence of depression measured as high as 50 percent.4
While psoriasis is an inflammatory response, it can lead to an infection if you frequently scratch the affected areas. However, psoriasis is not contagious, and you may be able to prevent outbreaks by using some of the strategies outlined below.
Not All Psoriasis Is Created Equally
There are actually five different types of psoriasis. Each of these have different symptoms but they are all just as irritating and itchy.
Plaque psoriasis is the most common type.5 It is characterized by red, raised skin patches that are often covered with dead skin cells appearing silvery white. The patches show up most often on the elbows, scalp, knees and lower back.
Guttate psoriasis usually shows up as small dot formations that begin in childhood. They may have been triggered by a streptococcal infection. About 10 percent of people who develop psoriasis experience guttate psoriasis, which is the second most common type.
Inverse psoriasis shows up in your body folds as dark red patches that may be smooth and shiny. Many people with inverse psoriasis will have another type as well. Blisters filled with noninfectious pus are characteristic of pustular psoriasis.
They appear more often on the hands and feet, and are filled with white blood cells that are not infectious.
The more severe form of psoriasis is called erythrodermic psoriasis. It is characterized by widespread itchy, painful areas that are fiery red and cover most of your body. It is rare, as only 3 percent of people who have psoriasis experience it in their lifetime.
How Psoriasis Develops
Your skin is the largest organ in your body, responsible for protecting your internal organs, regulating internal temperature and providing a barrier from infection.
Your skin has three major layers: the epidermis, dermis and deeper subcutaneous tissue made of fat and connective tissue. It is the growth rate of the epidermis that changes and produces the symptoms of psoriasis.
Your epidermis has another four or five layers through which the cells travel before being shed from your body. Cell growth production occurs at the basal level, closest to the dermis. The cornified layer, or the outermost layer, is composed of between 10 and 30 layers of skin, depending upon the area of your body.
The skin over your feet and palms of your hands is thicker than the skin under your eyes or over the back of your fingers. Most of the barrier functions of the skin are localized on the cornified layer of your skin.
Psoriasis develops when your body triggers an excessive production of skin cells at the lowest layer of skin. This overgrowth pushes more cells to the top layer of skin that has not yet differentiated enough to slough off your body.
This results in a buildup of skin cells on the top layer that may be itchy, red, patchy and have a silvery appearance due to the dead cells that have not yet fallen off.
Common Psoriasis Triggers and Treatments
Psoriasis is closely associated with eczema and may sometimes be triggered by allergic reactions to environmental factors, more often external triggers. Irritants that may produce an outbreak include:
✓ Laundry detergent
✓ Cleaning chemicals
✓ High levels of alcohol in men
✓ Skin injury, such as bug bites, cuts and sunburn
✓ Metals, such as nickel in your jewelry
✓ Skin infections
✓ Specific medications
✓ Dry skin
✓ Cold, dry weather
✓ Animal dander
It may seem obvious, but steering clear of environmental triggers is one way to reduce symptoms of your psoriasis. Once an outbreak has occurred there are several treatments your physician may recommend. Remembering how psoriasis develops, it is clear that steroid creams should be avoided.
Although they are effective immediately, your body quickly develops a tolerance. Also, steroid creams are made with synthetic steroids that absorb quickly into your skin and can wreak havoc with your adrenal system. Many other commonly prescribed medications also have dangerous side effects.
This includes vitamin A derivatives, anti-inflammatories, immunosuppressants and medications used off-label. Instead, it may be more helpful to use the natural strategies outlined below.
They're typically effective when used consistently and don't have the side effects of medications which can be significantly detrimental to your health. Side effects from commonly prescribed groups of medications may include:6,7,8,9
✓ Skin thinning
✓ Resistance to treatment
✓ Skin irritation
✓ Birth defects
✓ Back pain
✓ Joint pain
✓ Ringing in your ears
✓ Hearing loss
✓ Muscle stiffness
✓ Trouble sleeping
✓ Nausea and vomiting
✓ Redness of the skin
✓ Blurred vision
✓ Chest pain
✓ Loss of appetite
✓ Shortness of breath
✓ Swollen glands
✓ Mouth sores
✓ Hair loss
Most Common Type Responds to Vitamin D
Researchers have demonstrated a strong track record of successful results when sufferers optimize their vitamin D levels.10,11 One study found that many with plaque psoriasis suffer with vitamin D deficiency year-round. Insufficiency was found independent of age, gender, BMI, thyroid hormone levels and time of the year.
Interestingly, illnesses commonly associated with psoriasis, such as cardiovascular disease, type 2 diabetes, osteoporosis and metabolic syndrome, are also associated with low levels of vitamin D.12
Several conditions may contribute to low vitamin D levels, including sun avoidance, malabsorption and long-term use of corticosteroids, commonly used to treat psoriasis.
In a pilot study evaluating the use of high-dose vitamin D administration on the clinical course of psoriasis, researchers found significant success rates and commented that high-dose vitamin D therapy may be both effective and safe in the treatment of psoriasis.13
However, while safe sun exposure is best, it is vitally important to have your blood tested to ensure appropriate levels and take vitamin K2 concurrently if you use a vitamin D3 supplement.
In a comprehensive search of research databases to identify relevant literature, researchers found that both oral and topical vitamin D therapies provided patients with psoriasis comparable effective treatment to corticosteroids without the side effects commonly associated with steroid therapy.14
The researchers concluded that topical vitamin D derivatives may be considered indispensable in the treatment of psoriasis.
Science has discovered that the synthetic forms of vitamin D will slow the growth of skin cells, one of the hallmark characteristics of psoriasis.15 However, some of the analogue vitamin D forms are irritating to the skin, making natural production of vitamin D by your body a better option for treatment, and without the side effects of medications.
Vitamin D deficiency is common, especially in North America. In my previous article, "The Positive Choice Wellness Center Calls Out Sun Avoidance as "Misguided," is a discussion of the pros and cons of using safe sun exposure to balance your vitamin D levels, and the importance of blood testing to achieve your goals.
Simple Treatments May Reduce Potential Further Health Damage
Cold, dry weather may trigger an outbreak. By optimally hydrating your skin you may help to reduce your symptoms. Skin creams are rarely the answer, although topically applied virgin coconut oil may help. Hydrate from the inside out by drinking enough water so your urine is light straw color and consume high-quality, animal-based omega-3 fats.
Your best sources for omega-3s are marine-based fats like krill oil or fish oil. Plant-based omega-3 sources will NOT provide the clinical benefit you need to reduce inflammation and swelling in your skin. Reduce your exposure to harsh soaps and avoid drying out your skin with excessive bathing. Use a very mild soap when cleansing your skin, especially in the winter, to avoid stripping your skin of moisture.
Avoid grains to reduce sugar in your system, which will normalize your insulin levels and reduce inflammatory conditions, including inflammation in your skin. You may not realize it, but the health and quality of your skin is strongly linked to the health of your gut. Read more about improving your gut health in my previous article, "The Importance of Microbial Diversity in Gut Health and Disease."
Aloe vera gel and many essential oils have anti-inflammatory properties to help reduce inflammation from psoriasis or possibly from psoriatic arthritic pain.16 Aloe vera may also be effective in enhancing skin health, lessening skin inflammation, blistering, itching and treating rashes.17
Check Your Kitchen Cabinets for Simple Effective Remedies
Apple cider vinegar is a popular home treatment for a number of different skin conditions, psoriasis included. It's made by fermenting apple cider with specialized bacteria. The antiseptic properties of apple cider vinegar may help reduce the itching and irritation to your skin.18
Those who report good results with apple cider vinegar place it directly over the patchy skin, often on the scalp. Avoid using if the skin is cracked and bleeding as it can cause further irritation to the area.19 If full strength apple cider vinegar irritates your scalp or skin, dilute it with equal parts water and rinse it off once it has dried.
Oats naturally sooth your skin and often are used to ease the itch of chicken pox.20 Put your oats in a sock tied at the top and place it in your bath water for a soak. You can also make a paste with crushed oats and apply it directly to your affected areas for relief of itching and irritation. While it doesn't stop the progression of the condition, it does offer immediate relief.
Turmeric is an aromatic spice commonly used in Indian cuisine and has been prevalent in Eastern cultures as a natural medicine and spice for thousands of years.21 Although research has not been conclusive, some evidence suggests its potent anti-inflammatory and antioxidant properties may help manage your psoriasis.
One study evaluated a topical preparation of turmeric, noting significant improvement in symptoms over the nine-week course of treatment. There was also a reduction in the number of new lesions.22 The anti-inflammatory properties of turmeric are likely responsible for these improvements.23