Psoriasis
Psoriasis is a long-term skin condition that typically starts off as red areas of skin, perhaps 1 to 2 cm wide, with a slightly raised, dry and flaky surface. It most often affects knees, elbows, lower back and around the hairline, but it can appear anywhere including in the body flexures such as the armpits or groin. It may be a little itchy, especially if the scalp is affected, but is not usually painful.
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How common is psoriasis?
Psoriasis is a common condition affecting 2 out of every 100 people, with the majority of these being affected by small areas of redness, known as chronic plaque psoriasis.
Chronic plaque psoriasis
It can start at any age but usually develops between the ages of 15 and 30, and is more common in white people. You are also more at risk if you are a smoker, or if you have a close relative with psoriasis. If left untreated, plaques may increase in size and thickness and spread to other areas, and a silvery scale can appear over the areas of redness.
Pustular psoriasis
The second most common type of psoriasis is called pustular psoriasis, typically affecting the palms and soles of the feet. This causes small fluid-filled spots to develop in these areas, often with reddening of the skin and some tenderness. These spots are not infectious.
Some people are concerned with the appearance of psoriasis, and large thickened areas are more difficult to treat. Psoriasis can take several weeks or months of treatment to recover, and it may be persistent or recur. It can also affect the nails in around half of people with psoriasis as well as increasing the risk of other health problems developing such as heart disease and strokes. 10-20% of people with psoriasis also develop joint problems linked to it, called psoriatic arthritis, usually affecting the toes and fingers although any joint may be involved.
Psoriasis is not contagious – you cannot catch it from someone who has it. It may run in the family, and rarely can go with other conditions affecting the gut, joints, back and eyes.
Healthwords pharmacists' top tips
Pharmacy-based treatment for psoriasis aims to moisturise the skin and improve the appearance of dry, flaky patches. Emollients (medical grade moisturisers) are available from your pharmacist, and can soften skin to help other treatment creams to work, as well as helping to relieve any itch.
In addition to emollients, coal tar containing shampoo treatments such as 'Polytar' or 'Alphosyl' can help slow the rapid growth of skin cells and thus reduce the scaly raised lesions and restore the skin's appearance, as well as reducing itching and inflammation. The downside of these products is that they can have a strong odour due to the coal tar, and may also stain clothing they come into contact with.
Pharmacist recommended products
Am I fit for work?
Yes you are fit for work if you have psoriasis.
When should I see my doctor?
We would suggest booking a routine appointment with your doctor to discuss treatments as a number of these are now available. These include dithranol applied directly to the skin, salicylic acid, tazarotene gel, steroids and calcipotriol. Severe psoriasis can also be treated by phototherapy (ultraviolet light-based treatments) and specialist biological medication. The National Institute for Care and Health Excellence (NICE) has also recently approved the biologic treatments bimekizumab and secukinumab for severe psoriasis.
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