Diagnosis of Psoriasis
To diagnose psoriasis, your doctor usually examines your skin, scalp, and nails for signs of the condition. They may also ask questions about your health and medical and family history, such as whether you:
- Experience symptoms such as itchy or burning skin.
- Had a recent illness or experienced severe stress.
- Take certain medicines.
- Have relatives with the disease.
- Experience joint tenderness.
This information will help the doctor figure out if you have psoriasis, and, if so, identify which type. To rule out other skin conditions that look like psoriasis, your doctor may take a small skin sample to examine under a microscope.
Treatment of Psoriasis
While there is currently no cure for psoriasis, there are treatments that keep symptoms under control so that you can resume daily activities and sleep better. There are different types of treatment, and your doctor will work with you to decide which is best for you, taking into consideration the type of psoriasis you have, how severe it is, where it is on your body, and the possible side effects of medications. Your treatment may include the following.
Medications
- Topical therapies. Creams, ointments, lotions, foams, or solutions, especially those containing corticosteroids, are commonly used to treat people with mild to moderate disease. Other topical therapies include vitamin D-based medicines, retinoids (related to vitamin A), coal tar, anthralin (another tar product), phosphodiesterase 4 (PDE4) inhibitors, and medicines activating the aryl hydrocarbon receptor (AhR).
- Methotrexate. This medicine is in a class called antimetabolites, and it is available in an oral or injected form. It suppresses the immune system and slows down cell growth and division.
- Oral retinoids. These compounds, which are related to vitamin A, may help some people with moderate to severe psoriasis. They can be used in combination with phototherapy.
- Biologic response modifiers. These medications are injected and block specific immune molecules, helping to decrease or stop inflammation.
- Immunosuppressants. These medicines are normally used for severe cases, and they work by suppressing the immune system.
- Oral phosphodiesterase 4 (PDE4) inhibitors. These target enzymes inside immune cells and suppress the rapid turnover of skin cells and inflammation.
- Oral tyrosine kinase 2 (TYK2) inhibitors. These medications block the activation of certain immune cells.
Phototherapy
This treatment involves having a doctor shine an ultraviolet light on your skin in their office. A doctor may also prescribe a home ultraviolet light unit. Phototherapy is usually used when large areas of the skin are affected by the disease.
Who Treats Psoriasis?
Psoriasis is treated by:
- Dermatologists, who specialize in conditions of the skin, hair, and nails. You may want to find a dermatologist that specializes in treating psoriasis.
Other health care providers who may be involved in your care include:
- Rheumatologists, who specialize in conditions of the joints, muscle, and bone. Rheumatologists provide care to people with psoriatic arthritis.
- Mental health professionals, who provide counseling and treat mental health disorders, such as depression and anxiety.
- Primary health care providers, including family doctors, internists, pediatricians, or nurse practitioners.
Living With Psoriasis
Psoriasis can affect a person’s day-to-day life, including work and sleep. However, health care providers understand the impact of the disease and can work with you to help reduce the symptoms. In addition to going to your doctor regularly, here are some things you can do to help manage your symptoms:
- Keep your skin well moisturized. Bathe in lukewarm water and use mild soap that has added oils. After bathing, apply heavy moisturizers while your skin is still damp.
- Maintain a healthy weight. Obesity makes the symptoms of psoriasis worse.
- Eat a healthy diet. The Mediterranean diet has been shown to be helpful in several psoriasis studies.
- If you smoke, work with your doctor to make a plan to quit. Studies have shown that the more a person smokes, the worse the symptoms tend to be.
- Moderate your use of alcohol. Some studies suggest that excessive alcohol consumption aggravates symptoms.
- Expose your skin to small amounts of sunlight. Limited sunlight can alleviate symptoms, but too much can make them worse, so consult your doctor for advice.
- Avoid known triggers. Try to identify things that trigger psoriasis flares and work to avoid them. Some people have found that stress, cold weather, skin injuries, certain medicines, and infections spark flares.
- Join a support group or visit a mental health provider. The scaly patches of skin can make many people feel self-conscious about their appearance. Psoriasis can affect a person’s mental health, increasing the risk of anxiety and depression. Seeking out support can help you learn more about coping and living with the disease.