I have recently been diagnosed with psoriasis and am waiting to see a consultant dermatologist. How did I get it and what's in store for me treatment wise?

answer

Psoriasis is an inflammatory disease in which new skin cells are produced around ten times faster than normal. As a result, they push up to the surface faster than the dead cells can fall away from the body. Live cells therefore build up, and form characteristic raised, red patches covered with dead cells forming fine, silvery scales. Psoriasis symptoms vary and can include the appearance of bright red, scaly patches that vary in size from a few millimetres to extensive plaques covering most of the body. In some cases, sterile pustules form - usually on the palms and soles - while other people develop flaky scalp, thickening and pitting of the nails, and/or a form of arthritis known as psoriatic arthropathy.

Medically, a variety of skin treatments may be prescribed to soften the skin, remove scales, damp down inflammation or slow the production of new skin cells. These include emollients (eg aqueous cream, emulsifying ointment), vitamin D derivatives (eg calcitriol, tacalcitol) and the vitamin A derivative, tazarotene. Older treatments such as coal tar extracts and dithranol are messy, stain skin and are less pleasant to use. Some forms of psoriasis may be treated with ultraviolet phototherapy, or with oral drugs that affect the immune system and reduce cell division.

Psoriasis has been linked with abnormalities in essential fatty acid metabolism. Essential fatty acids found in fish oils (eg EPA and DHA) have an anti-inflammatory effect which has been shown to damp down psoriasis lesions. In one study of 80 people with psoriasis, taking a dose of 1122mg/day EPA and 756mg/day DHA significantly reduced psoriasis lesions within four to eight weeks. Itching decreased most rapidly, followed by scaling then redness with over 65 per cent of people showing marked improvement.

Aloe vera gel is noted for its wound healing properties, and a study of 60 adults with psoriasis found an ointment containing aloe vera gel (surprisingly, just 0.5 per cent but there's no reason why 100 per cent gel should not be used) applied three times a day healed over 80 per cent of plaques within four weeks compared with only eight per cent with placebo. Taking it by mouth may be beneficial, too.

Other topical treatments that can improve psoriasis include Dead Sea mineral salts/mud, Mahonia ointment (made from the Oregon grape extract), Gotu kola and Zambesia Botanica - a cream made from the African Kigelia tree. Some practitioners advise taking milk thistle and Cynara scolymus extracts to improve liver function, which seems to improve the rate at which new skin cells are produced. Avoid smoking and alcohol, which can trigger flare-ups.

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Psoriasis - coping with the diagnosis