Psoriasis is more than just a bad case of dandruff, it's a chronic disease. Distinct by its scaly patches of skin and flakes, many sufferers battle to overcome the feelings of discomfort and embarrassment associated with the condition

Dispelling the myths
Psoriasis is not contagious, it's a genetically determined inflammatory condition of the skin. One of the most common of the skin disorders, psoriasis affects one in fifty of the population - two per cent worldwide. Plaque psoriasis is the most common form of the disease and is characterised by inflamed patches of skin lesions topped with silvery white scales.

No-one really knows what causes it, but it tends to come on before the age of 35 and generally runs in families. Psoriasis is known as an 'immune-mediated' disease. It's understood that the immune system, which normally protects the body against foreign invaders, is somehow mistakenly triggered and begins targeting skin cells. New skin cells are produced at a faster rate than dead skin cells are shed and the excess skin creates plaques. Knees, elbows, scalp, stomach and back are the most commonly affected areas of the body.

Living with psoriasis
Most people will agree how maddening itches are, but for a psoriasis sufferer dry, itchy and painful skin is just part of life. Talk to any sufferer and their main complaint will be coping with the scaly, itchy skin. With no known cure, living with psoriasis can be tough. Outbreaks are painful and uncomfortable. Added to that, psoriasis is unpredictable and can flare up at any time, so sufferers cope with the additional stress of looming outbreaks.

As well as the obvious physical symptoms, it can also have a negative impact on a patient's life. While families and partners of psoriasis sufferers remain wholly supportive and helpful, strangers tend to stare, leaving sufferers feeling self-conscious. A recent survey of young patients by the National Psoriasis Foundation Patient Survey, found that 78 per cent suffered from feelings of unattractiveness because of their condition.

One of the main problems for psoriasis patients is that many people don't understand it. In fact, discrimination against psoriasis sufferers can be traced all the way back to Biblical times. Early reports of people confined to leper colonies are described as having the distinctly psoriasis silvery scaling skin.

Psoriasis patients speak out
iVillager Karen, aged 40 has lived with psoriasis for as long as she can remember. She says that, 'at school people used to stare at me and I felt like an outsider'. She mainly gets psoriasis on her scalp which leaves her feeling that she, 'can't wear black or dark tops because I get bad flakes and people stare'. Her condition can make her feel uncomfortable inside and out, 'It's awful when I take my jumper, bra or socks off and dry skin scales rain out of my clothes'.

Another sufferer, iVillager Jappann admits to feeling relieved when she found out. 'My scalp psoriasis really embarrassed me. Before I was diagnosed I thought that it was just really bad dandruff. It was a relief that there was a name for it and treatment'.

Jappann has suffered with psoriasis for 12 years. A bad outbreak leaves her covered in flakes and finding herself constantly having to explain herself to people. Normal activities that most women enjoy, she dreads. 'Going to the hairdressers is the worst. I feel so embarrassed'.

iVillager Nikki, aged 25 also finds outbreaks difficult to deal with. She's suffered from psoriaisis for nine years and since she developed patches on her scalp and face, feels shy about her condition. 'People do stare at me. If I go swimming I wear a T-shirt and shorts because I've had hurtful comments from children and adults who don't understand. I now try to go when the swimming baths are nearly empty just so people don't see me.'

Treating psoriasis
A combination of topical creams and phototherapy are the main ways to treat psoriasis. Topical creams generally work pretty fast to clear up an outbreak, but they can be fiddly to apply and also don't actually aid the remission of psoriasis. The sun generally has a good affect on psoriasis, and courses of phototherpay or UV light therapy are recommended. Though effective, this method poses other long-term risks such as skin cancer.

Most psoriasis sufferers fight the condition for years with no success. No surprises then that a recent survey by the National Psoriasis Foundation Patient Survey found that over three-quarters of psoriasis patients felt frustrated with their treatments.

'The hard thing is that my psoriasis is in little patches all over my body so it is really hard getting to all the places. My husband helps me with the creams', explains iVillager Jappann. But having to rely on people to help with application can be leave many sufferers feeling even more frustrated and helpless.

Many psoriasis patients find themselves becoming their own best experts for managing their condition and warding off flare-ups. Medical professionals advise keeping stress levels low and avoiding too much alcohol or smoking, which tends to provoke a flare-up.

New hope for psoriasis sufferers
Karen has tired all sorts of treatments, 'light therapy, creams, tar treatments? nothing has helped in the long run. It comes and goes'. The main complaint is the scalp psoriasis. 'Nothing has ever cleared it up there', she continues.

The good news is that scientists are now developing drugs that directly target the area of the immune system involved in psoriasis. In October 2004 a new drug, Raptiva (efalizumab) was launched in the UK. The drug is made from a living protein so has to be self-administered by injection.

To date, Raptiva has only received approval for patients with the most severe forms of psoriasis and those where all other forms of treatment have failed. 'Biological therapies give us a new hope providing patients with easier to manage, long-term control of their condition', says Professor Saurat, Chairman of the Dermatology Department at the University of Geneva. The Psoriasis Association welcomes the new developments as 'encouraging' and 'a notable step forward', but remains cautious about the long-term side effects.

For the time being, the majority of psoriasis sufferers will have to struggle on with the available treatments, but the new advances open up exciting potential for the future.

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