Psoriasis

Psoriasis

Psoriasis is a skin disorder that causes the appearance of red, flaky, itchy patches of skin, usually covered with white scales. There are many manifestations of psoriasis from mild to severe. In the past, severe psoriasis was an incredibly difficult skin condition to manage with a great impact on self-esteem and quality of life. However, there are now very powerful psoriasis medications that are safe and work well. If you have severe psoriasis- we recommend that you find a dermatologist near you.

Look for a board-certified dermatologist at AAD.org

If you have mild psoriasis and you want to treat psoriasis at home, read on to learn more about psoriasis and some of the remedies available to ease this inflammatory skin condition.

When you have psoriasis its even more important to stop any kind of inflammation. Make sure your face routine is right your your skin type.

For personalized skin care advice on skincare for your face and how to choose the right product and brand – take the quiz to find out your Baumann Skin Type.

Why treating Psoriasis is important

Psoriasis causes skin inflammation which can increase the risk of many other diseases. This is why you do not want to leave your psoriasis untreated.

Getting anti-inflammatory ingredients in your skin care and diet can help, but most psoriasis suffers require topical creams such as the new biologics that treat psoriasis effectively.

Psoriasis can cause heart disease

Psoriasis isn’t just inflammation in the skin; it’s a systemic inflammatory disease. Scientists have discovered inflammatory biomarkers in the blood of psoriasis patients, like C-reactive protein and the platelet activation marker P-selectin, which correlate with the severity of the disease. (10-11)

Stdies using PET-CT scans have shown vascular inflammation in psoriasis patients, suggesting that the inflammation from psoriasis affects blood vessels, leading to inflammation within the vessel walls. This can lead to heart disease.

Another connection between psoriasis and cardiovascular diseases is through insulin resistance. Insulin resistance, commonly seen in diabetes, is a key component in cardiovascular disorders. Insulin plays a role in stimulating the production of nitric oxide in the endothelium, leading to vasodilation and improved glucose disposal in muscles. However, inflammation can disrupt this balance, leading to insulin resistance and reduced nitric oxide production, ultimately causing endothelial dysfunction. Notably, TNF-α, a major cytokine in chronic inflammatory diseases like psoriasis, opposes insulin’s effects.

Many of the inflammatory factors that are increased in psoriasis may contribute to the development of heart disease.

Psoriasis is linked to diabetes

While only a handful of studies have delved into the connection between psoriasis and diabetes, 2008 findings underscore this association. A cross-sectional study analyzed data from the Clalit Health Services (CHS) database, comparing patients diagnosed with psoriasis to those without. Among 16,851 patients with psoriasis and 74,987 without, a noticeable trend emerged: patients over the age of 35 with psoriasis had a significantly higher prevalence of diabetes. (14)

This data highlights the importance of reducing other health risk factors, such as smoking, high blood pressure, and high cholesterol to further protect overall health.

What is the Main Cause of Psoriasis?

Psoriasis is caused when something triggers the immune system. We don’t know exactly what causes this immune response, but stress, injury, certain medications and infections like strep throat can trigger it.

It may be possible that genetics also plays a role in psoriasis, but scientists have not been able to find any specific genes that cause psoriasis – and you may get it even if you do not have a family history.

Biologics to Treat Psoriasis

There are so many new good drugs to treat psoriasis. Make sure you check in with your dermatologist to see which are right for you.

Prescription medications to treat psoriasis:

Biologic Drugs (Injectable/Infusable):

Adalimumab (Humira)

Certolizumab Pegol (Cimzia)

Etanercept (Enbrel)

Golimumab (Simponi)

Infliximab (Remicade)

Ustekinumab (Stelara)

Secukinumab (Cosentyx)

Ixekizumab (Taltz)

Brodalumab (Siliq)

Guselkumab (Tremfya)

Risankizumab (Skyrizi

Tildrakizumab (Ilumya)

Please note that this is not an exhaustive list and new medications are developed and approved often.

Non-Biologic Treatments:

Topical Treatments (these are not biologics):

Calcipotriene (Dovonex)

Betamethasone dipropionate (Diprolene)

Tazarotene (Tazorac)

Calcitriol (Vectical)

Clobetasol (Temovate, Clobex)

Tacrolimus (Protopic)

Pimecrolimus (Elidel)

Oral Treatments (pills for psoriasis):

Methotrexate

Cyclosporine (Neoral, Gengraf, Sandimmune)

Acitretin (Soriatane)

Apremilast (Otezla)

Types of Psoriasis

There are seven different types of psoriasis, the most common of which is plaque psoriasis (also known as psoriasis vulgaris), which affects approximately 80-90% of people with psoriasis.

All 7 types have inflammation.

What’s the Difference Between Psoriasis and Eczema?

As mentioned, there are different kinds of psoriasis, but in general, psoriasis is a thick plaque that feels raised on the skin. The skin over the plaque is usually light pink and covered with silver scales.

Eczema, on the other hand, is usually a flat patch of skin that starts out dry and itchy. It can turn pink and become scaled, but the scales are not as thick as those seen in psoriasis. The best way to tell the difference in eczema versus psoriasis is where on the body it is located.

Psoriasis more commonly appears on the extensor part (the bony part) of the knees or elbows, while eczema appears in the crease behind the knees or elbows. Psoriasis is also common on the face, scalp and lower back. Eczema tends to appear behind the ears, on top of the hands or wrists, or around the ankles.

Does Diet Help Psoriasis?

Diet can absolutely have an impact on the appearance of your skin, and therefore the severity of your psoriasis. Anti-inflammatory foods like salmon, flaxseed oil and argan oil are ideal. The oils in salmon and flaxseed oil (particularly omega 3 fatty acids) are well-known to reduce inflammation and boost the immune system. Argan oil has antioxidant and anti-inflammatory properties that benefit the skin and aid wound healing.

Are There Any Home Remedies for Psoriasis?

If you search the internet, you’ll likely find dozens of examples of home remedies to ‘treat’ psoriasis, but unfortunately, none of them work. Psoriasis is a skin disease of the immune system, so it requires more targeted treatments with medicated psoriasis creams, psoriasis cleansers, or prescription medications.

However, milk compresses might help to ease the itch, and oils like argan oil and safflower oil can help dryness, but you need a psoriasis medication to actually treat psoriasis.

There are so many new, effective prescription medications available for psoriasis including oral medications, injectable medications, and topical psoriasis creams with steroids or Vitamin D. We highly recommend that you see your dermatologist.

The Gut Microbiome and Psoriasis

The gut microbiome, which refers to the diverse community of microorganisms living in the human digestive tract, has been found to be significantly altered in patients with psoriasis compared to healthy controls, reflecting a condition known as dysbiosis. At the phylum level, the majority of studies suggest that patients with psoriasis tend to have a lower relative abundance of Bacteroidetes and a higher relative abundance of Firmicutes, though some findings have reported the opposite trend. (14-16)

There are indications of decreased amounts of Proteobacteria in individuals with psoriasis, while studies regarding Actinobacteria have shown inconsistent results—increased in some cases and decreased in others.

At the family level, psoriasis is associated with an increased relative abundance of several bacterial families, including Ruminococcaceae, Lachnospiraceae, and Enterococcaceae, among others. Conversely, a number of families such as Prevotellaceae, Lactobacillaceae, and Streptococcaceae are less abundant in individuals with psoriasis. Notably, the findings for some families, like Bacteroidaceae and Veillonellaceae, have been conflicting across different studies.

At the genus level, specific bacterial genera, including Paraprevotella and Alistipes, are found to be decreased in patients with psoriasis, while genera like Ruminococcus and Blautia appear to be more prevalent. The evidence for certain genera, such as Bacteroides and Faecalibacterium, is divergent between studies.

At the species level, notable shifts have been observed as well; for example, Prevotella copri, Faecalibacterium prausnitzii, and Akkermiansia muciniphila were found to be significantly decreased in psoriatic patients, while Ruminococcus gnavus and Escherichia coli were among those found to be increased compared to the control group. (14)

This gut microbiome in psoriasis patients highlights the complex interplay between the skin and gut, reflecting the systemic nature of psoriasis as an inflammatory condition and suggesting a potential target for therapeutic intervention. More studies need to be done before we can know which probiotics can help make psoriasis better.

What are the Best Skin Care Products to Use for Psoriasis?

It is essential to follow your dermatologist’s recommendation on the best medications to use for your psoriasis because there are so many effective ones. But these psorisis treatent s should be combined wiht skin care to reduce inflammation.

Anti-inflammatory skin care ingredients can soothe psoriasis. You can learn more about psoriasis skincare such as cleansers, moisturizers, oils, and creams in our Psoriasis Skin Care Routine blog.

Our favorite natural treatment for psoriasis are oils with soothing fatty acids.

DQH Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek. “Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more. Keep reading for the best anti-aging products for your 20s, according to skincare professionals. Sunscreen “We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.” Farmacy Green Defense Daily Mineral Sunscreen An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup. Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30 Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand. Vitamin C Serum “A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging. Drunk Elephant C-Firma™ Vitamin C Day Serum The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation. Sunday Riley C.E.O. Rapid Flash Brightening Serum This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants. Peptides Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.” Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses. Charlotte Tilbury Magic Eye Rescue Cream This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively. This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek. At-Home Peel Pads Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate. “The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.” According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says. Dermadoctor Kakadu C Intensive Vitamin C Peel Pad A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection. KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation. Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids. Emollient Night Cream “In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.” “Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products. Cerave Skin Renewing Night Cream One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid. RoC Retinol Correxion Max Hydration Creme “The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.

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