Psoriasis Psoriasis is an autoimmune condition in which the immune system causes the epidermis (outermost layer of skin) to grow much faster than normal. In healthy skin, the cells within the epidermis are usually produced at a rate which is roughly equal to the rate in which they’re shed. In psoriasis-affected skin, the cells are produced so rapidly that they ‘build up’ in thick layers. Also, because they’re produced so fast, they don’t have time to mature like normal skin. As a result, psoriasis-affected skin doesn’t have the same strength and resilience as healthy skin, so it tends to flake, itch, burn, etc. There is still no known cause for the overactive immune response which occurs with psoriasis. Patients often report that others in the family have psoriasis, so genetics does seem to be a factor. Unlike most genetic conditions, though, psoriasis usually doesn’t express itself until we’re adults. Some patients with psoriasis may also experience inflammation internally, within their joints, which is known as psoriatic arthritis. If you suffer from psoriasis, there are a number of general recommendations you should consider: Do your best to avoid picking and scratching the psoriasis-affected areas. It is well known that psoriasis tends to worsen with repeated scratching. Even excessive scrubbing in the bath or shower can cause it to flare. Try to avoid excessive fat intake, lack of exercise, poor sleeping habits, stress, and especially smoking and drinking. Eliminating these to the best of your ability can make the difference between having a mild, easily-controlled case as opposed to a more severe and difficult to treat case. Always follow the instructions provided with any prescribed medications. Topical steroids, for example, can cause ‘thinning of the skin’ if used excessively. If used too infrequently, though, they may not provide adequate results. The key is to find a ‘happy medium’ in which you’re able to control the inflammation, but not overuse the medication in a way that causes harmful side effects. There is naturally-occurring yeast on everyone’s skin which is known to aggravate psoriasis – especially on the oil-prone areas such as the face, scalp, and ears. Ironically, many patients see the dry flaking on their scalp and mistakenly believe they’re shampooing too often. In fact, shampooing typically helps the scaling because it removes the skin oils which in turn create a good environment for the yeast. Many prescription and over-the-counter ‘dandruff’ shampoos actually work by killing yeast, so they can also be helpful for those with psoriasis. Every now and then it’s discovered that a patient’s psoriasis has been triggered by some other health condition or underlying source of inflammation. For example, a patient with a chronically infected tooth might notice that their psoriasis greatly improves after their dental abscess has been treated. The point is that it’s wise to consider your overall state of health when looking to improve your psoriasis. If you have another health issue which has yet to be adequately managed, you should address this with your primary care provider as it just might help your Psoriasis. If you find that you’re still struggling to control your psoriasis after using topical medications and adhering to these recommendations, rest assured that there are other options available. You’ve likely seen commercials on TV for so-called biologics as well as other treatments. These other treatments generally do work better than topical medications alone, but they should be prescribed only after considering each person’s unique needs and circumstances. Please talk to your dermatologist about your situation, including how you’ve responded to past treatments, and together you can formulate a treatment plan which is right for you.