
Editor’s note: This article has been reprinted. First published December 14, 2016.
Psoriasis is a chronic disease of the immune system that causes cells to build up on the surface of the skin beyond the superficial skin condition. This causes thick, scaly red spots that are itchy and sometimes painful.
Approximately 7.5 million Americans suffer from psoriasis, which also has an alarming economic impact.1
The total annual cost of psoriasis was nearly $112 billion in 2013.2 It usually affects the skin, but can also affect the joints (psoriatic arthritis) and has been linked to diabetes, asthma, cardiovascular disease and depression.3
Psoriasis also has a severe emotional and psychological impact on patients, with a prevalence of depression reaching 50%.4
Psoriasis is an inflammatory reaction, but frequent scratching of the affected area can lead to infection. However, psoriasis is not contagious, and you can prevent psoriasis attacks by using several strategies outlined below.
Not all psoriasis is created equal
There are actually five types of psoriasis. The symptoms of each are different, but they are all equally irritating and itchy.
Plaque psoriasis is the most common type.5 It is characterized by red, raised skin patches that are often covered with dead skin cells that appear silvery-white. Patches most often appear on the elbows, scalp, knees, and lower back.
Guttate psoriasis usually appears as small dot formations that begin in childhood. It may be caused by a streptococcal infection. About 10% of people who develop psoriasis have wound psoriasis, the second most common type.
Inverse psoriasis appears as soft, shiny, dark red patches in the folds of the body. Many people with inverse psoriasis also have other types. Blisters filled with non-infectious pus are characteristic of pustular psoriasis.
They appear more often on the hands and feet and are filled with non-infectious white blood cells.
A more severe form of psoriasis is called erythrodermic psoriasis. It is characterized by extensive itchy, painful areas that are fiery red and cover most of the body. Psoriasis is so rare that only 3% of patients will experience it in their lifetime.
How Psoriasis Occurs
The skin is the body’s largest organ and serves to protect internal organs, regulate internal temperature, and provide a barrier against infection.
The skin has three main layers: the epidermis, the dermis, and the deeper subcutaneous tissue, which is made up of fat and connective tissue. It is the growth rate of the epidermis that changes and creates symptoms of psoriasis.
The epidermis has another four or five layers through which cells travel before leaving the body. Cell growth production occurs at the basal level closest to the dermis. The stratum corneum, or outermost layer, is made up of 10 to 30 layers of skin, depending on the area of the body.
The skin on your feet and palms is thicker than the skin under your eyes or behind your fingers. Most of the skin’s barrier function is confined to the stratum corneum of the skin.
Psoriasis occurs when the body causes excessive production of skin cells in the lowest layer of the skin. This overgrowth pushes more cells into the top layer of the skin, which is not yet differentiated enough for the body to shed.
This causes a buildup of skin cells in the epidermal layer, which can feel itchy, red, blotchy, and has a silvery appearance due to dead cells that have not yet shed.
Common Psoriasis Triggers and Treatments
Psoriasis is closely related to eczema and is sometimes triggered by an allergic reaction to environmental factors, more often by external factors. Irritants that can trigger an attack include:
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laundry detergent |
soap |
cleaning chemicals |
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higher alcohol levels in men |
Skin injuries, such as insect bites, cuts, and sunburns |
Metals such as nickel in jewelry |
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perfume |
skin infection |
certain medications |
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dry skin |
cold and dry weather |
animal dander |
It may seem obvious, but avoiding environmental triggers is one way to reduce psoriasis symptoms. If an outbreak occurs, there are several treatments your doctor may recommend. If you remember how psoriasis develops, it is clear that steroid creams should be avoided.
Although the effects appear immediately, the body quickly develops tolerance. Additionally, steroid creams are made from synthetic steroids that are quickly absorbed into the skin and destroy the adrenal system. Many other commonly prescribed medications also have dangerous side effects.
These include vitamin A derivatives, anti-inflammatory agents, immunosuppressants, and drugs used off-label. Instead, it may be more helpful to use the natural strategies outlined below.
In general, with continuous use, it is effective and does not have side effects of drugs that are significantly harmful to health. Side effects of commonly prescribed groups of drugs include:6,7,8,9
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thinning of the skin |
resistance to treatment |
skin irritation |
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birth defect |
back pain |
joint pain |
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ringing in ears |
hearing loss |
muscle stiffness |
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headache |
sleep disorder |
nausea and vomiting |
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redness of the skin |
blurred vision |
chest pain |
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loss of appetite |
shortness of breath |
swollen glands |
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mouth sores |
hair loss |
seizure |
The most common type responds to vitamin D.
Researchers have demonstrated a strong track record of successful outcomes when patients optimize their vitamin D levels.10,11 One study found that many people with plaque psoriasis suffer from vitamin D deficiency year-round. Deficiency was found regardless of age, gender, BMI, thyroid hormone levels and time of year.
Interestingly, diseases commonly associated with psoriasis, including cardiovascular disease, type 2 diabetes, osteoporosis, and metabolic syndrome, have also been linked to low levels of vitamin D.12 Several conditions can contribute to low vitamin D levels, including avoiding sunlight, impaired absorption, and long-term use of corticosteroids commonly used to treat psoriasis.
In a pilot study evaluating the use of high-dose vitamin D administration on the clinical course of psoriasis, researchers found significant success rates and noted that high-dose vitamin D therapy may be effective and safe for the treatment of psoriasis.13
However, while it is best to safely expose yourself to sunlight, it is very important to get a blood test to ensure adequate levels and to take vitamin K2 at the same time if you are using a vitamin D3 supplement.
After a comprehensive search of research databases to identify relevant literature, researchers found that both oral and topical vitamin D treatments provide psoriasis patients with effective treatment comparable to corticosteroids without the side effects commonly associated with steroid treatments.14
The researchers concluded that topical vitamin D derivatives could be considered indispensable in the treatment of psoriasis.
Science has discovered that synthetic forms of vitamin D slow the growth of skin cells, one of the hallmark characteristics of psoriasis.15 However, because some pseudo forms of vitamin D are irritating to the skin, a better treatment option may be to produce vitamin D naturally in the body without the side effects of medications.
However, a note about sun exposure — if you eat a diet high in seed oils containing linoleic acid (LA), it is best to avoid intense sun exposure during peak hours. This is because seed oil can accumulate on the skin and then be oxidized by sunlight, causing inflammation and skin damage.
To protect your skin health, avoid seed oils and processed foods for at least six months to remove most of these harmful fats from your body, allowing you to reap the health benefits of the sun without the toxic side effects. After you completely remove LA from your diet, you can re-expose yourself to sunlight at midday.
Simple treatments can reduce further health damage
Cold, dry weather can trigger an outbreak. Providing your skin with optimal moisture can help reduce symptoms. Skin creams are rarely the answer, but applying virgin coconut oil topically may help. Stay hydrated by drinking enough water to keep your urine a light straw color, and eat high-quality animal-based omega-3 fats (in moderation, as omega-3s are also a type of polyunsaturated fat).
The best sources of omega-3 are marine-based fats such as krill oil or fish oil. Plant-based sources of omega-3 do not provide the clinical benefit needed to reduce inflammation and swelling in the skin. Reduce your exposure to harsh soaps and avoid drying out your skin from excessive bathing. Especially in winter, when cleansing your skin, use a very mild soap to avoid stripping your skin of moisture.
Reducing sugar in the body by avoiding refined grains and processed foods normalizes insulin levels and reduces inflammatory conditions, including skin inflammation. You may not realize it, but the health and quality of your skin is closely linked to the health of your gut.
Aloe vera gel and many essential oils have anti-inflammatory properties that help reduce inflammation caused by psoriasis or psoriatic arthritis pain.16 Aloe vera boosts skin health, relieves skin inflammation, and is also effective in treating blisters, itching, and rashes.17
Check out your kitchen cabinets for simple and effective solutions
Apple cider vinegar is a popular home treatment for a variety of skin conditions, including psoriasis. It is made by fermenting apple cider with special bacteria. The antiseptic properties of apple cider vinegar may help reduce skin itching and irritation.18
People who have reported good results with apple cider vinegar apply it directly to uneven skin, often to the scalp. Avoid use if skin is cracked or bleeding. This may cause more irritation to the area.19 If apple cider vinegar irritates your scalp or skin, dilute it with an equal amount of water and rinse after drying.
Oats naturally soothe the skin and are often used to relieve the itchiness of chickenpox.20 Put the oats in a sock tied at the top and soak in bath water. You can also relieve itching and irritation by making a paste of rolled oats and applying it directly to the affected area. It does not stop the progression of the condition, but provides immediate relief.
Turmeric is an aromatic spice commonly used in Indian cuisine and has been widely used in Eastern cultures as a natural medicine and spice for thousands of years.21 Although studies have been inconclusive, some evidence suggests that its powerful anti-inflammatory and antioxidant properties may help manage psoriasis.
One study evaluated a topical preparation of turmeric and found significant improvement in symptoms over a 9-week course of treatment. The number of new lesions also decreased.22 The anti-inflammatory properties of turmeric are likely responsible for this improvement.23