9 Aug 2024

This common skin condition essentially speeds up the life of skin cells and causes them to build up quickly on the surface of the skin. The extra skin cells from Psoriasis scale and cause red patches that are painful and itchy. This is a chronic disease that comes and goes, and even has bouts of flaring to extreme levels. While there is no cure for psoriasis, there are treatments possible that focus on stopping the cells from growing as quickly.

What are the symptoms of Psoriasis?

The signs and symptoms of Psoriasis are unique for every person. The more common issues that people notice are as follows:

  • Red patches of skin covered with thick, silvery scales
  • Small scaling spots which are seen in children
  • Dry, cracked skin that may bleed
  • Itching, burning or soreness
  • Thickened, pitted or ridged nails
  • Swollen and stiff joints

The skin spots and patches from Psoriasis can range from major eruptions to large areas of scaling, dandruff like skin flaking. Most all forms of Psoriasis go through stages and cycles, flaring for weeks or months, and then subsiding or going into remission for periods of time.

What are the different types of Psoriasis you could be diagnosed with?

There are several types of Psoriasis. They are:

  • Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches or in smaller areas on your hands, feet or fingertips. It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.
  • Erythrodermic psoriasis. The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.
  • Psoriatic arthritis. In addition to inflamed, scaly skin, psoriatic arthritis causes swollen, painful joints that are typical of arthritis. Sometimes the joint symptoms are the first or only manifestation of psoriasis or at times only nail changes are seen. Symptoms range from mild to severe, and psoriatic arthritis can affect any joint. Although the disease usually is not as crippling as other forms of arthritis, it can cause stiffness and progressive joint damage that in the most serious cases may lead to permanent deformity.
  •  Guttate psoriasis. This type primarily affects young adults and children. It is usually triggered by a bacterial infection such as strep throat. It is marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp. The lesions are covered by a fine scale and are not as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.
  • Inverse psoriasis. This mainly affects the skin in the armpits, in the groin, under the breasts and around the genitals. Inverse psoriasis causes smooth patches of red, inflamed skin that worsen with friction and sweating. Fungal infections may trigger this type of psoriasis.
  • Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised, red skin lesions covered with silvery scales. The plaques might be itchy or painful and there may be few or many. They can occur anywhere on your body, including your genitals and the soft tissue inside your mouth.
  • Nail psoriasis. Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration. Psoriatic nails might loosen and separate from the nail bed, which is called onycholysis. Severe cases may cause the nail to crumble.

What are the causes and risk factors of Psoriasis? Does this skin condition have any triggers?

The overall cause of Psoriasis is unknown, but most all specialists do agree that it stems from an immune system problem with white blood cells called neutrophils, and T cells, inside the body. T cells fight against foreign cells, viruses and bacteria. With Psoriasis, the T cells attack healthy skin cells by mistake, causing the overproduction of cells. Why these T cells malfunction is not always explainable, but researchers do believe that genetics and environmental factors all play a role.

Psoriasis is triggered or worsened by certain factors in our day to day lives, and with our lifestyle. These factors include:

  • Infections, such as strep throat or skin infections
  • Injury to the skin, such as a cut or scrape, a bug bite, or a severe sunburn
  • Stress
  • Smoking
  • Heavy alcohol consumption
  • Vitamin D deficiency
  • Certain medications like those that include lithium, which is prescribed for bipolar disorder, high blood pressure medications such as beta blockers, antimalarial drugs, and iodides.

Risk factors that increase your chances of developing Psoriasis are:

  • Family history. This is one of the most significant risk factors. Having one parent with psoriasis increases your risk of getting the disease and having two parents with psoriasis increases your risk even more.
  • Viral and bacterial infections. People with HIV are more likely to develop psoriasis than people with healthy immune systems are. Children and young adults with recurring infections, particularly strep throat, also may be at increased risk.
  • Stress. Because stress can impact your immune system, high stress levels may increase your risk of psoriasis.
  • Obesity. Excess weight increases the risk of psoriasis. Lesions associated with all types of psoriasis often develop in skin creases and folds.
  • Smoking. Smoking tobacco not only increases your risk of psoriasis but also may increase the severity of the disease. Smoking may also play a role in the initial development of the disease.

I have Psoriasis on my genitals, and it is greatly affecting my intimacy. What can I do?

Psoriasis can happen anywhere on the body, including our intimate parts. This can wreak havoc on anyone’s intimate needs and desires, and affect your partner. Many people who have been diagnosed with Psoriasis are still too embarrassed and afraid to talk to their doctor about how this skin condition is affecting their reproductive systems. This is very common for those already diagnosed with Psoriasis and you should not hesitate to reach out to your doctor!

After talking with your doctor and finding an appropriate treatment that may ease the symptoms on your genitals, talk with your partner about how this is affecting you and your relationship. Often, being open and honest about this topic will help everyone feel more at ease with the circumstance and situation presented. This can often help lower stress levels, which can help you both to focus on working through the problem.

To help ease the friction caused by sexual intercourse and foreplay, it is best to add layers of protection to prevent that friction burn. Some ways to do this are:

  • Try lubricated condoms or other lubricants made for intercourse. An all-natural, organic silicone-based lubricant will be thick and long-lasting, which will help cut down on any skin-on-skin friction that may present. If you cannot tolerate silicone, a high-quality water-based lubrication free of additives and preservatives is something to try.
  • Keep the area clean.
  • Clean your genitals and reapply any topical medicine after sex, but use it only as directed by your doctor.
  • If the area is sore or the skin is inflamed, cracked, or bleeding, try again when it feels a little better.
  • Follow your physician’s advice carefully.
  • Use corticosteroids exactly as prescribed.
  • Do not apply high-concentration coal tar ointments to the penis, scrotum or vulva, or to areas with cracked skin. They can cause unneeded irritation.
  • Use mild cleansers without scrubs or perfumes.
  • Let your partner know that psoriasis is not contagious.
  • Acknowledge how genital psoriasis affects your daily activities and make sure your partner is aware of it.
  • Understand that genital psoriasis generally does not cause sexual dysfunction.

You should not worry about hurting yourself or the Psoriasis unless it does truly hurt. In that instance, simply stop doing whatever you’re doing, make a note, and continue with your other intimate routines.

What are the complications from Psoriasis?

If you have been diagnosed with Psoriasis, your risk for these complications are slightly higher than others. These complications are:

  • Psoriatic arthritis. This complication of psoriasis can cause joint damage and a loss of function in some joints, which can be debilitating.
  • Eye conditions. Certain eye disorders, like conjunctivitis, blepharitis and uveitis, are more common in people with psoriasis.
  • Obesity. People with psoriasis, especially those with more severe disease, are more likely to be obese. It is not clear how these diseases are linked, however. The inflammation linked to obesity may play a role in the development of psoriasis. Or it may be that people with psoriasis are more likely to gain weight, possibly because they are less active because of their psoriasis.
  • Type 2 diabetes. The risk of type 2 diabetes rises in people with psoriasis. The more severe the psoriasis, the greater the likelihood of type 2 diabetes.
  • High blood pressure. The odds of having high blood pressure are higher for people with psoriasis.
  • Cardiovascular disease. For people with psoriasis, the risk of cardiovascular disease is twice as high as it is for those without the disease. Psoriasis and some treatments also increase the risk of irregular heartbeat, stroke, high cholesterol and atherosclerosis.
  • Metabolic syndrome. This cluster of conditions, which include high blood pressure, elevated insulin levels and abnormal cholesterol levels, all increase your risk of heart disease.
  • Other autoimmune diseases. Celiac disease, sclerosis and the inflammatory bowel disease called Crohn’s disease are more likely to strike people with psoriasis.
  • Parkinson’s disease. This chronic neurological condition is more likely to occur in people with psoriasis.
  • Kidney disease. Moderate to severe psoriasis has been linked to a higher risk of kidney disease.
  • Emotional problems. Psoriasis can also affect your quality of life. Psoriasis is associated with low self-esteem and depression. You may also withdraw socially.

How will my doctor diagnose and treat my Psoriasis?

In most all cases, diagnosis is quite simple and straightforward. They may give you a physical exam and take your complete medical history. In some cases, a skin biopsy is taken, but most often the visual representation of the Psoriasis is enough for the doctor to diagnose. Treatments are done to help reduce the skin cell overgrowth, which will help to control the symptoms, itching and pain. The treatments most often used are:

  • Topical Treatments. These treatments are used to effectively treat mild to moderate psoriasis. They help to reduce inflammation and relieve itching and are generally safe for sensitive skin areas. Your doctor may prescribe you different strengths of corticosteroid creams for different areas of the body, or for milder or more severe flares. Long term use of these creams can cause a thinning of the skin and are best used for short term periods of time. These can include vitamin d analogues, which are synthetic forms of vitamin D to help slow skin growth; anthralin, which is a medication that helps slow skin growth; topical retinoids, calcineurin inhibitors, salicylic acid, coal tar, and other moisturizers.
  • Light therapy. This treatment can use natural or artificial ultraviolet light, which is often the simplest and easiest form of phototherapy. Other forms of light therapy work well, if they cover both UVA and UVB light sources. These include:
    • Sunlight offers exposure to both forms of UV rays. Brief, daily exposure may improve psoriasis.
    • UVB Phototherapy gives a controlled dose of UVB light from artificial sources. This method can be beneficial for those dealing with moderate to severe, stubborn psoriasis.
    • Narrow band UVB phototherapy is a newer treatment that involves narrow bands of UVB rays aimed at the patches on the skin.
    • Goeckerman therapy combines two therapies together: UVB treatment and coal tar used on the skin.
    • Psoralen plus ultraviolet A or PUVA therapy is a form of photochemotherapy involving light-sensitizing medications before exposure to sunlight or UVA light. This is an aggressive treatment.
    • Excimer laser is a form of light therapy used for mild to moderate cases of psoriasis, that uses controlled beams of UVB light. This requires fewer sessions than traditional phototherapy.

As with any light therapy treatment, speak with your doctor before beginning any new regimen without their input.

  • Oral or Injected medications. These can be useful if your case of psoriasis is stubborn or difficult to treat. This systemic treatment does have side effects, so many of these are only used for brief periods of time. Discuss these with your doctor if you are interested in any of these possible treatment solutions: retinoids, methotrexate, cyclosporine, immune system alteration medications or biologics, and some other medications can be given.

Many people also try holistic remedies to help alleviate symptoms of psoriasis. These things can normally be done alongside of medical treatments. The use of aloe vera gel, fish oil, and Oregon grapes or barberries all have been noted to reduce inflammation, redness, itching and pain.

If you have Psoriasis, or suspect you do, contact your doctor immediate to begin a treatment regimen to help control and ease your symptoms.

Citations:

Psoriasis.org

Mayo Health

American Cancer Society