What is Psoriasis?
It is a disorder of the skin which affects about 2% of the population. It results in areas of inflamed skin which are thicker and scalier than the surrounding skin. Psoriasis can develop in any area of the skin with the most common areas being the scalp, elbows and knees.

What is the cause of psoriasis?
There appears to be a genetic basis because psoriasis often runs in families. Most of the research suggests an immunological dysfunction. Essentially the cells in the superficial layers of the skin multiply excessively and do not mature into normal skin cells. The cells die prematurely and are shed as a scale. Psoriasis is a condition of inflammation and rapid skin cell turnover. The treatments available are aimed at controlling the pathological process.

Can psoriasis be transmitted from person to person?
No, psoriasis is not contagious.

Can psoriasis affect other organs apart from the skin?
Psoriasis can affect the nails causing pitting of the nails. In about 5% of psoriasis sufferers the condition can affect the joints resulting is a type of arthritis.

What are my therapeutic options?

• Stress management -- Exacerbations of psoriasis are often associated with periods of stress. Making lifestyle choices that minimise stress will be helpful in controlling the condition. A relaxed lifestyle will help to keep your skin healthy. Activities that help you to relax such as exercise, yoga, hypnosis, acupuncture will all help.
• Food chemical sensitivity --  A lot of patients suspect that some foods in their diet cause or aggravate their psoriasis. Some patients have successfully cleared or diminished their psoriasis by altering some component of their diet. The essential message is to avoid following excessively restrictive diets that can make you malnurished. If you suspect that a food is aggravating your psoriasis, go off it for two weeks. At the end of the two weeks you must reintroduce the food to see if it aggravates the psoriasis. Only test one food at any one time. If you continue to suspect a food or group of foods, consider seeking the advise of an allergist or food allergy unit.
• Sun exposure  -- Sun exposure produces anti-inflammatory effects on the skin. It also causes peeling of the skin. The combined effects of peeling and anti-inflammation can be very beneficial to the psoriatic skin, however, there are limits to this type of treatment because it increases the risk of skin cancer. There is very little doubt that psoriasis tends to worsen during winter and that a mid-winter holiday in the sun can be very helpful. 
• Cortisone Creams -- There are many cortisone containing creams available. Some of the weaker creams are available over the counter, at the local chemist, whilst the stronger creams are only available with a doctor's prescription. All cortisone creams have anti-inflammatory effects. Patients need to try a number of creams to determine which is most suitable for their psoriasis condition. Cortisone creams should ideally only be used for periods of time not exceeding one week. After one week of cortisone treatment, the cream should be stopped for one week to allow the skin to recover.  
• Oral cortisone -- Cortisone tablets are used very rarely for psoriasis. Only when there has been an extensive exacerbation of the condition which can not be controlled with other therapies.
• Tar based preparations -- These come in the forms of creams, lotions and shampoos. They are very soothing to the skin, however, they are associated with a tar odour which is unattractive to many patients. Some of the newer tar based preparations have a reduced odour. These products remain a very valid therapeutic alternative when the patient wants to take a break from other therapies. 
• Peeling creams  --  Include Urea and Salycilic acid based creams. These creams cause peeling of the skin and can be very useful in reducing scaling of psoriatic skin. They can be used in conjunction with other creams such as tar creams or cortisone creams to enhance their effect.
• Dithranol -- Has  been available for a long time. When applied to psoriatic skin, it reduces the rapid cell turnover and decreases the thickness of psoriatic plaques. The side effects of dithranol treatment are a burning feeling experienced by some and staining of the skin. Using dithranol can be a messy business. Precautions need to be taken to avoid staining of clothes and bedding. A short-contact-time regime has improved the situation. Instead of leaving the dithranol on all night, a higher concentration dithranol cream is left in contact with the skin for only 30 minutes and washed off before retiring. Dithranol remains a valid treatment for psoriasis.
• Daivonex   --  Is a Vitamin D based cream that has similar effects on psoriatic skin as dithranol without the staining of the skin. Its limitation is that it can only be used in limited areas of skin.
• PUVA -- This is an acronym which stands for P soralens U ltra V iolet A . This is a treatment available through most major public hospitals. Patients are placed in sun-tanning booths and are administered Ultra Violet A light which is the component of sun light responsible for tanning. Patients are given Psoralen capsules to enhance the effect of UVA on their skin. For greater convenience, a lot of patients attend tanning parlours.
• Drugs -- There is a whole range of drugs available for the treatment of psoriasis. A detailed discussion of these drugs is beyond the scope of this discussion. Drugs are only used when the psoriasis can not be controlled by other means or when it is associated with debilitating arthritis.
• Lasers   --  Because of their anti-inflammatory effects on the skin and their ability to stimulate a healing reaction, lasers are increasingly being used in the treatment of psoriasis. Many research articles have reported beneficial effects on psoriasis. Lasers have the potential of helping patients to achieve freedom from psoriasis for periods of time extending up to six months. The advantages of lasers are the ease of administration and the lack of side effects. The disadvantages are the cost and the fact that only small areas can be treated in any treatment session.

What do I do next?
Make an appointment for review of your psoriasis.