American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Scratching the Surface of Psoriasis

Man scratching his headAnyone who has struggled with flaky skin or red patches on their elbows, knees and scalp knows that psoriasis is not just another skin problem, but a chronic condition that can affect your physical and emotional well-being. Psoriasis, a common condition that typically begins between the ages of 15 and 35, is not contagious, but can be uncomfortable, and, at times, embarrassing for those who have been diagnosed. William T. Kirby, DO, a dermatology osteopathic physician from Los Angeles, explains the common symptoms and provides treatment options for managing psoriasis.

What are the common symptoms? 

According to Dr. Kirby, psoriasis is a skin condition that occurs when the immune system mistakenly speeds up the growth cycle of skin cells. This dysfunction causes a buildup of itchy, thick, red skin with flaky, silver-white patches called scales. Other common symptoms of this condition include:

  • Severe dandruff on the scalp

  • Joint pain or aching

  • Nail changes, including thick yellow-brown nails, dents, and nail lifts off from the skin

  • Genital lesions in males

How can I ensure a proper diagnosis?

“If you suspect that you might have this condition, schedule a visit with your dermatologist or rheumatologist,” Dr. Kirby advises. Your doctor will review your medical history and perform a physical examination of your skin, scalp and nails. In rare cases, a diagnosis may require a biopsy.

When you meet with your health care provider, Dr. Kirby recommends having an honest dialogue. “Your physician should understand the impact of psoriasis, not only on your physical health, but your emotional health as well,” he says. “Discuss the frequency of flare-ups or other medical conditions (such as fever or joint pain), disclose all your current medications, and share information about any family members with psoriasis. The only way to receive the proper diagnosis and treatment is to be open with your primary care provider.”

Is the condition controllable?

Psoriasis flare-ups may go away for a long time, but they return sooner or later. Even though psoriasis is a lifelong condition, it can be controlled with treatment. "There are several environmental factors that may trigger an attack of psoriasis or make the condition more difficult to treat,” Dr. Kirby explains. Common triggers include:

  • Bacterial or viral infections, including strep throat and upper respiratory infections

  • Dry air or too much/too little sunlight

  • Injury to the skin, including cuts, burns and insect bites

  • Some medicines, including anti-malaria drugs, beta-blockers and lithium

  • Too much alcohol

“Treatment is planned according to the type and severity of your condition. The goal of treatment is to control your symptoms and prevent infection,” Dr. Kirby adds. Your doctor might prescribe one or a combination of the following treatments:

  • Topical treatments, such as retinoid containing vitamin D or A, skin lotions with salicylic or lactic acid to remove the scaling, ointments that contain coal tar or anthralin, cortisone creams, or dandruff shampoos.

  • Systemic treatments (e.g. pills or injections) that affect the body's immune response.

  • Phototherapy, a treatment in which your skin is carefully exposed to ultraviolet light. You may have heard of this treatment, which is often associated with addressing seasonal affective disorder.

Prescription for managing psoriasis

There is no known way to prevent psoriasis. “Oatmeal baths, keeping the skin clean and moist and avoiding your specific psoriasis triggers, like stress, may help reduce the number of flare-ups,” says Dr. Kirby. “While there may not be a cure for psoriasis, with appropriate treatment, it usually does not affect your general physical health. Work with your doctor to develop a psoriasis treatment plan that’s right for you.” 

Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to understand how lifestyle and environmental factors affect your wellbeing. They listen and partner with you to help you get healthy and stay well. They also encourage your body’s natural tendency toward self-healing.​​​​


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