Skin care is a common routine for many people. Using creams, avoiding exposure to the sun and regulating food is part of the life of those who want beautiful and healthy skin.
But sometimes, conditions or changes in the body can affect the tissue, causing discomfort, for example, psoriasis, a chronic disease that can be quite uncomfortable.
Psoriasis is a chronic, non-contagious skin disease whose causes are still unknown. Acne is characterized by redness that forms plaques on the skin and peeling.
It is a disease that lasts a lifetime, but that can manifest itself intermittently, that is, it can pass several years between episodes. It is more common to appear before the age of 30 or after the age of 50.
According to data from the entity Psoriasis Brazil, currently, approximately 1.3% of Brazilians are affected by the disease. This represents an approximate number of 2.5 million people with acne.
As there are numerous types of skin diseases with similar symptoms, it is very important to get informed and know each one of them so that you are more likely to arrive at the correct diagnosis.
This importance is emphasized even more if we consider that the symptoms can worsen especially in cases of infection, such as colds or pharyngitis . It is also very common for symptoms to appear during the winter, after drinking alcohol or stressful situations.
However, even though it is a very uncomfortable disease, with proper treatment, patients have a good prognosis. According to a survey conducted by Lilly in 2018, approximately 64% of psoriasis patients say they are satisfied with the results of the treatment.
The disease can be found in the International Classification of Diseases through the following codes:
- ICD 10 – L40 – Psoriasis;
- ICD 10 – L40.0 – Psoriasis Vulgaris;
- CID 10 – L40.1 – Generalized Pustular Psoriasis;
- ICD 10 – L40.2 – Acrodermatitis Continua;
- CID 10 – L40.3 – Pustulose Palmar e Plantar;
- CID 10 – L40.4 – Gout Psoriasis;
- ICD 10 – L40.5 – Psoriasis Arthropathy;
- ICD 10 – L40.8 – Other forms of Psoriasis;
- ICD 10 – L40.9 – Psoriasis, unspecified.
Most people imagine that psoriasis exists only in one way, but that is not true. The disease presents itself in different varieties. Understand:
Plaque (or common) psoriasis
Plaque psoriasis, or vulgaris, is the most common form of the disease. It affects approximately 80% of people who have this dermatosis and manifests itself mainly on the elbows, knees, back and scalp.
It is characterized by delimited lesions and of varying sizes, usually having a reddish color, with dry, whitish or silvery scales.
Often, it can happen that these wounds start to itch, cause pain or even reach all parts of the body, including the genitals and the inner part of the mouth.
When the disease is severe, especially the skin around the joints suffers and may crack and bleed.
Guttate psoriasis is characterized by small sores or red spots on the skin in the form of a drop , which are covered by a fine whitish scale. Typically, these wounds appear on the torso, legs, arms and scalp.
According to data from the Brazilian Society of Dermatology (SBD), guttate psoriasis is more common in children and young people under the age of 30 and is usually triggered by bacterial infections.
Pustular psoriasis is characterized by the appearance of concentrated spots in some region, such as the feet and hands, or in all parts of the body. Its development is fast and comes with pus-filled blisters that appear a few hours after the skin turns red.
The pustular type can occur for two reasons: complication of plaque psoriasis or result of interruption of corticosteroid treatment of this disease. It is a relatively rare form of the disease and appears in less than 5% of people who have it.
Reverse or inverted psoriasis
Reverse psoriasis is the least common variation of the disease. It manifests itself through red, shiny and smooth spots around the folds of the skin, usually in the armpits, groin, under the breast or around the genitals.
People with obesity can have an aggravated condition, as well as when there is excessive sweating or a lot of friction in the region of the wounds.
Erythrodermic psoriasis is one of the rarest variations, however, of the most serious. It is characterized by generalized injuries. Most of the time, it affects up to 75% of the body with red spots that can itch or burn intensely. In more severe cases, the extent of the spots may be even greater than ¾ of the body.
The triggering factors for this variation of dermatosis are numerous, and among them, we can highlight the treatment with abrupt use or withdrawal of corticosteroids, infections, severe burns or poor control of previous psoriasis.
This type of psoriasis especially affects the fingers and nails of the hands and feet. When present, it causes the nails to grow abnormally, to thicken, to scale, to lose their color, giving rise to depressions or yellowish spots. In more severe cases, the nail may become detached or crumble.
Palmoplantar psoriasis is characterized by the appearance of lesions on the palms and on the soles of the feet.
The condition of scalp psoriasis represents between 50% and 80% of cases. The disease ranges from mild to very severe and its symptoms include red spots on the skin and itching.
It is very important to note that there is a difference between scalp psoriasis and dandruff.
Both are very common conditions and show similar symptoms, but dandruff happens due to excess oil on the scalp, while psoriasis is related to issues of the immune system.
If you are unsure whether it is dandruff or psoriasis, there is no need to see a doctor. He is the professional who will know how to analyze the case, arrive at the diagnosis and provide the appropriate treatment to treat your problem, whether it be dandruff or psoriasis.
Mild psoriasis can be alleviated and controlled with simple measures, which must be adopted on a daily basis.
Maintaining good skin hydration, with products indicated by the dermatologist, and exposing the skin to the sun – at appropriate times and for a long time – is essential. In general, this is enough for the red plaques to be gradually reduced and disappear.
Bathing care is also important, even in mild cases of psoriasis. It is worth remembering that very hot, long baths or with the use of irritating products (such as soaps) can aggravate the condition.
The condition can sometimes be confused with other diseases, such as allergies, especially when it does not manifest intense symptoms. Therefore, light frames may take time to be identified.
In general, the so-called exacerbations of the disease – that is, when the lesions suddenly worsen – are more common in patients already with more severe conditions.
However, those who have a mild case of the disease can also go through crises in which the injury worsens a lot and is difficult to be controlled.
It is not yet known exactly what the cause of psoriasis is, however, it is possible that the genetic factor has a great influence in at least 30% of cases. It is a chronic, autoimmune disease (in which the body attacks itself), non-contagious and possibly recurring.
Everything happens because of T lymphocytes (also called T cells), which are a group of white blood cells (blood cells) responsible for the defense and protection of our organism against unknown agents, such as viruses and bacteria.
Every time a wound appears or when the body has an infection, T lymphocytes play an active role in healing and fighting the problem.
In the case of psoriasis, it is believed to develop when T lymphocytes release inflammatory substances and form blood vessels in the body.
In these cases, immune responses occur, causing dilation of the vessels and accumulating defense cells called neutrophils. These, in turn, cause the cellular production of the skin to increase, resulting in the production of scales, since dead cells cannot be eliminated correctly.
Still, there are other suspicions of what can cause the problem and provide the appearance of wounds. Are they:
- Infections of the throat and skin;
- Skin lesions;
- Climatic variations;
- Excessive consumption of alcoholic beverages;
- Use of medications for the treatment of bipolar disorder, high blood pressure and malaria;
- Biochemical changes.
Although it is not known exactly what causes psoriasis, there are some risk factors already identified by the scientific community that may leave you more or less predisposed to develop or worsen the symptoms of this acne. Are they:
Relationship with a patient who has the disease is probably the biggest risk factor for the development of psoriasis. Studies note that approximately 1 in 3 people with psoriasis have a relative with the disease.
It is believed that up to 10% of the population can inherit 1 or more genes that are related to the development of psoriasis. Despite these numbers, only 2% to 3% of these people end up developing the disease.
People with lighter skin have a higher risk of developing psoriasis, while people with black skin are less likely.
It is known that people who experience constant infections are more likely to be diagnosed with psoriasis. In particular, infections by streptococcus-like bacteria demonstrate a strong link with guttate psoriasis.
People who have the HIV virus and have a compromised immune system are more likely to develop psoriasis.
The increase in stress levels is related to psoriasis, as many patients report the onset or worsening of injuries soon after stressful situations.
On the other hand, psoriasis itself is a major cause of emotional stress, as the patient feels embarrassed in relation to the disease’s own injuries and ends up being stressed because of it.
It is, therefore, a risk factor that can also present itself as a complication.
Obesity can be related to psoriasis insofar as it causes a pro-inflammatory state, that is, it is easier for the disease to manifest itself.
In addition, obesity itself may be a consequence of psoriasis, since metabolic dysregulations caused by the disease occur, as dermatosis promotes a pro-inflammatory state that favors the accumulation of adipose tissue.
Tobacco use, in addition to all the health ailments already known, can help to compromise the immune system, leaving the patient more subject to the development of psoriasis.
Often, the symptoms of psoriasis can only be confused with an allergy , so pay close attention to the signs and, in any case of doubt, see a dermatologist.
The manifestations tend to vary a lot from person to person, however, among them, we can highlight:
- Reddish lesions on the skin covered by a scaly whitish layer;
- Itching and burning;
- Small red spots;
- Dry skin, with easy bleeding;
- Thick and crumbled nails, with changes in the surface;
- Swelling in the joints;
- Rigid and painful joints;
- Plaques and flaking on the scalp, elbows and knees.
The diagnosis of psoriasis is made, primarily, by the dermatologist . In these cases, medical monitoring is of fundamental importance as soon as the first symptoms appear in the patient, as the disease can progress quickly.
During the medical consultation, the dermatologist does a physical exam, analyzing the aspects of the skin, nails and scalp, checking the intensity of the symptoms and the way they appear.
The professional will also survey and consider the patient’s medical history, taking into account issues such as allergies, and family history.
If in doubt, he may request a biopsy of the affected area to confirm the diagnosis.
No. Unfortunately, psoriasis has no cure. However, it has treatment . Through appropriate medical assistance, the patient can treat the disease, preventing its recurrence and alleviating the symptoms.
As much as the disease has no cure and there is also no effective way to prevent it, but there are treatments and ways to control recurrence.
Treatment will depend on the type of psoriasis that attacks the patient, varying between the following objectives:
- Reduce inflammation and plaque formation;
- Regulate and normalize the appearance of the skin.
From this, it is possible to choose, in general, 3 treatment options: topical (creams and ointments), systemic (oral or injectable drugs) or phototherapy . The choice will depend a lot on the type of psoriasis and the patient’s medical history.
In the mildest and most moderate cases, control is done through the use of local medication, skin hydration and exposure to the sun, that is, the use of topical medications and phototherapy preferably based on sunlight.
In the most severe cases, however, the use of oral or injectable medications is essential to improve the symptoms of the disease and decrease recurrence.
Its use should be done until complete (remission) or partial clinical improvement occurs. Thereafter, systemic drugs should be discontinued and topical treatment started again.
Oral or injectable remedies should only be used again if there is a new picture of psoriasis.
People who are unable to expose themselves to the sun every day have the possibility of taking UVA and UVB rays in specialized clinics, under the express medical guidance.
This treatment is called phototherapy . It uses special lamps capable of emitting exactly UVA or UVB rays. Although the technique is not suitable for children, it is often used in newborns to treat conditions such as hyperbilirubinemia (a condition that causes yellowing of the skin).
This treatment has also been widely used for aesthetic purposes, seeking to promote rejuvenation and combat small patches of skin that can be cured by the sun.
In addition, phototherapy can be used to treat the following conditions:
- Cutaneous T-cell lymphoma;
- Scleroderma (stiffening of the skin and connective tissues);
- Lichen planus (inflammation of the skin and mucous membranes);
- Chronic eczema;
- Chronic urticaria;
- Purpura (autoimmune disease that causes a decrease in the number of platelets).
As previously mentioned, drug treatment is essentially divided into two types: topical treatment, made with creams and ointments, or systemic treatment, made with oral or injectable drugs.
The remedies are usually indicated to relieve itching and inflammation, but they also help in the healing process of the lesions. Understand the difference:
Topical treatment consists of the use of ointments and moisturizers, in addition to exposure to sunlight. Many of the ointments used contain corticosteroids and other substances, always aiming to decrease the intensity of the symptoms.
The type of ointment or moisturizer will also depend on the location affected by psoriasis. When the disease reaches the scalp, for example, it may be necessary to use other medications. Understand:
Ointments for psoriasis on the body
Ointments for psoriasis on the body are diverse and may or may not have the presence of corticosteroids and other substances that aim to reduce irritation. Always talk to your dermatologist to see which option is right for you.
Check out some brands:
- Psorex Pomada ;
- Psorex Creme;
- Valerato de Betametasona ;
- Esperson .
Ointments for scalp psoriasis
There are specific ointments for the scalp and they should also only be used under medical guidance. Among the main brands are Daivobet and Psorex Capillary Solution .
Prices can vary from R $ 37.00 to R $ 150.00 depending on the presentation of the product and the pharmacy. Therefore, always use a price comparator such as Consulta Remédios when making your purchases!
Systemic treatment, unlike topical, aims to combat what is wrong with the body in general rather than treating the injured area only. Therefore, it is usually done orally or injectable.
The classes of systemic drugs used to treat psoriasis are:
- Immunosuppressants: are remedies that act on the immune system to decrease the body’s attack on itself;
- Biological drugs: genetic engineering produces molecules for the treatment of autoimmune diseases. These drugs are indicated especially in cases of psoriasis and psoriasis arthritis that cannot resort to conventional treatments.
Among the main drugs used in these cases are:
- Isotretinoína ;
- Methotrexate ;
- Cyclosporine .
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
In addition to the medications indicated by the dermatologist, it is also a good idea to invest in homemade treatments to help or optimize the result. Remember that they do not replace the recommendations of your dermatologist and that, before starting any therapy on your own, it is important to consult your doctor.
Check out the main homemade methods to help treat psoriasis:
- Consume blood purifying foods, such as watercress, saffron and coconut water, as they help eliminate toxins;
- Use ointments or creams based on Aloe Vera;
- Use moisturizing wheat germ cream;
- Take an immersion bath with water and sea salt;
- Consume omega-3 and chamomile, due to their anti-inflammatory properties;
- Make mallow compress at the site of the injuries.
If you suspect psoriasis in you or someone you know, see a doctor. Knowledge of treatment options and what to do in the moment of a crisis is very important for the patient and also his family.
Despite being a chronic disease, it is possible to control psoriasis with the proper treatment. It is very important that the patient understands that the disease can disappear for a while and return later, therefore, attention to one’s own health is of utmost importance.
It is also necessary to keep in mind that the factors that lead to the appearance of wounds are the most diverse, from infections to an unexpected drop in immunity, making the symptoms generally quite uncomfortable, affecting even the patient’s self – esteem .
Check out the tips below to try to live better with these problems:
Eat a healthy diet
A healthy and balanced diet makes all the difference for the proper functioning of the body.
Through it, it is possible to prevent overweight and obesity, and contribute to a better functioning of the immune system. As we saw earlier, these are risk factors for worsening symptoms of psoriasis.
It is very important that you avoid the consumption of processed, ultra-processed foods rich in saturated and trans fats, as they favor the production of pro-inflammatory substances in the body, which can aggravate psoriasis.
A tip for maintaining a healthy diet is to monitor and plan your diet. For this, it is possible to make a nutritional diary and better analyze the quality of meals.
At this time, it is important to eat more fruits, vegetables, whole grains, low-fat dairy products, lean meats and fish. In addition, it is essential to reduce the intake of red meat, alcohol, fat and refined sugar.
However, it is worth remembering that, before starting any change in diet, it is very important that you talk to your doctor and consult a nutritionist to make this food adaptation, taking into account your restrictions or possibilities.
As we saw earlier, stress is a factor that can make psoriasis symptoms worse. And the worst thing is that the patient can enter a vicious cycle, since the disease itself can be quite stressful.
Even if it is not always possible to avoid stress, it is quite possible to practice self-knowledge and try to exercise to relax. Thus, you learn to deal better with life’s situations.
Finding some time for yourself or trying to start practicing calming techniques, such as meditation and yoga, are good requests for those who want to reduce the impact of stress.
Talking to family members and close people is also essential. That way you can handle your feelings better instead of just letting them go. In addition to talking openly with these people, it is also possible to turn to professional help, such as a psychologist.
Choose comfortable clothes
Psoriasis causes wounds that can be made worse by contact with clothing. Therefore, it is important to focus on fabrics that do not cause too much friction on the skin, such as cotton, as they will reduce the uncomfortable feeling.
Rougher fabrics, such as wool, or synthetic fabrics, such as nylon, can cause irritation and worsen wounds, as well as not allowing the skin to breathe properly. Therefore, always look for soft and breathable fabrics.
Beware of medications
Various medications and skin products can have a direct impact on psoriasis symptoms. Therefore, try to keep in close contact with your doctor and inform him about the medications and cosmetics you have been using.
Also look for products that suit your situation, as many of them can help treat the problem.
An interesting tip is to use special soaps, especially those with moisturizing properties. So, glycerin, vegetable and baby soaps are good options, because the less aggressive the product, the better.
The ideal is to use the product without rubbing or scratching the skin, rinsing right away. Check out some of the most popular moisturizing soaps:
- Granado Baby Glycerin ;
- Glycerin Granado ;
- Johnson’s Baby;
- Nivea Leite ;
- Dove Deep Nutrition ;
- Palmolive Nutri Milk.
Take care of your mind
It is a fact that stress, depression or any exacerbated emotional tension can trigger or even worsen the symptoms of psoriasis. Therefore, seek emotional balance.
One way to do this is to practice meditation, relaxation, walking, yoga, therapy or anything that gives you pleasure.
If you are not able to relieve stress easily, do not hesitate to seek professional help from a psychologist.
The prognosis for psoriasis is usually good. Although there is no cure, the disease has treatment and, with due medical attention, it is possible for the patient to maintain quality of life.
Even so, many of the patients may feel socially pressured and go through situations in which they are embarrassed. This can have a major impact on mental health , causing them to walk away from friends and family out of shame or fear and resulting in a poor prognosis associated with emotional factors.
The important thing to note is that these situations are, for the most part, circumventable, even if the help of mental health professionals, such as psychologists and psychiatrists, is necessary.
If left untreated, psoriasis can bring several complications to the body.
As Dr. Ricardo Romiti, a dermatologist and coordinator of the Psoriasis, Collagenosis and Trichology Outpatient Department of the Dermatology Department at Hospital das Clínicas da USP, remembers, “severe and generalized forms of the disease can occur” , learn more:
Also called arthropathic psoriasis , it is estimated that 30% of people who have psoriasis also develop psoriatic arthritis. This disease is characterized by pain, stiffness and swelling around the joints.
It is more common that it affects the joints of the toes and hands, the spine and the joints of the hips, causing progressive stiffness and even permanent deformities.
One study showed that 84% of patients suffering from psoriasis arthritis develop skin lesions an average of 12 years before arthritis, so psoriasis can be a sign that arthritis is coming. So don’t forget to have your annual check-up!
Psoriasis is especially worrying when it affects patients who already have a mental disorder. Dr. Romiti explains that it “can have a great impact on the mental state of patients affected with anxiety , depression and even suicidal ideation”.
Because the patient may feel stigmatized because of his condition, and this can make the depression worse. That is why it is so important that awareness campaigns are carried out and that the debate is stimulated.
“They aim to reduce the prejudice that surrounds psoriasis, trying to guide people that it is not a contagious disease and that it does not present a risk of contagion” , emphasizes Romiti.
It has been observed that people with psoriasis, especially those with more severe forms of the disease, are also more likely to develop obesity.
The relationship between obesity and psoriasis is still not completely clear, but this may be related to the fact that patients with psoriasis do not practice physical activities regularly because of the symptoms of the disease.
Another explanation involves a double relationship: people with obesity have the potential for higher inflammatory levels (facilitating the onset of dermatosis) and, also, the events that trigger psoriasis can cause hormonal imbalance, facilitating the accumulation of adipose tissue, that is, fat.
In addition, it is also known that people with obesity are more likely to acquire the most severe forms of psoriasis.
Some researchers have found that patients who have psoriasis are at increased risk for myocardial infarction. In addition, tachycardia and other cardiovascular diseases are more likely to manifest in patients with psoriasis.
It is speculated that this happens because of an excess of inflammation or because of the side effects of some treatments.
It is also possible that this relationship between psoriasis and the increased risk of cardiovascular disease is explained by the increased chances that patients have of developing obesity, one of the main factors for the development of diseases that affect the cardiac and circulatory systems.
Type 2 diabetes
People with psoriasis have a higher risk of developing type 2 diabetes , as dermatosis generates inflammatory processes that can result in hormonal imbalance, causing, among other things, risks to diabetes.
In addition to all these complications, patients with psoriasis can still be affected by:
- Celiac disease (gluten intolerance);
- Parkinson’s disease
- Crohn’s disease (chronic inflammation of the lining of the digestive tract).
As much as there is no effective way to prevent against the disease, it is believed that keeping your skin always clean and hydrated is already a great step for that. In addition, food can be a very important factor for the prevention of psoriasis, as explained by Dr. Ricardo Romiti.
“A healthy diet combined with a good quality of life, avoiding alcohol and smoking , are the best ways to prevent psoriasis.”
Check now the main tips to prevent the appearance of wounds:
For patients with psoriasis, the use of body moisturizers is essential. It is worth remembering that every product must be approved by your dermatologist beforehand, in order to avoid risks.
However, we can say that psoriasis patients benefit most from products that have no perfume or color, as they decrease the chances of allergies.
Definitely, stay away from exfoliation. The procedure can cause the skin to rupture, triggering a new crisis, a phenomenon so well known that it even has a name: Koebner phenomenon .
Beware of epilation
For men it is free to shave with a razor normally, as long as care is taken with traumas that can cause injuries.
One should always opt for methods that are as less traumatic to the skin as possible. If you are allergic to the blade, for example, you should avoid using this product. If you are allergic to wax, try the blade.
There is no right answer. Each patient is unique and the most correct thing is to always talk to the dermatologist.
Fast and cold baths
The baths of the patient with psoriasis must be quick and without loofahs ! The soap used must be neutral, to reduce the risk of irritation and allergy. The towel must be soft and the patient must dry himself without rubbing, always taking extra care with the injured region.
Tattoo and piercing
The psoriasis patient must always be aware of the risks of trauma that a tattoo or piercing can cause, as chronic injuries can occur.
Skin lesions can manifest throughout the body:
Or stay localized:
Does psoriasis itch?
-Yeah . One of the possible symptoms besides the wound is itching, which can even be accompanied by burning and pain sensations.
Is psoriasis contagious?
No . Psoriasis is a disease that affects the immune system in a non-transmissible way, that is, it cannot pass from person to person.
Does SUS have a remedy for psoriasis?
YEAH ! The Unified Health System has been providing psoriasis medications free of charge since 2013. In total, there are eight types of drug that can be used. Check out:
- Salicylic acid : 5% ointment;
- Mineral tar : 1% ointment;
- Clobetasol: creme a 0,05%;
- Clobetasol : 0.05% capillary solution;
- Dexamethasone : 0.1% cream;
- Calcipotriol: pomada a 0,005%;
- Acitretin : 10mg and 25mg capsules;
- Methotrexate : 2.5mg tablets and 50mg / 2mL ampoules;
- Ciclosporin : 10mg, 25mg, 50mg and 100mg capsules and 100mg / mL oral solution 50mL bottle.
To remove the medication, you must receive the diagnosis and prescription of the medication by your doctor. If the indicated drug is part of this list and you want to withdraw it for free from SUS, you must bring:
- Copy of the National Health Card;
- Copy of the Identity Document (RG) and the original;
- Copy of proof of residence;
- Medication request report (LME) completed by your doctor;
- Clarification and Responsibility Term signed and check if there is any other procedure (such as exams) necessary to be carried out according to the particularity of each State.
If in doubt, talk to your doctor for further guidance on how to access the medication.
Is psoriasis more common in men or women?
The incidence of psoriasis is the same in both men and women.
What can activate or worsen the symptoms of psoriasis?
The reasons why psoriasis wounds will vary from person to person and can include stress, skin lesions, use of certain medications, decreased immunity or infections.
What parts of the body are most affected?
Psoriasis can affect any part of the body, but it is more common on the scalp, knees, elbows and torso.
Can psoriasis symptoms get worse in winter?
-Yeah . During the winter, we are left with naturally drier skin. In addition, exposure to sunlight is reduced and low temperatures can favor the appearance of new wounds.
At what age do most people develop psoriasis?
Psoriasis is not old enough to appear, but most people start to show symptoms from the age of 35.
Is psoriasis hereditary?
It is not possible to state that psoriasis is in fact hereditary, however, it is noteworthy that 1 in 3 people with psoriasis report having relatives with the disease.
Psoriasis is a chronic and non-contagious condition. With proper treatment, patients can recover and prevent symptoms from manifesting again.
Find out more about psoriasis and other skin conditions at Minute Healthy!