Psoriasis: What causes it and how can you treat it to get clean skin?

Understanding the causes of psoriasis and its link to other diseases: Expert explanations by Israeli dermatology specialist, Dr. Alina Luzinski.

  (photo credit: SHUTTERSTOCK)
(photo credit: SHUTTERSTOCK)

Psoriasis, a chronic autoimmune skin disease affecting multiple layers of the skin, can now be effectively treated to achieve clear skin. Dr. Alina Luzinski, a senior physician specializing in dermatology at the Sheba Medical Center Tel Hashomer Dermatology Department, sheds light on the treatment of this condition.

What is psoriasis?

Psoriasis is a chronic inflammatory and non-infectious skin disease characterized by red plaques. The most common areas affected by the disease include the scalp, elbows, and knees, but it can also occur on other parts of the body such as the back and palms. It is a significant and challenging condition for patients.

What causes the disease and how should outbreaks be managed?

Although there is a genetic predisposition to psoriasis, it doesn't necessarily mean it runs in families. Environmental factors play a role in triggering the disease. Treatment for psoriasis can be categorized into three groups: local treatments, skin treatments, and systemic treatments. Local treatment, which includes the use of moisturizers, is highly recommended.

How do you approach the treatment of a new psoriasis patient?

During the initial consultation, we discuss the onset of the disease and identify potential triggers. Known triggers include streptococcal infections, particularly streptococcal throat infections. Stress can also lead to flare-ups, which are not always controllable. It is important to assess the affected areas and determine if other systems, such as the joints, are involved. Treatment is tailored accordingly. I always engage in a conversation with patients to understand their preferences and level of commitment to the treatment. It is a collaborative effort, as success requires cooperation from both parties.

What are the treatment options?

The choice of treatment depends on the severity of the disease. Mild psoriasis without joint involvement can often be managed with ointments. For more extensive and less thickened cases, phototherapy may be considered. In Israel, to qualify for biological treatment, patients must undergo at least one systemic treatment in combination with phototherapy. Biological treatments are long-lasting, and discontinuation is not recommended. These treatments involve subcutaneous injections that can be self-administered at home. Pharmaceutical companies offer support and guidance throughout the process. The injections are generally painless.

Are there any side effects?

Compared to older systemic pills, biological treatments have fewer side effects. Prior to initiating biological treatment, laboratory tests are conducted to ensure patients do not carry any underlying diseases. Some patients may experience a slight increase in upper respiratory tract viral infections, but these are the main concerns.

Credit: IngImage
Credit: IngImage

Can psoriasis contribute to other diseases?

Psoriasis itself is not directly responsible for causing other diseases, but it serves as an indicator of underlying inflammatory conditions throughout the body. When left untreated or uncontrolled, it can lead to significant health consequences. However, studies have shown that psoriasis treatments can reduce the risk of cardiac morbidity among patients. Biological treatments, like any other long-term treatment, require commitment.

What is the emotional toll on patients who neglect their condition?

Living with psoriasis can be extremely challenging, as individuals often face discrimination and social stigma. Some people may even face discrimination in the workplace. This discrimination stems from ignorance, particularly when the disease is not contagious. Thanks to advances in treatment options, we can now achieve up to 90% improvement in skin clarity. Many patients have achieved clear skin through the use of new medications.