WHAT IS PSORIASIS?

 

Psoriasis is a common, chronic skin condition characterised by the rapid build-up of skin cells that form dry, thick patches that can feel itchy and sometimes sore. It affects about 1 in 50 people of all skin types and can start at any age, although often after puberty. Its appearance and treatment can vary, especially for individuals with skin of colour. While it is a lifelong condition, there are effective treatments to help manage it.
Sometimes, psoriasis can affect the nails or the joints, causing psoriatic arthritis, which leads to joint pain, stiffness, or swelling. If you experience these symptoms, it’s important to seek help early to avoid long-term joint damage. Psoriasis is also linked to other health issues, such as heart disease, diabetes, and anxiety. Regular health check-ups and a healthy lifestyle can help you stay well overall.

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UNIQUE CONSIDERATIONS FOR SKIN OF COLOUR

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• In individuals with skin of colour, psoriasis can present differently compared to lighter skin tones. Although similar areas of the body are affected, psoriasis may appear as darker brown, purple, or ashen-grey patches, with grey scale.

• Individuals with skin of colour are more prone to postinflammatory hyperpigmentation and

• hypopigmentation, where affected areas darken or lighten, respectively, after the inflammation has subsided and this can take a long time to resolve.

• Scalp psoriasis is more common in people with skin of colour and can lead to hair thinning or breakage if untreated.

• Individuals with skin of colour are more likely to explore alternative treatments such as traditional Chinese medicine, Ayurveda and Acupuncture.

• Phototherapy may not be popular due to cultural aversion to tanning.

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CAUSES AND TRIGGERS

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The exact cause of psoriasis is not fully understood, but it is believed to be related to an overactive immune system that speeds up the skin cell growth cycle. Several factors can
trigger or worsen psoriasis, including:

• Genetic Factors: Psoriasis tends to run in families. If you have a family history of psoriasis or other autoimmune diseases, you may be at a higher risk.

• Environmental Triggers: Stress, cold weather, and infections can trigger flare-ups.

• Lifestyle Factors: Smoking and excessive alcohol consumption can worsen symptoms.

• Skin Injuries: Cuts, scrapes, or sunburns can trigger psoriasis patches.

• Medications: Certain medications can exacerbate psoriasis or trigger flare-ups.

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WHAT DOES IT LOOK LIKE?

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Psoriasis symptoms can vary, but commonly include:

• Red, Scaly Patches: These patches can appear on the scalp, elbows, knees, lower back, umbilicus and skin folds. They may be dark brown, purple (see Image 2), or ashen-grey in skin of colour.

• Itching and Discomfort: The patches can be itchy, dry, and sometimes painful.

• Nail Changes: Psoriasis can affect the nails, causing pitting, ridges, or discolouration.

• Thickened Skin: The affected areas may feel thicker or have a rough texture.

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DIAGNOSIS AND TREATMENT

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A healthcare provider can diagnose psoriasis through a physical examination and, if necessary, a skin biopsy. Treatment aims to manage symptoms and reduce flare-ups. 

Common treatment options include:

Topical Treatments:

• Corticosteroids: These reduce inflammation and itching. They are often prescribed in various strengths depending on the severity of the condition.

• Vitamin D Analogues: Such as calcipotriol, help slow down skin cell production.

• Tar Preparations: Help reduce scaling and inflammation.

Phototherapy:

• UVB Light Therapy: Involves exposing the skin to controlled amounts of ultraviolet light to slow downskin cell growth.

Systemic Treatments:

• Oral Medications: Such as methotrexate, ciclosporin, or acitretin, may be used for more severe cases.

• Biologics: Injectable medications that target specific parts of the immune system involved in psoriasis.

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SELF-CARE TIPS

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To manage psoriasis effectively:

• Moisturise regularly: Use thick moisturisers to keep the skin hydrated and reduce scaling. Look for products that are free from fragrances and harsh chemicals.

• Practice gentle skin care: Use mild, fragrance-free soaps and shampoos. Avoid hot showers or baths, and pat your skin dry rather than rubbing.

• For scalp psoriasis, use medicated shampoos containing coal tar or salicylic acid. Be gentle when brushing or combing to prevent damage.

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CONCLUSION

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Psoriasis is a chronic condition that requires ongoing management, especially for individuals with skin of colour. Understanding the unique aspects of how psoriasis can present and affect your skin is crucial for effective treatment and improving quality of life.​​​​​​