5 Must-Know Facts About Psoriasis

While we'd like to think psoriasis is all about treating and preventing flare-ups, there’s a lot more to it than that. Psoriasis is a condition that is faced with enormous stigma. What can we do to fight this stigma? We raise awareness and we inform.

Important things to know about psoriasis

One of the major misunderstandings about psoriasis is that the disease is contagious, and can be passed from person to person. This is completely false.

So, what is the reality of psoriasis? What should individuals absolutely know? Let's get beneath the scratchy surface of this chronic condition.

Plaque psoriasis is the most common type

It's important to note that you can have more than one type of psoriasis simultaneously. That said, plaque psoriasis is the most common type of psoriasis, seen in about 80% of people with psoriasis symptoms.

The next most common type is guttate psoriasis, affecting around 18% of people with the disease. Guttate psoriasis tends to be more common among children and younger adults but can continue to affect people throughout their lives.

The other three types of psoriasis are much less common, affecting around 2% or less of people with psoriasis. Pustular psoriasis, a very severe type, is more common among older people than younger people. 

Inverse psoriasis tends to affect the skin folds, while psoriatic erythroderma is a very severe form of the disease that affects more than 90% of the body.

Psoriasis affects more than just the skin.

Psoriasis is an autoimmune disease that causes chronic inflammation and impacts many systems of the body, involves multiple inflammatory pathways, and has an introductory presentation affecting the skin.

With psoriasis, the body's immune system goes haywire, sending out faulty signals that speed up skin growth. These inflammatory processes can also affect the joints, vascular system, and eyes of people with psoriasis.

People with an autoimmune disease can have complex symptoms that complicate both diagnosis and treatment options. Autoimmune disease can also mean people will have periods when symptoms get significantly worse, or flare-ups, and periods of remission, when symptoms significantly lessen or seem to disappear.

While treatment options depend on the disease, for treatment to be successful, it is essential to target the specific inflammatory pathway believed to be most important to the disease symptoms and severity.

Psoriatic disease can lead to long-term health complications

While the primary presentation of psoriasis involves the skin, it impacts systems throughout the body. People with psoriasis have a dysregulated immune system, which leads to chronic inflammation.

Chronic inflammation affecting the skin means that people with psoriasis often experience frequent flare-ups, even when treatment leads to significant clearance of plaques.

Chronic inflammation of psoriasis, in turn, can affect the joints, the heart, and eyes of people with psoriasis.

People with psoriasis are at risk for several other health conditions and may also be more likely to have another autoimmune condition.

In addition to these affected body parts, other symptoms of chronic inflammation in people with psoriasis include fatigue, depression, inflammatory bowel disease, and vascular inflammation.

The treatment journey is complex

Most people with psoriasis will go through cycles of flares and remission with psoriasis. It is unclear how often remissions are triggered and what precisely may cause them in each individual, but it is possible to enjoy a respite from symptoms. 

On the other hand, it is possible to see symptoms spontaneously worsen with no apparent cause. With the arrival of therapeutic biologic agents on the scene, many people with psoriasis and healthcare providers alike are excited about having an improved treatment toolbox.

Even though biologics are potent therapies that offer promise to people with psoriasis, they don't work equally for everyone. Because of this, there has been considerable interest in clarifying the role of combination therapy for people with psoriasis. Combining therapies may be necessary to deal with flares and meet treatment goals.

For example, people who also have psoriasis and psoriatic arthritis or those who are at risk of organ damage due to long-term use of systemic therapies are most likely to be good candidates for combination therapy.

People who have plaque psoriasis that is generally well-controlled but is resistant to treatment in certain areas, like the scalp, might also be candidates for combination therapy.

Stress in the most frequent trigger of psoriasis flare-ups

Living with psoriasis can be very stressful for various reasons, including physical pain and discomfort from various symptoms, constant fatigue, feeling self-conscious about having obvious symptoms, and social isolation.

The unpredictable nature of psoriasis, frequent flare-ups, the time and effort to effectively manage symptoms, and the impact on work and relationships all add to the daily stress.

Researchers also believe that experiencing stress can affect the way a person's immune system functions, thus furthering the chronic inflammation that led to psoriasis symptoms in the first place. This can create a vicious cycle of psoriasis flare-ups leading to endless frustration. 

Managing stress or taking steps to alleviate it can help fight the cycle and leave those with plaque psoriasis feeling a little better, both physically and mentally.