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An estimated 4.5 million American adults (about 2.1 percent of the population) have been diagnosed with psoriasis, a noncontagious skin disease that causes patches of itchy, red, cracking, painful and scaly skin that sometimes bleeds.If both parents have psoriasis, a child has a 30 percent chance of developing it. About 5 to 10 percent of sufferers also develop psoriatic arthritis, a painful inflammatory arthritis that can cause irreversible joint damage while there is no cure.
The severe discomfort and negative body images psoriasis can create can greatly impact a person’s quality of life. For those reasons, psoriasis should be treated aggressively.
“That’s the bad news. The good news is that there are new treatments available that have fewer side effects than traditional approaches and extend the time between flare-ups,” says Joshua Fox, MD, dermatologist and founder of Advanced Dermatology and The Center for Laser and Cosmetic Surgery.
The most recent innovation is a new ointment that is coming on the market in the United States this spring. On January 10, 2006, the FDA approved the new drug application for TaclonexR, a topical ointment that was previously only available outside the U.S. A combination of calcipotriene and betamethasone dipropionate, the ointment contains a fluorinated corticosteroid to treat inflammation and a form of vitamin D to control cell growth. Studies have shown that it significantly improved mild to severe cases of psoriasis. Taclonex is expected to be available in the U.S. by June 2006.
“Up until now, topical steroids and vitamins have been prescribed separately. The use of both treatments in one product will make managing psoriasis much easier,” says Dr. Fox. Another major advance is the use of biologics to destroy psoriasis immunologically. While very expensive they often put extensive psoriasis into temporary remission. Some even help the psoriatic arthritis. These include Amevive and Humira. Use of Narrowband phototherapy (311 nm) and lasers to treat psoriasis have also been meeting with improved results for the appropriate patients.
Other developments in psoriasis care demonstrate the importance of preventative care studies. Namely they confirm that cigarette smoking increases the severity of the skin disease, probably because it suppresses the immune system. “These studies show that quitting or reducing cigarette smoking will significantly improve patients’ ability to manage this disease,” notes Dr. Fox.
In addition to these new treatment options, Dr. Fox recommends that psoriasis sufferers follow the tried- and-true management techniques:
1. Use moisturizing lotions. Dry skin will make psoriasis worse. Use a humidifier. It is critical to keep your skin moist. Dry, cold air can make symptoms worse.
2. Never pick at lesions or scales. Picking can cause more psoriasis or make it worse. Epsom salts, and oatmeal may help reduce itching and remove scales.
3. Bathe carefully with soothing products, such as tar solutions. Avoid excessive bathing or use of washcloths, soaps, cleansers, or scrubs.
4. Be honest with your doctor about all your medications — some can exacerbate psoriasis. If they do, ask about substitutes.
5. Stress or infections can cause flare-ups. Be careful when shaving; avoid insect bites, acupuncture and tattoos.
6. Get limited amounts of sun – 20 minutes a day tops. (Use sunscreen, as sunburn may make psoriasis worse.) Ultraviolet rays in sunlight slow the growth of skin cells and helps psoriasis.
7. Exercise and maintain a healthy weight. Obesity can worsen psoriasis symptoms.
Dr. Fox adds, “Many psoriasis sufferers feel that their disease tends to flare-up when they are under stress, drink alcohol or eat unhealthy. Proved or not, being mindful of these things can’t hurt and can only help.”