Dockyard | Early diagnosis key to fast recovery

Mala (name changed) was 20 when she first experienced symptoms of psoriasis. She mistook it to be a skin problem and assumed that it would cure in time. She relied on creams and moisturisers to relieve her symptoms. Every second month, she had similar rashes and she continued to resort to self-medication. Eight months later, she was diagnosed with psoriasis. She has, now, been living with this condition for eight years now.

Like Mala, there are a lot of women in India living with psoriasis and hesitant to talk about it. A global survey — Clear About Psoriasis revealed that 66 per cent of people face discrimination and humiliation because of their skin. The disease looms over the everyday lives of about 20 per cent of women, compared to 12 per cent of men. Nearly 60 per cent of women said psoriasis interferes with their quality of life.

The problem

The immune system mistakenly starts attacking healthy skin cells, accelerating the formation of skin cells and causing dead skin cells to rapidly build up on the skin’s surface. This results in raised, scaly, itchy, dry, and red rashes with silvery scales appearing on the skin, commonly occurring on the scalp, elbows, knees, lower back, hands, feet, nails, genitals, and skin folds.

The problem dramatically reduces the quality of life of affected individuals, and takes a mental, emotional, social, and economic toll on them. It is still not known why it happens, but the most common belief is that genetic factors, stress, skin injury and a faulty immune system triggers this condition.

An Indian epidemiological pattern study showed a point prevalence of 8 per cent. This figure might be higher as many patients with milder type of psoriasis may resort to home remedies and alternative therapies.

Types

There are three stages based on the amount of area of the skin damaged. Psoriasis is categorised as mild when plaques cover less than three per cent of the body, and moderate when they cover three per cent to 10 per cent of the body. When the disease affects more than 10 per cent of the body, it’s considered severe.Treatment

The treatment options are customised for each patient. The therapy requires continuous maintenance, lifestyle modifications and monitoring. With medical advancements and accessibility, best of the treatments are available in India. It is advisable for the patients to visit trusted dermatologists for consultation.

Lifestyle modifications

• Control stress and anxiety: Try keeping stress at bay as it might flare-up psoriasis. Breathing exercises, yoga and meditation can home handy to stay calm and collected. Since psoriasis patients are also at the risk of having depression, they need to be extra careful about their mental well-being
• Quit smoking & drinking alcohol: Smoking doubles a person’s risk of getting psoriasis. The risk increases with the number of cigarettes smoked per day and is higher in women than men. Like smoking, drinking alcohol also triggers the immune system. Psoriasis patients are advised to completely stay away from smoking and alcohol.
• Follow bathing and skin care routine: Avoid bathing with very hot water as it might dry the skin and use lukewarm water instead. Be gentle with towel drying and try to pat dry yourself after a shower. Use baby soaps and avoid using a loofah or exfoliate as it might damage the skin tissue. Moisturise after a shower and keep your skin moisturised throughout the day. For scalp psoriasis, use shampoos made with coal tar or salicylic acid.
• Eat healthy and stay active: Stick to a nutritious diet with lots of fresh vegetables and fruits. Avoid eating oily and junk food. Psoriasis patients should also include a regular exercise regimen in their daily routine. Brisk walking, yoga and dancing helps stay active and promotes positive thoughts.

• The writer Dr Shehnaz Arsiwala is Dermatologist at Saifee Hospital, Mumbai