Psoriasis: causes and treatment

Psoriasis is a chronic inflammatory skin disease that manifests itself in scaly patches of skin, redness and itching. Here you can find out about the causes and symptoms of psoriasis and what treatment options there are for psoriasis.

What is psoriasis?

Psoriasis, also known as psoriasis, is a chronic inflammatory skin disease. While normal skin regenerates about every 28 days, the skin cells of people with psoriasis move to the surface of the skin about seven times as fast, where they form itchy scales and reddish inflamed skin areas.

In Germany, about two to three percent of the population suffer from psoriasis. The disease usually makes itself felt for the first time during puberty, presumably triggered by changes in the hormonal balance. Psoriasis is much less common in small children and infants, but it can also be treated here with carefully coordinated therapies.

Psoriasis is not contagious and in most cases there are no health risks. Unfortunately, only the symptoms can be treated, not the causes of the disease. This means that psoriasis patients experience constant ups and downs, are often free of symptoms for a long time, but also have to reckon with new flare-ups. The good news: psoriasis is usually triggered by certain external factors. Anyone who knows their personal “triggers” knows how to prevent and contain a new flare-up.

Causes of Psoriasis

The causes of psoriasis are not yet fully understood. What is certain, however, is that the genetic predisposition to psoriasis is passed on from parents to their children. The risk of developing psoriasis is therefore higher for children of psoriasis patients. However, it does not mean that you will inevitably get psoriasis or to the same extent. Only external factors can lead to an outbreak of psoriasis and are usually also responsible for later flare-ups – so it is all the more important that the personal “triggers” are recognized as early as possible. Examples of possible triggers are:

  • Infections and diseases – for example infections of the respiratory tract, tonsillitis or middle ear infections , which often trigger a flare-up in children with psoriasis.
  • Skin injuries and abrasions – for example sunburn or skin irritation caused by tight clothing.
  • Psychological influences – relapses are often triggered by stress, fears or other mental stress.
  • Hormonal fluctuations and metabolic disorders – for example during puberty or during pregnancy.
  • Certain drugs and active ingredients – including, for example, beta blockers and chloroquine, but also various additives that get into the skin through creams or detergents.
  • Smoking, alcohol consumption, obesity – an unhealthy lifestyle can also promote the onset of psoriasis or worsen symptoms of the disease.

Symptoms of psoriasis

Most sufferers have a form of psoriasis called psoriasis vulgaris. Classic symptoms are:

  • inflamed, reddened areas of skin
  • silvery or white skin scales
  • severe itching

Psoriasis typically appears on parts of the body such as shins, elbows and the scalp because there are hardly any sebaceous glands there and these parts of the body dry out particularly quickly. Psoriasis manifests itself on toenails and fingernails as small “dents” and yellow or brownish spots on the nail surface. In children, the face, palms and bottom are also often affected. Psoriasis can be difficult to diagnose because it has similar characteristics to eczema or a fungal infection . Psoriasis is suspected above all when the inflamed areas are separated from the healthy skin by clear edges and the scales can be easily detached with a fingernail.

Special forms of psoriasis

In about 20 percent of psoriasis patients, psoriasis does not appear or only occurs on the surface of the skin, but also leads to painful and swollen joints. While classic psoriasis is uncomfortable but harmless, so-called psoriatic arthritis must be treated early, otherwise the joints can be permanently damaged. Pustular psoriasis develops even more rarely – in less than five percent of all psoriasis patients. Parts of the skin are covered with small, purulent scales that can both itch and hurt. Here, too, a therapy developed individually with the dermatologist is the be-all and end-all, because pustular psoriasis often requires even more attention than “ordinary” psoriasis.

treat psoriasis

There are different treatment approaches for psoriasis. However, not all of them are readily suitable for the treatment of children. Nevertheless, in the case of stubborn psoriasis, there is often no other way than to use preparations that are actually intended for adults. Let the dermatologist explain to you carefully about the active ingredient, dosage and application period and do not be afraid to ask questions if a treatment seems doubtful to you.

  • Mild creams and ointments: scaly, dry skin areas can be treated very well with moist compresses, ointments and creams, even in children. In order for active ingredients to be able to penetrate the skin, the scales must first be gently removed. Products with five percent lactic acid or ten percent urea (urea) are suitable for this. Over-the-counter mahonia creams can also help. They are rather mild due to herbal active ingredients and can be used from the first year of life.
  • Baths : Baths with tannic acid or baker’s yeast (bicarbonate) help to exfoliate the skin and relieve itching. Afterwards, the skin needs sufficient moisturizing care.
  • Cortisone preparations: Cortisone treatment is difficult to avoid in severe psoriasis. Cortisone is generally only prescribed for children as an external application, i.e. in the form of creams or ointments, and in low doses (agent class I or II). The period of treatment is usually limited to about two to three weeks. Important: Even if the skin areas heal quickly, cortisone should not be discontinued overnight. Because then there is a risk that the psoriasis will break out again and even stronger. Instead, it is advisable to switch to a lower-dose preparation and then follow up with products that contain urea.
  • Dithranol: A low dosage (between 0.05 and 0.1 percent) and short contact therapy (a few minutes) is also recommended for children with Dithranol. Dithranol discolours skin, clothing and objects that come into contact with the active substance, so it makes sense to have the treatment carried out directly by a doctor.
  • Retinoids and vitamin D3: Certain relatives of vitamin A (retinoids) must not be used in children, adolescents and pregnant women. Vitamin D3 is not an option for extensive psoriasis (more than 30 percent) and at the earliest from the age of six.

The medications and radiation therapies with UV light commonly used by adults are only an option for children when all other options have been exhausted. All psoriasis is not created equal and parents and child often have to try different therapies before they find something that really works. It is important that psoriasis becomes a part of your life without constantly being the center of attention.

Tips for at home

  • Daily skin care as a ritual: Daily skin care is an important preventive measure for psoriasis patients. Get your child used to taking care of their skin as early as possible. Combine bathing and creaming with caresses or a game, so that skin care is not a burden but a beautiful ritual in your everyday life.
  • Boost Immune System: A strong immune system protects against new outbreaks. Make sure your family has a balanced diet and plenty of exercise to keep your little ones fit. In addition, action and fun distract from the annoying itch.
  • Talk to other psoriasis families: Learning to live with psoriasis isn’t always easy, but talking to other sufferers can help you and your family. Other psoriasis families understand what you are going through and may have some helpful advice.

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