Tips for Caring for Psoriasis Patients

August 29 2022

General Psoriasis Symptoms

There are several different types of psoriasis, however, there are some common signs and symptoms. These include:

• A patchy rash, ranging from spots of dandruff-like scaling to major eruptions over much of the body
• Rashes that vary in color, from purple to brown to red
• Small scaling spots (common in children)
• Dry, cracked skin that may bleed
• Itching, burning, or soreness
• Cyclic rashes that flare, then subside

Types of Psoriasis

• Plaque Psoriasis: the most common type which causes dry, itchy raised skin patches covered with scales which often appear on the elbows, knees, lower back, and scalp.
• Nail Psoriasis: affects finger and toenails, causing pitting, abnormal nail growth and discoloration; nails might loosen and separate from the nail bed or cause the nail to crumble.
• Guttate Psoriasis: primarily affects young adults and children and is triggered by bacterial infections such as strep throat; marked by small, drop-shaped scaling spots on the trunk, arms, or legs.
• Inverse Psoriasis: mainly affects skin folds of the groin, buttocks, and breasts, causing smooth patches of inflamed skin that worsen with friction and sweating.
• Pustular Psoriasis: a rare type that causes clearly defined pus-filled blisters.
• Erythrodermic Psoriasis: the least common type which can cover the entire body with a peeling rash that can burn or itch intensely; can be both acute or chronic.

Psoriasis Symptom Triggers

Isolating triggers can help a patient minimize or prepare for a flare in symptoms. Here are common triggers:

• Infections (e.g. strep or skin infections)
• Weather, especially cold and dry conditions
• Injury to the skin, such as a cut, scrape, bug bite, or severe burn
• Smoking and exposure to secondhand smoke
• Heavy alcohol consumption
• Particular medications, including lithium, high blood pressure drugs, and antimalarial drugs
• Rapid withdrawal of oral injected corticosteroids

Psoriasis Complications

Having psoriasis can put you at greater risk for developing other conditions. Medical staff should pay close attention to any changes in health of psoriasis patients to make sure they stay ahead of the curve on any new diagnoses. Some of the conditions psoriasis patients can be at greater risk for developing include: obesity, type 2 diabetes, eye conditions, cardiovascular disease, high blood pressure, mental health conditions, as well as other autoimmune disorders and psoriatic arthritis.

Treatment for Psoriasis

The aim of psoriasis treatments is to stop skin cells from growing too quickly and to remove scales. Options include creams and ointments, light therapy (phototherapy), and oral or injected medications. The type of treatment prescribed depends on how severe the psoriasis is and how responsive it has been to previous treatment and self-care measures.

Patients should work closely with their health care provider to choose the right treatment approach for their individual case. Medication should be taken as prescribed. If it is a maintenance medication, the patient should be encouraged to continue to take the medication as prescribed, even if they are feeling better.

Some alternative therapies or products may be used in addition to medical treatments. It is important that the patient and medical team work together to see if any of these treatments are right. Some options include fish oil supplements or other vitamins, aloe extract cream, acupuncture, herbal products applied to the skin, or a special diet.

Lifestyle and Home Treatments

Helping psoriasis patients live a more comfortable life takes daily self-care. Patients should take a daily bath or shower. Lukewarm water and mild soaps that have added oils or fats can help as well as gentle scrubbing. Epsom salts or oatmeal in a bath can also help.

Patients should apply moisturizer daily. After a bath or shower, pat skin dry and apply the preferred product while skin is still moist. If the patient lives in a dry climate, they should use a humidifier to add moisture to the air.

During flares, patients should cover affected areas overnight. An ointment-based moisturizer should be applied to affected skin and then wrapped with plastic wrap. In the morning, remove the plastic wrap and wash away scales.

Sunlight can sometimes be used to treat the skin. If prescribed, help the patient expose their skin to short periods of controlled sunlight. Log the time spent in the sun and protect any skin that isn’t affected by psoriasis with clothing, a hat, or sunscreen of at least 30 SPF.

Encourage the patient to avoid scratching. If needed, an anti-itch cream or ointment can be used. For scalp psoriasis, a medicated shampoo should be used. Nails should be kept trimmed to avoid hurting the skin if scratching does occur and soft fabrics should be worn that won’t contribute to itchiness.

Skin being too hot can affect how the skin feels. Patients should wear light clothing if outside on hot days. Keep the skin cool by using air conditioning if possible. Cold packs can be kept in the freezer to apply to itchy spots for a few minutes of relief. Also try storing your moisturizer and lotion in the fridge for a cooling effect when applied.

Other healthy lifestyle habits, such as eating well, exercising, and reducing stress, should be followed and known triggers should be avoided.