Psoriasis - More Than Skin Deep - Symptoms, Causes, & Systemic Treatments

Psoriasis - More Than Skin Deep - Symptoms, Causes, & Systemic Treatments

Discover the truth about psoriasis. This comprehensive guide covers skin symptoms, diagnosis, root causes, and how it affects your organs. Explore effective chemical and herbal treatments to protect your overall health.

Psoriasis: The Complete Guide to Symptoms, Systemic Causes, and Effective Treatments

Psoriasis is often misunderstood as a simple skin condition. In reality, it is a chronic, systemic immune-mediated disease that causes inflammation throughout the body. While its most visible signs appear on the skin, understanding its full impact including its effects on internal organs is crucial for effective long-term management. This guide provides a comprehensive look at psoriasis symptoms, diagnosis, root causes, and the full spectrum of treatment options, from advanced pharmaceuticals to evidence-supported herbal remedies.

Part 1: Recognising the Visible and Internal Signs

Common Skin and Nail Symptoms

The most recognisable symptoms of psoriasis are those that appear on the skin's surface. These can vary but often include:

• Plaques of Red, Inflamed Skin: The most common sign (plaque psoriasis), these are raised patches covered with silvery-white scales.
• Dry, Cracked Skin that May Bleed: Skin can become so dry and tight that it cracks, which is painful and increases infection risk.
• Itching, Burning, or Soreness: Affected areas can be intensely itchy, leading to a cycle of scratching and further irritation.
• Thickened, Pitted, or Ridged Nails: Fingernails and toenails can develop small pits, discolouration, or may begin to separate from the nail bed.
• Swollen and Stiff Joints: This key symptom, known as psoriatic arthritis, indicates the disease is affecting the joints.

The Systemic Impact: How Psoriasis Affects Your Organs

The same widespread inflammation that causes skin plaques can damage internal organs. This makes psoriasis a whole-body disease.

• The Joints (Psoriatic Arthritis): Up to 30% of people with psoriasis develop PsA, where inflammation attacks joints and connective tissues, causing pain, stiffness, and potential permanent damage.
• The Cardiovascular System: Chronic inflammation damages blood vessels, accelerating atherosclerosis (hardening of the arteries). This significantly increases the risk of heart attack, stroke, and hypertension.
• The Metabolic System: Psoriasis is strongly linked to Metabolic Syndrome, leading to a higher risk of Type 2 Diabetes, obesity, and high cholesterol due to insulin resistance driven by inflammation.
• The Liver and Kidneys: The inflammatory state can contribute to Non-Alcoholic Fatty Liver Disease (NAFLD) and combined with higher rates of diabetes and high blood pressure, increases the risk of Chronic Kidney Disease.
• Mental Health: The visible nature of the disease and the inflammatory chemicals themselves contribute to higher rates of depression, anxiety, and social isolation.

Part 2: Getting a Diagnosis and Understanding the Causes

How is Psoriasis Diagnosed?

A proper diagnosis is essential. A dermatologist will typically:

1. Conduct a Physical Examination of your skin, scalp, and nails.
2. Review Your Medical and Family History, as genetics play a key role.
3. Perform a Skin Biopsy (if needed) to rule out other conditions like eczema.

Unravelling the Root Causes

Psoriasis is driven by a combination of factors:

• Immune System Dysfunction: Overactive T-cells mistakenly attack healthy skin cells, triggering rapid skin cell production. New cells build up on the surface in days instead of weeks, forming plaques.
• Genetics: The disease has a strong hereditary component.
• Common Triggers: A flare-up can be initiated by:

        - Stress

        - Skin injuries (the Koebner phenomenon)

        - Infections (e.g., strep throat)
        - Certain medications
        - Smoking and heavy alcohol consumption

Part 3: The Comprehensive Treatment Arsenal

Managing psoriasis requires a dual approach: treating the visible skin symptoms and managing the internal systemic inflammation to protect overall health.

1. Chemical & Pharmaceutical Treatments

Topical Treatments (First Line):

• Corticosteroids: Reduce inflammation and itching.
• Vitamin D Analogues: Slow skin cell growth and flatten plaques.
• Retinoids: Help normalise skin cell DNA activity.

Systemic Treatments (For Moderate to Severe Cases):

• Traditional Systemics: Methotrexate or Cyclosporine suppress the overactive immune system.
• Biologics: Advanced drugs (e.g., adalimumab, ustekinumab) target specific parts of the immune system (like TNF-alpha or IL-17). These are particularly important as they directly reduce the systemic inflammation that affects organs, lowering cardiovascular risk and halting joint damage.
• Light Therapy (Phototherapy): Controlled UV light exposure can significantly improve skin symptoms.

2. Herbal and Natural Remedies (Complementary Approaches)

Some herbal remedies show promise in managing symptoms but always consult your doctor before use to avoid interactions.

• Aloe Vera: Topical gel may help reduce redness and scaling [1].
• Oregon Grape (Mahonia aquifolium): Creams containing its extract have been effective for mild-to-moderate psoriasis [2].
• Turmeric (Curcumin): Oral supplements have potent anti-inflammatory properties and have shown potential in reducing severity in clinical trials [3].
• Capsaicin: Cream derived from chilli peppers can help block pain and reduce redness [4].

A Special Note on Henna: While sometimes considered, traditional henna poses a high risk of triggering the Koebner phenomenon (new lesions at the site of skin trauma). "Black henna-wich is not natural" often contains a toxic chemical (PPD) that can cause severe reactions. Most dermatologists strongly advise against using black henna for psoriasis.

Conclusion: A Holistic Path to Management

Living well with psoriasis means adopting a holistic strategy. Effective treatment does more than clear the skin it protects your joints, heart, and metabolic health. Combining medical treatments with stress management, a healthy diet, regular exercise, and avoiding triggers is the most powerful way to control the disease and safeguard your long-term well-being.

References

1. Syed, T. A., et al. (1996). Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Tropical Medicine & International Health.

2. Bernstein, S., et al. (2006). Treatment of mild to moderate psoriasis with a proprietary -Mahonia aquifolium- ointment. American Journal of Therapeutics.

3. Antiga, E., et al. (2015). Oral curcumin (Meriva) is effective as an adjuvant treatment and is able to reduce IL-22 serum levels in patients with psoriasis vulgaris. BioMed Research International.

4. Bernstein, J. E., et al. (1986). Effects of topically applied capsaicin on moderate and severe psoriasis vulgaris. Journal of the American Academy of Dermatology.

5. National Psoriasis Foundation: https://www.psoriasis.org/

6. Ogdie, A., et al. (2015). The Risk of Cardiovascular Disease in Individuals with Psoriasis and the Potential Impact of Current Therapies. Journal of the American Academy of Dermatology.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and before starting any new treatment regimen.