Man with psoriasis on hands and arms before being treated at Saguaro Dermatology - Phoenix Dermatologist

What is Psoriasis?

Most of us have heard of psoriasis. Not only have we seen television ads for medications to treat this common disease, many of us know someone who has a form of it. And while only 2 to 3 percent of the population globally develops psoriasis, that figure includes 8 million Americans. Still, other than the hallmark scaly red patches on the skin, what do we know about psoriasis?

When you think of psoriasis you probably think of its most common form, plaque psoriasis. In fact, there are five types of this disease. With plaque psoriasis, you see a pattern of raised, red patches or plaques commonly on the knees, elbows, lower back, or scalp. These lesions may be covered with a whitish layer of dead skin cells. They are often itchy, and they can crack and bleed.

Other forms of the disease appear as small red dots dispersed over the chest and abdomen (Guttate); smooth, shiny red patches under the arms, behind the knees, and in other body folds (Inverse); small, white blister-like pustules (Pustular); or severe, widespread, and painful inflammation (Erythrodermic).

If you have any of these symptoms, especially those of plaque psoriasis, you may think you have eczema. It’s not easy to tell the difference between these two skin diseases, but a dermatologist will be able to diagnose your condition correctly.

Psoriasis is an immune-mediated skin disease. “Immune-mediated” means your immune system functions abnormally: Rather than defending your body against infection triggered by germs or antigens, it overreacts or even attacks the cells in your body. This response causes the cells to go into hyperdrive, growing at an accelerated rate. This growth of cells results in the severe and persistent skin rashes and lesions we recognize as psoriasis. 

Genes also play a role in people with psoriasis. While you can’t catch psoriasis, patterns in families have been observed 1. Immediate and second-level relatives of psoriasis patients develop the condition at a higher rate than the general population, and about one third of people with psoriasis have a relative with the disease. In fact, up to ten percent of us probably carry one or more of the genes that predispose people to psoriasis.

However you get psoriasis, what you want to know is how to get rid of it.

When it comes to skin in general, summer beats out winter. That’s because skin likes warmth and humidity, and dislikes cold and dryness. For those with psoriasis, seasonal changes have an even greater impact, with spring and summer often bringing relief from symptoms and winter worsening them. In addition to the warmth summer brings, lighter clothing and exposure to sunshine and fresh air contribute to the improved condition of your skin.

There’s nothing you can do to change the weather where you live, but you can offset some of the negative effects of the cold in three ways: avoid materials like wool that irritate the skin; apply good-quality creams and moisturizers more generously; and invest in a humidifier. Your dermatologist can also help you to determine if your treatment plan needs to be tweaked to accommodate these seasonal changes.

Can Psoriasis Be Cured?

Psoriasis is a “chronic relapsing disease,” which means that it may come and go but it does not go away completely. It may require therapy over a long period of time. However, due to breakthroughs in the understanding of psoriasis over the last 15 years, highly effective therapies are now available.

There is no one “best treatment” for psoriasis.” That is because treatment depends on several factors: the type of psoriasis you have; the severity of the disease; your age; the part of your body affected; whether or not you suffer from other conditions (such as psoriatic arthritis); how you react to treatment; and your access to health care. However, typical treatments include the following:

  • Topical treatments (for mild cases): Moisturizers and over-the-counter and prescription creams and shampoos
  • Phototherapy/Light therapy: Exposure to sources of light, including fluorescent light bulbs, halogen lights, sunlight, and LEDs (light-emitting diodes)
  • Systemic medications: Drugs taken orally or by injection, such as glucocorticoids, vitamin D analogs (synthetic vitamin D), and biologics.

Frequently a combination of therapies is used, which could include topicals, phototherapy, a biologic, and/or an oral treatment. For example, in one review a combination of glucocorticoids, vitamin D analogs, and phototherapy was suggested as treatment for mild to moderate psoriasis 1.

Some systemic drugs used to treat psoriasis have become more familiar: Retinoids, for example, are compounds of natural or synthetic, biologically active molecules that are related to Vitamin A 2. Retinoids are used in cosmetic and dermatological treatments. Another systemic drug is an immunosuppressant called cyclosporin A. As is suggested by the term, an immunosuppressant is a drug that suppresses or reduces the response of your body’s immune system. In addition to treating psoriasis, cyclosporin A  is also used as a treatment for other autoimmune disorders like lupus and rheumatoid arthritis and as a drug to help to make the body less likely to reject a transplanted organ.

Advanced biological drugs (also called biologics) have shown great promise in recent years. Unlike nonbiologic drugs, biologics target specific parts of your immune system responsible for inflammation. Some biologics now being investigated are adalimumab, etanercept, infliximab, secukinumab and ustekinumab. While the safety of these drugs is still being studied, Japanese researchers have determined that with appropriate monitoring, biologics can be used safely 3. Other studies have concluded that not only is secukinumab both safe and effective for patients with moderate to severe psoriasis 4, but that it is also a major advance in the treatment of psoriasis for patients who require systemic therapy. As these drugs become more available, dermatologists will no doubt add them to their arsenal of treatments.

As with any treatment, what may work best for one person is not necessarily best for you. However, some people have found relief in home remedies like salt baths, creams containing aloe vera or Oregon grape, moderate exposure to sunlight, using a humidifier in the home, and increasing their intake of Omega-3 fatty acids such as fish oil supplements. You’ll find other suggestions on various Internet sites, but maintain a healthy skepticism. Remember that psoriasis is not simply a skin condition but also an immune system disorder. Moreover, your psoriasis is unique to your body, so it’s always best to talk with your dermatologist about any home treatment you are considering.

Besides having regular checkups with your dermatologist, two of the most important things you can do are to know your body’s limits and to manage stress. Like other chronic diseases, psoriasis can have a drastic effect on your social and psychological well-being. In fact, given the pain, itching, and bleeding psoriasis causes, researchers have equated the effect of psoriasis on quality of life to that of cancer, heart attack, or depression 1. While it is natural to feel stress about your psoriasis, additional stressors in your life can cause flareups. If you are experiencing heightened anxiety, step back and take stock of what other factors are causing you stress. Commit to regular activities that help you relax, like yoga, meditation, and exercise. Developing good sleep habits will likely help as well. In short, control the things you can control, and let your doctor help you manage the psoriasis.

Our Approach & Expertise

In treating your psoriasis, our board-certified dermatologist will not only consider the severity of the disease but also its effect on your quality of life. With guidance, you will learn how to develop a good skin care routine, recognize the triggers to flare-ups, and, when necessary, modify your lifestyle to prevent the psoriasis from becoming worse. With personalized consultation and regular follow-up, you can gain control over the condition.

As a chronic disease, psoriasis is one you have to live with. This doesn’t mean you have to suffer needlessly. As noted above, researchers are making great strides in new therapies based on a better understanding of the genetic causes of the disease. And your doctor can recommend treatments now that will reduce or even intermittently eliminate your symptoms. There are many things you can do, too, to know what triggers your flareups, to have a plan ready for how you will manage stress, and to take care of your mental and overall health. For more information, our board-certified dermatologist, Dr. Dathan Hamman and the caring staff at Saguaro Dermatology are here to help.

1 Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci 20-19;20(6):1475. doi: 10.3390/ijms20061475
2 Zasada M, Budzisz E. Retinoids: active molecules influencing skin structure formation in cosmetic and dermatological treatments. Postepy Dermatol Alergol 2019;36(4):392-397.  doi: 10.5114/ada.2019.87443
3 Kamata M, Tada Y. Safety of biologics in psoriasis. J of Dermatology 2018;45:279-286.
4 Blauvelt A. Safety of secukinumab in the treatment of psoriasis. Expert Opin Drug Saf 2016;15(10):1413-1420.

Saguaro Dermatology Reviews

Wendy L.

I had an awesome experience with Dr Hamann and staff. I was very comfortable and i was able to have all my questions answered without feeling rushed. The staff was courteous and welcoming.

Itaro Elaisa
Itaro Elaisa

“I totally recommend this place to anyone who’s looking for a dermatologist who’s professional, informative, respectful and very helpful. They are quick to solve your problems and get you home.”
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Kristin U

“Dr Dathan and the team were very helpful, kind and knowledgeable. Plus, there was no wait time so I was able to get back to work faster than expected. I would highly recommend.”

Robert P.

Staff was friendly, & on time. office is super clean!! Doctor was awesome, felt like a family member taking care of me.

Sally Shepstead
Sally S.

“Very friendly and professional. I had a great experience, Dr. Hamann was very good at answering my questions and concerns. I will certainly come back for another visit.”

Amanda C.

Great doctor and friendly, professional staff. The doctor spends time listening and answering questions, something rare to find anymore. The office is beautiful and very clean. I love all the artwork with saguaros.

L

Dr. Hamann is very knowledgeable, nice, and professional. You can tell that he truly cares about his patients by the way he operates. He took the time to listen to all of my concerns then address them with good, well-informed answers.

Kylin Chen
Kylin L.

“The office was recently renovated–it is a beautiful, clean, and calm environment. I would highly recommend this practice for anyone who is looking for a general dermatologist.”
Saguaro Dermatology | Phoenix Dermatology

About Saguaro Dermatology

Our comprehensive dermatology clinic is dedicated to providing you with the highest quality of care, innovative practices, helpful resources and state-of-the-art technology to prevent and treat a multitude of skin disorders. Led by Carsten R. Hamann, MD, PhD, Dathan Hamann, MD, FAAD, Michael McBride, DO, Millard Thaler, MD, Mohs Surgeon and Jenna Wald, MD, Mohs Surgeon, our passionate team looks forward to serving you with respect and compassion.

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