As a child, Alisha B. had a few patches of what looked like a rash on her knees and elbows. She and her parents didn't think anything of it. Then things changed, and her skin has ever been the same since.
After she had the chicken pox at age 7, most of her body was covered with red splotches. She was diagnosed with psoriasis.
That was 18 years ago, and Alisha tells dailyRx, "Psoriasis has made its dirty little way into all my decisions, from simple things such as shopping to the major life events like finding a mate. The physical anguish this disease has caused for me is nothing like the mental hurt and pain I've felt," Alisha said.
What is psoriasis?
People who have psoriasis have confused immune systems that send out wrong signals. The result of this autoimmune disease is accelerated skin cell growth cycles that cause different types of red lesions. Not very pretty.
- Psoriasis is not contagious.
- It can show up on any part of the body.
- Psoriasis is linked to other serious health issues such as diabetes, heart disease and depression.
- There are five types of psoriasis, and the most common is plaque psoriasis, which is what Alisha has.
- Lesions can vary from small red dots to large areas of inflamed skin accompanied by blisters, scaling and/or peeling
- Patches can be itchy or painful.
- It's estimated that some 7.5 million Americans have psoriasis
- Psoriasis is the most common autoimmune disease in the U.S.
What causes psoriasis?
It's believed that a person inherits genes from one or both parents that predispose them to this skin condition. Alisha thinks hers came from her father's side of the family.
So genes and certain "triggers" make the disease raise its ugly head. Common triggers for psoriasis include everything from stress and some sort of injury to the skin to various types of medications. People living with the disease also believe that diet, weather and allergies can cause flare-ups.
How is psoriasis classified?
Treating this disease depends on how severe the psoriasis is, and this is determined by how much of your body is affected:
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Mild psoriasis involves about three percent of the body, for example just the knees.
- Most people have mild cases of psoriasis.
- Moderate psoriasis affects 3-10 percent of the body
- Severe psoriasis touches more than 10 percent of the body.
The severity of the condition usually serves as a guidepost for treating it.
Alisha has severe psoriasis. "My legs have never cleared up, and my upper body only has its moments of clarity," she says.
How is psoriasis treated?
Mild cases of psoriasis are usually treated with over-the-counter or prescription strength moisturizers, creams, ointments and shampoos that are applied to the skin. This so-called topical treatment works by slow the production of skin cells.
There are various forms of topical treatments for psoriasis:
Other the counter topicals
The U.S. Food & Drug Administration has approved two ingredients for non-prescription psoriasis treatment - salicylic acid and tar.
- Salicylic acid actually peels away the scales and softens the skin.
- Tar, which comes from coal or wood, helps slow down the growth of skin cells and restore normal appearance; it also sooths itching, inflammation and scaling.
- Other treatments available without a prescription include aloe vera, jojoba, zinc pyrithione, capsaicin.
- Occlusion involves covering the medicine or moisturizer to make it more effective when covered.
Non-steroidal topicals
These creams and ointments require a prescription and include various medicines that slow cell growth and calm the affected skin. Your dermatologist will work with you to find the medication that works best for you. Non-steroidal topicals include:
- Dovonex (calcipotriene)
- Taclonex (calcipotriene and betamethasone dipropionate)
- Tazorec (tazarotene)
- Vectical (calcitriol)
- Zithranol-RR (anthralin)
Topical steroids
The most common type of creams used for treating mild to moderate psoriasis is topical steroids that reduce swelling and redness. are used as anti-inflammatory agents to reduce the swelling and redness of lesions.
These medicines, which are sold under dozens of brand names, contain natural corticosteroid hormones produced by the adrenal gland. Steroid topicals come in a full range of potencies
Alisha says she can clear up her upper body with topical steroids, "which I only use when a special occasion comes up and I need to wear a sleeveless dress, like on my wedding day. The topical usually clears my skin up within two weeks, but if I stop using it, I start to break out in matter of three days," the young woman from Alabama explains.
She adds, "Topical steroids work for me, but you can only use them over a period of time, and I have to use the strongest steroid creams on the market for my skin to clear."
Phototherapy
Light therapy is also useful for treating psoriasis. Phototherapy uses various methods to expose the skin to ultraviolet light on a regular basis. This therapy is given only under medical supervision.
Systemics
For moderate to severe psoriasis, you may be prescribed a systemic medication that works throughout the body. These drugs are sometimes used with people who don't respond to or can't take topicals or light therapy.
These medications are taken by mouth or given with an injection. There are two categories of systemic psoriasis medications - "traditional systemics" which have been used for more than a decade and "biologics" which are a fairly new class of drugs that treat psoriasis.
Biologics
Whereas traditional systemics work on the entire immune system, biologics are targeted therapies that block the action of certain cells and proteins involved in psoriasis. There are several types of biologics, and you'll work with your doctor to find the best remedy for you. Biologics include:
- Amevive (alefacept)
- Enbrel (etanercept)
- Humira (adalimumab)
- Raptiva (efalizumab)
- Remicade (infliximab)
- Simponi (golimumab)
- Stelara (ustekinumab)
Alisha says, "I'm on Enbrel now; it's been six months and my back is clear, but the rest of my body is not responding. I have also seen new spots in the last month."
Psoriasis no longer defines her life.
Living with psoriasis hasn't been easy for Alisha, who says that people can be very cruel. "It hurts when people stare, whisper, or point when they see a person with psoriasis."
This reaction caused Alisha to try and hide. "I hid because society says that you are supposed to have flawless skin, which in my case I can't live up to. I missed out on a lot in my life because of this disease, some things that I regret dearly, " Alisha recalls.
"I used to believe that I was less than and not good enough because of this disease. I thought I could never be considered pretty, or find a husband. The list goes on...
"But now I realize psoriasis does not have power over me, I have power over it! I've taken my struggles with psoriasis by the horns, and I'm defeating it!
"Now, with all of that being said, I still have my moments... But instead of asking 'why me?' I say 'psoriasis you picked the right person, because you will not win!'" declares the 25-year-old woman.
Today, Alisha B. writes a blog that she hopes will help others living with psoriasis to deal with a disease that's not pretty, but no longer overpowering for her.
