I’m embarrassed by my skin
QI’ve had psoriasis on my elbows and my legs for years. I feel ungrateful, because I know some people have far worse symptoms than me, but I’m so fed up of messy creams. Are there any alternatives?
APsoriasis affects about one in 50 people in the UK, most often starting from mid-teens to mid-30s. It can start at any age, however – about one in 10 people with psoriasis develops it before they’re 10. Hormones may have an effect; there’s another smaller peak among people in their 50s.
There are several different forms of psoriasis. The most common is ‘plaque’ psoriasis, where you have pink-red rough patches of skin with silvery-white flakes. Common sites of plaques are the back of your elbows, front of knees, scalp and lower back, although they can appear anywhere.
Psoriasis can’t be cured, and the severity of symptoms tends to wax and wane over your life. Treatment can broadly be divided into three categories: creams, light therapy and body-wide treatments (tablets or injections) that dampen down your immune system. This last option is
reserved for severe cases where other treatments haven’t worked, because of possible side-effects.
Creams range from moisturisers and steroid creams to vitamin D based creams and coal-tar based ointments. They’re effective but must be applied regularly and can stain clothes and irritate skin. More cosmetically acceptable ones have been developed in recent years. Enstilar is a new once-daily foam spray version of an effective combination – a steroid with a vitamin D ingredient – that you may find less messy.
Hospital-based courses of light therapy use ultra violet B or a UVA (known as PUVA) light treatment. Both these treatments are reserved for people with extensive psoriasis. However, if you have mild to moderate plaque psoriasis, you can buy a machine called Philips Bluecontrol, which lets you treat plaques with blue light at home. It may be worth a try.
QMy 19-year-old son has started going to the gym and buying protein powder, as he wants to bulk up! Are there any health
AYour son is by no means alone. Protein is made up of amino acids – the building blocks our body uses to make muscle. Protein supplements are marketed for everything from muscle growth to weight loss and anti-ageing.
On the whole I’m not a fan of supplements – too many of my patients see them as a magic bullet, but they’ll only make a difference if you’re exercising regularly, too. What’s more, if you rely on them rather than a balanced diet, you could be missing out on fibre and vital minerals and nutrients.
The recommended daily intake of protein a day is around 55g for men and 45g for women. In fact, most of us eat about 50% more than this. Guidance suggests it’s usually safe to eat up to twice this level. Very high levels of protein can make you prone to kidney stones, and there have been concerns about bone health and cancer risks, although the jury is still out on these.