Hot weather fires up psoriasis
trigger for lots of people, so managing this will help, as will cutting out smoking. It can be difficult to put into practice, but minimising scratching also helps – any trauma to the skin can worsen the condition, leading to new plaques developing. Interestingly, although for many CPP sufferers summer is not a fun time, for some the sunlight can actually improve their skin and the warmer months may be the best time for them.
We don’t fully understand what role, if any, diet has to play in managing psoriasis, but ensuring your diet is healthy, varied, and contains plenty of good fish oils is likely to help. Unless you are certain that specific foods cause a flare-up of your symptoms, I wouldn’t recommend exclusion diets (like gluten or dairy free) for this condition.
Controlling symptoms is usually achieved by using topical treatments, though in more severe cases oral medications may be needed.
The most common treatments include:
Emollients or moisturisers to soften the skin and reduce the thickness of the plaques – there are many different types available on prescription at low cost, so ask your GP if you can trial a few to make sure you get the one that suits you best.
Corticosteroids – creams such as hydrocortisone or locoid can be effective at dampening down small patches of CPP, but can’t be used long-term or for more severe flareups.
Vitamin D creams and ointments – known as calcipotriol or calcitriol, these medications work by slowing down the rate of skin cell division; they can be really effective and are simple to use, but you can’t take more than the recommended amount per week as there is a risk of toxicity.
If these treatments haven’t worked, you can try more oldfashioned ones such as dithranol, coal tar or salicylic acid. They are all available in lotions, creams and other preparations, and although they can be effective for some people, they can be messy to use and often irritate normal patches of skin so should be used with care.
If you have severe CPP that isn’t responding to topical therapy, your GP may consider referring you to a dermatologist for hospitalbased light treatment.
Lastly, if nothing else has worked, a specialist will talk you through more powerful medications such as methotrexate, ciclosporin, or biological ‘‘mab’’ treatments that can be lifechanging for psoriasis sufferers. They all carry risks and sideeffects, but the benefit can we well worth it.
For more information, visit dermnetnz.org.
Dr Cathy Stephenson is a GP and forensic medical examiner.