What is psoriasis: A Singaporean dermatologist on the causes, triggers, and treatment options of this skin condition
Chances are, you've probably already heard of psoriasis. From Kim K's open letter on her struggles with the condition to celebrated photography initiative, Get Your Skin Out, awareness of and willingness to speak about this autoimmune disease in has increased manyfold. It is a movement we're all for — and one we plan to further by providing you with reliable information on its causes, triggers, and treatments according to a bona fide Singaporean expert on all things skin. If you have psoriasis-related misconceptions, fears, and fallacies, we're here to bust them for real. WebMD? Never heard of her. Here's everything we learnt, below.
What is psoriasis?
"To put it simply, it is a chronic skin disorder affecting 1 to 2% of the population in Singapore," elaborates Dr Hui Min Liew, dermatologist and founder of HM Liew Skin & Laser Clinic. "It occurs when skin experiences a higher cell turnover rate than normal, and is more commonly seen in adults — though symptoms may begin within the first two decades of life."
What are the symptoms of psoriasis?
The main indication of psoriasis are lesions that appear as pink-to-red patches on the skin covered by grey, silvery-white scales. According to Dr Liew, common psoriasis sites include the scalp, hairline, elbows, knees, umbilicus, lower back, and genital regions. Attempts to remove the scales can lead to bleeding. Sometimes, psoriasis can also show up in the form of pitting, discolouration, onycholysis (the separation of nail from nail bed), and thickening of the nails. This is often mistaken for a fungal infection.
What causes psoriasis?
Both genetic and environmental factors have a part to play. "Many patients I have come with a family history of psoriasis," Dr Liew points out. "Psoriasis can be triggered by environmental factors, too, with drugs, streptococcal infection and even skin trauma causing it to surface. Flares of psoriasis have also been linked to physical and emotional stress."
Does psoriasis pose any danger to your health?
Only in severe cases. "When it comes to those suffering from extensive psoriasis, the whole body can be covered with psoriatic rash, which is usually red and scaly," Dr Liew explains. "In these cases, the person can feel sick with dehydration and infection. If the individual seeks help early and takes steps to prevent the deterioration of the skin condition, they can prevent these complications." It should also be noted that patients suffering from psoriasis are at a higher risk of developing diseases such as high blood pressure, diabetes, hyperlipidaemia, Parkinson's disease, and more.
Is psoriasis contagious?
Not at all.
Can psoriasis be cured?
Unfortunately, no. "Psoriasis usually follows a chronic course that waxes and wanes," Dr Liew says. "At the moment, there is no permanent cure for psoriasis. It can, however, be controlled so it becomes easier to manage."
How can psoriasis be treated?
First things first, skin trauma and friction should be kept to a minimum. Dr Liew recommends keeping affected areas well-moisturised with emollients to prevent cracking, bleeding, and scratching. There's also topical treatments to consider, such as topical steroids, calcineurin inhibitors, vitamin-D analogues, salicylic acid, and tar preparations, though it is best you get a dermatologist to evaluate your skin before trying any of the above.
For more extensive cases, Dr Liew recommends ultraviolet light (narrowband UVB or PUVA) treatments or systemic medication. "These are reserved for those suffering with severe forms of psoriasis, or pustular forms of the disease," she clarifies. "Medications include methotrexate, acitretin and ciclosporin, as well as biologic injections. They tend to have both short and long-term side effects, and require regular blood testing in the clinic. Use of these treatments requires careful discussion with your dermatologist."