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Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Psoriasis
Overview
Psoriasis is a long-term medical condition that occurs when skin cells grow too quickly, resulting in thick, silvery, or red patches of skin called plaques. Ninety percent of people with psoriasis have plaque-type psoriasis. It is not contagious.
The second most common type of psoriasis is called guttate psoriasis. The onset of the condition usually follows a strep infection. You get skin patches shaped like raindrops. Guttate psoriasis usually affects people younger than 30. It may occur as a single outbreak or in repeated episodes, especially in the case of individuals with ongoing respiratory infections.
Psoriasis affects both men and women, most often appearing in adolescence and early adulthood, but it can develop in infancy or later adulthood.
The exact cause of psoriasis is unknown. Research points to an abnormality of special white blood cells that triggers inflammation of the skin. Heredity, stress, infections, and physical injury to the skin may trigger psoriasis.
There is no cure for psoriasis, but treatment options are available to keep your psoriasis under control and lessen your symptoms.
Symptoms
Psoriasis can be mild, with small areas of rash, to moderate or severe, with inflamed skin and raised red areas topped with loose, silvery, scaling skin. In severe cases, skin may itch and be tender. Large patches of skin with psoriasis can be uncomfortable and embarrassing.
Psoriasis may affect the fingernails and toenails, causing the nail to pit, change colors, and separate from the nail bed. Swollen, stiff joints may be a sign of psoriatic arthritis.
Psoriasis appears as thick silvery or red patches of skin called plaques.
Psoriasis appears as changes in the nails including pitting, color, and separation from the nail bed.
Guttate psoriasis appears as skin patches shaped like raindrops.
Diagnosis
We diagnose psoriasis by looking at the patches on your skin. Usually, no special tests are needed. Severity is indicated by the amount of redness and scaling, thickness of the plaques (large areas of raised skin patches), and percentage of skin affected.
Occasionally, we remove a skin sample (biopsy). We may order X-rays if joint pain is present or take a skin test to rule out a fungal infection.
In the case of guttate psoriasis symptoms, we may check for strep throat.
Causes
The cause of psoriasis is unknown. The tendency to develop psoriasis may be inherited since one-third of people with psoriasis have family members with the condition. We believe that the immune system may also be a factor. Other factors contributing to development of psoriasis include:
- Cold, dry weather
- Injury to the skin
- Stress
- Certain medications (nonsteroidal anti-inflammatory drugs, or NSAIDs, beta-blockers, and lithium)
- Infections such as strep throat
Risk Factors
The following factors may increase your risk of developing the disease or increase the severity of the disease:
- Family history
- Emotional or physical stress
- Other medical conditions, including HIV and strep throat in children
- Smoking
- Obesity that causes skin creases and folds
- Alcohol consumption
Home Remedies
While you cannot prevent psoriasis, skin care at home may help improve your appearance and ease the discomfort of damaged skin. These tips will improve symptoms or reduce flare-ups:
- Keep skin moist by taking daily baths and using ointment-based moisturizer while your skin is still moist.
- Follow instructions for skin products and prescribed medication.
- Soften psoriasis crust with cream.
- Use over-the-counter medicated tar shampoos like selenium sulfide, pyrithione zinc, salicylic acid, tar, and ketoconazole to reduce the itching of scalp psoriasis.
- Avoid becoming sunburned because it can cause psoriasis flare-ups and skin cancer.
- Be aware of and avoid medicines that make your psoriasis symptoms worse.
- Avoid cool, dry climates.
- Avoid scratching or picking at plaques and avoid skin injuries. Keep your nails trimmed.
- Avoid stress and anxiety, which appear to bring on psoriasis flare-ups.
- Avoid infection that can cause guttate psoriasis.
- Do not smoke.
- Limit your intake of alcohol.
Treatments and Medications
Psoriasis treatment focuses on slowing the rapid growth of skin cells and reducing inflammation and plaque formation. Removing scale and soothing the skin are also part of treatment. There are 3 main types of treatment:
Topical medications
- Topical corticosteroids slow down cell turnover by suppressing the immune system. This reduces inflammation and itching.
- Vitamin D compounds slow down the growth of skin cells. They may be used alone or in combination with phototherapy.
- Anthralin, a topical cream, slows skin cell growth and removes scale, making the skin smoother. It may stain your skin and clothes, so we recommend that you use it only for short periods and then wash the affected skin.
- Topical retinoids slow skin cell growth and may decrease inflammation. Common side effects are skin irritation and sensitivity to sunlight.
- Tar products.
Light therapy or phototherapy
These therapies involve the use of natural or artificial ultraviolet light for the treatment of psoriasis.
- Sunlight slows skin cell turnover and reduces scaling and inflammation. Exposing your skin to controlled amounts of natural sunlight may improve psoriasis.
- UVB phototherapy can be used to treat single patches, widespread psoriasis, or psoriasis that resists topical treatments. Side effects include redness, itching, and dry skin.
Oral medications
We may recommend prescription medication for moderate or severe psoriasis or if topical medicines and phototherapy are not working for you.
- Methotrexate decreases the production of skin cells and suppresses inflammation. It cannot be used by women who are pregnant or planning to become pregnant. Men whose partners are planning to become pregnant should also avoid this medication. Long-term use can lead to serious liver damage and decreased production of blood cells.
- Retinoids reduce the production of skin cells. They do not weaken the immune system and thus are sometimes used for children and people with other conditions such as HIV. Side effects are dry skin and mucus membranes, itching, and hair loss. Retinoids can cause birth defects, so women of reproductive age should discuss taking this medication with us.
- Cyclosporine suppresses the immune system. It increases your risk for infection and other health conditions including cancer. Cyclosporine may increase your susceptibility for kidney problems and high blood pressure as well.
- Biologics are given by intravenous infusion or injection. These medicines act on specific parts of the immune system to decrease the inflammation associated with psoriasis. Biologics may be effective and may be safer for the liver and kidneys, but long-term safety is unknown.
Alternative Medicine
Complementary therapies include the use of herbs, vitamins, certain diets, and stress reduction. These therapies may relieve symptoms in some people:
- Aloe vera. This cream may decrease redness, scaling, itching, and inflammation.
- Capsaicin cream. An extract from chili peppers, capsaicin cream may decrease itching and severity of psoriasis. You may experience a burning sensation the first few times it is used.
- Fish oil. Omega-3 fatty acids, which can be obtained in fish oil supplements, may reduce the inflammation associated with psoriasis.
Coping and Support
Psoriasis can cause complications such as low self-esteem, depression, stress, anxiety, and social isolation. Psoriatic arthritis can be debilitating and painful, interfering with daily activities and causing erosion in joints. To cope and feel more in control:
- Become educated about your disease and treatment options.
- Find a support group.
- Use coverups, clothing, or cosmetic coverup products.
Additional References:
- External Link to National Psoriasis Foundation
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This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.