Will there ever be a cure for psoriasis is a question all psoriasis sufferers ask on a daily basis. Unfortunately, to date, there is no known cure for this annoying and stressing skin disorder.
But, the good news is that there are more and more remedies, recipes and actions that we can take to reduce the flare ups and live a better, if not, a totally normal life.
Psoriasis is a skin disease of unknown origin. Frequently, it affects 1% to 3% of the population, both women and men. About one-third of patients suffer from a moderate to severe form.
But, how can we control this chronic disease and improve the quality of life of patients?
Psoriasis manifests itself by red patches with dander (small patches of dead skin that come off) spread over different parts of the body. In its mild form, psoriasis appears on the scalp, knees, nails, feet, elbows, hands and occasionally to the genitals. In severe cases, it can extend and cover the entire body.
Typical psoriasis patches of the knees
This chronic condition of the skin evolves very individually, with outbreaks, but also remissions during which the lesions disappear. The respite is of very variable duration and the remission often incomplete. To date, there is no actual remedies to cure psoriasis completely. However, it is possible to control it. To reduce the extent of the lesions and improve the quality of life of the patients.
A lot of progress has been made in recent years: a better understanding of the mechanisms leading to the disease, better recognition of the severity of psoriasis and impairment of quality of life, the identification of associated diseases, but also the development of new drugs we call “biological”, or bio-therapies.
Mechanisms of appearance of the disease
The specific causes and triggers of psoriasis are unknown. The disease has genetic, immunological, microbiological and environmental components.
Excessive stimulation of the immune system causes inflammation of the dermis (the thickest part of the skin). As a result, the epidermis (the most superficial layer of the skin) renews itself too quickly, in only four to six days, instead of the usual three weeks. Epidermal cells accumulate on the surface of the skin and form a layer of white dandruff called scales. Perfectly harmless, they have the disadvantage of being unattractive.
We now understand better the immunological mechanisms leading to this inflammation. In particular, a molecule called TNF alpha is produced in excess in the skin by certain immune cells; it is probably responsible for the important skin inflammation of psoriasis. New drugs that specifically block it can now be very effective.
In almost a third of cases, there is a family predisposition. A number of genes have been identified as potential risk markers, some of which would be involved in the regulation of the immune system.
There may be a link between psoriasis and medication
They can also be due to an infection, for example by streptococcus. Their frequency is very variable and, in general, the triggering factor of the thrust is not identifiable. Excessive alcohol consumption is a factor of aggravation.
Some medications sometimes exacerbate psoriasis; these are essentially those of the class of beta-blockers, which we use in particular to treat high blood pressure or disorders of the heart rhythm. Their judgment is often present in discussions on a case-by-case basis as other risks.
In contrast, sun exposure has an obvious protective role! Of course, a proper diet is always recommended.
Quality of life, associated illnesses and social cost
While psoriasis rarely puts the lives of those affected at risk, it has a severe impact on the quality of life. Psoriasis has an impact on all areas of existence, greatly underestimated so far: the professional. The disease can also affect relational, family and sexual life of patients.
Many other factors contribute to the deterioration of the quality of life of psoriasis sufferers: the stress inherent in new outbreaks, the presence of pruritus and dander, the constraints and side effects of treatments. This is why taking into account the quality of life is a fundamental element in the care of patients; it plays a leading role in the doctor-patient relationship.
Several studies suggest that patients with severe psoriasis have associated diseases (comorbidity), an increased risk of cardiovascular disease or depression, but also decreased life expectancy, especially if psoriasis is associated with the “metabolic syndrome”: obesity, diabetes, abnormal lipids in the blood. These factors must be identified and treated, for a comprehensive care of a patient with psoriasis.
Finally, from a public health perspective, recent evidence suggests that psoriasis causes significant direct costs – treatment, hospitalization – and indirect costs – work limitations and lost productivity.
Will there ever be a cure for psoriasis?
Although current treatments do not cure, they do control psoriasis effectively. They all act in one way or another on the immune system to make it less aggressive.
In mild cases, we can use local cream treatment as a first attempt: topical corticosteroids (acting at the application site) and vitamin D analogs, most commonly used in a combined treatment. Topical corticosteroid therapy will be as intense and brief as possible. In severe or treatment-resistant cases, we use medical treatment with ultraviolet light (phototherapy) as well as systemic (oral or injectable) medications, particularly retinoids, methotrexate or ciclosporin.
New treatments are in development on a regularly basis, significantly increasing the therapeutic arsenal and providing hope for better management. Advances in knowledge of the immunological factors of psoriasis have led to the development of a range of new therapeutic options.
These are so-called “biological” drugs or biotherapies, among which mention may be made of adalimumab, etanercept or infliximab. These treatments, administered only by injection, specifically block TNF-alpha.
They are extremely effective, but there are several restrictions on their use. With regard to side effects, there are some that we know very well, especially the appearance of infections (eg reactivation of tuberculosis). However, there is insufficient data on the use and risk of long-term side effects of these treatments as they have only been available for five to ten years.
On the other hand, they are extremely expensive and medical funds or insurances might only reimburse in special cases. These biotherapies are therefore only for cases of failure or intolerance to usual treatments.
Thanks for reading
If you know of any natural treatment that proved to be successful and would like to share your experience with us, you are welcome to do so here below. Any questions? Please use the box below and I, or someone, will respond as soon as possible. If you are creating your own psoriasis home remedies that work, please do share them with us. Also feel free to share this socially. I will be very much appreciate it!
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