In the past, psoriasis was viewed primarily as a cosmetic issue that would not extend beyond the obvious lesions on the skin. With a better understanding of the immune responses involved in this disease, and clinical evidence indicating the frequent associations between psoriasis and other serious diseases, we now know that psoriasis is a much more serious disease affecting the whole body and quality of life.
Psoriasis is a common skin disease that affects more than 6 million people in America. Psoriasis usually occurs as red, scaly, crusty patches that reveal fine silvery scales when scraped or scratched. These patches may itch, irritate, and cause discomfort.
Psoriasis is most common on the knees, elbows and scalp, but can appear anywhere on the body. In some types the nails or joints are also affected. The condition is chronic, lasting for many years, sometimes painful, disabling, especially when coupled with arthritis.
Causes Of Psoriasis
The reason psoriasis occurs is unidentified. However, it is accepted that the immune system plays an important role in the disease development. When psoriasis strikes, the over-reactive immune cells release inflammatory cytokines and cause the rapid turnover of skin cells. Under normal conditions, it takes up to 28 days for newly formed skin cells to rise to the surface of the skin and separate from healthy tissue, but in psoriasis it takes just two to six days. When the skin cells replenish themselves too quickly, they are immature and defective as part of skin barrier.
According to medical research, it is now established that psoriasis is a chronic immune-mediated hyper-proliferative inflammatory skin disease. Psoriasis is characterized by an over-production of inflammatory mediators and complicated interactions among epidermal cells and inflammatory/immune network.
Psoriasis Is Associated With Serious Medical Conditions
There is a growing awareness that psoriasis is more than ‘skin deep’. Over the years, several studies have uncovered that psoriasis is linked with a number of potentially serious medical conditions including cardiovascular disease, cancer, obesity, psoriatic arthritis, metabolic syndrome, diabetes, autoimmune diseases (Crohn’s disease), psychiatric diseases (such as depression and sexual dysfunction), sleep apnea, and chronic obstructive pulmonary disease (COPD).
Recently, a convincing association between psoriasis and vascular diseases has emerged. Psoriasis patients have an increased incidence of heart disease, stroke, and peripheral vascular disease. Studies also showed that patients with severe psoriasis have shorter life expectancies by an average of three to five years than those who are not affected by psoriasis.
Inflammation Is The Causal Link Between Psoriasis And Cardiovascular Diseases
The exact connection between psoriasis and cardiovascular diseases is unknown, but available evidence supports that inflammation may be the causative link between psoriasis and vascular disease.
Psoriasis and atherosclerosis (hardening of the arteries, the leading cause of heart attacks, stroke, and peripheral vascular disease) share similar immune-inflammatory responses. In psoriasis, local release of inflammatory mediators causes a cascade of immune-inflammatory cell activation, continuous skin cell proliferation, and development of psoriatic plaques. In atherosclerosis, activated inflammatory cells gather at the sites of vascular injury, become part of atherosclerotic plaque, and destabilize the plaque which eventually leads to heart attack and stroke.
Psoriasis treatments are aimed to suppress the over-reative immune-inflammatory responses, slow down cellular growth, and relieve associated itching and scaling.
- Treating psoriasis often involves combination of different medications and interventions such as:
- Topical drug therapy (including steroids, vitamin D analogues, tar preparations, dithranol preparations and vitamin A derivatives)
- Phototherapy (also known as light therapy)
- Systemic medications (prescribed to block specific immune-inflammatory molecules or pathways in the body)
Along with drug treatments, moisturizers are often used to avoid water loss and ease the dryness associated with the disease or caused by treatments.
Apparently, there are side effects and risks linked with long term drug treatment. Common side-effects of corticosteroids include skin thinning, loss of pigment, allergic to steroids, and increased risk of infection.
Common side effects of systemic immunomodulatory therapy (impact the entire immune system) and newer biologic drugs (target individual factor or specific parts of the immune system) include increased risk of infection, flu-like symptoms, injection site reactions, and compromised immune system.
Can Treating Inflammation Benefit Both Psoriasis And Cardiovascular Disease
Due to essential role of inflammation in psoriasis and atherosclerosis, it is thought that suppressing immune-inflammatory responses may be effective treatments for both psoriasis and atherosclerosis. Various studies are performed to determine whether a treatment to reduce inflammation in psoriasis patients could be associated with a decrease in cardiovascular diseases.
Although there is no conclusive evidence, initial results suggest that treating psoriasis patients with drugs targeting inflammatory pathways can reduce vascular inflammation in psoriasis patients. Nonetheless, long-term follow-up studies are required to confirm whether reduced inflammation in psoriasis patients is associated with smaller and stable atherosclerotic plaques and decreased incidence of heart attack and stroke.
Topical Anti-inflammatory Remedies For Psoriasis Relief
To avoid systemic side effects related to long term drug treatments, natural anti-inflammatory remedies, especially topical anti-inflammatory herbal remedies, are often used as alternative treatments for psoriasis relief. Anti-inflammatory herbal extracts have been used for centuries to ease inflammatory skin conditions including psoriasis. Some results from clinical trials using herbal remedies to treat psoriasis have been promising.
Commonly used anti-inflammatory herbs for psoriasis relief include White willow, Aloe vera, Licorice, Coptis, Scute, Rhubarb, Honey suckle, and Indigo naturalis. Pharmacological studies have shown that these herbs have anti-oxidant, anti-inflammatory, anti-allergic, and immuno-regulatory properties.
Topical Anti-inflammatory herbal remedies may provide following benefits for psoriasis relief:
- Ease of inflammation-related scaling and itching
- Balanced immune response against allergens, irritants, oxidative stress, and infections
- Augmented endogenous (i.e., derived internally) antioxidants, the most effective disease-fighting molecules in the body
- Nurturing environment for recovery of damaged skin cells and enhanced tissue repair