Psoriasis is a skin disease that’s little understood, and one that goes far beyond cosmetic appearance or minor discomfort – in fact, it’s an immune abnormality which, in effect, causes the body to attack itself. In normal circumstances, when skin is wounded, skin cells multiply to heal the wound; even in the absence of a wound, cells are in a constant cycle, where new cells are formed and rise to the surface of the skin to replace dead ones.
Psoriasis, however, causes skin cells to multiply at lightning speed when there is no need for them to do so. The result is raised, scaly, lumpy patches on the skin’s surface; depending on skin tone, these are usually silvery or purplish in appearance. The condition is long term and incurable – although some flare-ups will be worse than others, and there will be periods of time when it has appeared to have ‘gone away’.
As someone who’s suffered with the condition since childhood, I can vouch for how much discomfort it causes. As much as you may try to resist itching, the impulse can sometimes be too great, or even unconscious. I, and others, know what it’s like to wake up with blood-stained sheets from scratching in our sleep.
And yes, there’s also the self-consciousness that any skin condition can cause. Psoriasis can occur anywhere, but most frequently manifests on areas such as the knees, elbows, ankles and scalp. That said, it can also – as it used to do for me – appear on the face, generally in areas where there is hair growth, such as around the eyebrows, on the upper lip and around the hairline. This, obviously, is much harder to hide than when on the body, although both can be just as debilitating.
So what causes psoriasis? Firstly, it’s important to note that the condition is not contagious, although it can be hereditary. This isn’t to say that having a relative with psoriasis means that you’ll get it, but that where other factors or triggers – such as stress, hormone imbalance, and even cold weather – exist, the predisposition may be greater.
There’s also increasing awareness of the relationship between the gut and various other parts of the body. From the gut/brain axis to the gut/organ axis, we are now realising the role that the gut microbiome plays on skin health – and this is applicable to everything from acne to psoriasis. Nurturing your gut microbiome can, therefore, significantly reduce the risk of psoriasis developing or flaring up – so avoiding processed foods, limiting alcohol and ensuring you get lots of healthy bacteria by way of fermented foods (such as kimchi and kefir), as well as probiotics, found in foods such as oats and bananas, can all be useful in maintaining overall health, as well psoriasis specifically.
As mentioned above, the toll that psoriasis can take goes far beyond self-consciousness. A study published in Clinical Epidemiology in 2023 demonstrated that those with the condition (plus those with eczema) ran a higher risk of suffering with depression and anxiety, as well as sleep disruptions. There is also some evidence to suggest that those with psoriasis grapple with suicide ideation (thoughts and even plans around suicide) more than those without the condition.
In recent years, a number of celebrities – including Cara Delevigne and Kim Kardashian – have opened up about their struggles with psoriasis, which has helped to remove the stigma around it and encourage conversations about the disease and how it can affect one’s mental health, mood, social relationships and confidence. Still now, however, it’s not entirely understood: as noted above, it’s not contagious in the way that an STD can be – yet large numbers of people still believe that it can be transmitted through contact which, of course, may just add to the feelings of social isolation in the sufferer.
Doctors will generally prescribe steroids for the treatment of psoriasis, but like most pharmaceuticals, these are not without their potential side-effects. So, if you have psoriasis, like me, here are some tips I have found useful to manage the condition more naturally:
Try to minimise stress
Easier said than done in this 100-miles-an-hour world, granted, but taking a little bit of time out to tend to your mental health has benefits for every part of your being, including your stress. Practise breathwork, meditation, gratitude or yoga to lower your cortisol (the stress hormone) levels.
Take a salt bath
People have long flocked to the Dead Sea for the effect that these salt-packed and mineral-rich waters can have on their psoriasis. You can create a similar experience at home by pouring Dead Sea or Epsom salts into a lukewarm bath, which may provide some ease from the symptoms.
Reassess your diet and lifestyle choices
As mentioned above, the link between gut health and skin health is only just beginning to be recognised, but basing your diet, largely, on unprocessed wholefoods and ensuring you get enough fermented foods and probiotics can all be beneficial. In addition, try to limit, or even kick, habits such as smoking and drinking.
Keep an eye on the weather
Cold weather can cause psoriasis flare-ups or aggravate existing ones, because such temperatures make skin drier, which is the last thing psoriasis-prone skin needs. When the mercury drops, have your defence mechanisms ready to go. Keep the skin moisturised, wear breathable layers and take lukewarm baths or showers. Additionally, while this may feel counterintuitive, you should try to limit your bathing to once every few days, since excessive washing can strip the skin of its natural oils. If you can’t countenance the thought of this, keep showers brief. You can also increase air moisture by using a humidifier at home and, in the absence of sunshine, treat your skin to light therapy.
Trim your nails
When the impulse to scratch – consciously or subconsciously – is too much, the last thing you want are open wounds with bacteria from under your nails creating a risk of infection. You may also choose to wear mitts or gloves to bed, to minimise damage from scratching in your sleep.