Psoriasis often requires medication control, but we should also pay attention to the inducing factors!

Author: Li Linfeng, Chief Physician, Beijing Friendship Hospital, Capital Medical University

Reviewer: He Yanling, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Psoriasis, also known as psoriasis, is a very common chronic, recurrent inflammatory skin disease. In addition to the red papules and red patches on the skin, there are a lot of silvery white scales on the surface of the lesions, so it is named psoriasis.

Figure 1 Copyright image from the gallery, no permission to reprint

So far, the cause of psoriasis is still unclear, and it may be related to multiple factors such as genetics, infection, mental factors, and trauma.

Many people believe that psoriasis is contagious and are unwilling to contact people with the disease. In fact, psoriasis is not contagious and is not a communicable disease.

If you suspect you have psoriasis, be sure to go to a regular hospital for treatment.

1. Can mild psoriasis be controlled without medication?

Psoriasis is divided into four types: vulgaris, arthritis, erythroderma, and pustular. 90% of psoriasis is vulgaris.

Psoriasis vulgaris is divided into three stages: active stage, quiescent stage, and remission stage. In the active stage, the rash will increase and the scales will increase; in the quiescent stage, the rash will no longer increase, and the original rash will no longer expand, but it will not disappear, and it is very stable. After these two stages, through self-regulation, adjusting life and psychological state, it can get better without treatment and enter the remission stage. During the remission stage, the number of rashes gradually decreases, the original rashes also shrink, and can even disappear completely, with no scales or erythema.

For skin lesions that are relatively small and have little impact on the patient's social and psychological well-being, such as a small patch on a covered area of ​​the body, the possibility of spontaneous resolution is relatively high. Mild skin lesions can very likely be controlled by adjusting one's mentality and lifestyle and by avoiding triggering and aggravating factors.

However, most cases of psoriasis will recur and the condition will be severe. A large number of skin lesions and scales will affect daily life and make people very painful. It also has a great impact on the psychological side and will affect social interaction, so active treatment is needed.

People have now realized that psoriasis is not only a skin problem, but also may be accompanied by other systemic diseases, also known as comorbidities, such as hypertension, heart disease, diabetes, hyperlipidemia, etc. Therefore, it is important to pay attention to early examination and treatment.

2. Can psoriasis be cured?

Psoriasis is now considered incurable in medicine. Many patients suffering from the disease will believe in some advertisements, such as so-called ancestral secret recipes and folk remedies. This is a very wrong understanding. Many cases of psoriasis will be aggravated due to improper treatment.

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So far, there is no way to completely cure psoriasis worldwide. We can only control symptoms and reduce recurrences. The good news is that there are some studies at home and abroad that have followed up some psoriasis patients for a long time and found that some patients can have no recurrence for many years after treatment. At least at this stage, they are cured and disease-free. Therefore, psoriasis patients should have confidence that through doctor-patient cooperation, they can still achieve a long-term disease-free state.

3. What are the treatment principles for psoriasis?

We are against the use of overly strong treatments for psoriasis. Many patients hope to be cured and eliminate psoriasis as quickly as possible after they have it. In fact, this idea is a bit extreme. Treatment should be based on each person's specific situation and the appropriate treatment should be chosen.

For example, mild skin lesions can be treated with topical medications alone. Some topical medications take effect quickly, but the chance of recurrence may be higher; some medications take effect slowly, but the chance of recurrence in the future is lower. Doctors will use them in combination or sequentially according to the situation.

For patients with large psoriasis lesions that affect their normal work and life, or patients with small lesions that affect their quality of life, such as a small patch on the face or hand, these cases also require active treatment. Some patients do not care and do not treat large lesions, thinking that they are just skin problems. In this case, it is still necessary to check for systemic comorbidities and intervene early.

The treatment principles of psoriasis are standardization, safety, and individualization. The purpose is to eliminate skin lesions, reduce recurrences, and control comorbidities. There are many treatment methods at present, and different safe treatment methods need to be selected according to the severity of the disease and whether there are other diseases. Such as topical medications, oral medications, injections, phototherapy, etc. As for which one or which treatment methods to choose, it can be left to the professional doctor to judge. The doctor will give an individualized treatment plan. Targeted treatment will have a good treatment effect.

4. What should psoriasis patients pay attention to during treatment?

Although the cause of psoriasis is still unclear, there are many predisposing or aggravating factors. Avoiding these factors is the key to improving efficacy and reducing recurrence.

First of all, we must pay attention to the triggering factors of psoriasis itself. For example, there is a type of psoriasis called guttate psoriasis. The current clear triggers are pharyngitis and tonsillitis, which are caused by streptococcal infection. Generally, young people don't pay much attention to it. After getting pharyngitis, they will have a fever, swollen tonsils, and a red throat. After being cured, red spots will begin to appear on their bodies about half a month later. At present, it is believed that if this type of psoriasis can control the pharyngitis and no longer recur, psoriasis can not recur. Therefore, it is recommended that these patients exercise well, strengthen their physical fitness, and get more sun exposure, so that they can avoid recurrence for many years.

Many psoriasis patients can find and avoid the triggering or aggravating factors if they carefully look for the circumstances under which the condition is prone to aggravation. Most of these triggering and aggravating factors are related to living habits such as food, clothing, housing and transportation. It cannot be said that once you take medicine, you can ignore the rest. Failure to avoid triggering factors will lead to repeated attacks of the disease. You must not rely solely on medication. You must actively cooperate with the doctor and strive to find and control the triggering or aggravating factors in order to better control psoriasis and reduce the recurrence rate.