Acceptance and management of the skin disease psoriasis

Acceptance and management of the skin disease psoriasis

By Laois psychologist and Operation Transformation Expert Dr Eddie Murphy.

I remember from my nurse training that our skin is the biggest organ in the body. From a psychological point of view how we see our skin and how our skin is can impact on mood and our quality of life.

Psoriasis is a chronic, systemic inflammatory skin disease that is estimated to affect more than 73,000 people in Ireland.

There is a strong cross over between chronic health conditions and our psychology; how we think, feel and do.

In conjunction with Selene Daly, Dermatology Nurse Specialist working in Sligo University Hospital and myself, here are our top Ten Tips to helping you understanding this condition an and tools for managing psoriasis.

top ten facts

1). Psoriasis is a chronic illness

Currently there is no cure for psoriasis. Once the disease is triggered the condition is lifelong.

Psoriasis can come and go and vary in severity and up to 10% can develop a form of arthritis called psoriatic arthropathy.

The good news is that with the right medical care psoriasis can be managed.

2). It is genetic but other factors affect it

Psoriasis is an inherited skin condition with a complex genetic pattern.

For many people factors such as infection, stress, medications (non-steroidal anti-inflammatories, beta blockers, lithium and anti-malarias) smoking and alcohol can cause psoriasis to trigger and flare.

The relationship with foods and flares of psoriasis have not been established.

3). Skin Turnover

Simply explained psoriasis is a process where the rate of skin turnover is dramatically increased. The normal rate of turnover is 3-4 weeks. In people with psoriasis this process happens in 3-4 days.

Skin affected by psoriasis is scaly red and raised off the surface of normal skin.

Some people suffer from psoriasis of the hands and the feet and can develop painful cracks and fissures which can affect their work and hobbies.

Nail psoriasis can be embarrassing and painful as the nail can become thick and cracked and sometimes fully lift from the nail bed.

When psoriasis effects the scalp it may appear as mild dandruff or in more severe cases it can form thick white scale and result in hair loss

4). Treatments are varied

Psoriasis can vary from mild to moderate or severe. Mild psoriasis can be managed with topical treatments such as soap substitutes and moisturisers and vitamin D analogues.

People with moderate psoriasis can be treated with a course of phototherapy.

Phototherapy light is delivered in a controlled way to treat psoriasis and is a safe form of UV exposure.

In addition Dermotology doctors can prescribed treatments for the management of moderate to severe psoriasis.

5. Healthy Lifestyle

Maintaining a healthy lifestyle is vital for people with psoriasis.

Eating a healthy diet, never smoking/stopping smoking and regular exercise are all effective ways to reduce the incidence of cardiac disease.

6).The mentalt impact

Not surprising, people who suffer from moderate to severe psoriasis have an increased chance of developing anxiety and/or depression.

This can also be associated with an increased risk of alcohol or substance abuse.

A survey carried out among Irish people with psoriasis found that half of those surveyed said that having psoriasis has had a serious impact on their quality of life.

The challenge is trying to move our mindset from the CURE model to the management model and accepting ourselves.

People suffering with psoriasis often tell me that people will stare or offer well meaning but useless advice on how to ‘cure’ their skin disease.

Many psoriasis sufferers I have dealt with have had to change careers due to discrimination at work secondary to the appearance of their nails or skin.

Patients have been excluded from social or sports activities due to the misunderstanding that the skin condition is contagious.

These experiences can affect psoriasis suffers with their own personal relationships with co-workers, friends, partners and relatives.

7). Feel Fabulous

Certain clothing materials, colours and cuts can disguise psoriasis.

Camouflage make up can also cover and conceal redness. Getting some practical tips can make living with psoriasis easier.

Follow @flakyfashionista for advice on how to live well with psoriasis.

8) Maximise your hospital appointments

Many people living with psoriasis in Ireland have waited a long time to see a dermatology consultant.

When they do receive their appointment the clinic they attend can be overbooked and they may feel rushed.

Preparation is key. A great tip is to write everything down and bring two copies of your list of concerns and questions to your appointment, one foryou an your consultant.

Learning all you can about psoriasis from good sources such as and is invaluable as it will make it a lot easier to have a conversation around treatment options.

Talk to your consultant about feelings of low mood and anxiety. Report any joint stiffness or aches and pains.