DEAR DR. GOTT: I have had psoriasis for about 55 years. During that time I have tried many different types of treatment and many years I have just lived with it. Always I have had significant involvement in my scalp, knees and elbows. Other times I have also had varying degrees of involvement on my trunk, legs, arms and buttocks. About 9 years ago due to a significant flare-up, I began receiving UV light treatments 2-3 times per week, along with topical steroids. The results, during the six years I continued this treatment, were moderate improvement but I still had red scaly patches scattered over most of my body.
A conversation with a person at the gym who has psoriatic arthritis led me down a different path. He mentioned taking various natural substances, in addition to eliminating coffee and caffeine. The coffee/caffeine seemed easy to do, so I started with that. In addition, I eliminated all the light treatments and steroids. Six months into the program I saw very significant improvement and after a year, dramatic improvement. After continuing for three years, I have a very slight amount of redness on my elbows but no dry scales. Also, there are no spots on my knees or the rest of my body. The psoriasis in my scalp still remains and I treat that with a tar shampoo but use no other medications.
DEAR READER: Psoriasis is a common condition that causes redness and irritation of the skin. It presents with thick, red, silver-white patches known as scales. It common appears between the ages of 15 and 35. In the healthy individuals, skin cells that grow deep in the skin rise to the surface about every 30 days. The person with psoriasis has this same occurrence, but the process is too rapid and dead skin cells build up on the surface of the skin.
The condition can, as you have pointed out, be difficult to treat. Conditions such as stress, insufficient or too much sunlight, bacterial or viral infections, some medications, and even the consumption of too much alcohol can trigger an attack.
Treatment options are many, to include topical cortisone creams, dandruff shampoos, lotions, salicylic acid, light therapy and more. Newer drugs on the market, referred to as biologics, include Humira, Enbrel, Remicade and Amevive, are sometimes prescribed when other treatments fail to be effective.
Psoriasis is generally a life-long condition that, fortunately, can be controlled to a large degree with treatment. It has been known to go away for an extended period of time, only to return. There is no known means to prevent psoriasis.
Psoriatic arthritis is a form of arthritis that can affect those individuals with psoriasis. Most individuals will develop the psoriasis first and the arthritis will follow; however, joint problems can sometimes precede the lesions.
Treatment includes NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen for control of pain and stiffness; and immunosuppressant drugs such as cyclosporin, leflunomide or azathioprine. Severe cases may be treated with TNF-alpha inhibitors to include Humira, Enbrel, Remicade and Simponi.
Some believe that specific foods such as commercially grown fruits and vegetables can cause allergic reactions and worsen symptoms, as can simple sugars, saturated fats, citrus fruits, wheat gluten and foods or beverages containing caffeine such as coffee, black tea and chocolate. That is because of the risk of dehydration in the bloodstream that can impair the body’s ability to eliminate toxins that triggers an attack of psoriasis. That said, to the best of my knowledge, no scientific study has been able to prove a relationship between foods and caffeine and psoriasis, but that isn’t to say it doesn’t exist, at least for some sufferers.
Readers who would like related information can order my Health Report “Dermatitis, Psoriasis and Eczema” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
