Tips on Managing Psoriasis

Dear Ask The Doctor: I have Psoriasis on my elbows..bits on my arms.. and the worst is on both my knees.. they are hard crusts . I have creme that I apply to the areas twice daily it is called Prevex HC my question is this.. what else can be done for my knees.. its gross.. and it has bled too.. itchy.. not all the time but sometimes , plus im also one for taking hot baths.. do this cause flare ups as well..?

Dear Laurie: Psoriasis can be a frustrating condition to live with but the important thing is that greater than 80% of all cases can be managed with good cosmetic results.

It is first important to understand Psoriasis. Psoriasis is a skin condition where normal skin replicates and is replaced at a faster rate than normal and at a faster rate than surrounding skin.  We do not fully understand why this happens but we are learning more and more every year. This is why it is important to have a regular doctor so you can keep up with the changes in knowledge and understanding of psoriasis and how it may effect your treatment.

The first rule of Psoriais managment is KISS - keep is simple stupid !. We try to use the minimum amount of treatment possible.  This means it is best to first analyze your lifestyle. The healthier your lifestyle and diet, the healthier your skin will be. DO NOT OVERLOOK THIS POINT.  In addition, healthy skin needs to be moisturized daily. This means preventing moisture loss which can occur from hot showers (take cooler showers) and apply a skin moisturizer after your shower and before you sleep.  You may have to experiment with many moisturizers before you find the right one for your skin.  Other tips that may helkp your skin include using mild detergents for your clothes, avoiding fabric softeners and fragrances, minimizing UV exposure and drinking plenty of water.

If medications are required, its time to consult your doctor. There are many options.  Categories include mild steriods, strong steriods, coal tar, anthralin, calcipotriene, and tazarotene.  Often more than one is required and differnet combos may be required depending on the stage of your psoriasis. Regular visits with your doctor are required for you to understand when to use each type of cream.

It advances cases, phottheyrpy or oral medication can be tried but topical agents shoudl be used first.

I hope this helps.