Under the Microscope: Psoriasis

What is it?  Psoriasis is a chronic skin problem that presents itself as a red patch of skin with a buildup of white, dry skin cells. According to the National Institutes of Health, psoriasis affects between 5 and 7.5 million Americans. Though there are various forms of psoriasis, the most common is what is known as "plaque" psoriasis. Everyone sheds and rebuilds skin cells. It takes about a month for skin cells to rise to the surface and flake off. However, with psoriasis, this turnover of cells happens in only a few days. Consequently, dead skin cells build up on the surface of the skin, creating the dry, silvery patches associated with the disease.

How do you get it?  The exact cause of psoriasis is unknown, but most doctors agree that the problem stems from the immune system, and that it can be hereditary. Because a compromised immune system and psoriasis are closely related, psoriasis sufferers should limit their exposure to environments that contain allergens such as dust or cats, for example, or work-related allergens such as the products we use every day in the salon.

How is it treated?  Treatment for psoriasis has three stages. The first is topical creams, the second is light therapy, and the third is "systemic therapy," which means patients take medications to treat the whole system of the body. Topical treatments can include aloe, jojoba oil, bath oils, and moisturizers, as well as cortisone creams. Light treatment is administered mainly at the doctor’s office, though in some cases patients can be treated at home. Sometimes light therapy is as simple as exposing the skin to sunlight. Systemic treatment is used for severe cases of psoriasis; these treatments are administered orally or through injection.

What can a tech do?  Because psoriasis has many forms and such varied reactions to treatments, it’s best for a client to be under a doctor’s supervision. This will allow the doctor to monitor the client’s reaction to different over-the-counter treatments. Also, a doctor will be able to write a prescription for medication if the client does not respond to common over-the-counter products. Psoriasis is not contagious, so techs working with clients who have psoriasis can feel comfortable touching skin to skin.

What else?  Although psoriasis is typically found on the elbows, knees, scalp, and lower back, it can occur on any area of the skin, and even the nails. When psoriasis affects the nail matrix, it can show up in different forms. If it affects the most proximal portion of the matrix (the part closest to the body), it shows up as small dents on the surface of the nail plate. If the distal portion of the nail matrix (the part farthest away from the body) is affected, it causes onycholysis (separation of the nail plate from the nail bed). Any damage to the nail matrix can cause a white spot, also known as leukonychia. Rarely, if the nail posriasis is severe enough to affect the entire nail matrix, the nail plate can crumble and be lost completely. If the psoriasis affects the nail bed, a reddish-brown discoloration resembling a small drop of oil will appear on the nail bed.