Many people have struggled with dandruff at some point in their lives - usually in the form of harmless scalp flakes that disappear after a short time. However, there are also many for whom patches of dandruff form, for example, on their elbows and knees, where they stubbornly persist and itch. This is known as psoriasis.
In this article, we will explain how psoriasis develops, how to recognize its symptoms, and what can help you with treatment.
1. What exactly is psoriasis and what does it look like?
2. What exactly are the causes or triggers of the skin condition?
3. What symptoms are typical for psoriasis?
4. What is the difference between psoriasis and neurodermatitis?
5. Treating psoriasis – how to properly care for your skin
6. What should be avoided in skin care?
What exactly is psoriasis and what does it look like?
Psoriasis (from Greek "psao" = I scratch), like neurodermatitis and rosacea, is a chronic inflammatory, non-contagious skin disease that typically occurs in flare-ups.
It primarily manifests as flaky skin changes that appear on reddish skin and can itch. Psoriasis often progresses very individually and can be exacerbated by so-called trigger factors (e.g., infections, medications).
What exactly are the causes or triggers of the skin condition?
The cause of psoriasis is an autoimmune reaction of the body. The immune system is overactive and releases increased amounts of certain messenger substances, which trigger various inflammatory reactions. Some of these messenger substances affect cell division, causing the uppermost skin layer, the stratum corneum, to renew itself faster than usual, and dead cells cannot be shed quickly enough. The skin in the affected areas becomes thicker due to increased keratinization and flakes heavily. The skin under the scales is reddened due to inflammation.
This immune reaction is often based on a family history. There are two types with different age peaks. While Psoriasis Type I represents the early form, occurring between the ages of 10 and 30 and tending to be familial, Type II is the late form, which appears later and is generally milder.
Psoriasis can occur in flare-ups or persist permanently. So-called trigger factors that can provoke such flare-ups include:
- Sunburn
- Showering too hot
- Psychological stress
- Nicotine and alcohol
What symptoms are typical for psoriasis?
Psoriasis can occur in various forms, which also present different symptoms. Among them, we distinguish:
Psoriasis vulgaris:
The so-called Psoriasis vulgaris, also known as "plaque psoriasis," is the most common form of psoriasis. In this form, the skin is reddened, and silvery, shiny, clearly defined raised skin areas, known as plaques, form and flake heavily. Psoriasis vulgaris can theoretically appear anywhere on the body, but typical areas include the scalp, elbows, knees, and back. Additionally, the affected skin in severe psoriasis or a flare-up tends to itch intensely. The natural reaction of scratching further irritates or even injures the skin.
Psoriasis inversa:
If psoriasis also appears in skin folds, it is called Psoriasis inversa or "Psoriasis intertriginosa". In this form, no scales appear because the skin there is rather moist, but rather severely reddened skin.
Pustular psoriasis:
Here, additional blisters appear on the skin.
Nail psoriasis:
It is not uncommon for psoriasis to also form in the nails, leading to so-called oil spots, pitting, and crumbling nails.
Guttate psoriasis:
The rarest form, guttate psoriasis, manifests as an acute, widespread rash with punctate papules and occurs mainly in children and adolescents after an upper respiratory tract infection.
The diagnosis of psoriasis should only be made by the treating physician.
What is the difference between psoriasis and neurodermatitis?
Both neurodermatitis and psoriasis are chronic inflammatory skin diseases that can lead to redness and flaking. Neurodermatitis is characterized by eczema, while psoriasis presents with so-called plaques.
The essential difference is that in neurodermatitis, the skin barrier is disturbed, leading to moisture loss in the skin. People with neurodermatitis tend to have very dry skin. Acute eczema occurs due to trigger factors.
In psoriasis, on the other hand, there is no disturbance of the skin barrier, but rather excessive keratinization. The skin tends to be generally dry. Trigger factors here lead to an overreaction of the skin, as if an injury were present. The result is an enormously increased formation of new skin cells.
Thus, in neurodermatitis, the focus is on repairing the skin barrier, while in psoriasis, calming the underlying inflammation is paramount. What they have in common is that intensive moisturizing is important for both skin conditions.
Treating psoriasis – why proper skin care can be important
Psoriasis therapy is based on various pillars - the removal of scales and the reduction of the autoimmune reaction are paramount. The choice of therapeutic agents is complex and should be made by the treating physicians.
However, you can keep the affected skin areas and scales supple with emollient, moisturizing creams or ointments and even temporarily relieve itching. We recommend our rich med Basic Cream with 5% evening primrose oil and high-quality, plant-based glycerin.
Additionally, our med Bath Oil can counteract uncomfortable feelings of tightness after bathing. The nourishing and protective oil components of jojoba oil, organic shea butter, and squalane form a wafer-thin film on the skin's surface and can prevent further fluid loss.
What should be avoided in skin care?
You should generally avoid aggressive ingredients (e.g., strong surfactants, synthetic fragrances) in care products. You should also avoid sunburn. We recommend our Sunscreen Sensitive SPF 50 with extra high protection for particularly sensitive skin.
O U R E X P E R T
Dr. med Michaela Hagemann I boep-founder, physician & 3-time mom
