Tuesday, 26 November 2013

Living With Body Psoriasis

Good Day Everyone,

A quick disclaimer to say that I am not a medical professional and that you should not make any changes to your psoriasis treatment without discussing it with your doctor first. Whilst I will be talking about the treatments that I have tried, I am not recommending that you try them too. This is simply my personal experience of living with body psoriasis.

Apologies that I've been absent for the past week and missed a few blog posts. I typically try to post three times a week but lately Arthur (aka arthritis) has been getting the better of me. I’m right handed and the arthritis in my right wrist has flared up quite badly making it very difficult for me to type. So I’m now typing with my left hand, albeit very slowly, but I figured the more I type with my left hand the faster I’ll get with the practice :o)

Today’s post is about my experience of living with the skin condition psoriasis. I’m going to focus on body psoriasis in this post and cover scalp psoriasis in a separate post partly because I think this post would become very long if I covered both here, but primarily because my experience with body psoriasis has been different to that with scalp psoriasis.

Psoriasis is a skin condition which consists of raised, flaky, silvery scales of skin. These raised patches of very dry skin are as a result of an increased turnover of skin cells. In people without psoriasis normal skin cells shed and regenerate every 30 or so days but in psoriasis suffers, skin cells turnover every three days, so around 10 times faster than normal. This means that layers of skin build up creating plaques or raised patches of very thick, dry skin that can also be itchy. Eventually this thick layer of skin will peel off leaving behind very sore, tender, fresh layer of skin which is very red and thin. If you scratch this thin layer of skin it will inevitably break, bleed and it can even get infected.

Psoriasis is a chronic (long term), non-contagious condition for which there is no cure but the condition can go in to remission, stablise and flare up again. No one really knows what causes psoriasis. There are various theories involving abnormalities with the immune system which causes inflammation in the skin causing skin cells to turn over at a very fast rate. There are also theories suggesting genetic involvement. You are more likely to develop psoriasis if someone in your family has it. In my family, my aunt had it as a teenager but grew out of it (she’s now in her 40s and psoriasis free). Two of my female cousins also have it. It seems to run in my dad’s side of the family rather than my mums. Funnily enough none of the men in my dad’s family suffer from psoriasis, just the women.

When I was 17 I noticed a dry patch of skin on one of my elbows and within a few weeks this one dry patch had progressed to psoriasis patches the size of golf balls on both my elbows. I recall my mum taking me to see our GP (family doctor) who prescribed a topical ointment / cream (I don’t remember the name) but a few weeks later I had developed huge psoriasis patches, almost the size of tennis balls, on both my knees and the ointment / cream that I had been using hadn't had any real effect. The skin was so tight and dry on my knees that it became very  painful for me to bend my knees as the dry skin patches lacked the normal elasticity the skin over the knees has, resulting in the psoriasis patches cracking and bleeding.

Our GP realised that topical creams and ointments were not going to be strong enough given how quickly my psoriasis was spreading and so he referred me to a dermatologist (skin specialist). By the time I went to see the dermatologist the psoriasis patches from my knees had spread further down my legs. I’d also developed a few smaller patches on my back. I couldn't believe how in a matter of just a few months I’d gone from having normal skin to this scaly, itchy, painful and ugly skin condition.

The dermatologist initiated me on a phototherapy course. This involved a trip to the hospital three times a week, before college, to have light therapy on my body. I would have to stand in what can only be described as a vertical sun bed, with protective gear for my eyes, whilst my body was exposed to ultraviolet light. Whilst having light therapy I was also using topical ointments / creams as well.

Luckily for me the light therapy made a significant difference in slowing my skin turnover rate and greatly reduced my psoriasis patches. After the light therapy course I continued using various ointments and creams. Over the years I have used Dovonex, which contains a vitamin D derivative, to normalise and slow down the rate of skin cell turnover, Elocon, which contains a corticosteroid that reduces skin inflammation, as well as various coal tar treatments. I’m sure there were other treatments that I cannot remember the names of.

By the time I entered my 20s my psoriasis patches had cleared on my legs. The only reminder I have is some slight skin discolouration but it really isn't all that noticeable. The patches on my elbows took a few more years to ease. In my 20s I started using an ointment called Diprosalic which worked wonders. It contains two active ingredients, betamethasone a topical corticosteroid which reduces the skin inflammation and salicylic acid which breaks down the excessive keratin (a protein that forms part of the skin structure) to help reduce the thickness of the skin scales, thus allowing the betamethasone to penetrate through the skin and be effective.

Now as well as drug and light treatment, I was also told by my Dermatologist back when I was a teenager that a diet rich in fresh fruits and vegetables, low in processed and sugary foods would also help with my skin condition. I was also recommended to eat fresh oily fish such as salmon and mackerel two-three times a week. As a teenager I did used to eat oily fish (my mum made sure I did!) but as I've gotten older I have started to find it more and more difficult to eat oily fish and have resorted to taking fish oil capsules instead. I don’t like seafood and do not eat any form of shell fish, I do however, on occasion eat white fish such as seabass or dover sole and I can eat fresh tuna but I really struggle with salmon and other forms of oily fish – I struggle even though I know it’s good for me.

Back when I was a teenager, I didn't take much interest in finding out about my psoriasis but as I got older and my scalp psoriasis got worse I did to turn to the internet for information. That’s when I came across psoriatic arthritis and realised that as a psoriasis sufferer, I was more likely to develop arthritis, which is also an inflammatory immune system condition, just like psoriasis. I've always had a niggle at the back of my mind that I would develop arthritis, I don’t know why I thought that, just a gut feeling I guess but what I didn't expect was to develop it at such a young age (31). I always thought (or hoped) that I would get when I was in my fifties and beyond as that way I’d have had children, worked on my career, travelled and basically done the things that one hopes of doing. However, such is life and you just have to deal with the cards you’re dealt and that’s what I’m (trying) to do :o)

I've always felt quite lucky with regards to my body psoriasis (scalp psoriasis is a whole other story and I was not so lucky!) as for the most part, it has always been on parts of my body that are easy to hide with clothing. I have cousins who have had psoriasis all over their hands, forearms, neck and even parts of their face. Now that must take a huge toll emotionally, as well as physically. For me, other than the physical discomfort of body psoriasis and not being able, or rather willing, to wear short sleeves in the summer I feel I have gotten off quite lightly, relatively speaking.

I think it would be fair to say that for the past five years at least, my body psoriasis has been in remission and stable. Whenever I discover the early signs of a new psoriasis patch forming I treat it with the Diprosalic ointment and so long as I apply it regularly I find that within a week or two the new patch psoriasis patch has disappeared.

I can appreciate that many other psoriasis sufferers many not have gotten off as lightly as I have. I have seen YouTube videos of people talking about how their psoriasis affects their lives and I can hear and sense the same despair that I once felt with my scalp psoriasis. My heart really goes out to other fellow sufferers because psoriasis is not a pretty condition to look at and we live in such a 'looks' orientated society plus you can't always 'hide' (and nor should you have to) your psoriasis if its on your face or hands. Luckily there are numerous different types of medications now available so if something doesn't work for you then usually there are other options to try. In addition, I also believe that taking a 'holistic' approach to health is the way to go where we don't just turn to drugs for answers and solutions but also look at food, drink, mental and emotional health as well as physical. I know first hand the beneficial effects a change in diet can have from my arthritis experience. Like arthritis, psoriasis is also an inflammatory condition and eating lots of anti-inflammatory foods whilst reducing / eliminating inflammation causing foods from your diet could have a beneficial effect but we must be realistic in our expectations from dietary changes. Its going to take more than a few months of eating the right healthy foods to undo decades of eating the not so healthy, wrong foods.

Stress is known to trigger flares and aggravate psoriasis and I believe it is really important to minimise the stress in one's life. Now I know that's not always easy to do but at the very least please make sure that you have someone that can provide some emotional support for the days when you are struggling or feeling fed up - it can make a huge difference, trust me I know. There are lots of support organisations and groups where you can talk to and interact with fellow sufferers and I've listed a few below. If you are struggling then please do not struggle in silence, do talk to your doctor or family member or friend or reach out for support from one the groups below. You can even reach out to me :o)

Love Sheen xxx

Online community of psoriasis sufferers:

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