What is psoriasis?

In psoriasis, the skin is inflamed with an increased rate of skin cell turnover, resulting in thick scales on the skin surface. The scalp, back, elbows and knees are commonly affected, with red and scaly patches. Nails may show changes like small pits on the surface in up to 50% of people with psoriasis. Joint pains and swelling may occur in more extensive psoriasis.

1-2% of the population in Singapore have psoriasis. It usually starts in the 20s, has a delayed onset and seldom remits permanently.

Why do I have psoriasis?

Genes play a role in the development of psoriasis. Certain infections or medications can trigger psoriasis due to an imbalance in the immune system.

What makes psoriasis worse?

  1. Physical and emotional stress
  2. Throat infections or flu
  3. Some drugs eg. steroids and certain medicines to treat hypertension

Is psoriasis contagious?

No it is not.

Will I pass my psoriasis to my children?

Not necessarily so. Only about 10% of people with psoriasis have a family member affected by psoriasis. Inherited genes do not always express disease without the appropriate environmental triggers.

Are there any foods to avoid, or supplements to help my psoriasis?

No, you do not need to avoid any food. However, excessive alcohol consumption is best avoided.

I need help to treat my psoriasis!

It is best to avoid oral or injected steroid treatment. Although it helps to clear psoriasis very fast, it invariably results in a quick and severe rebound of the condition. There are multiple effective treatment options, speak to your dermatologist about your suitability for these treatments.

  1. Topical medications
    These include topical steroids and non-steroidal vitamin D3 derivatives e.g. calcipotriol and calcitriol.
  2. Phototherapy
    Psoriasis responds to ultraviolet (UV) light treatment, which is used a few times a week in gradually increasing doses over a period of several months.
  3. Oral drugs
    In severe conditions, oral medications such as methotrexate, cyclosporin and acitretin may be required. However, side effects of these drugs will require regular blood tests for monitoring.
  4. Biologic treatments
    There are newer and effective drugs available to treat extensive disease. Biologics work by balancing the skin’s immune system. Examples of biologics include secukinumab (Cosentyx), ixekizumab (Taltz) and guselkumab (Tremfya). Your dermatologist will be able to advise on your suitability.

Tips on managing your psoriasis

  1. Use treatment regularly as directed and keep the skin well moisturised as this will help reduce itching and scaling
  2. Develop healthy lifestyle habits, eat in moderation, exercise regularly and manage your stress levels.
  3. Go for regular health screening as obesity, diabetes, high blood pressure and cholesterol problems are more common in psoriasis.
  4. Do not scratch as this may damage the skin and worsen psoriasis.
  5. Treatment takes a few weeks to show effect, so be patient and do not give up too early.