Some interesting descriptions of various skin complaints and helpful write ups…
Common skin woes explained. Sometimes your skin is more troublesome than simply being too dry or too oily. Caro Verster finds out more about a few common skin conditions.
Psoriasis
Psoriasis is usually characterised by defined red patches covered in fine, silvery scales. These patches are sore and itchy and although psoriasis is not contagious, it can make you feel extremely self-conscious. Psoriasis is caused by abnormal skin growth, when cells have divided too quickly and create a build-up. New skin cells are formed about 1000 times quicker than normal because of a disturbance in the cell's replication control mechanism. It's believed to be an inherited condition and it affects men and women equally.
Know your type
There are five main types of psoriasis:
Chronic Plaque Psoriasis affects the knees, elbows or other crevices. It's the most common type, causing scaly red patches.
Flexural Psoriasis affects body creases such as the elbows, armpits and under the breasts. It typically causes reddening, but no scales.
Guttate Psoriasis (or teardrop/raindrop psoriasis) affects the entire body, except for the palms and the soles of the feet. This type of psoriasis often starts a week after a sore throat infection (if you are prone to psoriasis) and seen as tear-shaped scaly patches. It can be successfully treated if caught early, but can develop into chronic plaque psoriasis.
Pustular Psoriasis affects the entire body. It causes painful pustules, which are often accompanied by fever and may be aggravated by the use of strong steroids.
Erythrodermic Psoriasis also affects the entire body. This is a very rare form of psoriasis, where much of the skin is red and scaly. It's known to affect body-fluid balance and temperature.
Treating Psoriasis
Stress or emotional disturbances can cause psoriasis flare-ups. Treat these causes first before trying other treatments.
External Emollients are commonly used to moisturize affected areas. Other options are salicylic acid, retinoids, steroids, vitamin D, and medications that help stop cell growth, but these may have side effects so patients are monitored very closely. Ultraviolet light therapy, in conjunction with psoralen (which increases the skin's sensitivity to light) is used as a last resort because of the association between cancer and UV light. Limited sun exposure, and seawater have had positive effects – a common destination for psoriasis sufferers is the Dead Sea. To recreate the Dead Sea experience at home, try bathing in water than contains 1kg of Epsom salts and 500g of salt. Liquorice, camomile and cayenne pepper extract have also been known to be effective.
Internal If you have noticed that you are suffering from constipation, poor digestion or food allergies, toxins may be seeping into the body and affecting the skin. Faulty digestion of protein is closely linked to the development of psoriasis. It causes toxicity in the bowel, weakening the gut lining and poisoning the rest of the body. Maintain a diet that supports good digestive and liver health: beans, whole grains (wheat, oats, rye), root vegetables, lentils, fresh fruit and vegetables (especially the green variety). Avoid sugar, alcohol and fats, which have a negative effect on the liver. Supplements may be an option, especially those containing vitamin A and zinc, but large doses of vitamin A (more than 5000 IU a day for men and 4000 IU for women) can cause toxicity. Long-term overdose of vitamin A can cause symptoms ranging from hair loss to enlarged liver and spleen. Consult your healthcare practitioner before starting any supplementation.
Eczema and dermatitis
Eczema is an inflamed, red rash that's very itchy. In more extreme cases, the skin becomes broken, weepy and scabbed. This condition is also known as dermatitis.
Know your type
Atopic Eczema is usually a hereditary condition that is often associated with an increased susceptibility to allergies, such as hay fever and asthma.
Seborrhoeic Dermatitis affects the oilier arrears of the body, such as the face.
Treating eczema
External Moisturizing emollients are used to keep the skin soft, and proper cleansing is essential. Corticosteroid creams can relieve swelling and itching, although users may build up resistance to them, so you may find that you need stronger doses after prolonged use. There are side effects with steroid creams: stunted growth, weakened bones and suppressed adrenal gland function can occur. However, if patients are managed properly and monitored closely, side effects are minimized.
Internal If your eczema isn't hereditary, food allergies are the first place to look – eczema sufferers are usually intolerant of cow's milk and eggs. Other possible allergens are gluten (found in wheat products such as bread and pasta), fish, peanuts and food additives. If you suspect a food allergen is the cause of your eczema, eliminate these allergens from your diet for at least 10 days and see if your symptoms improve, then reintroduce foodstuffs one at a time. If your symptoms worsen when you start eating a certain food again, you have probably identified your food allergen. Atopic eczema sufferers may also suffer from hay fever or asthma. Disrupted fat metabolism makes their skin drier and an abnormally high presence of Staphylococcus aureus bacteria causes abnormalities in the immune system, so they release more histamines that cause itching and inflammation. If you're trapped in this cycle, ask your healthcare practitioner about anti-staphylococcal measures you can take.
Urticaria and Hives
Both of these skin conditions are characterized by raised white welts surrounded by redness. The swelling and redness are caused by the release of the body's allergy chemicals, histamines. Many factors can trigger a reaction – a scratch, heat, cold. Food and additives can all be causes.
Know your type
The most common cause of hives and urticaria are reactions to medications including antibiotics (such as penicillin), aspirin, the polio vaccine, quinine, essential oils and morphine, among many others.
Hives may be causes by pressure: fabric, jewellery or skin contact. Within minutes welts can come up.
A ‘prickly heat' rash is caused by heat exposure and overactive sweat glands. Any type of heat exposure can cause a reaction: heat from the sun, exercising, a hot bath, eating spicy food, or stress.
In other cases an urticaric reaction is brought on by cold – cold air, cold water or cold objects.
Hives may also be the result of a food allergy.
Treating hives and urticaria
External
If you react to heat or cold, protect yourself from temperature extremes. Wear natural fabrics to allow sweat to evaporate and avoid the use of heaters and electric blankets in winter.
Internal
Common food allergens include milk, fish, meat, eggs, beans, nuts, chocolate, cured meat, chicken, citrus, shellfish and food additives. It's important that the digestive tract is in good shape so that toxins don't build up. Eating fresh food is your best bet. Identify allergens to which your body reacts, using the food-allergy plan suggested for eczema sufferers, then eliminate these triggers from your diet. If you think your skin condition may be linked to a medication, ask your healthcare practitioner for alternatives.
Useful contacts
Dermatology department, Groote Schuur Hospital (021) 404-5250 UCT
Skin and Hair Centre, (021) 406-6890
International Psoriasis Association: e-mail mail@psoriasis.demon.co.uk
Cape Town Psoriasis Associa tion, (021) 981-1650
Words by Caro Verster
We would like to thank Caro for her interesting write up and hope that she will write many more interesting reports on this troublesome skin disorder, which we are all trying our best to help fine a solution.
