A BRIEF SUMMARY

Once a diagnosis is made, there are medications that can soothe the redness and irritation. Tar baths, antihistamines, and antibiotics are often used, but these meet with limited success. Topical creams or ointments that contain corticosteroids are frequently prescribed to help control itching. It’s best to limit the use of these products to a two week period or less. Overuse of corticosteroids (also called steroids) can cause increased redness, thinning of the skin or further damage that may aggravate an existing condition or cause another condition which may prove more difficult to treat such as steroid-induced rosacea. Your doctor might also recommend medications you take internally, such as oral corticosteroids. Treatments that don’t seem to work include vitamins, mineral supplements, enriched diets, or nutritional supplements. Another treatment option is the use of ultraviolet light or sunlamps. Some in the medical profession question the use of light therapy as it is more of a temporary “fix” than a solution to the problem. Light therapy should also be used with caution as it can cause redness, burns, blistering or further skin damage. Under a physician’s supervision, some sufferers find this treatment helps, but so many more find it to be just another disappointment. One treatment option which has found success for individuals whose skin has been left sensitive and delicate by over-the-counter or prescription medications is Dermatitis-Ltd III.

Even though there is no cure for eczema, there are lots of things you can do to feel better if you have it:

• Don't scratch! Sometimes this can seem like the hardest thing to do. But when you scratch, it makes your skin sore. The skin can even break open, bleed, and become infected with bacteria.

• Keep your fingernails cut short. You're less likely to break your skin open if you scratch an itch.

• Take short baths or showers with warm water. Hot water can make you itch more. Ask your doctor about the use of oatmeal soaking products in your bath to help control the itching.

• After bathing, don't rub your skin dry with a rough towel. That just irritates your skin more. Gently pat it dry to get the water off. Then put on some moisturizing lotion to help keep your skin from getting too dry. You can spread the lotion on several times a day.

• Do your skin a favor and drink lots of water, increasing your water intake, increases the moisture in your skin.

• Wear loose clothing to help your skin feel better. Make sure you wear cotton or other natural fibers. Wool and synthetic cloth can make you feel itchy all over.

• Relax. You may find that your eczema gets worse when you're stressed. Find ways to deal with things that bother you.

Keep a diary of anything you ate or came in contact with just prior to a flare. If you're allergic to any foods or other things that may make your eczema flare up, you'll want to be sure to avoid them.

Unfortunately, eczema cannot be cured, though certain types will eventually clear up and others can be resolved by avoiding particular triggers. For many sufferers however, this is a lifetime condition that has to be carefully managed and monitored.

The person with eczema may be quite sensitive about their condition. Self-consciousness is common. People may withdraw socially, believing that skin conditions carry a stigma. This can affect the person's social and emotional development.

No one knows for certain what conditions specifically cause eczema, although problems with the body’s immune system may be to blame. Substances and events that are often perceived to cause the condition are actually triggers. The triggers cause underlying skin conditions to flare up and existing skin rashes to worsen, but they don’t actually cause the condition.

Research into human genetics may hold the key to discovering the root cause of eczema. Until then, sufferers should attempt to avoid substances known to trigger skin rashes.

General measures to relieve itching of psoriasis include:

• Keep your skin cool; warmth tends to make itching worse;

• Wear light clothing for coolness and to avoid scratchy pressure against your skin; and,

• Keep your skin moisturized with a light emollient recommended by your dermatologist, as dry skin tends to be more prone to itching.

There are a number of measures which you yourself can take to help improve and reduce aggravation of your psoriasis:

• There is a well-known link between excessive alcohol consumption and severity of psoriasis. This is not observed with other skin disorders. Research shows that men with psoriasis are more likely to be heavy drinkers than the rest of the male population. While this is not the case among women, it does indicate some sort of link between psoriasis and heavy drinking. This association between excessive alcohol consumption and psoriasis is not seen with other skin conditions.

• Likewise, smoking is associated with a particular type of psoriasis called palmoplantar pustular psoriasis and ideally should be discontinued in individuals with this disorder. Smokers are at an increased risk of developing pustular psoriasis on their palms and soles. They also have a greater chance of developing chronic plaque psoriasis. This is thought to be because of the damage that smoking can do to the immune system.

• Medications known to aggravate psoriasis should be avoided where possible, eg. lithium, beta blockers, anti-malarials and sudden withdrawal of systemic steroids.

• Diet seems to have little effect on psoriasis (although you should always try to maintain a healthy and varied diet to help keep you in general good health). If a person is obese, losing weight may bring some relief to certain areas of the body affected by psoriasis. For example, chafing (rubbing together) of layers of fat around the stomach area may result in persistent plaques, therefore losing weight may help.

• Psoriasis is aggravated by trauma and thus you should avoid picking at your psoriasis, since this can actually make it worse.

• Occasionally people with AIDS develop very severe psoriasis. This can be difficult to treat because of the weakened immune system involved.

• Skin Infections - Skin infections have a viral, bacterial, or fungal basis. Rashes caused by athlete's foot, impetigo, and chicken pox all fall into this category. Bacterial and fungal skin infections are usually successfully treated with antibiotics and other medications. Viral skin infections must be combated by the body's own immune system, although the symptoms associated with the infection can be treated. Skin conditions caused by infections may appear as rashes or other types of lesions such as pustules.

• Sun Exposure, Sunburn and Heat Rash - Sunlight contains harmful ultraviolet rays that can damage the skin. Sunburn increases your chance of developing a skin condition, as does tanning and lengthy unprotected exposure to the sun. Skin cancer is the best known condition caused by sunburn and tanning. Premature aging of the skin also occurs with prolonged exposure to the sun.

• Certain drug reactions increase the skin's sensitivity to sunlight, thereby increasing the chance of sunburn or heat rash. Hyperpigmentation, a skin condition where areas of skin become darker than the surrounding area, can be caused by unprotected exposure to sunlight and may be caused by drug reactions; excessive sun exposure while taking certain medications is ill advised. Adverse drug reactions can cause rashes, hives, and swelling. As mentioned above, some medications increase the skin's sensitivity to the sun. Notify your doctor of any skin problem that develops after you start a new medication.

In hot, humid weather, prickly heat rash can develop. Staying cool and dry, wearing light, cool clothing and drying thoroughly after bathing are the best defenses against the irritating prickly heat of the heat rash pustules.

• Pregnancy - Certain skin conditions occur more often during pregnancy. Almost 90% of pregnant women have temporary hyperpigmentation called Melasoma, or the "mask of pregnancy" where naturally darker areas of pigmentation (such as freckles, scars, moles, and nipples) appear darker than usual. The condition slowly disappears after childbirth.

• Natural Irritants and Allergies - Many temporary skin problems are caused by natural sources. Insect bites inflame and irritate the skin. Poison ivy and other irritating plants cause skin rashes, pustules and itching. Parasites such as lice and mites can cause extreme itching and discomfort.

A food allergy can cause skin rashes, hives and even facial swelling. While the symptoms of a food allergy are often dramatic, tracking down the food that causes the allergic reaction can sometimes take time. If you suspect you have a food allergy, consult your doctor: allergy testing may be in order.

• Diaper rash is caused by exposure to urine and feces, allergies to disposable diapers, soaps and detergents, or by diapers that are worn too tightly. While most cases of diaper rash are mild and resolve in a day or two, more severe cases form painful pustules that cover the baby's bottom, and may even result in a yeast infection. All cases of diaper rash should be monitored for potential secondary infection by bacteria or yeast.

• Genetics - People whose parents suffer from skin-affecting allergies may themselves be at increased risk of developing allergies. Acne has a hereditary pattern, as do some other common skin conditions. In the field of new drug development, a skin rash is considered to be a relatively "minor" side effect. Even medicines that successfully treat problems for most people frequently list the side effect of causing or worsening skin problems for an unfortunate few.

• Over-the-counter medications are available without a prescription because they contain relatively low concentrations of active ingredients. They are "not designed to treat the causes" of a skin condition, but to give some relief of "symptoms." Many good moisturizers are available as over-the-counter products. They are important in terms of prevention and maintenance to reduce eczema's impact. Regular use of these products may reduce the frequency of flare-ups.

• Prescription medicines, by contrast, are usually much more powerful in treating the underlying cause of a condition. They are closely regulated in the U.S. by the Food and Drug Administration (FDA), and are approved for use in treating a specific disease only after they have demonstrated effectiveness and safety. No prescription drug is free of side effects, and FDA approval is sometimes given to drugs that must be used with caution to avoid the negative effects which could result in something worse than the disease itself. Consequently, these drugs must be administered under the watchful eye of a licensed practitioner - a doctor or, in some states, a nurse practitioner.

People with psoriasis on less than 2 percent of their body are considered to have a mild case. Generally, isolated patches of psoriasis are found on the knees, elbows, scalp and hands and feet. Topical treatments—including moisturizers and over-the-counter and prescription creams, ointments and shampoos—are usually sufficient to keep the psoriasis in check.

Moderate psoriasis is defined as affecting between 2 percent and 10 percent of the body's surface. Psoriasis may appear on the arms, legs, torso, scalp and other areas. Appropriate therapies include topical treatments, phototherapy and oral medications, depending on the location and extent of the psoriasis and other individual factors.

Psoriasis covering more than 10 percent of the body is considered severe. Extensive areas of skin may be covered with psoriasis plaques or pustules, or widespread erythrodermic psoriasis can cause severe peeling of the skin. People with severe psoriasis are more likely to develop psoriatic arthritis. Powerful treatments, including phototherapy, oral medications or a combination of these, are usually necessary to manage severe psoriasis.

Treatments:

• It is important to maintain a good skin care regimen. Avoid soaps and use soap substitutes such as Cetaphil “moisturizing cleansing bar for dry sensitive skin”

• The skin should be moisturised daily, eg. Diprobase, Eucerin (with /without urea), Emulave, E45, Jojoba Oil, etc.

• Crude coal tar is the sticky black liquid left behind when coal has been heated to remove the volatile components. It works by decreasing the turnover of cells in the top layer of skin (epidermis), which are replaced too rapidly in psoriasis.

• Many over the counter products are available containing both crude (mucky, but more effective) and refined (cleaner) coal tar. Some people find the smell intolerable and others find these products too messy for home use. However, they can be an extremely safe and effective treatment for all types of psoriasis at all ages. Curea is the combination of coal tar and urea and can be applied liberally under old clothes. Avoid the body flexures with tar preparations since they can irritate the thinner skin at these sites. Other tar containing over the counter products include Alphosyl, tar pomade, Pragmatar, Psoriderm, etc. Coal tar products such as Cocois ointment and tar pomade can be applied to thick plaques of psoriasis in the scalp and left overnight, mainly as de-scalers. These are then washed out with tar shampoos such as Capasal, T-gel and Polytar. Coal tar bath emollients are also available and can play a role in the overall skin care programme eg Polytar emollient, Balneum with tar and Psoriderm bath emulsion. Coal tar products must not be put on exposed skin during sunny weather, since tar is a photo sensitizer and will render the skin far more susceptible to sunburn.

Through scientific research from medical staff and dieticians throughout the world over a number of years, there has not been any obvious link found between psoriasis and any particular food in the diet.

There is no clear cut evidence to say that gluten causes psoriasis. One paper suggested that antibodies to gluten were reduced and there was some improvement in psoriasis in some people who had a gluten free diet.

However it should not be expected that a gluten free diet will clear psoriasis, but consult your doctor if you have concerns. Gluten causes another condition called dermatitis herpetiformis.

Psoriasis is a skin disease that can have substantial psychological, emotional and social impact on a person with psoriasis and on his/her family and friends.

Stress—physical, emotional and psychological—can be a trigger for psoriasis. Stress can be an initiating condition, or for worsening of existing lesions

Just the fact of having psoriasis is, in itself, psychologically and emotionally stressful. Lack of understanding by spouse, parents, children, other family members, friends, and co-workers can add another level of stress.

For most skin conditions, including psoriasis, there are probably multiple genes involved in producing the sequence of events that result in the condition. Complicating the picture still further is the probability that genes found to be associated with psoriasis may or may not cause psoriasis in an individual person, depending on the activity of the genes in relation to one another. The activity of genes in relation to one another is often determined by the pattern in which they were inherited from parents.

Both dermatologic and systemic infections have been known to trigger the onset of psoriasis or a worsening of psoriasis. The incidence of infectious triggering has varied from study to study, but the triggering effect of infections is well documented. Systemic infections that have been associated with triggering include viral upper respiratory disease, streptococcal pharyngitis ("strep throat"), and human immunodeficiency virus (HIV). Staphylococcal skin infections (boils) have been a trigger.

Psoriasis is a chronic, lifelong condition that can be controlled with treatment. It usually does not adversely affect general health, unless it is neglected or occurs in the elderly or very young.

Treatments for psoriasis can often control the disease for long periods. However, none of the available treatments is a cure. The disease can come back when treatment stops.

Remeber the cause of skin conditions range from a sunburn, drug reactions to genetics and even pregnancy. Many of the causes can be avoided with a little prevention, while others are more random in occurrence.