The cause and methods of treatment of psoriasis on the head

Psoriasis is a chronic, non-infectious, inflammatory skin lesion with a negative impact on the quality of life of patients ("Psora" from Greek - scales). It is from there, like many other diseases, that the first observations about psoriasis are described. This term was introduced by Galen, one of the key researchers in medicine.

The cutaneous signs of psoriasis created confusion among people and healers, as leprosy was widespread at the time, with dire consequences. Patients with psoriasis were subjected to social pressure, they were avoided, they were forcibly isolated. In Europe, such people were forced to warn others of their arrival by ringing bells. Attempts at treatment consisted of the use of manure, onions, sea salt, oil, urine, but all were ineffective and made psoriasis patients outcasts.

PREVALENCE OF PSORIASIS

The disease can appear at any age, but more often occurs in the age group from 49 to 69 years. The reported prevalence of psoriasis in countries ranges between 0. 09% and 11. 4%, making psoriasis a serious global problem.

Despite the widespread misconception that psoriasis is not as serious as other non-dermatological conditions, psoriasis creates a disease burden that extends far beyond dermatological symptoms. Its psychological effects are similar to cancer, heart disease, diabetes. Psoriasis plaques are often visible, which can negatively affect interpersonal relationships, school or work success. Not surprisingly, people with psoriasis have higher rates of depression with an increased number of suicidal thoughts.

Patients with psoriasis are also at risk of developing serious comorbidities that will complicate disease control and increase the risk of early death. Cardiovascular disease and metabolic syndrome are more common in patients with psoriasis.

In addition, psoriasis is itself a risk factor for cardiovascular disease, tripling the relative risk of developing myocardial infarction. Severe psoriasis is also associated with an increased risk of mortality, resulting in a 3. 5 and 4. 4 year reduction in life expectancy for men and women, respectively, compared to people without psoriasis.

CAUSE OF PSORIASIS ON THE HEAD

There have been many theories about the origin of psoriasis. This is the influence of microbes, viruses, allergies, poor hygiene, disturbed blood supply to the skin, disruption of the functional balance of internal organs, and one of the most urgent at the moment is the autoimmune nature of the disease, when human immune cells attack their own tissues. And even this assumption remains a theory, since so far no antibodies that damage the skin have been found in patients with psoriasis.

At the moment, the cause of the pathology remains unknown. But in the course of research, scientists have identified factors that, with a certain degree of probability, can provoke psoriasis.

The following points are distinguished:

• Heredity. There is no one hundred percent chance that even if the mother and father are sick, their child will necessarily suffer from psoriasis. But in such a situation, the risk of getting such a pathology is higher. It was also noted that if among identical twins one is sick, the second twin is more likely to get sick than compared to the usual risk in the population. This proves that this nosology has a genetic prerequisite.
• Skin injuries: accidental knife cuts, cat scratches, mosquito bites, sunburn increase the risk of triggering another outbreak.
• Infections: staphylococcal, streptococcal and other infections can also act as triggers. Children often have streptococcal tonsillitis before the onset of the cutaneous manifestations of psoriasis.
• There are medications that can trigger the disease, for example, anti-malaria drugs, some anti-depression drugs.
• Changing your HIV status to positive can also give an impetus to the development of psoriasis. Therefore, testing for HIV when psoriasis is suspected is not strange.
• Stress. The most famous trigger for laymen. “It's all because of stress” - every psoriasis patient has heard this phrase at least once. Some people are dubious about this phrase, but it has its own justification. Scientists believe that our immune systems can respond to emotional and mental pressures as well as physical defects such as trauma and infections.
• Excess weight negatively affects the entire body systemically, and if an obese person has a history of psoriasis, treatment is more difficult and often less effective.
• Smoking. It has long been noted and it is no secret to anyone that cigarettes have a negative effect on the skin condition. Hence the likelihood of provoking psoriasis, especially the head and hands are damaged.
• Alcohol is one of the common individual triggers for psoriasis.
• Hormonal changes. The disease often manifests itself during puberty. Menopause can also provoke psoriasis, but during pregnancy a decrease or even complete regression of plaques has been noticed.

SYMPTOMS OF PSORIASIS ON THE HEAD

In 50% of cases, psoriasis makes itself felt from the head. Psoriasis can appear anywhere on the head. Sometimes small plaques develop that are easy to hide in the hair, but when the entire scalp is covered, it is difficult to hide the plaques.

The appearance of psoriasis on the head will manifest itself as follows:

• Reddish spots on the scalp. Some spots may be subtle due to their fading, but there are also bright red elements that are easy to see.
• Scales peeling off psoriatic skin. The condition of the scalp in this pathology may resemble ordinary dandruff. But there are differences, for example, with psoriasis, a silvery sheen is observed, and it can also be accompanied by itching.
• Dry scalp. The scalp can be so dry that the skin will crack and bleed, which will create conditions for the addition of an infection, the treatment of which in such a location has certain difficulties.
• Itching. This is one of the most common symptoms. Someone experiences a slight itching, which the patient may forget about in everyday activities, and some experience such severe itching that work, study and even sleep is impossible.
• Bleeding. Because scalp psoriasis can be itchy, the patient may scratch the skin, damaging it. In addition to bleeding, scratching can worsen the course of psoriasis by making the plaque larger and denser. This is why dermatologists tell their patients, "Try not to injure the scalp. "
• Burning. The patient may describe his scalp as literally “burning”.
• Hair loss. Scratching the scalp, using force to remove scales can lead to hair loss. Although this phenomenon is temporary, it can still cause inconvenience to the patient.

These clinical manifestations can quickly, both increase and collapse. This is an individual process. In one patient, the entire pathological process will end on one pale plaque under the hair, while the other will have many bright lesions all over the head. This is influenced by, among other things, the triggers described above.

A number of problems the patient may face:

1. Skin manifestations visible to others. Living with psoriasis can make a person shy. Any aspect of social life can be stressful for these people, such as holding hands on a date.
2. Finance. Treating psoriasis can be costly. This is more true for widespread psoriasis resistant to conventional therapy, for the treatment of which new drugs based on monoclinal antibodies are used.
3. Pain. Chronic pain can occur with psoriasis, which further increases stress levels. This will be especially true when skin manifestations are combined with inflammation of the joints, while reducing the daily activity of a person.
4. Healing. Especially when the patient seeks help late, some procedures do not have the expected effect, which, of course, worries the patient, emotionally oppressing him. Other procedures can take a long time. For example, you may need to receive phototherapy 3 times a week for up to a year. For some, such a regime will be difficult to be compatible with the standard life rhythm.
5. Living with a Chronic Illness. Psoriasis, like many other chronic pathologies, requires great volitional efforts. It is difficult for the patient, especially at the initial stages, to cope with a number of additional problems that have “fallen on his head”. This creates conditions for the occurrence of depression.

DIAGNOSTICS OF PSORIASIS ON THE HEAD

The decision of whether to see a doctor or not is up to the patient depending on the severity of the symptoms. However, the best solution, regardless of the localization of the plaques, would be to visit a doctor. For further treatment to be as successful as possible, it is necessary to make an accurate diagnosis, even if the symptoms are mild.

In most cases, scalp psoriasis is diagnosed after a physical examination and analysis of the medical history.

A dermatologist is able to determine scalp psoriasis by examining pathological elements of the skin.In exceptional cases, the patient may be advised to undergo a skin biopsy to rule out other diseases.

TREATMENT OF PSORIASIS ON THE HEAD

Unfortunately, at the moment there is no cure for this ailment. Therapy is required throughout life and is aimed at maintaining remission. In addition, caring for patients with psoriasis requires not only skin treatment, but it is also very important to control existing chronic diseases and prevent new ones.

These conditions will include cardiovascular disease, metabolic disease, and psychological health.

Treatment goals:

• Achieve the patient's clinical recovery as soon as possible;
• Remission must be stable and long-term;
• Maintaining a positive psychological status of the patient.

DIET FOOD

Treatment traditionally begins with diet. Foods containing antioxidants such as vitamin C, E, beta-carotene (vegetables, fruits, sage, ginger and others) can play a positive role, as well as omega-3 fatty acids, which are rich in salmon, sardines and other fish.

The link between alcohol and psoriasis is unclear, but experts say drinkers respond less well to treatment, and psoriasis remissions are longer after they stop drinking alcohol. In addition, some antipsoriatic drugs are not compatible with alcohol.

A clearer correlation is observed with overweight. In obese people, as a rule, the pathology progresses faster with a brighter clinical picture.

SHAMPOO

Hair makes the treatment of scalp psoriasis particularly difficult. Few people agree to remove their hair in order to more effectively resolve the clinical manifestations of the disease, especially considering the fact that the defects will be even more noticeable to others.

Conventional hair care products are not suitable in this situation, as they can additionally irritate the scalp, contributing to the progression of the pathology. Therefore, tar shampoos are used, the effectiveness of which in the fight against scalp psoriasis has been noticed for a long time.

Tar has a "soothing" effect on the epidermis of the scalp, inhibiting the formation of scales. In addition, shampoos with phenolic acid are used, since it has a keratolytic effect (destroys dense horny scales). The plus is used to enhance the penetration of other medications, including corticosteroids.

When prescribing shampoo, individual characteristics of a person in hair hygiene are taken into account. For example, some women do not wash their hair every day, so it would be best for them to apply the solution to their hair before going to bed 2-3 times a week, followed by washing their hair in the morning.

PHENOLIC ACID

Phenolic acid can also be used alone as an ointment. The fact that the ointment is applied for a relatively long time increases its effectiveness of hyperkeratic properties. And for patients who complain about the difficulty of separating scales from their hair, applying an ointment before a shower can help resolve this situation.

COAL PITCH

Coal tar has been used as a treatment for psoriasis for several decades due to its antiproliferative, anti-inflammatory, and powerful antipruritic effects.

Although, raw coal tar is the most effective resin. Applying raw stone tar to the scalp is problematic. It is generally recommended to use a resin solution (5-20%) formulated as a lotion or added to a corticosteroid. This remedy helps fight psoriasis, but it has a number of side effects: coloring, thinning hair and a more serious negative effect - carcinogenic, due to which the use of this method is limited.

For example, for this reason, coal tar is prohibited in Canada and the European Union.

CORTICOSTEROIDS

Of all the topical treatments available, corticosteroids have been shown to be the most effective in clinical trials for scalp psoriasis and are the most commonly prescribed treatments. Corticosteroids are also convenient in that there are a large number of production forms for any situation: creams, lotions, ointments, oils, gels, foams, solutions, sprays and shampoos.

Do not underestimate the importance of psychological harmony in this pathology. Stress can both become a trigger, causing a detailed clinical picture, and inhibit the treatment process. Therefore, patients with internal anxiety are advised to consult a psychotherapist, psychologist.

CARE RECOMMENDATIONS FOR HEAD PSORIASIS

It is important for a patient with psoriasis to first of all follow the advice of a doctor, but, nevertheless, following the simple rules that will be described below, you can further improve the quality of life:

1. Use moisturizing lotions. Skin manifestations of the disease worsen markedly when the skin is dry, so it is important to keep the skin moist. Specialized cosmetic ointments, lotions, or, for example, regular petroleum jelly can help with this.
2. Take good care of the skin with psoriatic plaques. When washing your hair, never forcibly peel off the scales that are tight to the skin, as you can only spread the process to nearby, healthy tissues.
3. Be careful when trimming your nails. Cases are described when accidental damage to the growth zone of the nail with manicure scissors provoked the appearance of new cutaneous elements.
4. Find the right shampoo for you that doesn't flake your skin to use on your scalp in remission. Or just continue to use tar altogether, only with a lesser concentration, for daily care.
5. Climate can also play a role. It is noticed that cold has a negative effect on patients, provoking the development of plaques. Sunny weather provokes regression of skin manifestations, but not always.

6. Use a humidifier. This can keep the skin moist and eliminate dry air, which is bad for psoriasis patients.
7. Do not take medications that can harm your skin. The doctor should be told about any drugs you are taking, even those that you think are harmless. For example, for the treatment of depressive conditions, preparations containing lithium salts can be used, which are contraindicated for patients with psoriasis.
8. Avoid all kinds of damage to the skin: scratches, cuts, bumps. Injuries to the skin can cause a condition called Koebner's phenomenon (when psoriatic elements develop along the line of damage to the skin). Be careful when shaving. Try to avoid acupuncture, avoid getting tattoos on your body, and do whatever you can to prevent insect bites.
9. Try to appear in the sun, but in moderation. Ultraviolet rays in sunlight slow down the growth of skin cells, so getting moderate doses of UV is good (30 minutes at a time is enough). Excessive exposure to the sun, paradoxically, can provoke psoriasis. Also, keep in mind that certain medications can make your skin more sensitive to UV rays.
10. Patients with psoriasis should reduce their level of anxiety. Of course, this is easy said than done, but relaxation techniques such as meditation or yoga can be tried.
11. Estimate how much alcohol you drink. The link between alcohol and psoriasis is unclear, but scientists still believe it can worsen symptoms, especially in men. It is well known that alcohol is dangerous when combined with certain psoriasis medications.
12. Balance your diet and try to lose weight. If it is difficult for you to do this on your own, seek help from specialists who can assess in which direction it is worth working better.

RECOMMENDATIONS FOR THE CONTROL OF PSORIASIS OUTBREAKS ON THE HEAD

By monitoring the progress of psoriasis, you can help the patient better control their disease and take the necessary measures in time, as well as increase the productivity of the doctor-patient relationship. A few simple rules will help you with this:

• Create a “self portrait” of a psoriasis outbreak. A digital camera, smartphone or just a piece of paper will help you with this, where you can record all the changes that occur with the plaques. It is also worth recording where the changes initially appear and in what sequence they increase. For such introspection, the doctor will only praise you and will know that you are determined. Over time, analyzing the recordings, one can identify patterned situations, for example, an outbreak always begins with a plaque in the occiput.
• Every time psoriasis regresses or progresses, try to find out what it is. Maybe the weather has changed? Out of medicine? Are you taking a new medication? Recently damaged skin? Such triggers can be individual, which makes it difficult for the doctor to understand without introspection of the patient (for example,an attack provokes a certain type of coffee).

Although the disease is not transmitted by contact, the appearance of patients scares away those who do not know. Beauty salons are afraid to provide services, some taxi drivers do not want to transport such people, it is difficult to get a job. Not to mention starting a family, and the fear that their children will be doomed to the same suffering prevents them from having children.

There are even cases when people with psoriasis were denied access to the Olympic swimming pool in response to collective complaints from other athletes. The management had to refuse such people, despite the fact that they perfectly understood that this pathology is not dangerous in an infectious sense.

It is difficult for them to engage in everyday, daily activities, since the burden of psychological pressure is high, and a person needs social contact. For these reasons, societies for the protection and support of psoriasis patients are being formed in many countries. Companies are being deployed aimed at informing third-party people about this disease.

People should be judged by their actions, deeds, and not by their appearance. Indeed, among patients with such a nosology there are highly professional doctors, police officers, firefighters, athletes, and many others, for whose actions not only their relatives, but also their country can be proud of them.