Genetics and Your Skin

Genetics plays a large role in all of medicine, says Dr. Goldberg. It’s a field that is being widely researched, and new discoveries are made on a daily basis. From acne, psoriasis, and aging to melanoma, many dermatological conditions have genetic components. Some of these genetic links have been proven, and others can simply be surmised from familial relationships and medical histories.

“For example,” Dr. Goldberg explains, “with something like melanoma, we know that there is a gene involved. With other skin cancers, we know that there are genes involved. And there are certain syndromes where an individual is more likely to get basal cells – we know what the gene is that causes that.”

Genetics, however, are not the single determining factor in whether or not someone will ultimately suffer from particular condition. While genes may make a person more susceptible to certain things, various environmental factors also come into play. These environmental factors may be managed, and medical treatments employed, to make even genetically-linked skin conditions less severe and more controllable.

Overcoming Genetics

The extent to which someone with a genetic predisposition to a skin condition is “stuck” with it depends on several factors. Many genetically-linked conditions, although maybe not curable, are controllable with proper treatment. The goal of the dermatologist should be to make such an individual as comfortable and disease-free as possible for as long as possible. This is accomplished through the right combination of lifestyle changes and medical intervention.

“In some cases,” says Dr. Goldberg, “the patient may always have a low level of disease, but every day there are advances in dermatology, and some really amazing things have come out recently.” Dermatologists are better able to control things that at one point weren’t controllable.

Some examples of genetically-linked conditions that can’t be cured, but can be controlled, include psoriasis and even acne. With acne, while some individuals will never experience it at all, others will struggle with it well into adulthood. With psoriasis, symptoms will likely come and go throughout a patient’s life. But thanks to advancements in treatment options, the fact that a patient’s parents or grandparents had a particular condition doesn’t condemn that patient to being unhappy and uncomfortable for life.

“Even though there may not have been effective treatments available when your parents suffered from acne, for example, we’ve come a very long way in the past 30 years,” Dr. Goldberg says. With the help of a skilled dermatologist, you may well be able to overcome your genes and experience healthy, beautiful skin.

Psoriasis is a chronic skin condition involving the accumulation of large patches of dead skin cells on the surface of the skin. The most common complaints associated with psoriasis are pain, discomfort, unsightly skin patches and, in severe cases, movement difficulties.

Whereas normal skin cells mature and shed about once a month, psoriasis causes the body to shed skin cells in some areas every three to four days. This creates a build up of old skin cells that irritate the new skin below and eventually begin to flake off. Affected areas of the skin may be red and scaly (“silvery” scales are common), may appear dry and cracked, and will likely become itchy or painful. The condition is sometimes associated with arthritis and can cause joint pain and stiffness.

According to the National Psoriasis Foundation and U.S. National Library of Medicine, the exact cause of psoriasis is not known, although the condition appears to be passed down through families. Psoriasis is assumed to be an immune system disorder and several factors seem to trigger outbreaks, including infections, damage to the skin, changing seasons, stress, prescription medications and the use of tobacco or alcohol.

Psoriasis is not only a cosmetic condition. This disease carries with it some significant psychological and emotional effects as well. People with psoriasis often suffer from a negative self-image and believe that they are treated differently from others because of their appearance. They may tend to avoid social situations and recreational activities due to fear of rejection. Because psoriasis seems to be worsened by stress, and having psoriasis is stressful in and of itself, a vicious cycle can be created that perpetuates both the psychological effects of the condition and the severity of the condition.

Can It Be Treated?

For years, dermatologists and cosmetic surgeons have struggled to find ways to cure psoriasis. Unfortunately, a cure is still not available. With the help of cutting-edge treatment options, though, psoriasis can certainly be managed. However, what works for one patient will not necessarily work for another. So it’s important to approach treatment with an open mind, realistic expectations and the patience to try multiple approaches until your doctor finds the right method to treat your condition.

Treatment options for psoriasis include topical creams, behavioral modifications, dietary changes and medications. Your doctor will likely recommend a combination of several therapies in order to maximize your benefit. Still, until recently, no single treatment or combination therapy has been able to completely stop symptoms from occurring.

However, new laser technologies have even enabled doctors to eliminate the symptoms of psoriasis completely (albeit temporarily), relieving the pain, discomfort and cosmetic effects associated with the condition for an extended period of time. For the first time, psoriasis patients have the potential to be able to live essentially symptom-free for a stretch of several months.

What Are the Benefits of Laser Treatment?

Laser treatment is showing excellent results. In fact, the National Psoriasis Foundation cites anecdotal evidence of patients achieving total freedom from their psoriasis for up to eight months after treatment, but admits that little long-term data is available and that results will vary. Because a small, targeted light beam is used, only the affected skin is treated—surrounding tissue is left unharmed. This helps speed the healing process and keep discomfort to a minimum. In most cases, laser treatment yields results more quickly than topical medications and the results are often much more dramatic.

What Are the Risks?

All medical procedures come with some degree of risk and laser psoriasis treatment is no exception. Laser treatments are generally associated with minimal risk although adverse effects are sometimes reported. The most common side effects are redness and blistering at the treated sites.

Of course, there is always the chance that the treatment will not yield the dramatic results you may be hoping for. Because psoriasis is a chronic condition, you can expect it to return eventually. Your results may be relatively long-lasting after laser treatment, but there is a possibility that your condition will worsen again shortly after your procedure. Laser treatment is most effective on those patients with mild to moderate psoriasis. Those with more severe symptoms will likely see an improvement in, but not the complete elimination of, their psoriasis.

The Bottom Line

No one should have to suffer the physical pain and psychological effects of psoriasis when such effective treatment methods are available. Management of your condition may be the only thing standing in the way of you and the healthy, happy, socially active lifestyle you dream of.

The skin is the biggest organ of the body and it is the first thing someone notices about you. Psoriasis affects various parts of the body and is not contained to just one area. There are also many types including:

• Plaque Psoriasis
• Nail Psoriasis
• Scalp Psoriasis
• Guttate Psoriasis
• Inverse Psoriasis
• Pustular Psoriasis
• Erythrodermic Psoriasis

There is the possibility of treating the psoriasis so that you can regain confidence in yourself and your skin. While many treatments are readily available either over the counter or by prescription, how can we know which one will be the most effective?

What is Psoriasis Treatment?

There are three categories of psoriasis treatments which include topical, light therapy, and oral medications. All three categories have the same results:

• Stop the overproduction of skin cells which increase plaque and inflamed skin
• Smooth roughened skin and decrease scales on skin

Topical medicines come in cream or ointment form and ease mild to less moderate kinds of psoriasis. When the autoimmune skin disease is on the more severe side, the topical creams and ointments can be used simultaneously with oral medications. Topical Creams and ointments include:

• Topical corticosteroids: Help decrease inflammation in the skin as well as decreases skin cell production which causes irritation and itching. Strength of the corticosteroids depends on the severity of the psoriasis as well as the location o the body. For instance, a lower dosage may be used on the face area while a higher dosage may be used on the arms or legs.
• Vitamin D analogues: A cream or ointment containing Vitamin D to help decrease skin cell growth. Works well alongside other creams and phototherapy. Individuals with skin disease are said to have a deficiency in vitamin D; this is where the treatment has been derived from.
• Anthralin: A cream-based medication which is used, then washed off as it stains the skin. Used to help rid the skin of scales and smooth skin over. Can help balance skin cell production.
• Topical retinoids: May help decrease inflamed skin and balance skin cell production. Has been used for treating acne but has recently been shown to help psoriasis, as stated by Mayo Clinic.
• Salicylic acid: Comes either over the counter or by prescription. Helps relieve the skin of dead skin cells and to smoothen out rough skin. Should not be used over long periods of time. Can also be used in shampoo form for the scalp.
• Coal tar: Exactly how it sounds, it is a thick black substance that comes from manufacturers of petroleum and coal. It is the oldest known effective product used for treating psoriasis.

Light therapy or phototherapy is used to help stop skin cells from developing thus allowing for decrease in scales and itchy skin. Types of light therapy include natural sunlight, UVB phototherapy, Narrowband UVB therapy, Photochemotherapy, and Excimer Laser Therapy. All of these therapies use some sort of form of ultraviolet light waves to help decrease the psoriasis symptoms.

Oral medications can also be taken to help relieve the individual of psoriasis. These medications include Retinoids, Methotrexate, Cyclosporine, Hydroxyurea, and Immunomodulator. The oral medications are usually used with more severe cases of psoriasis and are normally not taken for long periods of time. They are also used alongside other treatments such as topicals.

Who Are The Best Candidates For Psoriasis Treatment?

The Journal of American Academy Dermatology issued guidelines in 2009 for topical treatments of psoriasis. The guidelines show that almost 80% of the patients being treated for psoriasis have less than 10% of their body being affected by the disease. This makes them good candidates for topical therapies.

The topical creams are highly effective as well as safe. Depending on your severity, length of use will vary as well as if additional treatments are necessary. If you are nursing or pregnant, consult your physician before attempting topical medications as well as if they are going to add in supplemental treatments such as light therapy. If you have a moderate to severe case of psoriasis, topical creams should not be used alone and should include additional therapies.

If you are considering light therapy or oral medications in addition to the topical treatments, consult with your physician to ensure you are the right candidate. If you are nursing, pregnant, or looking to conceive, you should not take oral medications for psoriasis as it can cause birth defects. Again consult with your physician in order to obtain up-to-date information on all medications.

Benefits

The benefits of seeking psoriasis treatment is the reduction of psoriasis symptoms.
These symptoms include:

• Scaly skin
• Itchy skin
• Red, flaky skin
• Overproduction of skin cells

The most important benefit would be the higher self-esteem you feel once your skin condition is under control. The patient would be mentally, physically, and emotionally better.

Risks

Overuse of topical medications can cause the skin to thin out. Depending on the severity of the psoriasis and the medicine used, lengths of use will vary. Photo therapy or light therapies have the risk of the patient getting sunburned. Patients undergoing this kind of therapy usually have to visit the medical office three times a week and will have a higher risk of  getting skin cancer.

Oral medication are used for more sever cases of psoriasis and carry several risks. According to the American Academy of Dermatology, oral medications should not be used by nursing patients, pregnant patients, or patients in childbearing years. Certain medications can cause risks including:

• Methotrexate: nausea, fatigue, inflammation of the mucous membranes of the mouth, anorexia, white blood cell and platelet deficiency, liver damage and lung scarring. This oral medication can also cause birth defects as well as miscarriage.
• Cyclosporine: glomerulosclerosis and scarring of the kidney’s blood vessels.
• Acitretin: alopecia, nausea and abdominal pain, joint and muscle pain, and can cause birth defects.

When attaining psoriasis therapies, you should be closely watched by your physician. If any side effects seem to be occurring, seek medical attention immediately. As always, consult with your medical doctor before proceeding with any treatment.