Frequently Asked Questions, myths and misconceptions of psoriasis...
Is psoriasis caused by being unclean?
Psoriasis is a condition where the immune system is overreacting and producing too many skin cells, too quickly. It is not brought on by poor hygiene, and the presence of psoriasis does not mean that a person’s hygiene is poor.
Is psoriasis contagious?
Psoriasis is not contagious, it cannot be caught by person-to-person contact, or by sharing of bodily fluids (such as by kissing or sharing food or drinks). It also cannot be caught by others in close contact public areas, such as in swimming pools or in saunas. There does seem to be a family history link with psoriasis, but it is also worth knowing that many people with a family history never develop the condition and likewise many people with no family history of psoriasis can also develop the condition.
Is psoriasis just a skin condition?
The visible part of psoriasis is the red, scaly plaques that appear on the surface of the skin. However, the effects of psoriasis run much deeper. People with psoriasis often suffer with low confidence and self esteem, which in turn impacts on their relationships and social lives.
The treatments can be time-consuming with unpleasant side effects, and people with psoriasis often spend the day feeling uncomfortable, embarrassed, itchy and in pain. Psoriasis on the hands or feet can make everyday activities difficult, and psoriasis on areas such as the groin or buttocks can make even sitting down or going to the toilet quite painful. Psoriasis is also linked to the development of psoriatic arthritis, although not everyone with psoriasis will develop this condition.
There is ongoing research into the role that inflammation plays in psoriasis, and the potential links to other conditions such as cardiovascular disease, and if there is a link, whether the risk is related to the severity of psoriasis.
Will I have psoriasis forever?
Psoriasis is a long term condition, and is known to wax and wane (meaning it comes and goes - sometimes in flares). Like other long term conditions (for example arthritis, diabetes or asthma), there is no 'cure', although there is a wide variety of treatments which can be used to manage psoriasis. Everybody is different, and so it can be a process of trial and error to find a treatment or combination of treatments which work well for you, but many people do find treatments which work for them,
Due to the nature of the condition, some people find areas of psoriasis clear up on their own in time. Some people may experience just a handful of psoriasis 'flares' in a lifetime, whereas others might have some stubborn patches which are almost always there. It can be hard during a flare, but try to remember that psoriasis often does follow this waxing and waning pattern, and that there are treatments to help you get a flare under control.
Can people with psoriasis use hair dye, make up, self tan, or other cosmetics?
Certain dyes can be quite harsh to the scalp, and can irritate open lesions, but if milder dyes are used, patch tests carried out, and reputable hairdressers consulted, there is no reason why someone with psoriasis should not dye their hair. This also applies to the use of other hair products.
The face is a delicate area, care should be taken that makeup does not irritate it, and it is always unwise to apply cosmetics to open sores. However, like with hair products, if a patch test is carried out and no irritation occurs, there is no harm in applying makeup. This is the same for fake tan on the body.
Remember, however, that tanning beds have health risks, which can be increased if the individual is undergoing UV light therapy. Fake tanning products such as bronzers, gels and lotions are the safest way to tan. You might also be interested in finding out about camouflage makeup, specifically designed to cover scars and skin conditions such as psoriasis.
Is it okay to have sex if you or your partner has genital psoriasis?
People with psoriasis anywhere on their body may feel self conscious when it comes to sex, and this is likely to be increased if psoriasis is actually in the groin or genital area. Also, people with psoriasis in these areas may find that sex can irritate the psoriasis. However, neither of these potential problems means that someone with genital psoriasis should not have sex.
There are practical tips for making sex more comfortable, such as using lubrication or condoms to lessen friction, and body confidence issues can hopefully be dealt with through honest communication with a loving partner. Remember, psoriasis is not contagious and is not sexually transmitted.
Will drinking alcohol affect my psoriasis?
People taking certain medications for psoriasis or psoriatic arthritis- such as methotrexate or acitretin should avoid alcohol, or limit its’ consumption as it can influence the way in which the medications are broken down in the body, or raise the risk of potential side effects. You should always check with a doctor or pharmacist, and check the patient information leaflet of any medication you are taking, before you drink alcohol.
There are plausible arguments for why drinking might affect psoriasis (alcohol is dehydrating, and therefore could dry skin out even more), but no research has found that it significantly worsens the condition. Some people might find that alcohol does worsen their condition, but if an individual does not find this, and it is safe to combine alcohol with whatever treatment they are undergoing, then moderate alcohol consumption can be one of life’s pleasures.
Drinking is not an effective way of coping with your skin, or other emotional problems. If you think you may drinking because you feel upset, worried or depressed, you should talk to your GP.
Can people with psoriasis work?
Many people with psoriasis have little or no problem with their ability to work, and most can and do have jobs and successful careers. In certain areas of work, environmental conditions, the use of chemicals, gloves, and frequent hand washing might make psoriasis worse - you should discuss this and your condition with your employer, and work together to find ways around these issues. This advice is also useful in terms of taking time off work to go to appointments and have treatment.
Some industries, such as food handling and even the NHS, sometimes have concern over psoriasis and if it is likely to harbour infection or contaminate food and clean areas. Most of the time, this can be addressed by covering the psoriasis with dressings when at work. Do get in touch with the Psoriasis Association for more information on this or any other employment issues.
Does having psoriasis make you more likely to have a heart attack?
A number of studies, published recently, have been reported on in the popular media, stating that if you have psoriasis, you are more likely to have high blood pressure, develop heart disease, and have a heart attack or stroke. Whilst it does look as though there is some sort of a connection between severe psoriasis and certain heart conditions, much more research needs to be carried out to help us understand this better. Firstly, there are many factors that could lead to someone having a heart condition (family history, being overweight, history of smoking, other underlying conditions) that they may have in addition to psoriasis. This does not necessarily mean that their psoriasis would have anything to do with their heart condition. Secondly, the presence of a link between the conditions does not mean that psoriasis is an independent risk factor (ie. it actively causes or contributes) to heart disease. It could instead mean that the conditions share some of the same risk factors, and therefore can occur in the same people.
Research on this topic is ongoing, most notably the IMPACT project based at Manchester University, which is looking into the potential co-morbidities (related conditions) of mild to moderate psoriasis. This is a multi-million pound study, that the Psoriasis Association is involved in directing.
The National Institute for Health and Care Excellence (NICE) guideline on the assessment and management of psoriasis (CG 153) recommends that doctors should discuss cardiovascular risk factors with all people who have psoriasis, and support any lifestyle changes (such as weight loss, quitting smoking ,etc) that might be needed. It also recommends that people with severe psoriasis should be offered a cardiovascular risk assessment every five years.
The best thing to do is to take control of the risk factors we know for sure about; make efforts to eat a healthy, balanced diet and to keep active, try to give up smoking and to moderate alcohol intake. Visit the British Heart Foundation website for more information on how to keep your heart healthy.
How do I make an appointment to see a Dermatologist?
You will need to have a referral from your GP in order to see a Dermatologist, whether this is via the NHS or if you chose to be seen privately.
For more information, or for a list of resources used in the production of this resource, please contact the Psoriasis Association.
December 2014 (Review: December 2016)