Psoriasis

What psoriasis is

Psoriasis is a chronic autoimmune skin condition whose mechanism is still not well understood. The immune system signals skin cells to grow far faster than normal, and the surplus cells pile up as thick red patches covered in silver-white scales.

Where the fingernails and toenails are affected it is classed as psoriatic nail dystrophy; where the joints inflame, as psoriatic arthritis — which is identified in up to 40% of people with psoriasis.

It can clear on its own, or persist for years, typically worsening in the colder months and easing in warm weather and sunlight. It is not usually painful, but it carries a considerable weight of emotional stress and, for some people, social isolation.

The five types

• Plaque psoriasis — the most common by far, around 80% of cases. Flaky scales on the elbows, knees, scalp, palms, feet, genitals or the outer side of the joints.
• Guttate psoriasis — small drop-shaped lesions.
• Inverse psoriasis — smooth red lesions in the folds of the skin.
• Pustular psoriasis — blisters holding a thick white fluid.
• Erythrodermic psoriasis — widespread reddening and swelling.

Psoriatic arthritis resembles rheumatoid arthritis appearing alongside psoriasis.

What is understood about the causes

Medical science has not established the exact mechanism. Studies point to an autoimmune response, which may be inherited or set off by some form of stress — injury, emotional strain, a change of climate, infection, or sun exposure.

Several things are known to aggravate it: viral or bacterial infection, particularly of the upper respiratory tract; injured skin; dry skin or dry air; too little sunlight or too much; alcohol; and stress.

Symptoms

They can arrive suddenly and recede the same way. Red skin appears most often on the elbows, knees or trunk, though it can appear anywhere. The look varies from dry patches under silver-white scales to raised, thickened areas of salmon red. Affected patches are sometimes itchy. Other signs include genital lesions in men, severe dandruff, changes to the nails, and joint pain.

What helps day to day

There is no known way to prevent psoriasis, but general care of your health does help: a moisturising routine, neither excessive nor insufficient sunlight, good hygiene, avoiding alcohol and tobacco, avoiding prolonged exposure to water, leaving out animal fats, eggs and processed food, and attending to stress and mental wellbeing.

The Ayurveda and Siddha approach

Vaidya Nithi has worked with clients whose psoriasis improved substantially following thorough detoxification and a diet matched to their constitution and symptoms.

The full-body detoxification known as Panchakarma is used alongside a long-term Ayurvedic diet. In outline: seven days of ghee taken orally, then Vamanam, Virechanam and Vasti, followed by several months — the length depends on the individual — of herbal preparations and ghee. The diet is strictly vegetarian, with no animal protein or fat.

Results depend heavily on following the diet and the regimen closely, and they differ from person to person. Nothing here is a promise of a particular outcome, and this is not a substitute for the care of your doctor.