Psoriasis: Why It Happens, And How You Can Keep It Under Control

Elle Gordon investigates the pesky skin condition.

I first came eye-to-eye, literally, with psoriasis when I was 15 years old. I was in boarding school and had just been for a swim. I can remember walking back from the changing rooms feeling self conscious about my dripping wet hair and hastily applied tinted moisturiser. Remember Natural Collection? Ah, the good old days.

I stopped off in the shop on my way, and still could feel eyes glancing my way. Hmm, possibly should have looked in the mirror properly before leaving? Then my friend appeared. “Elle!” she said with concern, “What have you done to your skin?” “What are you talking about?” I asked, before scurrying to find a shiny surface. And then I saw the first vestiges of what would turn into a 12-year (and counting) stint of trying to keep it under control. Red, inflamed and dry skin around my eyes. ‘Must have been the chlorine?’ Perhaps, that could have been part of the inflammation, but it was as though something had been triggered, and that was it. I had psoriasis.

So what is there to be done about it? I have tried it all. From eye masks, to hydration masks to expensive eye creams, to different emollients. Even the highly potent, and not recommended without prescription and supervision by a medical professional, hydrocortisol cream. If skin is inflamed enough and sore enough, and you’re feeling highly frustrated – I think you would agree that it can push you to try options you would rather not.

Since my days as a morto teen, I have managed to grapple against it and occasionally win. Sometimes I will not see it for months on end, and in those times I will think I have found the cure. For instance, for me, a trip to sunnier climates is like a natural remedy and having been away a lot with work in recent times I thought I had it figured out. A slight sun-kiss (wearing SPF 50 of course) and I’m grand. That is, until I moved jobs last November and… whoosh! It’s been back with a bang.

I am not alone in railing against this pesky ‘oul skin condition. Supermodel-turned-actress Cara Delevingne has spoken openly in the past about her struggles with it. For her, this is one of the reasons she left catwalk modelling for acting. Speaking to the UK Times she said it made her feel, ‘hollow’ and ‘ugly’. Given she is one of the most beautiful humans most of us have ever seen it might be hard to comprehend that a bit of red sore skin could have that impact. But that is the thing about this skin condition, it can dole out a serious blow when it comes to self-confidence. Even Kim Kardashian, Kween of Konfidence has spoken out about despair over the condition on her reality show.

I spoke to Consultant Dermatologist Dr Rosemary Coleman from Blackrock Clinic to find out more about this inflammatory skin condition that is estimated to affect about 73,000 people in Ireland. She explained:

Psoriasis is a genetic condition predominantly manifesting in the skin in a red scaly rash. What can make it fluctuate is stress and a high sugar diet, because that is pro-inflammatory, so it can act as a fuel for the fire. I also have some patients who will tell me that wheat and dairy intake affects their psoriasis as well. Who am I to say it doesn’t? I see it so often in people, any of the above can certainly be contributing factors.

I ask about over-the-counter treatments as an effective part of the solution. “Emollients are essential and using gentle skincare products which have very few nasty chemicals and perfumes will be kinder to the skin,” she says.

In simple terms, this means you should opt for a skincare regimen that is not going to aggravate your skin further with harsh ingredients. For me, what has been extraordinarily effective in the last few weeks is Yonka’s latest collection for sensitive skin. I have trialled Crème Peaux Sensibles (€55), Sensitive Crème Anti- Rougers (€55), and Comforting and Soothing Sensitive Masque (€46) and have truly been bowled over by their effectiveness in soothing, softening and easing the redness around my eyes.

However I also understand that investing in pricey skincare may not work for everyone, so another option I have been using (on prescription from GP) is Silcock’s Base, an emollient, 500g of which you can pick up in your local pharmacy for approximately €4. An interesting cream that Dr Coleman flagged that I have not tried yet is tar-based cream, which she mentions some chemists and health food shops stock. “Tar-based creams can be very helpful as it slows down the turnover of the cells.” she says. “It doesn’t smell great but it can be very effective.”

When it comes to the sun and different kind of phototherapy treatments, Dr Coleman advises caution.

Patients with psoriasis are at an increased risk of skin cancer, this is not just the patients who get the phototherapy, it is an independent risk factor and therefore I would be loath to people going out in the sun, or worse using sunbeds – never ever use a sunbed!

As dermatologists, we limit how much phototherapy we use in treatment. We don’t want the psoriasis to be gone and for the person to have skin cancer instead. We have to be very careful about how much phototherapy we allow people to do.

For Dr Coleman, the first port of call in effective treatment is to live well and eat well. “Alcohol is another factor that flares psoriasis, it can greatly aggravate it and smoking aggravates it as well. If you live well, you can’t make it go away but you can certainly help it be less severe.”

However, there are some people who genetically have a very severe form of psoriasis and all the good living in the world won’t make it go away. They need drugs such as hydrocortisol and the different topical treatments out there. ere are steroid alternatives such as topical tacrolimus ointment which we would prefer to use on the face and it’s safer long term. You must of course use your SPF over it. I recommend consulting with a dermatologist to find the one that works best for you.

Finally Dr Coleman advises, “Another key thing is to watch that your Vitamin D levels are normal and if low, take a Vitamin D supplement. If these solutions are not working, you can move up to tablet treatments and then we have injected drugs.”

Having clarified all the above I feel more cautious about jumping into something like phototherapy treatment when there are many avenues I haven’t yet explored. First, I’ll be checking my Vitamin D levels and getting my hands on a tar-based cream. And if I took anything from this, it’s to manage your stress levels. I’ll be aiming to keep calm and carry on – perhaps joining something like a yoga class is mine and your ticket to calm and happy skin.