Psoriasis, is a highly prevalent chronic and recurring inflammatory skin disease. It is characterized by distinct patches of red skin covered with silvery scales. Epidemiological studies indicate that around 2% of people in the Western world are affected by it.

Psoriasis is not an infectious disease, but it plays a significant role in the quality of life for those affected. People with psoriasis often face stigma and limitations in certain activities, such as visiting swimming pools.

Recognizing triggers of the disease, managing symptoms, and making lifestyle changes are extremely important and can have a positive impact on the severity of psoriasis symptoms.
 

What is psoriasis?

Psoriasis is an autoimmune condition that leads to a rapid cell division cycle and the accumulation of cells. This results in the formation of what are called skin plaques and scaling on the skin's surface.

Epidermal cells are formed in the basal layer of the skin and then travel towards the skin's surface, where they are shed and become keratinized. In healthy skin, this process takes about 28 days, but in the case of psoriasis, it occurs in only 3-4 days.

In addition to the disrupted skin cycle, there is also an immune-mediated inflammation. When this inflammation extends beyond the boundaries of the skin and affects the joints, it leads to psoriatic arthritis or joint inflammation.

Anyone can develop psoriasis, but it is more common in adults than in children. The predisposition to its occurrence is often genetically conditioned. If at least one parent has psoriasis, the likelihood that their children will also have it is approximately 10-30%.

There are several forms of psoriasis known:

Plaque Psoriasis or Psoriasis Vulgaris:
This is one of the most common forms of psoriasis, characterized by reddened and inflamed patches of skin covered with silver scales. It appears as raised, red lesions covered with silvery-white scales. Plaques usually develop in a symmetric pattern, most commonly on the scalp, torso, and limbs, particularly on the elbows and knees. The scalp is often affected at the margins.

Guttate Psoriasis:
This type typically appears in children or young adults and looks like small red dots, usually on the trunk or limbs. Outbreaks are often triggered by upper respiratory infections, such as a sore throat. In children and adolescents, psoriasis usually appears 2-3 weeks after an upper respiratory infection, especially streptococcal angina.

Palmoplantar Psoriasis:
In this case, the palms and soles are affected. The skin in these areas becomes thickened, cracked, and very painful. This form of psoriasis can be highly bothersome, as it hinders daily activities.

Pustular Psoriasis:
With this type, pus-filled bumps known as pustules appear, surrounded by red skin. It typically affects the palms and soles, but there's a form that covers most of the body. Symptoms can be triggered by medications, infections, stress, or certain chemicals.

Inverse Psoriasis:
This form appears as smooth red patches in skin folds, such as under the breasts, in the groin, or in the armpits. Friction and sweating can worsen the condition. In individuals with more body weight, psoriasis can develop within skin folds due to rubbing.

Erythrodermic Psoriasis:
This is a rare but severe form of psoriasis characterized by red, scaly skin over a large part of the body. It can be triggered by intense sunburn or the use of certain medications, such as corticosteroids.

Psoriasis can also often affect the nails. Typically, nail psoriasis presents with small pits, yellowish spots resembling drops of oil, or thickened, yellowed, and deformed nails.

When psoriasis appears only on the nails, it is often mistaken for a fungal infection and may consequently be treated with antifungal medications, which, of course, do not bring the expected improvements.

Psoriasis Symptoms:

Psoriasis symptoms can vary greatly between individuals. Some of the most common symptoms include:

⇒ Thickened reddened patches of skin with silvery-white scales, itching, or burning, usually on elbows, knees, scalp, torso, palms, and soles.
⇒ Dry and cracked skin that itches or bleeds.
⇒ Thickened, ridged, and unevenly colored nails.
⇒ Some patients experience an associated condition called psoriatic arthritis, characterized by stiff, swollen, and painful joints.

Psoriasis symptoms typically cycle through outbreaks that last for a few weeks or months, followed by periods of calm or remission.

There are many ways to alleviate psoriasis, and the treatment plan depends mainly on the specific condition. Most forms of psoriasis are mild or moderate and can be successfully managed with creams or ointments. Managing common triggers, such as stress and skin injuries, can also help keep symptoms under control.

Psoriasis and the Risk of Associated Conditions:

⇒ Psoriatic arthritis, a chronic form of arthritis causing joint pain, swelling, and stiffness, affecting joints and sites where tendons and ligaments attach to bones.
⇒ Cardiovascular diseases; heart attacks and strokes.
⇒ Mental health issues such as low self-esteem, anxiety, and depression.
⇒ People with psoriasis may also have an increased likelihood of developing certain types of cancer, Crohn's disease, diabetes, metabolic syndrome, obesity, osteoporosis, uveitis (inflammation of the middle layer of the eye), liver disease, and kidney disease.
 

Triggers of Psoriasis:

Psoriasis is an autoimmune disease, meaning the immune system doesn't function normally but reacts excessively, causing problems. In psoriasis, immune cells become active and produce molecules that trigger rapid skin cell production, leading to inflamed and scaly skin.

Scientists don't fully understand what triggers the improper activation of immune cells, but they know it's a combination of genetics and environmental factors. Many people with psoriasis have a family history of the disease, and researchers have identified specific genes that can contribute to its development. Almost all of these genes play a role in the immune system's functioning.

Some external factors that can increase the risk of developing psoriasis:

⇒ Streptococcal infections
⇒ Certain medications
⇒ Smoking
⇒ Obesity
 

Diagnosis and Treatment of Psoriasis:

If you suspect you have psoriasis, visit your doctor. You should also see a doctor if your condition:

⇒ Becomes more pronounced and widespread
⇒ Causes discomfort and pain
⇒ Affects your quality of life
⇒ Current treatments are not effective

To diagnose psoriasis, a doctor examines your skin, scalp, and nails to identify specific signs of the disease. Your doctor will also ask general questions about your health, any previous issues, and your well-being.

These details help the doctor determine if it's a case of psoriasis. To rule out other skin conditions that resemble psoriasis, your doctor may take a small skin sample and examine it under a microscope.
 

Forms of Psoriasis Treatment:

Although there's currently no cure for psoriasis, there are treatment methods to manage symptoms. Various types of treatment are available, tailored by the doctor to the individual and the specific form of psoriasis.

For psoriasis, there are several forms of localized therapy available. Creams, ointments, lotions, foams, or solutions, especially those containing corticosteroids, are typically used to treat people with mild to moderate disease. Other local therapies include vitamin D-based medications, retinoids (vitamin A derivatives), and coal tar preparations.

Therapies:

⇒ Methotrexate. This medication belongs to a class called antimetabolites. It suppresses the immune system and slows down cell growth and division.
⇒ Retinoids. These compounds, derivatives of vitamin A, can help some people with moderate to severe psoriasis. They can be used in combination with phototherapy.
⇒ Biologic response modifiers. These drugs are injected and block specific immune molecules, helping to reduce or stop inflammation.
⇒ Immunosuppressants. These medications are usually used in severe cases and work by suppressing the immune system.
⇒ Phosphodiesterase 4 (PDE4) inhibitors. These target enzymes within immune cells and inhibit rapid skin cell turnover and inflammation.

Phototherapy:

In this type of therapy, a doctor administers controlled exposure to ultraviolet light on the skin. Phototherapy is typically used when the disease affects larger areas of the skin.
 

How CBD Can Help with Psoriasis:

One of the most well-known properties of the cannabinoid CBD is its anti-inflammatory action and support for the immune system.

Humans have an endocannabinoid system in their bodies. It contains receptors that interact with endocannabinoids, helping to maintain organismal homeostasis. When the body is sick, tired, or stressed, it doesn't produce enough endocannabinoids.

That's where phytocannabinoids come in – these are plant-derived endocannabinoids. Among them, the most famous is CBD. Through phytocannabinoids, the body regains balance and equilibrium.

The endocannabinoid system is also present in our skin. This means that endocannabinoid receptors are also located in our skin, giving CBD exceptional potential for therapeutic effects in the case of skin issues. These findings are supported by studies that suggest a significant potential of phytocannabinoids in combating skin problems such as psoriasis.

https://www.ncbi.nlm.nih.gov/pubmed/17157480

https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bph.12309

A brief summary of how CBD works on psoriasis:

Cannabinoids from industrial hemp have anti-inflammatory effects and inhibit the growth of keratinocytes, cells that renew the skin's top layer by producing new cells. In psoriasis, the production of keratinocytes in the skin's top layer is too rapid, and cannabinoids normalize it. This leads to a reduction in scaly skin and calming of inflammatory processes.

A natural solution that doesn't burden the skin

The positive effects of CBD products are also evidenced by numerous satisfied users who have alleviated their psoriasis condition with the help of cannabinoids without further burdening their skin.

For most of them, using CBD has helped alleviate itching, redness, skin peeling, and swelling. Some have even managed to completely eliminate psoriasis.

For optimal effect, simultaneous consumption of CBD drops is recommended, as they support the immune system and balance the skin from the inside out, along with appropriate skincare using a combination of targeted creams.

Skin Care in Psoriasis

If you're struggling with psoriasis, you need to take extra care of your skin. It's important to use gentle soaps and gels that respect the pH of your skin. An occasional oil bath is also recommended, and regular care with natural butters and oils that support the skin's renewal cycle and restore its balance is crucial.

With consistent use of nurturing and targeted creams, you can achieve fewer and less severe psoriasis flare-ups.

Living with Psoriasis

Psoriasis significantly impacts daily life. It's a condition that can undermine our self-confidence, limit certain activities, and affect our well-being and sleep quality.

Psoriasis undoubtedly marks the patient, so understanding and support are much needed. With a few general guidelines, sufferers can also influence the condition and development of symptoms:

⇒ Ensure your skin is well moisturized.
⇒ Bathe in lukewarm water and use mild soap. Apply moisturizing lotions after bathing while your skin is still damp.
⇒ Maintain a healthy weight. Obesity worsens psoriasis symptoms.
⇒ Quit smoking. Studies have shown that the more a person smokes, the worse the symptoms become.
⇒ Moderate alcohol consumption. Some studies suggest that excessive alcohol intake worsens symptoms.
⇒ Expose your skin to small amounts of sunlight.
⇒ Avoid known triggers. Try to identify triggers for psoriasis outbreaks and avoid them. Some people have found that stress, cold weather, skin injuries, certain medications, and infections trigger inflammation.
⇒ Consciously build your self-esteem and connect with people facing similar conditions. Support and the exchange of experiences, information, and feelings can be invaluable in this case.

Frequently Asked Questions

What is psoriasis?
Psoriasis is a highly prevalent chronic, recurring inflammatory skin disease. It is characterized by distinct areas of reddened skin covered with silver scales.

What are the symptoms of psoriasis?
Patches of thickened, reddened skin with silvery-white scales that itch or burn, along with dry and cracked skin displaying inflammatory changes.

Where on the body does it most commonly appear?
Psoriasis typically appears on elbows, knees, the scalp, torso, palms, and soles.

What triggers psoriasis flare-ups?
Activation of immune cells that leads to an excessively rapid production of skin cells. This results in inflamed and scaly skin for individuals with this condition.

How to care for psoriatic skin?
Regular use of nurturing and targeted creams can help reduce the frequency or significantly limit psoriasis flare-ups. In psoriasis, the production of keratinocytes in the skin's outermost layer is accelerated, and cannabinoids from hemp normalize this process. This leads to a reduction in scaly skin and calming of inflammatory processes.

Sources:

Practical Dermatology, Mateja Lisjak, MD.

https://www.niams.nih.gov/health-topics/psoriasis

Cannabinoids inhibit human keratinocyte proliferation through a non-CB1/CB2 mechanism and have potential therapeutic value in the treatment of psoriasis: https://www.ncbi.nlm.nih.gov/pubmed/17157480

Epigenetic control of skin differentiation genes by phytocannabinoids: https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bph.12309

The endocannabinoid system of the skin in health and disease: novel perspectives and therapeutic opportunities: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757311/

Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736837/

TRP Channel Cannabinoid Receptors in Skin Sensation, Homeostasis, and Inflammation: https://pubs.acs.org/doi/10.1021/cn5000919

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