PSORIASIS is a chronic, non-contagious disorder which affects the skin and joints, characterized by flaking, redness and inflammation of the skin. Once thought to be a skin disorder, psoriasis is now understood to be a condition originating in the immune system.
The scaly patches caused by psoriasis, called psoriatic plaques, are areas of inflammation and excessive skin production. Skin rapidly accumulates at these sites and takes on a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area including the scalp and genitals. In contrast to eczema, psoriasis is more likely to be found on the extensor aspect of the joint.
The disorder is a chronic recurring condition which varies in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) – and can be seen as an isolated finding. Psoriasis can also cause inflammation of the joints, which is known as psoriatic arthritis. 10 to 30% of people with psoriasis have psoriatic arthritis.
Psoriasis is considered a non-curable, long-term (chronic) skin condition. It has a variable course, periodically improving and worsening. It is not unusual for psoriasis to spontaneously clear for years and stay in remission. Many people note a worsening of their symptoms in the colder winter months.
Psoriasis is seen worldwide, in all races, and both sexes. Although psoriasis can be seen in people of any age, from babies to seniors, most commonly patients are first diagnosed in their early adult years. Patients with more severe psoriasis may have social embarrassment, job stress, emotional distress, and other personal issues because of the appearance of their skin.
Here, Psoriatic Arthritis requires a special mention as it may develop in up to 30 percent of people who have the chronic skin condition Psoriasis. Anyone who has psoriasis and joint pain may have psoriatic arthritis. Common symptoms of psoriatic arthritis include:
- Pain, swelling, or stiffness in one or more joints.
- Joints that are red or warm to the touch.
- Sausage-like swelling in the fingers or toes, known as Dactylitis.
- Pain in and around the feet and ankles, especially tendinitis in the Achilles tendon or Plantar fasciitis in the sole of the foot.
- Changes to the nails, such as pitting or separation from the nail bed.
- Pain in the area of the Sacrum (the lower back, above the tailbone).
Along with the above noted pain and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion lasts for days to weeks without abatement. Psoriatic arthritis may remain mild, or may progress to more destructive joint disease. Periods of active disease, or flares, will typically alternate with periods of remission.
Psoriatic arthritis is a lifelong condition that causes deterioration, pain, and stiffness in the joints. Some people experience only joint problems and never develop psoriasis. About 70% of people who get psoriatic arthritis develop psoriasis first. Studies show that in these cases, psoriasis usually precedes psoriatic arthritis by about 10 years. However, a person can develop psoriatic arthritis within a few months of getting psoriasis or decades later.
Psoriatic arthritis most commonly involves the fingers and toes. Joints in the neck, back, knees, ankles, and other areas also may be affected. In addition to being painful and stiff, the involved areas usually feel hot. Affected joints tend to have a purplish discoloration.
Almost 90% of people who develop psoriatic arthritis see nail involvement first. The nails may pull away from the nail bed or develop pitting, ridges, or a yellowish-orange discoloration. Dermatologists urge their patients who have psoriasis that involves the nails to contact them if they experience any joint problems. Joint deterioration can be prevented with treatment.
Early warning signs of psoriatic arthritis include hand pain, foot pain, and “tennis elbow.” These early warning signs may be overlooked if psoriasis lesions are not present. Other indications are shoulder, neck, or back pain.
Psoriatic arthritis ranges in severity. It can involve one digit or an entire hand. It can become so severe that it is disabling. According to the National Psoriasis Foundation, about 20% of patients living with psoriatic arthritis have more than five totally damaged joints, which significantly impairs their ability to perform everyday tasks and reduces their quality of life.
Ayurveda perspective & Management of Psoriasis
Ayurveda believes that impurities in the blood associated with emotional factors are the cause of the disease.
Psoriasis is believed to occur due to vitiation of all the three doshas (Vata, Pitta, Kapha) in varying degree, but predominantly Vata and Kapha according to the Ayurvedic concept.
Ekakusta, kitibha and Sidma are some of the types of Kshudra and Maha Kustas (skin diseases) narrated in Ayurveda closely resemble the classical symptoms of Psoriasis.
The predominance of vatha causes pain, dryness and scaling of skin. Pitha vitiation leads to burning sensation, redness, inflammation etc and that of kapha causes rashes, itching, discharge, thickening of skin etc. From these signs and symptoms, the doshic involvement is analyzed carefully in each patient, which is of utmost importance in the management of this disease.
Irregular food habits, consumption of foodstuffs that are advised not to be eaten together (incompatible foods like dairy products with fish), excessive intake of yogurt, paneer, black gram, seafood, sour and salted items etc can activate the pathogenesis. The produced toxins accumulate in deep tissues like rasa (nutrient plasma), rakta (blood), mamsa (muscles), and laseeka (lymphatic). These toxins cause contamination of deeper tissues, leading to Psoriasis. Alcohol and tobacco consumption will act as a catalyst here. Ayurveda also emphasizes on the effect of stress in the pathogenesis of Psoriasis.
The vitiated doshas affect the skin and blood tissues. They also influence water element of the affected region on skin. Thus the skin which is influenced by affected doshas becomes discolored (white or copper colored), scaly and thin.
At CHARAKA, our treatment primarily focuses on blood purification and balancing the vitiated Doshas. Management of Psoriasis comprises of:
- Shodhana chikitsa (Detoxification) done through Panchakarma therapies like Vamana, Virechana, Rakta mokshna etc & an exclusive therapy called Thakra dhara
- Shamana chikitsa through administration of internal medication and external applications
- Rasayana chikitsa (immunomodulation) through kayakalpa
- Very strict Diet regime
- Lifestyle changes
- Stress management
We have experienced best treatment success rate in treating Psoriasis. If the patient can implement all the instructions as advised and completely follows the diet regime & healthy lifestyle, Psoriasis is completely curable without any recurrence.