Psoriasis (Includes Psoriasis of the Scalp)
Psoriasis is characterised by sharply defined, red patches of skin which soon become covered with dry, silvery scales. Beneath the scales the skin is inflamed. It cannot be stressed too often that psoriasis is neither infectious nor contagious.
In normal healthy skin, the cycle of cell multiplication, growth and shedding of the outer layer takes about 4 weeks. With psoriasis, this process becomes abnormally rapid, the cycle is reduced to between 3 and 6 days. This is one of the reasons for the thickened, scaly skin. Psoriasis occurs mainly on the knees and elbows, on the scalp and sometimes the back. It may also occur on the chest or affect the fingernails (which become disfigured). However, any part of the skin may be involved.
Psoriasis occurs in several forms: The most common is the chronic or plaque form. This may sometimes change and flare up into an acute form with severe inflammation which will tolerate mild preparations only. Corticosteroids may be used until the acute phase has passed. Other forms are pustular and guttate, which are rare, but require medical attention. Psoriasis may also occur on the scalp. Scales or crusts may appear on the scalp, but do not affect the growth of the hair or cause baldness. Snowstorms of white, dandruff-like flakes may cause embarrassment but usually respond well to treatment.
The overall aim of the treatment is:
1. To reduce the activity of the skin cells.
2. To relieve the associated inflammation.
3. To help the patient feel better, as very often he or she is convinced that the appearance of the skin cannot be changed or that they
might be infectious.
4. A reduction of tension and stress as well as learning to relax is important. Emotional shock or stress can provoke a flare-up of the condition. Correct therapy, which initially may include corticosteroids, will clear the skin; maintenance therapy will help to prevent recurrence.
Tar baths can bring the patient relief and help psoriasis recur less often. The advantage of the tar derivatives is that the skin, once cleared, usually remains free of psoriasis for much longer periods.” * Rotstein, H., Management of Psoriasis, Patient Management (1978), 2,10.
Advice for the Patient
It should be emphasised that whilst psoriasis is considered “incurable”, many people have learned to control it by simple means. There may be a tendency for psoriasis to recur. Once a successful treatment has been established, this should be resumed at the slightest sign of a recurrence. Careful exposure to some sunlight is often helpful, but sunburn must be avoided.
Although psoriasis may recur, it can be brought under control. Encouragement and reassurance are important to the patient.
The following advice may be helpful for the patient:
1. General good health should be maintained, with a minimum of physical and emotional stress.
2. Cuts, burns or infections on the affected area should be avoided as these may provoke a recurrence.
3. It may be necessary to vary the treatment to identify the most efficient therapy for each stage.
4. Treatment should not be terminated suddenly. The preparation which was used to clear the condition should be used less frequently for some weeks after the surface of the skin has cleared, to allow the underneath layers time to improve.
5. Maintenance therapy is important to overcome “hot spots”.
6. Soap should be avoided as this may irritate or exacerbate the condition.
Products to Help (Anti-pruritics, Soap Alternatives)
An anti-itch, anti-inflammatory and cleansing solution with a pH of 6.5, Pinetarsol Solution relieves itching and reduces inflammation. Bathing also helps to keep the skin and fingernails clean to reduce the risk of secondary infection caused by scratching. Add 15 - 30 mL to a warm to tepid bath (5 mL to baby’s bath). Bathe for 5 - 10 minutes, once daily or more often in severe cases.
PINETARSOL BAR, PINETARSOL GEL
Pinetarsol Bar and Pinetarsol Gel are soap alternatives which can be used to cleanse the skin when ordinary soaps are contraindicated. Both Pinetarsol Bar and Pinetarsol Gel contain pine tar to relieve itching and reduce inflammation.
PINETARSOL BATH OIL
Pinetarsol Bath Oil is a non-greasy, water dispersable bath oil for the treatment of dry, itching, inflamed skin conditions. Containing pine tar, Pinetarsol Bath Oil reduces inflammation and relieves pruritus. Pinetarsol Bath Oil also contains emollient oils to hydrate the skin. Due to the cleansing properties of Pinetarsol Bath Oil it may be used as a soap alternative. Add 15-30mL to a warm to tepid bath (5mL to a baby’s bath or hand basin) and bathe for 10 minutes once daily, more often in severe ases. Pat skin dry.
Products to Help (Topical Anti-inflammatories - Hydrocortisone)
DERMAID™ 0.5% CREAM*
DermAid™ 0.5% Cream is a topical corticosteroid with anti-inflammatory and vaso-constrictive properties that’s suitable for the majority of skin types. It contains dissolved hydrocortisone in an occlusive base which provides increased skin penetration and enhanced effectiveness for treatment of red, itchy skin. DermAid™ also contains a moisturising element which helps prevent dry skin, and it’s lanolin and paraben-free to help avoid secondary allergic reactions. DermAid™ 0.5 Cream contains 0.5% hydrocortisone.
DERMAID™ 1.0% CREAM*
DermAid™ 1.0% Cream is a topical corticosteroid with anti-inflammatory and vaso-constrictive properties that’s suitable for the majority of skin types. It contains dissolved hydrocortisone in an occlusive base which provides increased skin penetration and enhanced effectiveness for treatment of red, itchy skin. DermAid™ also contains a moisturising element which helps prevent dry skin, and it’s lanolin and paraben-free to help avoid secondary allergic reactions. DermAid™ 1.0% Cream contains 1.0% hydrocortisone.
DERMAID SOF™ 0.5% CREAM*
DermAid Soft™ 0.5% Cream has been formulated especially for people with sensitive skin. The essential difference with DermAid Soft™ is that the hydrocortisone is dispersed throughout it so that it gently penetrates the irritated skin. DermAid Soft™ is smooth and non-greasy. It’s easy to apply which also helps prevent further trauma, especially if skin is already tender and inflamed. The emollients in DermAid Soft™ moisturise and soften dry, inflamed skin, helping to restore its hydration and suppleness, as well as reducing skin roughness and encouraging the healing process. DermAid Soft™ 0.5% Cream contains 0.5% hydrocortisone.
DERMAID SOFT™ 1.0% CREAM*
DermAid Soft™ 1.0% Cream has been formulated especially for people with sensitive skin. The essential difference with DermAid Soft™ is that the hydrocortisone is dispersed throughout it so that it gently penetrates the irritated skin. DermAid Soft™ is smooth and non-greasy. It’s easy to apply which also helps prevent further trauma, especially if skin is already tender and inflamed. The emollients in DermAid Soft™ moisturise and soften dry, inflamed skin, helping to restore its hydration and suppleness, as well as reducing skin roughness and encouraging the healing process. DermAid Soft™ 1.0% Cream contains 1.0% hydrocortisone.
*DermAid Cream 1.0%, DermAid Soft Cream 1.0% and EgoCort 1.0%
Known sensitivity to any of the ingredients.
Chickenpox, herpes, other viral infections and other skin infections, otherwise concurrent antimicrobial therapy is required. Acne.
(DermAid Cream 1.0%) Apply a small amount to affected skin 1-2 times daily as required.
(DermAid Soft Cream 1.0%) Apply a small amount to affected skin 2-4 times daily as required
(EgoCort 1.0%) Apply a thin layer 1-2 times daily to the affected skin.
Products to Help (Topical Anti-inflammatories - Nonsteroidal)
EgoPsoryl TA is a non-staining tar gel for use as an aid in the control of intense itching when the skin is not inflamed. Helps to remove scales. Do not use for prolonged periods without consulting a medical practitioner. Do not use with other forms of psoriasis therapy such as ultra-violet radiation or prescription drugs unless directed by a medical practitioner.
Apply 2 - 4 times daily after bathing with Pinetarsol Solution. For severe scalp psoriasis apply to scalp at night and remove with Sebitar the next morning. Caution: Do not use on inflamed skin as alcohol base may sting.
Egoderm Cream is a mild anti-inflammatory product containing ichthammol. Egoderm Cream has an emollient base and is recommended for the treatment of dry, inflamed skin, particularly on the face and hands. Egoderm Cream is suitable for all age groups. Apply to affected skin 3 times daily.
Products to Help (Scalp Treatment)
Sebitar is a scalp cleansing treatment for psoriasis, dandruff, itching or flaking scalp and seborrhoea. Sebitar contains coal tar and pine tar to reduce inflammation and relieve itching. Salicylic acid is included to help remove the scales. The gentle formulation will not damage permed or coloured hair. Sebitar relieves the symptoms of eczema and psoriasis of the scalp and helps remove scales.
SebiRinse is a conditioning treatment especially formulated for use after Sebitar. SebiRinse smooths and protects the hair surface, helps prevent dryness and tangles and removes any tar odours remaining on the hair. SebiRinse restores hair shine and manageability without waxy build-up on the hair or scalp.