Speaker 1 00:00:01 Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, pharmacist and mom of three. I combine healthcare and practical advice to support you on your parenting journey. This season is all about family skincare and it's proudly sponsored by real life. Real life. Believe your skin says how you feel, and this is so, so important as we explore family's skincare concerns. This week I'm talking all about psoriasis. I'm gonna talk about its causes and its treatment. I have loads of brilliant product recommendations for you. It's really good to understand what's in them and why they'll work because there is an awful lot of marketing going on out there. When you have a chronic inflammatory condition like psoriasis, it can be very mentally challenging because you have to live with it and you don't want to, you just want it to go away. Just like with eczema, that can't always happen, but what you can do is minimize its impact and its symptoms. Speaker 1 00:01:06 So some of the products that I'm going to talk to you about today contain really good ingredients and I'll explain them as well. So first of all, what is psoriasis? Psoriasis is another chronic inflammatory disease, which mostly causes symptoms on the skin. It's known to be a relapsing and remitting disease, which basically means it can go through phases of being severe or mild or disappearing for a while and then coming back. It affects about 2% of the European population, but the real figure is likely to be higher because a lot of people with mild psoriasis might never go to the doctor for a diagnosis. The most common form of psoriasis is plaque psoriasis. It accounts for 80 to 90% of all cases. So I'll be focusing on that a little bit more throughout the episode, but I will touch off some other types and obviously if you have a rare form of psoriasis, don't hesitate to send me a private message through at WBA care on Instagram and I will try to give you the information that you need. Speaker 1 00:02:12 So plaque psoriasis usually causes salmon pink lesions with white silvery scales, and these usually have well-defined boundaries. It can be harder to see these lesions on darker skin. These lesions can be big or they can be absolutely tiny and they can often occur in a symmetrical pattern on the body. So for example, on both knees or on both elbows, these areas along with the scalp are the most common areas affected. The exact cause of psoriasis is unclear, but there is definitely a genetic influence and we do know that it's an immune mediated disorder. Environmental factors can also contribute to symptoms. It can develop at any age, but it often first shows up in early adult life. Patients who have suffered from psoriasis in the long term will often find that their nails might become affected. Nails can often separate away from the nail bed. The scaling involved in plaque psoriasis is not generally seen with dermatitis or eczema. Speaker 1 00:03:13 Another form of psoriasis is guttate psoriasis, which often occurs in children or young adults after a strep throat infection. This causes a widespread rash of small scaly patches and generally it is self-limiting so it will settle down and go away. In the majority of cases, some people with psoriasis will experience an associated painful arthritis. This is similar to rheumatoid arthritis, but it's often less symmetrical Because of these reasons, diagnosis of psoriasis can be quite difficult and a doctor visit is always required. Once you have a psoriasis diagnosis, your pharmacist can support you to manage your condition. Due to our wide ranging knowledge of skincare and over-the-counter products, these can be extremely helpful when used appropriately alongside any treatment your doctor has recommended. So today I'll be talking you through some really useful tips and products which will help to promote good skin health. If your doctor has put you on any prescription medicines, do have a little chat with them before you start using these products. Speaker 1 00:04:18 Management and skincare for psoriasis patient can be really time consuming and messy and patients often suffer what's known as treatment fatigue and frustration with the condition. This episode aims to help you to understand the products and the supports that are available. As I said, the market is flooded with products promising you the sunstar moon and no one has time to waste trying out a million different products, which just don't work. So how do we manage it? Many patients will suffer from a clinically milder localized disease. For example, it might just be limited to the elbows, but even this can take its toll on your feelings of self-worth and mental health. Skin conditions can be so very upsetting to live with, and so it's really important to optimize your skincare management. The first step with any degree of psoriasis is to use a really good emollient. Speaker 1 00:05:07 This helps to prevent drying of the areas involved. Good amol include reema ultra hydrating lotion or lip carm from the ERO range. If that's not doing the job on its own, then I recommend using an emollient with added urea. Urea is a lytic, which means it breaks down the protein keratin in the outer layer of your skin. This helps to get rid of scaling or flaking skin. You life have two body moisturizers which contain urea. They break down the scales as well as hydrating products, which contain less than 10%. Urea are mainly used for the moisturizing action, whereas products which contain more than 10% urea have added lytic action. This became exceptionally clear to me when I tried the You life 50 cream on hardened skin on my feet recently in a panic before holidays, I recorded an episode about the results. So do check it out. Speaker 1 00:05:58 It's called Are Your Feet Flip Flop? Ready? On that note, you like 50 is really worth trying on stubborn hyper keratotic patches of skin. It is a thick paste, so I find it helpful to warm it up a little before you're using it. If you're applying it in the morning, maybe sit on it for a couple of minutes. It's really worthwhile going to this effort because it has efficacy rates on plaque clearance of 36% by day seven and 92% by day 21. But back to the fall, body moisturizers, you can use the eLife 10 or eLife 20 all over your body, and it has moisturizing and skin smoothing effects. I've used the eLife 20 myself and I find it lights on with ease. So it's definitely one I'll be reaching for regularly in the future. Emollient should be used continuously as a base level of skincare for psoriasis patients. Speaker 1 00:06:49 Okay, some other products and ingredients which are really helpful. So the first one is col tar. It's an oldie but a goodie. It's been used for years and that is because it has anti-inflammatory antibacterial and antiotic effects. Antiotic basically means anti-itch. It's often combined in products with salicylic acid, which is a lytic and that helps to break down scales. Another ingredient often used in combo with COTA and salicylic acid is coconut oil as it's an ent, which helps with descaling. Examples of these products are cap therapeutic shampoo, so very useful for when you have scalp involvement. It contains cold tar, salicylic acid and coconut oil, and it's suitable for any age. Another product that contains cottar and salicylic acid is coco ointment, and it also contains sulfur, which has some antifungal action. Cocos can be used in anyone over six years of age, but it can cause a little bit of local skin irritation. Speaker 1 00:07:56 So if you're using it on a child between six and 12, I'd recommend having a little chat with the GP first. One big warning with this product is that it can stain your clothes, your jewelry, and even your skin. In terms of products, which are specifically for the scalp, obviously there's the Capel Therapeutic shampoo, which I mentioned there, but I really want to mention U Life 10 Eco Foam. This is a relatively new product in Ireland, and it's similar to the cream I mentioned earlier in that it contains urea, but it's actually designed for the scalp to help produce dry and flaking skin. It contains 10% of urea, so it really helps to restore moisture to the scalp and it will be ideal to use at night, and they may be washed out in the morning. I haven't used it myself because I have no scalp symptoms, but I have heard that it doesn't make your hair too greasy because it is specifically designed for the scalp. Speaker 1 00:08:50 In studies with this product, 75% of people had a visible reduction in peeling and flaking skin after 14 days and 85% after 28 days. So the power of urea should not be underestimated, especially at high doses. So I spoke earlier about the U Life 50, and that is the strongest potency that you can get, and it is a really thick paste, so it's only used on areas of particularly thick skin. Another good product if your feet are affected kind of more broadly would be the Eli 40 obviously contains 40% urea and they do a hand cream as well. So you know treatments are advancing and products are getting easier to use. I remember people using awful cold tar products years and years ago, and literally the bedsheets would be brown and yellow after it. It's not like that now, and I think people who have psoriasis are just exhausted from trying different products and having to try and manage their disease, and it can be hard to show interest when a new product range comes out, but I can tell you now after using the eLife range on my own dry skin, that it is definitely worth a try. Speaker 1 00:10:11 You also want to sign Post you to a really helpful website, which is Irish skin.ie. There is loads of information over there on psoriasis and particularly important one that jumped out at me as a potential trigger for psoriasis. Obviously, I've spoken about infections and we do know some medications like beta blockers and lithium can cause worsening of symptoms, but the biggest thing which is really difficult to manage is emotional stress. So any kind of stressful event, like if you're prepping for an exams or you've experienced grief in your life, all of this can either trigger the first episode of psoriasis or cause a flare up of previously controlled psoriasis. So you can't obviously control stress in every scenario, but it's definitely worthwhile trying to carve out some time to get some fresh air and head space on your own. I know I'm always harping on about this, but I find when I go for my runs or if I go for a walk with the dogs, it just does me wonders and I come back like a new woman and a lot more effective, shall we say, or productive. Speaker 1 00:11:27 And yeah, I just think it's something that's really undervalued. So try and incorporate some form of outdoor exercise into your daily routine as a way to help manage stress. Other things that can cause flareups in terms of lifestyle factors, art, alcohol, smoking, and obesity in terms of when you need to see the doctor. If you are suffering from any kind of joint pain and you have psoriasis, or if you suspect psoriasis but you haven't received a diagnosis, then I would be inclined to go to the doctor first. Also, if any part of your psoriasis plaques or rash becomes ular, so meaning it forms kind of fluid-filled spots, particularly on the hands and feet, then you definitely need to see the doctor. Other than that, then in terms of tips, while itch isn't one of the most common symptoms of psoriasis, it's still a good idea to keep your nails trimmed so that they're not sharp, so you're less likely to scratch yourself. Speaker 1 00:12:33 Keeping on top of emollient and good quality bath products can really help. In terms of the bath, there are a couple of lovely bath oils which are really good at adding moisture into your skin and helping to promote good skin barrier function and health. So one of them is the ReLife bath oil and the lae do one in their paka range as well. For the shower, obviously an oil isn't always convenient and it's easier to use something that comes with a pump dispenser. A good one for the shower is the res email lipid replenishing cleanser as it's both soothing and beneficial to your skin. Do you remember always to wear sun factor? While it's thought that psoriasis can benefit from sunlight, it's also known that sunburn can cause flareups of psoriasis. If you're a man and you have psoriasis on your face, then maybe just be careful when you're shaving or reduce the amount you're shaving. Speaker 1 00:13:35 Good time to grow beard. Don't feel alone if you have psoriasis. We know that there's at least 73,000 people in Ireland with it, and it's just important to know where to get support and what products are actually going to help. Obviously, I've talked you through all the pharmacy products there, which are dermatologically tested. Also, you can check out that website where they've loads of information about the prescription medicines, which are also available, which I'm just not gonna go into today. So that's Irish skin.ie. I really hope that you found this episode helpful, and if you did, please give a little review or a follow and subscribe. Do tune in next week when I will be back talking all about the different kind of rashes you can get in the summer. Everything from nettle stings to prickly heat to sun allergy to problems with your medicine, and when you need to see the doctor. I will talk to you then and I hope you have a really great week. Thanks so much for listening.