Psoriasis may seem only skin deep, but it begins inside the body within the immune system.

It affects millions of people around the world but there's a lot people don't understand about the condition. Symptoms include red, scaly skin patches with sharply defined edges, lesions that occur most commonly on both elbows and changes in fingernails or toenails, such as splitting, thickening or loosening. We spoke to dermatology nurse specialist Selene Daly about the condition and what you need to know. Here is what she had to say.  

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What is psoriasis? Psoriasis is an auto-immune disease causing inflammation to spread in the body. Simply explained, psoriasis is a process that dramatically increases the rate of skin cell turnover. The normal rate of skin turnover is 3-4 weeks, but for people with psoriasis this process happens in just 3-4 days, leaving the affected skin scaly, red and raised off the surface. Psoriasis of the hands and feet is quite common and can cause painful cracks and fissures, affecting peoples’ work and hobbies. Nail psoriasis, causing the nail to become thin, cracked and sometimes fully lifted from the nail bed, can be painful and embarrassing. Psoriasis can also affect the scalp, appearing as either more mild dandruff or, in more severe cases, thick white scales resulting in hair loss.  

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Psoriasis is a chronic illness, not a contagious disease There is no cure currently on the market for psoriasis. Although it can vary in severity, once psoriasis develops, the condition is life-long. The good news is that psoriasis is not contagious and can be managed with the right medical care.   Environmental factors can trigger a flare up While psoriasis is a genetic skin condition with a complex genetic pattern, flares of psoriasis can often be triggered by infection, stress, medications (non-steroidal anti-inflammatories, beta blockers, lithium and anti-malarias), smoking and alcohol. The relationship between flares of psoriasis and foods has not been established, though some patients feel certain foods can trigger a flare up.   Potential development of arthritis Psoriatic arthritis, caused by the immune system attacking the joints, affects approximately 10% of psoriasis patients and results in pain, swelling and stiffness of joints, particularly in the morning. Leaving psoriatic arthritis untreated can cause irreversible deterioration of the joints, so if you have psoriasis and are experiencing joint pain, make an appointment to see your GP or dermatologist as soon as possible.   Treating mild & moderate psoriasis Mild psoriasis is manageable through topical treatments such as soap substitutes and moisturisers, including products like silcocks base and Elave total emollient therapy. Vitamin D analogues (calcipotriol) can create similar effects to that of moderate strength topical steroids but without the side effects. Dovonex, which is now available direct from pharmacies, is an easy, once-a-day calcipotriol ointment that will help keep flare ups at bay. Moderate psoriasis can be treated with a course of phototherapy, which is a safe form of UV exposure – these are NOT sunbeds, nobody should be using sunbeds as they are proven to cause skin cancer. A course of phototherapy treatment usually takes 8-10 weeks, during which time the patient will be seen by dermatology nurses 2-3 times per week.   Treating severe psoriasis If topical treatments and phototherapy fail, dermatologists will prescribe systemic treatments, i.e. treatments that spread throughout the body, for severe psoriasis. Tablet options, such as methotrexate and fumaric esters, are common treatments as are injectable treatments, known as biologics, which work by slowing down the over-active immune system which pushes the skin cells into over-drive.   Other health effects of psoriasis The inflammation caused by psoriasis can lead to a build-up in fatty tissue of the heart vessels, inevitably increasing the risk of heart attack or stroke. The British Journal of Dermatology has stated that people with moderate to severe psoriasis are three times more likely to suffer from heart disease than people without psoriasis. Research also shows psoriasis patients are more likely to suffer from diabetes. Therefore, eating well and exercising regularly is particularly important for those with psoriasis.   Psoriasis side effects: Depression and Anxiety People who suffer from moderate to severe psoriasis are at a higher risk of developing anxiety and/or depression, which can also be linked to an increased risk of alcohol or substance abuse. A survey conducted among Irish people with psoriasis found that the skin condition has had a serious impact on the quality of life of at least half of those surveyed. Often times the general population can be naïve about psoriasis and its causes, excluding patients from social or sports activities out of the misconception that their psoriasis is contagious. It’s no surprise that these experiences can have negative effects on personal relationships and I would encourage anyone with feelings of despair or anxiety to contact their GP or dermatologist.   Inform your doctor if you are planning to conceive Many medications should be avoided during pregnancy, so if you are planning on having a child it is important to notify your doctor so your treatment can be tailored.   Feeling fabulous in your own skin Psoriasis can cause people to feel embarrassed, but it doesn’t have to be a life sentence. There are so many well-known people living with psoriasis, Kim Kardashian, Cara Delevigne and LeAnn Rimes to name a few, who have all found ways of being glamorous whilst managing their psoriasis. Quality Care is a free online resource which provides practical and helpful support for psoriasis sufferers. They include bloggers such as make-up artist Rena Ramani  and Irish girl Helen Hanrahan who share their expert tips on camouflage make-up and fashionable yet practical clothing so that people living with psoriasis can feel confident in their own skin.