Close-up of hands


August is National Psoriasis Awareness Month, and local dermatologists want people to know that there are newer, more effective treatments than ever before to help control the red, scaly patches caused by the disease.

Dr. Michael Heffernan of Central Dermatology treats some of the most stubborn cases of psoriasis and collaborates with colleagues around the world on researching new treatments. “It’s exciting to get involved on the ground floor of finding better treatments,” he says. “And it’s very reinforcing to take people who have terrible psoriasis and treat them so they can go out without embarrassment. It’s a very emotionally rewarding part of dermatology.”

Psoriasis is related to immune function and tends to run in families. Scientists don’t know exactly what causes the immune system to overreact, producing skin cells in localized areas too rapidly. The rapid cell turnover causes pink or red raised patches of scaly skin. The degree of psoriasis varies from mild, in which only small, occasional flare-ups occur, to severe, in which large portions of the body are affected. Knees and elbows are classic sites for psoriasis outbreaks. “It tends to occur in areas of trauma to the skin, where there’s been an injury or a lot of irritation,” says Dr. Luciann Hruza of Clayton Dermatology. “Also, a strep infection can trigger a new onset of psoriasis, so people who have a family history of psoriasis should make sure that possible strep is diagnosed and treated quickly.”

Stress also is known to worsen psoriasis in some people. “Psoriasis is an immune-mediated disease, and we know that stress affects the immune system,” Heffernan says. For some individuals psoriasis outbreaks themselves cause psychological stress. Although the disease is not contagious, people may react negatively to the sight of someone who has the telltale skin condition.

“The most important thing to understand about psoriasis is that there are more effective and safe treatments now than in the past, and new medications are in the pipeline,” says Dr. Daniel Ring with West County Dermatology. “Patients who tried creams for years without success should contact their dermatologist to discuss new treatments.”

Treatments are individualized and may involve a combination of approaches. “For some patients, topical medications can control their psoriasis; for others, ultraviolet light can be used very effectively via laser or UV booth; and for the most severe, a newer class of medications called biologics is given either by injections or infusions in a doctor’s office,” Ring says. “These have revolutionized the treatment of psoriasis in the past eight years, allowing patients to achieve up to complete clearing of their skin disease and maintain clearance with periodic treatments.”

Heffernan is working on research projects involving new drug approaches that may help regulate the immune response that triggers psoriasis outbreaks.

“Doctors will do as much as they can to help you feel comfortable with your skin,” Hruza notes. “Treatement strategy depends on each individual situation and on what we feel is safe and effective in that situation, but it’s a very rare person who can’t be treated effectively.”