Understanding And Managing Psoriasis In Different Age Groups

Psoriasis is a skin condition that can be present at all ages. Psoriasis is for life, but the impact it has on people’s lives varies enormously. The varying degrees of severity result in different needs and challenges. Treatments are available to control skin symptoms; however, treatments that work for adults may not necessarily work best for children or young people with psoriasis, who also need to manage their condition during various stages of development (i.e., puberty). Children and young people with psoriasis need to feel well enough to participate in social activities; this might involve missing days at school or restricting their participation in sports or other activities.

Psoriasis is a chronic, lifelong skin condition characterized by red, itchy patches that can appear anywhere on the body. The patches are often covered with silvery scales, which sometimes fall off. Psoriasis may affect the nails and joints as well as the skin. People of all ages can have psoriasis, though it usually first develops between 15-35. While older people are more likely to have milder forms of psoriasis that involve minimal discomfort or impact daily living, young children may experience severe itching and scratching, leading to significant weight loss, bleeding, infections or scarring.

Adolescents who develop moderate to severe psoriasis have an increased risk for depression. This is at least partly due to substantial effects on functioning, self-esteem, and appearance when these issues are critical in social development. It is therefore essential to address these concerns in an open and empathetic manner. The presence of psoriasis in children or adolescents can provoke significant anxiety in their families, leading to overprotectiveness. Therefore, parents and caregivers need to receive appropriate diagnoses, prognoses, treatment options, coping strategies, and available self-help techniques.

Childhood psoriasis and management:

Children and adolescents may be less likely than adults to complain of pain or itching, so the psoriasis condition often goes unnoticed. Mild psoriasis in children can manifest as barely visible red spots, while more severe cases involve thick, reddened plaques and silvery scales on knees and elbows. Most children with mild forms of psoriasis grow out of their symptoms by adulthood, but about 10 percent will have persistent disease into adulthood.

Management: The goal is to reduce skin inflammation; that means controlling outbreaks, improving appearance through topical treatments, managing pain, and scaling back the side effects from phototherapy. Oral medications are reserved for people with extensive or disabling psoriasis who have few other treatment options. A dermatologist can recommend which treatments are the most suitable for your child. It is essential to keep children with psoriasis involved in making decisions about their care while also coping with social stress. Reduction of psoriasis symptoms can also improve psoriatic arthritis, minimizing pain, stiffness, and swelling. A multidisciplinary approach involving a paediatrician, dermatologist, nurse educator, and therapist is usually required for children with psoriasis; they may need help dealing with self-esteem, peers’ reactions, or school intolerance. Treatment aims to maintain remission. Current treatments are generally well-tolerated, but side effects may occur.

Middle age psoriasis and management:

The prevalence of psoriasis increases with age, affecting 5-20% of middle-aged people. It is also more common in men than women during this period. Psoriasis tends to worsen over the years for most people who have it, though about half experience spontaneous remission. The risk of complications does not appear to be higher in middle-aged or older adults compared with young adults. However, these individuals are more likely to suffer from medical conditions that can complicate psoriasis treatment. For instance, cardiovascular disease, hypertension, and diabetes are the top three comorbidities seen in older patients with psoriatic arthritis. There are apparent differences between early-onset psoriasis and that that occurs at a later stage in life. Middle-aged and older people with psoriasis may have less joint inflammation and be more likely to experience pain related to skin changes. It is also reasonable to assume that unrecognized comorbidities will occur more frequently for this age group.

Management: Treatment options such as topical therapies, phototherapy, or systemic medications effectively treat psoriasis in middle-aged or elderly patients. However, these treatments are often insufficient. There may also be the need to use greater concentrations of drugs due to reduced clearance of medication from the body. Health care providers should consider alternative medical treatment if the goal is complete remission sustained over time, rather than short-term improvement.

Late-onset Psoriasis and management:

As many people develop psoriasis in their 50s or 60s, the condition is increasingly observed in older adults. One study found that 19 percent of people with psoriasis are aged 65 years and older, which means it is the sixth most common chronic disease among this age group. While older adults with psoriasis develop skin symptoms similar to those observed in younger people, they may have different physical complaints depending on comorbidities. For instance, around one-third of late-onset psoriasis patients indicate joint pain as a result of arthritis. A recent paper notes that individuals over 50 with psoriatic arthritis often also have other severe medical conditions such as cardiovascular disease or diabetes.

Management: Treatment options are generally the same for older adults with psoriasis, though health care providers might modify drug regimens to minimize side effects. While elderly patients can often tolerate topical therapies, phototherapy, or low potency systemic medications, their use may be limited by age-related conditions such as cataracts. Treatments that are prescribed should consider the increased risk of side effects when dealing with an aging population.

What are the treatment options available for psoriasis?

Treatment options depend on the type and severity of psoriasis, its location on the body, and whether chronic or acute. While several treatment options are available for psoriasis, these options often vary in their effectiveness and can cause different side effects.

Topical therapies:

Topical therapies are applied directly to the skin. They can include coal tar, anthralin, topical retinoids, vitamin D analogs (calcipotriol or tacalcitol), topical corticosteroids, salicylic acid, sulphur, resorcinol, psoralen plus ultraviolet A phototherapy (PUVA). The presence of other medical conditions may necessitate a particular treatment approach. For instance, if cardiovascular disease or hypertension are complicating factors for an older adult with psoriasis, treatments should focus on low-potency systemic medications.

Systemic therapies:

Systemic therapies are taken orally or injected and can include methotrexate, cyclosporin , acitretin, thalidomide, infliximab. These medications are often the first choice for people with inflammatory types of psoriasis. Methotrexate is an effective systemic medication that carries relatively few side effects for middle-aged or older adults. However, it does not work for all types of psoriasis and can cause nausea or liver damage in some patients.

Phototherapy:

Phototherapy involves exposure to ultraviolet light. It is often used as a maintenance therapy to treat moderate forms of psoriasis after other treatments have been used to “melt” plaques. PUVA is a form of phototherapy that combines topical psoralen with exposure to ultraviolet A light.

Systemic retinoids:

These drugs are derivatives of vitamin A which are taken orally to treat psoriasis. They are often combined with other treatments for moderate inflammatory lesions that cover more than 10-20 percent of the body. However, systemic retinoids are not usually used as monotherapy since they have many side effects. Acitretin is one such medication that can cause nausea, hair loss, elevated triglyceride levels, and congenital disabilities in the fetus if taken during pregnancy. In older adults, acitretin can also cause elevated liver enzymes.

Systemic corticosteroids:

These medications are typically injectable drugs that can be used for short periods to treat acute exacerbations of psoriasis. They carry the risk of significant side effects, including weight gain, osteoporosis, diabetes, and cataracts. However, they may be helpful for older adults with limited treatment options since their potential side effects are well-known. More recently, systemic corticosteroids have been replaced by biologic response modifiers (BRMs) like etanercept (Enbrel), infliximab (Remicade), or adalimumab (Humira) which are injected once or twice weekly. The advantage is that they do not cause severe side effects. However, they are relatively expensive and can be associated with an increased risk of severe infections and lymphomas.

Systemic biologic response modifiers:

A newer treatment class involves the use of medications that target specific proteins found in psoriasis lesions. These drugs block certain immune system signals that cause inflammation. They work differently than systemic corticosteroids or immunomodulators such as methotrexate. Hence, BRMs allow for a targeted approach to treating psoriasis. Since they only affect specific cells involved in the disease process, BRMs have fewer side effects than other cytotoxic treatments like methotrexate. However, they do carry a risk for infection and serious adverse events linked to the drug. In addition, patients must be monitored closely to assess the efficacy and for negative consequences.

What are the side effects of steroid and conventional psoriasis treatment:

Psoriasis treatment depends on its severity and type and the age of the person affected by it. If an older adult or younger has limited functional capacity or poor nutritional status, topical treatments are often preferred over systemic medications. However, even patients with limited psoriasis may benefit from consideration of systemic therapies since early intervention can prevent more severe diseases in the future.

The side effects of conventional treatment include:

1. Osteoporosis
2. Hypertension
3. High blood pressure
4. Diabetes mellitus
5. Gastrointestinal ulceration or bleeding
6. Emotional instability or depression
7. Muscle weakness and easy fatigue
8. Cataracts
9. Glaucoma
10. Loss of skin elasticity
11. Stretch marks
12. Hair loss
13. Cushingoid appearance
14. Infection
15. Bone fractures
16. Increased susceptibilities to infection
17. Osteonecrosis of the hip
18. Acne
19. Visual disturbance
20. Skin bruising
21. Fluid retention

There are many side effects of conventional treatment. Many people may not be aware that psoriasis is a chronic disease that can get worse over time if poorly managed. However, early intervention with medication helps in slowing down the process of cell multiplication and reduces severity by controlling the immune response. You can seek homeopathic treatment for psoriasis as it is a safe and natural treatment.

Benefits of using the homeopathic treatment for Psoriasis:

1. No side effects attached with it.
2. Well tolerated by patients of all age groups.
3. An affordable treatment option.
4. Treatment of the root cause of psoriasis rather than just suppression of symptoms.
5. Prevention of recurrence after successful completion of the treatment course.

With homeopathic treatment for psoriasis follow:

• A Healthy Lifestyle can help in reducing the symptoms of psoriasis. Exposure to sunlight or ultraviolet rays may provide some relief from the itchiness, especially during the summer season.
• Physical activity can improve your overall health, including body weight and heart condition. It may also reduce the need for medications to control pain and inflammation. Other lifestyle changes that can help with psoriasis include:
• A balanced diet of fresh fruits and vegetables, whole grains, legumes, nuts, seeds, lean meats, and healthy oils will give you the energy needed to combat psoriasis.

Take help of the homeopathic treatment for psoriasis at it is a safe and effective way to treat this chronic disease with no side effects. You can book an appointment with a homeopathy doctor through OHO Homeopathy now!