What is Psoriasis?

Psoriasis is a chronic disease of the skin affecting 2-3% of the population. The topmost layer of the skin, the epidermal cells, grow at 10 times the normal rate. With this rapid rate of growth the cells do not mature properly resulting in the characteristic psoriatic lesion.

The physiology of psoriasis is intricate and complex involving over 1,000 genes. Currently, psoriasis is classified as an autoimmune disease. However, research has revealed that both arms of the immune system (innate and learned), the nervous system, the integumentary (skin) system and likely the gastrointestinal system all interact to create the disease process.

The basic pathological feature of psoriasis is a perpetual cycle of inflammation within the skin that extends to the entire body. T cells as well as other types of immune cells play a critical role in creating the inflammatory cycle. Pro-inflammatory mediators, or signaling proteins, such as TNF-alpha, IL-17 and IL-23 are increased in psoriasis and are targets for drug therapy.

What are the physical manifestations of psoriasis?

There are several forms of psoriasis with plaque psoriasis being the most common.

Plaque

raised, red patches with a silvery scale that can be thick and will often bleed or ooze.

Guttate

small, reddish/pink lesions with a fine scale most often spread across the trunk and limbs.

Pustular

White pustules (blisters) filled with noninfectious fluid containing white blood cells surrounded by red skin.

Inverse

red, smooth, shiny lesions within the body folds such as the axilla.

Erythrodermic

a severe and rare form of psoriasis characterized by redness and shedding of the skin. This form can be fatal and immediate medical attention is required.

Does having psoriasis affect psychologic health?

Most people with psoriasis suffer both socially and emotionally. Indeed, a recent study revealed that the physical, emotional and social impacts of having psoriasis is similar to and can often be greater than that of most chronic diseases including diabetes, arthritis and even cancer. Self-esteem can be significantly impacted especially as many individuals develop their disease at a very vulnerable time of life, the teenage years. Psoriasis sufferers often withdraw from social interactions and intimate relationships. Additionally, some feel limited in their choice of career due to the appearance of their skin and career success can suffer as a result of missed days at work. Consequently, there is a high incidence of depression and anxiety. Sadly, 10% of people with psoriasis consider suicide.

Talking about your condition to loved ones and even serving as a role model for others with psoriasis can help you to overcome some of your own social anxiety. World Psoriasis Day gives a global and an individual voice to those suffering with psoriasis.

What diseases and conditions are associated with psoriasis?

Unfortunately, having psoriasis increases your risk for the development of several other diseases. This is as much of a concern as the psoriasis alone as the health implications can be serious.

The inflammation in psoriasis is systemic (affecting the entire body). It’s this inflammation that drives the development of other diseases that are also inflammatory in nature.

A person with psoriasis can have up to a 7 fold increased risk for heart disease; a 30 year old with severe psoriasis has a 200% increased risk of having a heart attack. Psoriasis increases the risk of metabolic syndrome including diabetes. Multiple other autoimmune diseases are coincident with psoriasis. Depression and anxiety is not only a result of the emotional burden of the disease but the inflammatory process extends to the brain directly impacting psychologic health.

Diseases and conditions associated with psoriasis:

  • Metabolic: metabolic syndrome, dyslipidemia, diabetes, hypertension, obesity
  • Cardiovascular: cardiovascular disease
  • Cancer: lymphoma and non-melanoma skin cancer
  • Autoimmune: inflammatory bowel disease, uveitis, celiac disease, psoriatic arthritis respiratory
  • Liver: non-alcoholic fatty liver disease
  • Respiratory: chronic obstructive pulmonary disease
  • Neurologic: parkinson’s disease
  • Psychologic: depression, anxiety, alcoholism, suicidal ideation

What are the conventional medical treatments and their risks?

Fortunately, there are several medical treatment options for psoriasis.  Challenges to these treatments do exist.  They can be time consuming, uncomfortable or may come with significant health risks. But, thankfully many people with psoriasis have found relief allowing them to lead more functional and happier lives.

The newer biologic medications have offered immense benefit to many.  They do, however, have serious side effects to consider.  The risk of acquiring a critical infection is significant. Also, despite improvement in skin lesions the systemic inflammatory process may not be resolved and this unchecked inflammation can have major health implications.

The National Psoriasis Foundation provides a more in-depth overview of the various treatment options available today.

What is the healthiest way to treat my psoriasis?

Medical experts recognize that the treatment of psoriasis requires a holistic approach including a multidisciplinary team of care providers. A comprehensive treatment program may include conventional medical treatments in addition to an emphasis on nutrition, emotional health, mindfulness, exercise and immersion in nature.

Rather than only directing treatment at one specific mediator in the disease process via pharmaceutical medications the Elements of Care simultaneously target multiple organ systems that play a role in the mechanism of disease.  Applying the Elements of Care addresses the inflammatory process in the skin as well as the total body inflammation.  Therefore, you can clear your skin while also decreasing and even eliminating the risk of developing associated diseases

The Elements of Care are a perfect compliment to any conventional treatment or can be used as a stand alone treatment approach. By teaming together with your healthcare providers a specific treatment program can be tailored to your needs.

What are the Elements of Care?

The Elements of Care is a comprehensive treatment program that can be tailored to fit your lifestyle. The 3 components of the Elements of Care include: 1) Diet and Fasting (when appropriate). 2) Mindfulness, Nature therapy and Exercise and 3) Balneophototherapy (sun or UV exposure and water therpay). Please visit the Elements of Care page for a more complete explanation.

What is the dietary foundation and will I enjoy it?

Your new diet will most closely follow the principles of the anti-inflammatory diet developed by Dr. Andrew Weil. This diet pattern emphasizes whole foods with an abundance of fresh fruits and vegetables and limited high-quality sweets. The process by which you clear your skin will likely require a more limited diet initially and possibly fasting for those in which a fast is safe and appropriate. I encourage you to choose organic produce when you can to limit your toxin exposure. The Environmental Working Group offers a yearly guide to help avoid the most problematic conventional fruits and vegetables, The Dirty Dozen. Once you have adapted to the changes that you make I guarantee that you will enjoy your diet and find great pleasure in how it makes you feel.

Is it hard to learn to meditate?

Many people are intimidated by the concept of meditation.  The idea that you must have an empty mind to be successful turns people away from even getting started.  However, the benefits of meditation can be achieved even after your first session.  Yes– to be of clear mind is a goal but the road to getting there offers immeasurable gifts.  You may consider your time in meditation simply as a time of quiet.  In our busy world it is rare that we take even a couple minutes of quiet time.  There are many resources to help you get started. John Cabot Zinn has authored many books and has a series of guided mindfulness meditation that can guide you on this journey. Additionally, there are several new apps, such as the popular Headspace app, that have helped many to make meditation a part of their daily regimen.

What is balneophototherapy?

Balneophototherapy is the use of UV light treatment or direct sunlight in combination with bathing to treat psoriasis. Diet and Mindfulness works from the inside out versus balneophototherapy which works by direct action on the skin. In addition to sun and water you must also consider what you are putting on your skin for lubrication. Choosing a non-toxic product is essential. Referring to the Skin Deep website can help you to make smart choices.

Is there a scientific basis for the Elements of Care?

Yes. The Elements of Care are based in science and each element has sound research confirming it’s legitimacy as a treatment modality. The different aspects in the Elements of Care have also been tested by time as they have been passed down through generations of healers around the world.

Is adapting a lifestyle following the guidelines in the Elements of Care easy?

Yes and No. Truly applying the Elements of Care requires dedication, motivation and a significant amount of work. Changing lifestyle habits is never easy. However, it has been shown that after approximately 1 month individuals are better able to maintain healthy changes that they have made as it simply becomes a way of life. Together with feeling better and discovering a sense of control you will find that you enjoy your new diet and lifestyle.  Therefore, after the initial hard work of changing habits you will find that the Elements of Care are a natural way to live and eat and, therefore, easy to apply.

Can children apply the Elements of Care?

Most definitely! With the exception of fasting, which I do not advise for children, the Elements of Care provide great benefits to children. Empowerment, a sense of control and adopting healthy habits that will provide them with immeasurable benefits throughout their life in addition to healthy skin will serve them well. I began applying the Elements of Care at the age of 6 and am exceptionally grateful to my mother who never gave up and to my physician who was a fearless pioneer.

Is it possible to lead a full life free of disease?

YES!! There are many examples of people with psoriasis who have been able to overcome their disease and lead highly successful and happy lives. The Elements of Care provide a pathway for you to have the same success and define your life not by the limitations of your disease but rather by your dreams.