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Skin conditions need treatment strategies that are comprehensive, as many individuals would attest to, it can be a rather a challenging road to travel. The basics of healthy skin lie in balancing gut flora, encouraging detoxification, and restoring epidermal integrity. Along with this, other variables unique to the state also have to be contemplated. Included in these are handling anxiety, balancing the immune response, supporting elimination routes, and of course great nutrition and lifestyle guidance. Reaching these goals takes time, therefore it is essential that effectual and fast relief from the pain and discomfort of skin afflictions is reached with external applications in the mean- time.

Psoriasis is an immune-mediated inflammatory disease of the skin characterised by red scaly spots (psoriasis plaques). A diagnosis of psoriasis is generally predicated on the look of the skin. There are not any specific blood tests or diagnostic procedures for psoriasis. Occasionally scraping, or a skin biopsy, of the plaques could be required to support the identification and to eliminate other illnesses. These plaques are sites of inflammation as well as excessive skin cell generation due to the increased ratio of cyclic GMP within the dermis to cyclic AMP. Newly created cells rise to the surface of the skin within days, gathering in thick, crusty spots. Plaques often appear on the skin of the elbows and knees, but can change to any region, including genitals and the entire scalp.

The condition is recurring or persistent and can fluctuate in severity, from minor patches that are localised to whole body coverage. Fingernails and toenails are often changed (psoriatic nail dystrophy), as are the joints (psoriatic arthritis). Determined by location and the severity of outbreaks, people may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, like self-care, walking and sleep. Plaques on hands and feet can prevent people from playing sports, working at certain occupations, and caring for a household or family members. People with psoriasis may also feel self-conscious about their appearance and have a bad self-image.

Signs and Symptoms

Common signs and symptoms of psoriasis may include:

• Increased skin lesions, strong pink with reddish edges and silvery surface scales; may be debilitating and broken
• Blisters oozing aseptic pus
• Scarred, discoloured, and perhaps thickened fingernails or toenails; could be divided from underlying skin
• Itching around plaques of skin
• Joint pain (psoriatic arthritis) in some instances
• New lesions may appear following injuries to the skin
• Susceptibility to sweating and friction
• Potential swelling of the affected regions

What Causes Psoriasis?

Although there is as yet no clear cause of psoriasis, studies have linked the incidence of psoriasis to several conditions and lifestyle customs. Included in these are:

• The first outbreak is occasionally reported following major illness or anxiety/injury.
• Genetic/genetic predisposition
• Immune system disorders (including AIDS)
• Obesity
• Alcoholism
• Skin damage
• Rheumatoid arthritis
• Immune system dysfunction
• Diseases
• Autoimmunity
• Hereditary characteristics (parts of chromosomes 16, 17, 20, 6)
• Psychological anxiety
• Skin harms/sunburn
• Specific drugs (chloroquine, gold, lithium, beta blockers)
• Acidic foods
• Increased intracellular calcium levels or reduced intracellular magnesium levels
• Low zinc/ copper levels that are high
• Potential B12, Folate, and iron deficiencies. Psoriasis is broadly accepted as a genetic, autoimmune illness with thickening of the epidermis. Psoriatic skin was discovered not only to have low rates of B12 compared to non-psoriatic skin, but in addition significantly greater expression of inducible nitric oxide synthase (iNOS), a mediator of cellular proliferation as well as inflammation.
• Changes in climate and season can activate psoriasis outbreaks.
• Excessive alcohol consumption, smoking and recreational drug use may exacerbate psoriasis or make the managing of the state hard.

The Three Tiers of Psoriasis Management

1. External Symptomatic Relief

A topical lotion of anti-inflammatory herbs combined with antimicrobial capability is perfect to safeguard and soothe the skin.  External application of essential herbs are used to supply anti-inflammatory and antioxidant benefits for the skin. These herbs include:

• Aloe barbadensis (Aloe vera),
• Oenothera biennis (Evening primrose oil), and
• Lavendula angustifolia (Lavender), along with
• Calendula officinalis (Marigold),
• Chamomilla recutita (German chamomile), and
• Avena sativa (Oats).

2. Diet & Lifestyle, Waste Removal and Immune Equilibrium

Diet and Lifestyle Advice for Psoriasis

Lifestyle and dietary guidelines that will help in the control of psoriasis include:

• Reduce pro-inflammatory foods in the diet including saturated fats (meats, particularly poultry, and dairy products), processed foods, and sugar. Patients sensitive to antibiotics should eat only organic meats to avoid antibiotic contamination.
• Stress management techniques ought to be used. Anxiety is a powerful cause as stress hormones are understood to act in the skin causing inflammation activating psoriasis. Anxiety is a driver of skin conditions, which isn't astonishing when we consider the consequences of stress on the body are more evident on the skin. For instance, when we're stressed our skin flushes, we sweat more, and it often exacerbates present conditions like psoriasis. Length and the course of psoriasis flare ups may change depending on stress or anxiety levels, so nervous system support should be an integral part of the efficient control of the psoriasis.
• Patients frequently reap the benefits of mind-body treatments and stress management.
• cAMP increases and enhances overall well-being.
• Proper hydration to assist elimination via the kidneys and bowel.
• Eliminate simple sugars, processed foods, limit alcohol, and saturated fats found in dairy products and meat as these foods often exacerbate [soriasis. Avoid acidic foods (pineapple, oranges, coffee, and tomato) and any foods you are sensitive to (wheat, citrus, milk, corn and eggs are some of the most common).
• Digestive enzymes assist appropriate protein digestion and ought to be used with each meal. This really is very important as incomplete protein digestion inhibits the formation of cAMP, thereby leading to the cell proliferation which characterises psoriasis.
• Sun/ultraviolet light is a valuable treatment for people that have psoriasis. Exposure to UVB or the sun for half an hour is a treatment that has been found to be helpful.

Immune Equilibrium

The diet may be a big source of irritants that generate an immune response. An elimination diet with food challenges is usually used to efficiently identify irritants and dietary antigens that can lead to immune susceptibility. Reducing the over-responsiveness of the immune system is an essential element used to handle the inflammation that accompanies psoriasis flare ups.

Acute and chronic inflammation are all too-common characteristics of psoriasis. Fish oil is among the strongest anti-inflammatories accessible to efficiently target the inflammation underlying this condition. Fish oil products should include well below the Australian allowable rates of heavy metals and pesticides, solvents.

Waste Removal

Detoxification pathways through the bowel, kidneys and lymphatic systems ought to be supported. Overburdened routes of removal add pressure on the skin to behave as an organ of elimination. Enhancing the function of these removal pathways helps decrease the effect of toxins on the skin.

3. Principles for Skin Health

Detoxification

In addition to ensuring great removal routes, reducing the toxins that are ingested is also needed. Typically this would include alcohol reduction/avoidance and smoking cessation. Seeking the guidance of a hypnotherapist is likely to help changing habitual use of nicotine or other drugs. A local recommended hypnotherapist is Wendy Gadsby of Make Changes in Sunshine www.makechanges.com.au.

Gut Flora Health

Psoriasis will flare with bowel inflammation, weakened digestion and exposure  to toxins and environmental stressors. These factors can all also influence the health of the gut flora. A probiotic form of anti-inflammatory bacteria, demonstrated to lessen inflammation both locally in the intestine along with having a systemic anti-inflammatory effect ought to be selected to help re-establish the gut flora.

Skin Integrity

Healthy skin is an important element of good health. Not only does the skin supply a physical barrier to shield us from the outside surroundings, but is also an immunological barrier which safeguards against bacterial, fungal, and viral infection. As a starting point in the synthesis of vitamin D, this semi-permeable membrane serves among other functions to prevent water loss, and is also responsible for up to 80% of heat transfer within the entire body, which makes it essential for fluid regulation. Given the significance of the organ, it comes as no real surprise that even a moderate change in barrier function might have important repercussions not only on skin quality, but on general health.

Skin Cell Regulation

Zinc with Vitamin C are highly regarded when it comes to controlling skin cell development. Both are necessary for cell formation and healthy collagen. These are among the most essential nutrients for skin function and healthy immunity, involved in wound healing and resistance to disease.

Medical Treatment for Psoriasis

Pharmaceutical Treatments

• Corticosteroids: taken internally or used topically to reduce inflammation/irritation. Prolonged use causes pigment changes, skin thinning, and suppresses the immune apparatus, commonly causing vengeful flare ups upon cessation.
• Coal tar ointments/shampoos: used topically these ease distress, enhance effectiveness of UV light therapy but might cause folliculitis and may increase squamous cell carcinoma danger.
• Methotrexate and other anti-cancer drugs: drugs like Anthralin are used to reduce proliferation of skin cells. Long term use causes liver, renal and blood toxicity; nausea, diarrhoea and vomiting, with an increased risk of metastatic carcinoma and squamous cell.
• Immune modifiers: may be utilized for severe psoriasis. Included in these are biological response modifiers like etanercept and efalizumab, and immunosuppressive agents including cyclosporin. Etanercept is a tumour necrosis factor (TNF) receptor antagonist: it may be related to increased prevalence of diseases and tumours. Efalizumab is a monoclonal antibody which reduces T lymphocyte-mediated inflammation, and could lead to increased illness, thrombocytopenia and other serious adverse effects.
• Retinoids: Acetretin is a retinoid which reduces keratinisation and epidermal proliferation with psoriasis.
• Salicylic acid ointments: used topically to encourage scale shedding.
• Vitamin D derivative may additionally be successful through suppression of epidermal cell proliferation.
• Cell turnover is reduced by Dithranol by activities that might contain free radical

A Multifaceted Approach to Psoriasis

A multifaceted strategy is required for efficient management of skin conditions including psoriasis. As holistic practitioners, naturopaths realise the implications of skin conditions goes way beyond that which we can find on the surface. To change the path and severity of the common dermatological condition psoriasis, we must consider not only the physical condition of the person, but also the mental and emotions facets. By integrating both lifestyle and herbal/nutritional support interventions for stress management

If you have eczema, chances are you’ve gone to bed with a wide range of smelly, sticky potions smeared all over your skin, resulting in stained sheets and pyjamas. Or perhaps you’ve gone to bed mummified, with toilet paper enveloping your limbs in an effort to keep things neat and tidy? This mix of eczema creams and bed linen protection doesn’t prevent you itching, in fact you may have given up on a potion that can prevent itching. But it does cover the lesions up that weep and bleed during the night and the exudate from drying to anything it comes into contact with. Sadly, this is the nightly ritual of many with eczema.

What about probiotics?

If you have allergies in the family, eczema might be only one of the allergic conditions playing havoc with a good night’s sleep. Asthma may also plague your evenings and scratching through the night can result in skin lesions becoming infected and if bad enough can call for an aggressive course of antibiotics. Tummy woes can follow a course of antibiotics as disruptions to the intestinal microflora frequently lead to antibiotic side effects including diarrhoea. Fortunately, probiotics are readily available to recolonise the intestines with health-boosting microbes. But which probiotic would you pick? Research is turning up increasing amount of information on the appropriate use of probiotics and it is no longer a one size fits all scenario. Choosing to take a probiotic suited to minimising antibiotic linked disruptions can also reduce the chance of a runaway growth of Candida albicans and a potentially nasty case of thrush. With the cycle of eczema, itching, infection and antibiotics, it is interesting to note that Candida albicans overgrowth is linked to the exacerbation of eczema symptoms in sufferers. So choosing the right probiotic can mean the difference between healing the infection and relapsing straight back to itching and scratching and potentially winning a reprieve for a moment or two.

Further research is looking into the effect of probiotics in preventing inflammatory afflictions like eczema. Preliminary studies show good results for people with eczema simply by changing your strain of probiotic. In fact, the intestinal flora primes the immune system to stop it overreacting to the environmental, food or anxiety triggers found to stimulate inflammation of the skin.

Probiotics have also been investigated for the primary prevention of eczema in babies. In families with history of hereditary allergies, it was found that only supplementing pregnant mums and their infants for the first 6 months of life can reduce the frequency of allergic eczema by half. So, it seems if you are keen on preventing eczema in your children, early supplementation is a true bonus for getting a good result here. Often the best probiotics are also available in a dairy-free form, as hereditary allergies may also manifest as food allergies.

About 15-35% of kids with allergic eczema will have food allergies and from talking to new mums it is clear food allergies are on the rise. Delaying the introduction of solids has previously been recommended as the best prevention for food allergies in children, however new research suggests that this has not been the case in practice and may possibly have the opposite effect. Further research is needed but it seems babies between the ages 4-6 months have a natural tolerance of foods introduced in this time frame. The Australasian Society of Clinical Immunology and Allergy (ASCIA) now advocates introducing of these foods, including egg, peanuts, nuts, wheat, cow’s milk and fish along with other solids. Their Infant Feeding Guide with a full list of recommendations can be viewed here: www.allergy.org.au

Tips for dealing with eczema symptoms

Meanwhile, helpful symptomatic advice for those of you who have already developed eczema includes:

1. Keep your skin moisturised. Your skin is the barrier to the outside world and its ability to control water loss in compromised with eczema, so moisturising becomes very important.
2. Prevent overheating. You are advised to use thin layers of cotton blankets instead of thick doonas. This way your temperature can be more easily controlled. Much like layering your clothing, you can just peel off a layer to prevent overheating.
3. Avoid hot baths and showers. Limit tub time to 10 minutes as this will ensure you are out before your skin starts to get wrinkly – a sure sign that essential moisture is being lost by your skin and it will dry out.
4. Swap your soaps for more gentle soap replacements.
5. Wear soothing fabrics that do not irritate the skin. You don’t need any further triggers for potential itching.
6. Chlorine and sand are skin irritants. Be sure to rinse off and moisturise after a day at the seashore, in the sandbox or in the swimming pool.
7. Identify food allergies. Nuts, eggs, soy and cow's milk cause about 90% of food allergies.Other offenders include chocolate, gluten, shellfish, fish, citrus fruits, tomatoes, strawberries and food additives (such as MSG and sulphite derivatives).

Will healing the gut help treat eczema and food allergies?

While infants seem to have an all-natural tolerance of foods when introduced between 4-6 months, in adults, food allergies or intolerance may originate from overexposure to a particular food, incomplete digestion or “leaky gut”. Could you have a leaky gut? Having a leaky bowel or damaged intestinal lining makes it easier for food particles to overcome the diminished obstacles of the intestinal immune system and spark inflammation. By relieving intestinal inflammation and strengthening bowel functions probiotics show another facet to their healing purpose in eczema treatment.

Eliminating food triggers is part of healing a leaky gut, as these foods continue the cycle of inflammation when they are consumed. Coupled with a reduction in environmental allergens by changing to low-allergenic face washes, body washes, laundry powder, moisturisers and detergents and maintaining your probiotic supplementation may be prescribed as part of a program to heal your digestive system. Meanwhile, intermittent treatment with steroid creams may still be needed for the severe cases of eczema. Often these are used for 10 days, then stopped for 4 days, with treatment being duplicated as needed.

Anti-inflammatory foods: Omega 3 fatty acids

Systemic inflammation is something that must be tackled from the inside as well as the environment. The anti-inflammatory effect Omega 3 fatty acids are well known and are understood to modulate immune responses to possibly help allergic disorders such as eczema. One study found the use of fish oil supplements in pregnant women from 20 weeks until delivery resulted in a reduction in the incidence of eczema in their children recorded at one year. In addition, it has been found that Omega 3 nutritional supplements taken during pregnancy and lactation reduce the danger of food allergy and allergic eczema in babies with a family history of allergic disorder. The preventative effects were found at doses of 1.6g EPA and 1.1g DHA daily. High strength, high quality,  purified, fish oil capsules or liquid fish oils are the best for getting this amount of active Omega 3 from supplements. Higher amounts are recommended for the treatment of recognised cases of eczema.

In reading this you may be aware that there is not any one remarkable magic bullet that will take your incessant itch away. It generally takes months of intensive interventions both naturopathic and potentially conventional to return to comparative normality. Still, the relief you will feel when you no longer need to plaster yourself in creams and potions in order to get a good night’s sleep will be worth every step you have taken on the path to becoming well.