The biology behind Eczema and Psoriasis
Understanding these two common skin diseases
So… it’s July, which means Dr Claudia is going to be here very soon!! Did you know that Dr Claudia was directly responsible for the discovery of the neurogenic inflammatory pathway within the skin? It was this discovery that has largely contributed to the success of Dermalogica’s UltraCalming Segmentation line, especially when it comes to combating severely inflamed and reactive skin types and conditions. A lot of Dr Claudia’s research revolves around inflammatory conditions that the skin is susceptible too. Read below, on her explanation of the difference between eczema and psoriasis.
Eczema and psoriasis are some of the most challenging skin conditions encountered by skin care professionals. Eczema, along with asthma and allergies, are on the rise; in fact, eczema is much more common today than it was 30 years ago, especially in children. This rapid spike in apparent incidence is cause for concern, and may be due to many factors, such as inadequate diet, pollution and other environmental stressors. It is significant to note that neither condition is contagious, nor are they infections; and they aren’t transmitted by external contact or exposure. The origins of eczema and psoriasis are genetic; however, the triggers that cause their distressing and visible symptoms may include stress and environmental factors. The truth is, it isn’t known exactly what causes eczema or psoriasis. The good news is, more and more is being learned about these inflammatory skin diseases and strategies are being developed to effectively manage their symptoms.
A rash by any other name is still a rash. The terms “eczema” or “dermatitis” are very broad and can mean a whole family of skin conditions, ranging from dandruff, to contact dermatitis to atopic dermatitis. This can lead to many a confused client and skin care professional. In dermatology and skin care, the word “eczema” typically refers to atopic dermatitis (AD), a chronic inflammatory skin disease. It causes dry, itchy, irritated skin that requires daily care. There’s another type of eczema that shows up as the same itchy rash, but does not involve allergic responses. This is known as non-atopic eczema, and it affects millions of adults. Although most—about 90%—develop atopic dermatitis before age 5, non-atopic dermatitis develops in adolescence or adulthood, typically by age 15. 7- 8% of these people don’t have heightened allergic responses or specific allergies, but still get dry, itchy skin. Even if a client is classified as atopic or non-atopic, the end result is the same itchy patch of skin, which must be cared for in the same manner.
Psoriasis has been confused with eczema, lupus, boils, vitiligo and leprosy. As with eczema, it presents as itchy, red skin and involves altered immunity. However, its complexities reach far beyond the surface of the skin. People with psoriasis have an increased risk of cardiovascular disease, metabolic syndrome, obesity and other immune-related inflammatory diseases—even cancer. Psoriasis is a chronic, inflammatory multisystem disease affecting 1–3% of the world’s population. Whereas the rashes on eczematous skin can have irregular edges and texture, psoriatic lesions tend to be more uniform and distinct. Red or pink areas of thickened, raised and dry skin typically present on the elbows, knees and scalp. This presentation tends to be more common in areas of trauma, abrasions or repeated rubbing and use, although any area may be affected. As of today, psoriasis has no cure. A single cause of the disease has yet to be uncovered, but it is known that developing the disease involves the immune system, genetics and environmental factors. In psoriasis, aberrant immune activity causes inflammatory signals to go haywire in the epidermis, causing a build-up of cells on the surface of the skin. While normal skin takes 28–30 days to mature, psoriatic skin takes only 3–4 days to mature and, instead of shedding off, the cells pile up on the surface of the skin, forming plaques and lesions. The underlying reason may be due to the hyperactivity of T-cells, which end up on the skin and trigger inflammation and keratinocyte overproduction. Although it is not known why this happens, it is known that the end result is a cycle of skin cells growing too fast, dead cell-debris accumulation and resulting inflammation.
Managing the Symptoms
Although there is no cure for eczema or psoriasis, there are ways to manage symptoms. Although eczema and psoriasis are clinically distinct from one another, they do share some common features. Both eczema and psoriasis skins have impaired barrier function and increased inflammation, so the treatment goal will be to protect and repair. Always check first with your client’s physician for contraindications to medications and therapies, because some ingredients may counteract each other. For example, salicylic acid may seem a likely choice for exfoliating psoriatic skin, but could, in fact, inactivate a common topical treatment for psoriasis. A thorough consultation with the client and possibly her physician must be completed, and a treatment using minimal products and procedures performed. Incorporating stress-relieving techniques become vital, because there is a psychological component to eczema and psoriasis. Complementary therapies, such as aromatherapy, acupressure, reflexology, massage and inhalation techniques can be coupled with very mild skin treatments to lower stress hormones and control inflammation and work exceptionally well.
Gentle cleansing and exfoliation is crucial to allow the penetration of rich, emollient moisturisers used on dry, sensitive skin. Avoid harsh exfoliants and detergents, and look for ingredients, such as lactic acid. Use anti-inflammatory ingredients, such as red hogweed, ginger, oats and chamomile, coupled with barrier-repairing oils, including evening primrose, borage, argan and sea buckthorn. Always including a physical sunscreen, such as zinc oxide or titanium dioxide, will ensure that harmful UV rays do not cause further damage.
Apart from visits to the skin care centre, home care is also an integral part of skin health maintenance. Not only do sufferers need to comply with their prescribed skin care regimen; they will also need to have realistic expectations in terms of time, and expect to see the extended benefits of their treatments long after they are performed.
Dermalogica Products that can assist with Eczema and Psoriasis
*In extreme cases, please consult your doctor before using products
Stress Relief Treatment Oil
UltraRich Body Cream
Conditioning Body Wash
Add the Hydro-Active Mineral Salts to your bath