Psoriasis treatment in Zurich

Psoriasis is a chronic skin disease. It is quite common, about 2.5 to 3 percent of Northern Europeans are affected by this disease. The predisposition is often inherited, and several factors can be considered as triggers. As the name suggests, psoriasis is characterised by scaly and dry, reddened areas of skin. The skin areas become inflamed, itchy and burning. Besides the skin and nails, psoriasis also affects other organs, the blood vessels and the joints. The heart and liver can also be affected. It is not uncommon for the metabolism to be affected (metabolic syndrome). The majority of those affected develop psoriasis before the age of 40; this is the so-called Type 1 psoriasis. Type 2 psoriasis does not develop until the fifth decade of life and is also called late type.

The term psoriasis comes from the Greek word psora (itching) and thus stands for a characteristic symptom of the skin disease. Psoriasis is either chronic or occurs in irregular episodes. There can be long periods without symptoms or with only minor symptoms. Even though psoriasis cannot be cured conclusively, there are extremely effective therapies available today that significantly improve both the symptoms and the quality of life. Since psoriasis can manifest itself in very different ways, the diagnosis should only be made by a qualified dermatologist.

Psoriasis is a very broad skin disease that can also affect other organ systems. If only mild skin problems are present, then the external application of ointments is often sufficient. Another possibility are tablets to be taken internally or injections. At the Swiss Derma Clinic in Zurich, we also use phototherapy (light therapy) to treat psoriasis. In recent years, the importance of drugs that regulate the immune system (biologicals) has become increasingly important. Often we can significantly prolong the periods of time when there are no symptoms.

• Ointments, also magistral formulations, which are prepared in the pharmacy to suit your skin. Depending on the severity of the psoriasis, also with cortisone and vitamin D3 analogues.
• The appropriate skin care: Oily ointments and creams to keep the skin supple and protect it from itching and flaking.
• Light therapy (phototherapy)
• Anti-itching medication
• Biologicals (immunomodulating drugs): The defence reaction of the immune system is inhibited.

UV light therapy (phototherapy) can often effectively alleviate the symptoms of psoriasis. A total of several sessions are necessary to set the anti-inflammatory processes of the skin in motion. The affected areas are individually dosed and irradiated with UV light in a controlled manner. At the beginning of the therapy, several sessions per week take place, the intervals are gradually extended. For the treatment of psoriasis, we use specific wavelengths in the UVB range and/or in the UVA range. Light therapy is often combined with appropriate medications or lotions.

Important note: Solariums or outdoor sun exposure are not comparable with light therapy, as exact control of the light spectrum and dosage is not possible here.

The course of psoriasis varies greatly. By far the most common form is psoriasis vulgaris. Characteristic here are the inflamed and scaly shiny skin areas. These areas (plaques) can occur anywhere on the body. The head, elbows, knees or feet and hands are often affected, often including the nails. Sometimes they are very small and limited spots with a diameter of only a few centimetres, sometimes they occur on several parts of the body at the same time. The typical symptoms are itching and increased sensitivity (burning when touched) of the plaques.

In other and rarer cases, psoriasis appears in the skin folds and is less scaly. Another form of psoriasis occurs mainly on the fingernails and toenails.

Other manifestations of psoriasis are pustules and rarely a very extensive rash.

Biologicals belong to the newer therapies in the treatment of psoriasis. They interrupt certain processes (exchange of messenger substances) in the body and can thus also improve severe forms of psoriasis in the short term and sustainably. Biologicals can, so to speak, intervene in the misdirected immune defence. As a result, inflammation, itching and scaling heal.

Biologicals are produced biotechnologically. There are various agents available for the treatment of psoriasis, which we use depending on the individual clinical picture. For example, if the joints are involved, different medications may be considered than for psoriasis that is exclusively skin-related. Often, with biologicals, serious improvements can be achieved, up to and including freedom from symptoms, within only a few weeks.

Important note: The biologicals used in psoriasis only inhibit those messenger substances that are responsible for inflammation in psoriasis. The immune system as a whole is not influenced!

The main cause of psoriasis is thought to be a genetic predisposition. However, even if you have such a predisposition, this does not necessarily mean that the disease will develop. According to the RKI, 30 to 40 percent of those affected have family members who also suffer from psoriasis. In addition, there are various factors that can lead to an outbreak of psoriasis and acute flares. These triggers include:

• Bacterial and viral infections in childhood and adolescence such as tonsillitis, sinus infections or dental infections. Also sexually transmitted diseases and gastrointestinal infections.
• mechanical skin irritations caused by tattoos, skin injuries, sunburns or tight-fitting clothing.
• hormonal fluctuations and certain metabolic disorders.
• allergic reactions to food and ingredients.
• prolonged strain and stress
• environmental toxins such as alcohol and tobacco
• medications such as certain antihypertensives, beta-blockers, interferons or special anti-inflammatory drugs

Psoriasis belongs to the so-called autoimmune diseases. The body's own immune defence is misdirected and directed against healthy body structures. This can affect the skin, but also certain organs, the joints or bones. In psoriasis, the consequences include inflammation of the skin. The body produces new skin cells at an excessively fast rate. These push over and into each other. This is how scaly eczema and skin thickening develop. Today, psoriasis can be treated well in many cases with substances that regulate the body's own defence system, so-called biologicals. As with other autoimmune diseases, a complete cure for psoriasis is not possible, even if the symptom-free periods can be increasingly extended today.