Psoriasis Healing Signs

"Psoriasis is a chronic, autoimmune skin condition where you have red, scaly patches on the skin," Dr. Saakshi Khattri, a dermatologist/rheumatologist at Mount Sinai Health System, previously told SurvivorNet. "It is a chronic condition, which can ebb and flow. You can have good days and bad days."

Unfortunately, psoriasis is a chronic condition which means that it doesn't go away. These plaques can affect several areas of the body including the following:

• Face
• Scalp
• Elbows
• Knees
• Genitals
• Lower back
• Nails (of the fingers and toes)
• Palms
• Feet

Psoriasis doesn't discriminate, it can affect people of all ages, races, and genders. However, it's less common in children than in adults and the peak ages of onset are between 30 and 39 years as well as between 50 and 69 years.

Evidently, it affects millions of people around the world causing many symptoms, these include the following:

• Inflammation of the skin
• Itchiness
• Dryness of the skin
• Pain
• Cracked nails
• Scales in the scalp
• Joint pain (when associated with psoriatic arthritis)

Even though psoriasis isn't contagious, there's still a stigma surrounding its patients exposing them to a significantly reduced quality of life both physically and mentally.

Additionally, a recent study in 2022, claims that many people with psoriasis experience depression as well due to their poor quality of life.

What's the Goal of Psoriasis Treatment?

When it comes to treating psoriasis the best you can hope for is to control the symptoms and have your skin clear up. Thus, doctors typically approach psoriasis treatment in a series of steps until they find the best fit for your condition.

"The majority of patients with psoriasis overall are managed with topicals only,” Dr. George Han, a dermatologist at Northwell Health/Lenox Hill Hospital, said in a previous interview with SurvivorNet. “But I have patients who come in after having been to many other medical practices and not really getting much hope or really good treatments for it, and we’ll give them a systemic medicine that these days are very effective.

“We have treatments where over half of the patients who have moderate, severe psoriasis are getting a 100% clear. So, we definitely are in a good era of treatment when it comes to psoriasis, but overall, the majority of patients still get topicals first.”

To decide on a specific treatment option, doctors first take into account the following:

• Type of psoriasis you have
• The severity of your condition
• Your age and overall health
• Whether you have any underlying medical conditions
• Any previous treatments taken

Then, they will proceed with any of the following treatments:

• Topicals which include creams and ointments,
• Phototherapy or light therapy,
• Systemic treatments include injectable treatments (biologic or non-biologic medications)

When is Psoriasis Treatment Considered Successful?

Psoriasis treatment is considered successful when the symptoms are gone for a long period, this is known as remission. Psoriasis remission usually lasts between 1 to 12 months.

If you're experiencing remission, it's perfectly understandable that you'd want to stop treatment right away. However, you should only do this under the supervision of your doctor. This is mainly because psoriasis is unpredictable and at some point, it's very likely that it will return. So, you should always consult your doctor before taking this decision to avoid psoriasis rebounds.

Psoriasis Healing Stages

There are no specific guidelines on the healing stages of psoriasis because it varies from patient to patient according to the type and severity of the disease. Ideally, your symptoms should dial down gradually until they disappear, there will be no visible symptoms (remission stage).

According to a recent research study conducted in 2022, about 10-60% experience remission from psoriasis.

When you've reached the stage of psoriasis remission, your doctor will advise you on the right method for you to stop treatment and on how to avoid triggers that can end remission and cause flare-ups (rebound).

Signs that Your Psoriasis is Healing

Generally, there are five signs that you've reached the remission stage, these include the following:

1.     Your patches will significantly decrease or disappear completely. When you're in remission, the plaques and scaly patches will start to gradually decrease in size and go away.
2.     That itching sensation will go away. Since one of the most burdensome symptoms of psoriasis is constant itching, many patients start to notice that they're healing when their itching is decreased, and they start using fewer topical medications to treat it.
3.     Your skin will be less flaky and inflamed. A sign of progress with psoriasis is when your skin is less red and flaky. This means that it's healing, and your skin is less dry.
4.     Your nails will look healthier. If your nails are affected with psoriasis, then it's a very good sign that you're heading into remission when your nails look healthier and stronger with no discoloration or abnormal growth and pits.
5.     Your joints will not hurt anymore. Around 30% of people who have psoriasis also suffer from psoriatic arthritis which affects the joints. Thankfully, many medications work both in treating psoriasis for skin and joints. Thus, one of the indications of remission is when your joints start to hurt a lot less and be less swollen.

What Happens When Treatments Don't Work?

When a treatment doesn't work, doctors try another approach to manage psoriasis. Luckily, there are numerous alternatives to choose from that make it easier for doctors to change strategies according to patients' treatment responses.

As Dr. Ashley Jenkins, MD, a dermatologist and adjunct professor of dermatology at the University of Missouri in Columbia shares in an interview about her thoughts on psoriasis treatment "Different people respond to different treatments. In some cases, a medication may be effective for a while and then stop working. That's when it's time to try something new."

Another reason for changing treatment strategies besides medication that doesn't work or stops working suddenly can be that a specific medication brings about intolerable side effects for the patient.

How to Prevent Psoriasis from Returning

There's no particular timeline for remission, while some may experience it for months others may have it for years. The key players in determining whether you'll have a short or long-term remission are a mix of genetic and environmental factors.

As Dr. Keith Choate, M.D., Ph.D., a dermatologist at Yale Medicine says "Psoriasis requires both genetic susceptibility and an environmental trigger. When these co-occur, the immune system is inappropriately activated, leading to inflammation in the skin but also, potentially, in the joints and blood vessels."

Thus, maintaining your medication and avoiding triggers can be the optimal way to prevent flare-ups and stay in remission as long as possible. Below is a list of the most common triggers to steer clear of if you have psoriasis and want to extend your remission period, these include the following:

Strong sunlight. Sunlight especially in the summer can cause skin damage and trigger psoriasis flareups. It's important to ask your doctor about how much sun you can handle and whether or not there are sunscreen products that you can use to protect you from any damage.

Stress. Stress can be one of the triggers that can lead to symptoms of psoriasis. It's best to practice relaxation and avoid stressful situations.

Dry weather. Similar to sunlight, cold and dry weather can contribute to flaky skin which can cause irritation and bring about flareups. To avoid being triggered in the winter, moisturize your skin regularly using lotions and creams to avoid psoriasis rebounds.

Rough scrubbing. When you're taking a shower, try to refrain from scrubbing your skin roughly as it can trigger your flareups. Instead, try to gently wash your skin and use natural products or products without high concentrations of chemicals.

Chronic infections. If you have psoriasis, you're at a higher risk of getting infections, especially if you have a weakened immune system. When that happens, you'll be subject to more flares and fewer remissions. You need to consult your doctor on how to avoid getting infections and whether there are medications that can help on strengthening your immune system.

Unhealthy habits. Practicing unhealthy habits is the pitfall of most diseases. You should refrain from the following habits and improve your lifestyle to avoid being triggered. These habits can include the following:

• Smoking
• Drinking alcohol
• Obesity

Instead of these, you can practice eating healthily, getting regular exercise, and quitting smoking to improve your recovery outcomes and retain psoriasis remission.

Questions To Ask Your Doctor

• How can I prevent possible outbreaks?
• How can I best manage my symptoms?
• Can psoriasis ever go away completely?
• What is the best treatment you recommend for me?
• Is there anything else I should do to improve my quality of life with this disease?

The Bottom Line

There are many treatment options when it comes to psoriasis, and there are considerable research efforts that are still underway to obtain a cure. Nevertheless, what's more important than choosing the right treatment option is how to retain the effect of this treatment to remain in a state of remission and avoid flareups.

Learn more about SurvivorNet's rigorous medical review process.