For someone with psoriasis, everyday life requires a little more thought. From lifestyle choices to choosing the right beauty techniques, all can impact on your condition.
Selene Daly, advanced nurse practitioner in dermatology at Sligo University Hospital, knows these everyday challenges from seeing first-hand what her patients experience. She has worked with people living with psoriasis since 2005 – “our kids have grown up together” – and acts as their educator and counsellor when it comes to managing their condition.
While psoriasis tends to first present itself in adulthood, there is no typical patient profile, Daly says. Though it is characterised by thick red scaly patches that can occur anywhere on the body, psoriasis is a “full body inflammatory disease”.
It can happen after a trigger like a stressful incident or an infection like a sore throat or even taking medication
“I might see a 60-year-old who has just lost their job and the stress of the job loss has led to a psoriasis flare-up, or perhaps a 30-year-old whose marriage has broken up,” she says. “It can happen after a trigger like a stressful incident or an infection like a sore throat or even taking medication like an NSAID” – non-steroidal anti-inflammatory drug.
Daly features in the second episode of a new video and podcast series by Janssen Sciences Ireland UC. PsO Let’s Talk Psoriasis aims to support and empower people living with psoriasis as they await access to specialist dermatology care.
Unfortunately, Ireland’s paucity of hospital dermatology services means her patients often must deal with their condition for many years before finally getting to a specialist clinic. There are currently 39,324 people waiting to access dermatology services, with 30 per cent (12,118) waiting more than 12 months, according to the latest figures released by the National Treatment Purchase Fund.
“People may have significant psoriasis when they access specialist care, so at least 30-40 per cent of their body is covered in psoriasis,” Daly says. “We see people who may have had psoriasis for their entire life, but have never seen a consultant dermatologist in their entire life and never used proper creams or medication in their lives.”
While waiting to access specialist care, many of those living with psoriasis source information about the condition and how best to manage it by themselves. PsO Let’s Talk Psoriasis aims to fill this void by providing expert guidance and practical tips directly from some of Ireland’s leading dermatologists and people living with the condition.
Alongside Daly in the second episode of the series, Prof Caitriona Ryan, consultant dermatologist at the Institute of Dermatologists, answers some of the most frequently asked questions. Both healthcare professionals regularly field questions around moisturising and beauty techniques, important considerations for many people living with psoriasis.
I always find the best moisturiser to use is the one that you want to use yourself
We address some of the most frequently asked questions below:
Is there a difference between emollients, eg Silcock’s Base, aqueous cream, emulsifying ointments? Which should people use?
Daly: I always find the best moisturiser to use is the one that you want to use yourself. Silcock’s Base, for example, is cheap, it’s effective, it’s great to use as a soap and a moisturiser, so it’s a great all-rounder. It also comes in a squeezable tube now so you can use it in the shower pretty easily compared with trying to use the big tub.
Can you use emollients on your scalp?
Daly: If you have some scales on your hair, you could use a paraffin gel on the scalp, or coconut oil is a little bit easier to use. There’s something called a fish tail comb, they’re in all pharmacies that are about €1 each. I recommend using the fish tail comb to part the hair every inch or so and put coconut oil on the scalp. Warming the oil a little bit makes it nice and runny.
Is it true that parabens in skincare can irritate skin? Is it best to use only paraben-free products on both the face and body?
Prof Ryan: There is no evidence that parabens are dangerous, even in high percentages on the skin. Parabens are actually very important preservatives in a lot of our cosmetics and skincare products. They minimise the risk of infections as well and typically have an anti-inflammatory effect.
Can the shampoo and conditioner someone with psoriasis uses make it worse?
Prof Ryan: They are unlikely to be making it worse, but there are certain shampoos that would be best to use, like anti-inflammatory shampoos, or even the typical anti-dandruff shampoos that you find in the supermarket. Hair dye is not likely to make psoriasis symptoms worse; you can absolutely dye your hair. It’s bad enough to have scalp psoriasis and then to have grey hair on top of it as well. I say that to patients all the time.
If someone has bad nail psoriasis, can they have shellac manicures to make their nails look better or will it make the psoriasis worse?
Prof Ryan: Shellac can create more nail psoriasis. You can absolutely paint your nails, but don’t use shellac or acrylics. It’s called the Koebner phenomenon, where anything that traumatises the skin or nail, in this case the removal of the shellac. It’s the same principle for laser hair removal, which should be avoided at times when psoriasis is active. Waxing can also be problematic, but shaving isn’t as bad.
Will fake tan or spray tan irritate psoriasis?
Prof Ryan: I tell patients to absolutely go ahead with your fake tan or spray tan. I couldn’t live without fake tan. For anyone who has dry skin, fake tan can irritate it and make it dryer. The trick is to make sure your skin is really moisturised in advance. It’s the only safe tan, so I’ve absolutely no issue with this.
PsO Let’s Talk Psoriasis is available free of charge online, with the four episodes released on a weekly basis throughout May 2022, at www.janssenwithme.ie/pso/resources/pso-lets-talk-psoriasis. The audio versions are available on all popular podcast platforms.
References relating to this article are available upon request.
