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The Facts About Psoriasis

What Is Psoriasis?

Psoriasis is a medical condition that impacts around three percent of people in the United States. There are over five million men and women with psoriasis across the nation. Psoriasis is characterized by inflammation and scaling of the skin, and is mainly seen in adult patients, though psoriasis can also become an issue during childhood and adolescence. There is no gender divide with this condition, as both women and men are equally likely to experience the condition.

How Does Psoriasis Impact Skin Health?

The mechanism which causes scaling and inflammation is that new skin cells, which normally mature beneath the skin and rise to the surface, move to the surface before they have sufficiently developed. It normally takes a newborn skin cell around thirty days to reach the top layer of the skin, but in the case of Psoriasis, this process of turnover can take place in just a matter of days.

What Are the Symptoms of Psoriasis?

In the most common form of the condition, Psoriasis leads to high levels of inflammation, and the skin becomes red and topped with scales. The areas where scaling develops are called plaques, and they can lead to soreness and severe itching. Common areas where Psoriasis appears on the body are the soles of the feet, palms, face, lower back, scalp, knees, and elbows, although these patches can appear anywhere on the body.

Other areas where Psoriasis can appear are inside the mouth, on the genitals, and underneath the toenails and fingernails. If Psoriasis occurs on the joints, it can lead the inflamed area to become cracked and this can lead to bleeding. The psoriasis can also inflame the joints, which leads to arthritis symptoms. If this occurs, it is referred to as Psoriatic Arthritis.

How Can Psoriasis Negatively Impact Quality of Life?

People that have Psoriasis can experience life-altering issues resulting from the pain and itching associated with Psoriasis. Also, Psoriasis can limit movement in some cases, leading to limited disability.

Some patients experience severe pain and itching, which prevents them from living and appreciating their day to day life, causing sleep to be restless, making bathing a painful chore, and even making walking difficult. Patients that have Psoriasis Plaques on the feet and hands can have issues with any activity that involves those body parts, and they may not be able to participate in some sports or even have jobs in some careers. This can even inhibit their ability to care for their loved ones.

In order to mitigate the symptoms of Psoriasis, it can require frequent trips to the doctor, and the cost to treat the medical disorder is very high, as a result of the chronic nature of the condition. Psoriasis also impacts self-perception, because they are embarrassed about the way they look as a result of their condition. This can lead them to become withdrawn, or make it harder for them to enter romantic relationships. These issues can lead to social isolation, depression, and other psychological issues related to their poor self-image.

What Causes Psoriasis?

Psoriasis is a medical condition that results from an overactive immune system, and it is related to the body's production of T-Cells. T-Cells are powerful immune cells which fight disease and infection. When a person has Psoriasis, the body activates T-Cells for no reason and this causes a cascade of immune response which both causes immature skin cells to rise prematurely while also causing high levels of inflammation.

There is a genetic component to Psoriasis, and scientists have been able to link particular genes to the condition, based upon their study of certain family lines which are heavily impacted by the condition. Not all patients with Psoriasis have a family history, however.

What Causes Psoriasis Skin Flare-Ups?

Most people with psoriasis experience periods where their skin health becomes more problematic. These periods are known as flares. Psoriasis will temporarily become much worse, before recovering somewhat. There are a number of issues that can cause these flares to occur, including weather changes that lead to drier skin, stress, and infection.

There are also some medications that can exacerbate Psoriasis, including lithium and blood pressure medications known as Beta-Blockers. Finally, Psoriasis is more likely to flare up in areas of the skin that have experienced damage or irritation from issues such as infection, sunburn, scratches and lesions.

How Do Doctors Diagnose Psoriasis

Sometimes, Psoriasis can be problematic to diagnose, because it shares symptoms with a number of other skin conditions, such as Sebhoerric Dermatitis. The best way to clinically diagnose Psoriasis is by taking a small patch of the inflamed skin and looking at it through a microscope.

What Are the Types of Psoriasis?

There a number of kinds of Psoriasis. Below is a partial list:

• Plaque Psoriasis - Characterized by inflamed, red skin covered in shiny scales.

• Guttate Psoriasis - Characterized by small, round areas of inflamed skin on the scalp, limbs, and trunk. This form of the disease is commonly a reaction to strep throat or other infections of the upper respiratory system.

• Pustular Psoriasis - Characterized by the formation of blisters which are not the result of infection. These blisters are filled with puss, and can be caused by stress, infections, medicines, and contact with particular chemicals.

• Inverse Psoriasis - Characterized by inflamed areas along skin folds, such as the armpits, beneath the breasts, or around the genitals. Sweating and friction can exacerbate this form of Psoriasis.

• Erythrodermic Psoriasis - Rapid and widespread appearance of Psoriasis that is commonly caused by corticosteroid medicines or significant sunburn. This form of Psoriasis can also occur as an extension of other forms of Psoriasis which are not effectively controlled. This is the most severe form of the condition, and requires an immediate visit to a medical professional.

What is Psoriatic Arthritis?

Psoriatic Arthritis is a medical condition that is related to and caused by Psoriasis, itself. In this case, Psoriasis penetrates into the skin and causes lesions and inflammation of the joints. Patients can experience both forms of Psoriasis simultaneously, or either alone at any particular time.

How Can Psoriasis Be Effectively Treated?

There are a number of methods that physicians use to mitigate the symptoms of Psoriasis, dependent upon the specific characteristics of the disease, including the locations of inflammation, the form of psoriasis, the surface area of inflammation, the severity of the psoriasis, and the way that the patient has responded to previous treatment.

The following are some common means by which Psoriasis can be treated:

• Injectable and Oral Psoriasis Medication

• Phototherapy via Light Exposure

• Topical Medications

Like any medication, the treatments listed above can lead to side-effects, some minor, some more significant. Always talk to your physician and pharmacist about potential side-effects so you can be armed with the knowledge to recognize them.

There are some issues that make Psoriasis hard to treat. For one, the body can develop a resistance to certain forms of treatment, limiting their effectiveness over time. This is especially true of corticosteroids delivered topically.

Second, every patient responds differently to treatment, and the same medication or therapy may be highly effective for one patient while producing no benefit in a second patient. As a result of this, physicians often switch from therapy to therapy until they find one that works effectively with few or no side effects.

Topical Psoriasis Treatment

These forms of therapy are delivered as creams, gels, or ointments directly onto the skin. There are a number of Topical Psoriasis Medications, including Anthralin, Coal Tar, Retinoids, Vitamin D3, and Corticosteroids, and all are effective for some patients.

For patients that are simply seeking respite from the itching or pain associated with therapy, there are lubricants and bath solutions that can reduce the severity of these symptoms, but most are not very strong and must be used in combination with more potent treatments.

Topical Corticosteroids for Psoriasis - These are some of the most common forms of Psoriasis Therapy. They work by slowing down the rate at which skin cells turnover, and they also ease inflammation and reduce the activity of the immune system.

Generally, Topical Corticosteroids are quick solutions that are used to treat ongoing outbreaks of inflammation, because dependence and overuse of these treatments can lead to issues such as resistance, internal complications, and weakening of the skin.

Synthetic Vitamin D for Psoriasis - This includes any medication or supplement which imitates the function of Vitamin D. These supplements can reduce the severity of Psoriasis by slowing down the rate at which the skin cells rise. Taking too much Vitamin D can cause problems, because Long Term Vitamin D Overdose leads to an overabundance of calcium.

Vitamin A Retinoids for Psoriasis - Retinoid Ointments deliver Vitamin A to the skin. Women that are pregnant or could become pregnant must be careful, because, although these treatments are safe for adult patients, they can cause birth defects if the patient is pregnant.

Coal Tar Solution for Psoriasis - These treatments can be purchased both via prescription and over the counter, dependent upon the concentration of Coal Tar. Coal Tar is often an ingredient in shampoos designed to relieve inflammation and dandruff, and they can also be massaged into the skin or used in order to medicate bathwater. The main issues with Coal Tar are that the medication can stain clothing and skin, has a potent smell, and can lead to skin irritation or sensitivity to sunlight.

Anthralin for Psoriasis - This medication treats Psoriasis by limiting inflammation and the increase in skin cell division. Physicians can prescribe it as a paste, cream, or ointment, designed to be administered daily for a short period of time in order to treat inflamed skin. After Anthralin has been applied, it must be cleaned off the skin in order to protect the skin from irritation. A downside to the treatment is that it is highly discoloring, and effects the majority of surfaces, including the skin.

Salicylic Acid for Psoriasis - This treatment is available in a wide variety of topical products, from creams to shampoos, and mitigates scaling by encouraging flaking.

Bath Products for Psoriasis - There are a wide variety of lubricants and oils which can help mitigate itching and wash off scales, including Dead Sea salts, Epsom salts, oiled oatmeal, and Coal Tar.

Lubricants for Psoriasis - These treatments are applied topically over a regular basis in order to reduce the discomfort associated with Psoriasis. Greasy and thick lubricants are most effective, because they reduce itching and scaling by locking water in the skin.

Phototherapy for Psoriasis

Ultraviolet Light, although damaging in high quantities, can be a very effective treatment for patients that suffer from Psoriasis. UV light stimulates the production of Vitamin D3 by the skin, which is one way that Psoriasis complications can be reduced. This light can either come directly from the sun or via artificial sunlight.

It's important to either follow a physician's advice exactly or have the physician personally assist in Light Treatment so that symptoms do not become exacerbated by sunburn or other issues, and so that the patient can minimize risk of cancer and skin damage via UV Light.

How Does Sunlight Treat Psoriasis?

Sunlight is comprised of a wide range of bands of Ultraviolet Light. When the skin absorbs sunlight, the Ultraviolet Rays kill off the sensitive T-Cells that are active in inflamed areas, reducing the effects of the disease. This simultaneously reduces the rate at which scaling occurs and mitigates inflammation.

Phototherapy with UVB Light for Psoriasis - Another method to treat and control Psoriasis is via UVB light. These are rays which are produced by sunlight or artificial sunlight which are absorbed into the deeper layers of the skin. UVB light can be an effective means to reduce the appearance and severity of moderate or mild Psoriasis. This is often the first course of action by many physicians, because it bypasses any form of medication.

Another form of UVB Treatment, known as Broadband UVB, is an alternative which is sometimes used to treat inflammation that is resisting normal creams and ointments, and it can also be used for general treatment of widespread or relatively minor Psoriasis. These treatments are provided via a box or panel that emits light, and in some cases, the patient may be approved to use one of these UVB emitters at home with a physicians permission and guidance.

There is also a third form of UVB Therapy for Psoriasis known as Narrowband UVB. This form of treatment specifically delivers the range of light that has been found to be most effective at treating Psoriasis. This form of treatment is considered to be more effective than Broadband UVB, but less effective than Psoralen with Ultraviolet A.

Narrow Band UVB is often used as an intensive treatment, administered several times in a short time frame in order to most rapidly improve the skin. If this intensive therapy is effective, patients often only require occasional treatment in order to preserve the benefits provided by the initial treatment. The main risk of Narrowband UVB therapy is that it can lead to longer and more severe burns as compared to Broadband UVB Light Therapy.

Psoralen and UVA Phototherapy for Psoriasis - This is considered the most effective means of light therapy for Psoriasis. In this form of treatment, UVA exposure is combined with a Topical or Oral Medication known as Psoralen, which amplifies the benefits of UVA light. Psoralen amplifies the skin's sensitivity to UVA light, and because UVA Rays affect deeper layers of skin than UVB light, this combination provides the fastest form of Light Treatment for Psoriasis.

This form of therapy is prescribed 2-3 times per week, and is able to eliminate Psoriasis symptoms very quickly. The issue with this form of treatment is that it can lead to a number of temporary side-effects, including itching, burning, fatigue, headache, and nausea. It is paramount to keep eyes covered with specialized glasses during therapy as well.

Long Term UVA-Psoralen Treatment also comes with an enhanced risk of Squamous-Cell Skin Cancer, and may also increase the risk of Melanoma.

Systemic Treatment of Psoriasis

The worst cases of Psoriasis are often treated with injections or pills which circulate treatment throughout the entire body. This form of Psoriasis Therapy is known as Systemic Treatment.

Methotrexate Therapy for Psoriasis - This form of treatment functions like an internal dose of cyclosporin. When taken via injection or pill, this treatment reduces the activity of the immune system, thereby reducing the rate at which turnover of the skin cells occurs.

This treatment is not without risks, however, and the patient much be monitored intently by the prescribing physician, because Methotrexate can reduce the concentration of platelets, white blood cells, and red blood cells in the blood stream while also potentially leading to liver damage.

Because of these risks, physicians do not prescribe this treatment to patients that have a history of anemia and liver disease. Also, this treatment should never be used by women that are pregnant, because the treatment can lead to birth defects.

Retinoid Systemic Therapy for Psoriasis - These synthetic treatments simulate the function of Vitamin A, and can be effective in the case of severe psoriasis that is resistant to treatment. Like the oral form, this treatment can lead to birth defects if used by pregnant women.

Oral Cyclosporine for Psoriasis - This treatment comes in the form of a pill, and reduces the rate of skin cell turnover. This treatment is effective very quickly, but only works for as long as the medication is in the system. It is most effective for stemming rapid-onset Psoriasis in order to prevent hospitalization.

Cyclosporine does come with side effects, and can lead to hypertension or impaired renal function. As such, a physician should closely monitor therapy. Cyclosporine is also not suggested for patients with a history of skin cancer or an impaired immune system.

Biologic Treatment for Psoriasis - These medications are comprised of proteins that are produced by living cells in order to suppress the processes of the immune system which lead to inflammation and the rapid production of skin cells. These treatments are delivered via injection, and can be self-administered.

Like most other oral and injectable Psoriasis treatments, ongoing treatment must be monitored closely by a physician. These treatments do lead to an enhanced infection risk, and they can impact the ability of vaccines to function effectively. There is also some correlation between Biologics and other medical disorders such as lymphoma, cancer, blood diseases, and CNS Disorders. The link between Biologics and these conditions has not been fully established, and these medications are only intended for use by adults.

Combination Psoriasis Treatment

Because of the complexity of Psoriasis, physicians often prescribe multiple forms of treatment simultaneously. This can reduce the risk of side-effects from various therapies by reducing the dosage needed to provide effective therapy and relief.

Psoriasis Counseling and Group Therapy

Many patients with Psoriasis benefit from getting psychological attention in order to mitigate the social costs of Psoriasis and improve psychological quality of life. Patients that have self-image issues commonly find relief by talking about their problems with a counselor, or having a support group of men and women that are suffering from the same condition.

Ongoing Psoriasis Research

Because Psoriasis is such a complex and problematic condition, and because it affects so many people, there is a lot of medical research going on to help advance the science of Psoriasis Treatment. Ongoing areas of research include how to help Psoriasis sufferers experience healthier skin and any way that it may be possible to stop or suspend the condition.

In recent years, medical knowledge regarding the genetic factors behind Psoriasis are becoming quickly illuminated. Today, there are a number of genes that are classified as being implicated in some way in the formation of the medical condition. Genetics is only one piece of the puzzle, however, and there are a number of factors which cause the disease to appear independent or only partially dependent upon genetics.

What medical researchers do understand is that there are certain genes which increase the likelihood of the expression of the disease. In addition to understanding the genetic mechanism behind the disease, researchers are also looking to understand the mechanism behind the sensation of itching more completely so that the side-effect of itching can be treated more effectively.

Ever since researchers found out that T-Cells are the primary affective culprit of Psoriasis, increased time and resources are being spent studying state-of-the-art treatments that can effectively reduce skin reactions cause by immune system over-response. One of the most promising areas of research is in promoting treatments which either limit the activities of cytokines or block T-Cell response. Cytokines are a form of protein that is responsible for inflammation.

The ultimate goal of these medical researchers is to figure out a way to treat Auto-Immune Psoriasis without suppressing the activity of the rest of the Immune System. If researchers are able to accomplish this, the benefits could branch out to other Auto-Immune Disorders as well.

What Are the Health Risks Associated with Psoriasis?

Medical studies have shown that men and women with Psoriasis have a correlated increased risk of a number of conditions including diabetes, hypertension, obesity, and cardiovascular complications. These issues are more apparent in patients with more severe forms of Psoriasis.

Scientists are attempting to figure out the physiological mechanisms by which these medical conditions are potentially linked in order to be able to provide patients with greater comprehensive treatment as well as learn more about how the various systems of the human body interact with one another.

Preventing Testicular Shrinkage with HCG

One of the most embarrassing and frustrating issues associated with Testosterone Restoration for Men is Testicular Atrophy. The testes produce less Testosterone as a result of the body receiving a flush of Testosterone from an outside source, and this causes the testes to reduce their function significantly, and this also causes the testicles to shrink significantly.

Many men choose to live with this symptoms, but you would likely be happy to know that there is a way to preserve the appearance of the testicles and prevent Testicular Atrophy via Human Chorionic Gonadotropin supplementation. HCG is a potent fertility medication that can help both men and women conceive more readily, but is also highly effective preventing the shrinkage of the testicles.

How Does HCG Work?

HCG stands for Human Chorionic Gonadotropin. Be careful not to confuse HCG and HGH, because they are totally different hormones. HGH is a hormone which controls cellular metabolism, whereas HCG is a hormone which is normally produced by women during pregnancy that also has the ability to promote the physiological changes normally associated with Luteinizing Hormone, an important Testosterone Precursor which also has other functions with regard to fertility.

There are two times in human development and the human lifespan when HCG is produced. First, HCG is produced just after conception by the embryo as it divides and develops. Later in the process, the mother will produce HCG via the placenta. In women, the role of HCG during pregnancy is to sustain the production of Progesterone at a constant rate, and to prevent the Corpus Luteum from breaking down, which keeps the fertilized Embryo properly implanted..

This all allows the embryo to form and develop uninterrupted. When used as a fertility treatment for women, it encourages the ovaries to release their eggs, allowing women to conceive more readily.

If I'm a Man, Why Should I Care About HCG?

We understand that it may seem strange that a hormone that is only produced by women can be so beneficial to men. We agree. At first glance, it does seem a bit counter-intuitive, but HCG has a number of uses for boys and men, and does not have any significant adverse consequences of use, outside of rare side-effects.

For one, HCG is used very commonly as a means to spur puberty in boys that are not experiencing the adolescent change at the same time as their peers. Subcutaneous HCG Injections provide the hormonal burst necessary to cause the testicles to drop and start producing their own Testosterone. Also, HCG is used after Testosterone Therapy in order to restore normal testicular form and function after a patient has suspended treatment.

Why Does Testosterone Therapy Cause Testicular Shrinkage and How Does HCG Therapy Maintain Testicular Size and Fullness?

When a patient undergoes Testosterone Treatment via Patches, Creams, Injections, or other forms of viable Bio-Identical Therapy, the hypothalamus senses the increased Testosterone Concentrations and responds by vastly slowing down the release of Gonadotropin-Releasing Hormone, also known as GnRH. GnRH is responsible for stimulating the pituitary to produce Luteinizing Hormone.

If the testes do not get stimulated by Luteinizing Hormone, they will not produce Testosterone, because the Leydig Cells which are responsible for the synthesis of Testosterone do not receive the signal. If the Leydig Cells remain dormant due to a lack of Luteinizing Hormone, the testes will atrophy, and the testicles will shrink in size as the testes enter a state of dormancy.

The cool thing about HCG for Men is that Human Chorionic Gonadotropin and Luteinizing Hormone are biologically very similar, and both have the same, exact impact upon the testicles. If a patient has been taking Testosterone, and his testes have been inactive for a long period of time, HCG can kick start the function and form of the testicles just as it does among young boys.

Why Can't Patients Use HCG as a Sole Form of Testosterone Treatment?

It would be theoretically possible for men to boost Testosterone with HCG, but there are a few important reasons why HCG is not used explicitly as a Testosterone-Boosting Treatment by itself. First, Injectable HCG, when used as a primary treatment, is more likely to increase Dihydrotestosterone Levels and Estradiol Levels than Bio-Identical Testosterone Therapy.

Second, HCG would only be effective as a Testosterone Treatment if administered every day, whereas there are a variety of Testosterone Therapy Options that are either less invasive (Testosterone Creams, Testosterone Patches, Testosterone Gels) or require less frequent administration (Testosterone Injections, Testosterone Pellet Implants).

Finally, Testosterone is simply more potent, meaning that it takes less Testosterone to provide the same Testosterone Enhancement as it does HCG, and the treatment is much cheaper for that reason. For these three reasons, Injectable HGH is used as a supplement during or after Testosterone Therapy in order to preserve Testicular size and function during treatment.

How Much Does HCG Cost?

Brand Name Human Chorionic Gonadotropin is much more expensive than Generic HCG. If you go brand name, you can expect to pay more than $150 for ten thousand IUs of the hormone. If you acquire your Bio-Identical Medication via Hormone Compounding Pharmacy, however, the cost for the same amount of Bio-Available Product is $80.

Most people that choose to supplement their Testosterone Optimization Therapy with HCG go the generic route, because HCG Supplementation is considered Off-Label, so most insurance policies don't cover the treatment, even though it is highly effective.

How is HCG Sold?

You will generally see Human Chorionic Gonadotropin sold in vials between 3,500-10,000 IUs. In order to preserve the stability of the hormone over time, HCG is delivered as a lyophilized powder, and must be combined with Bacteriostatic Water before injection.

How is HCG Injected?

Human Chorionic Gonadotropin can be delivered both Subcutaneously or Intramuscularly. Intramuscular Injections are delivered directly into the larger muscles of the body, and Subcutaneous Injections are delivered into the fatty layer just underneath the skin. Subcutaneous Injections are generally less painful than Intramuscular Injections, but neither form of injection is more than very mildly painful.

What is the Proper HCG Dose?

As of today, there are no real set guidelines with regard to exactly how much HCG should be administered in order to promote its various benefits. For example, the range of dosage for men that are looking to conceive can be anything from three times per week 1250 IU to two times per week at 3000 IU, and neither of these studies discussed the use of HCG as a supplement to Testosterone Restoration.

Similarly, there are no Human Chorionic Gonadotropin Guidelines for men that wish to maintain normal testicular form and function while taking supplemental Testosterone. One particular clinical study involving Injectable Testosterone Enanthate revealed that a 250 IU Dose of HCG was capable of maintain the normal function of the testes, whereas 125 IU was not sufficient, and 500 IU was also sufficient. A second study just measured the effectiveness of the 500 IU dose, and corroborated that this concentration was capable of protecting sperm count, as well as testicular size and function.

When taking HCG with Testosterone, it is important to keep in touch with a Licensed and Board Certified Hormone Doctor, because HCG can sometimes increase Dihydrotestosterone and estradiol levels. The optimal HCG dose is able to restore testicular form and function while minimizing changes in the concentration of these two hormones. Of course, the exact dose needed to achieve this will depend on the specific biological and genetic make up of the patient.

Most physicians that utilize Human Chorionic Gonadotropin Injections with Low-T Treatment prescribe based off of these and similar studies, providing 250-500 IU of HCG two times per week for patients that want to maintain fertility and/or the normal appearance of the testicles. A minority of Hormone Specialists prescribe between 1,000-5,000 IU two times per week, but this is not generally recommended, because this could unnecessarily raise levels of Dihydrotestosterone and Estrogen to levels which could cause the appearance of Side-Effects. There is also the potential that such a flush amount of HCG could cause the testicles to become sensitized to the high concentrations.

HCG with Testosterone Sometimes Combined with Estrogen Blockers

It may be beneficial to make an appointment with your physician thirty days after initiating therapy in order to test your Hormone Levels to see if your Hormone Balance would benefit from an Estrogen Blocker such as Anastrozole or Tamoxifin, which can counteract the increase in Estrogen Levels that may occur. It is vital to keep Estrogen at ideal levels because excess estrogen can lead to edema and gynecomastia, but too little can affect neurological health and Bone Mineral Density.

Why Not Just Us HCG Injections Instead of Testosterone Therapy?

Many men are curious about why Testosterone Treatment are necessary if HCG is also capable of increasing Testosterone Levels. There are some good reasons why this is the case. For example, Injectable HCG is not as effective at restoring Libido and sexual function as Bio-Identical Testosterone, eve if HCG restores Testosterone to normal levels. Also, too much HCG can lead to issues such as gynecomastia, moodiness, water retention and acne, which are normally only apparent in the case of Testosterone Overdose.

By combining Bio-Identical Testosterone with Restorative HCG, it is possible to enhance the benefits of treatment, maintaining a healthier hormone spectrum, enhancing sexual desire, maintaining the healthy function of the testes, and normalizing the normal balance of the bloodstream.