Psoriasis is a skin condition that estheticians are seeing more often these days in the treatment room. Psoriasis is an immune-mediated disease that causes raised, red, scaly patches to appear on the skin. It’s a disease that comes and goes. At this time, there is no cure for it; however, there are ways to avoid its triggers, as well as products and treatments that can help alleviate the symptoms when the skin flares up. Psoriasis should first be treated by a physician. Afterwards, professional skin care treatments can help to relieve and destress the client and calm the reactive state of the skin during a flare-up.
Psoriasis scales and red patches are itchy and can occur all over the body. At times, this can be painful, as psoriasis tends to speed up the life cycle of cells and causes layers to rapidly build up on the epidermis. It is not contagious. It can affect both men and women, and usually shows up in early adolescent years. Psoriasis is often mistaken for other skin conditions such as dandruff, eczema and seborrheic dermatitis.
How to Differentiate
Seborrheic dermatitis is commonly called dandruff when found on the scalp, where psoriasis can also be found. Psoriasis is more common on the scalp if the person also has it elsewhere on their body. Scales are usually a good way to distinguish the two, as psoriasis scales are thick and tend to be silver or grey in color, while seborrheic dermatitis flakes are thinner and tend to be more yellow or white and greasy in appearance. Seborrheic dermatitis is not usually painful, while psoriasis on the scalp is very tender and painful to touch.
Eczema, or atopic dermatitis, is more common than psoriasis. Skin diagnosed with eczema may appear red, inflamed, peeling, cracked, blistered, or pus-filled. It does not build up into dead, scaly skin like psoriasis does.
There are five main types of psoriasis: plague, guttate, inverse, pustular and erythrodermic. No set cause has been determined, but studies suggest genetic, environmental and immune factors are the most likely culprits. Discuss with your client what type of psoriasis their physician has diagnosed. Are they on medications? Have they noticed anything specific that triggers a flare-up of the condition? Are there any items or treatments that they have noticed aggravate or dissipate symptoms? You can look for contraindications with any treatments or products that you use in your treatments.
What Triggers a Flare-Up?
Diet
While skin care professionals are not doctors, we can suggest to a client who presents psoriasis that they should discuss with their physician which things to eat and to avoid in their diet. Many foods are commonly thought to be triggers, such as alcohol, foods containing gluten, nightshade family foods (tomatoes, white potatoes, eggplant), red meats including processed ones like sausage, junk food, dairy, refined sugar, citrus, certain condiments and spices. Some of these foods link back to obesity, diabetes and inflammatory reactions, which may trigger a flare up of psoriasis. One should also look at their vitamin D levels, as low levels can cause issues as well.
Lifestyle
A variety of other lifestyle habits can also trigger a breakout. Smoking, heavy alcohol usage, and stress can also be triggers. Stress can affect a person’s immune system negatively, which can trigger a psoriasis flare-up and make symptoms worse. Where a person lives, works or plays should also be considered, as temperature, chemicals and fragrances in that environment can subsequently cause irritation.
Injury to the Skin or Infections
Cuts, scrapes and even bug bites can set off a reaction. Recent illness affecting the immune system may also trigger the skin to be irritated.
Medications
Certain medications can trigger conditions. People suffering from psoriasis should always let any physician or skin care professional they see know they have been prescribed some medications for diseases like high blood pressure, malaria prevention, arthritis and mood disorders, which may interfere with other medications or cause skin reactions.
Spa Therapies – “Do No Harm”
Sanitation: A client with psoriasis can be more prone to other bacterial skin infections than the normal client. In the treatment room, it is recommended to “go the extra mile” when it comes to sanitation. Consider using gloves as protection so they do not get any other infections. Make sure that the room is clean and that all equipment that may touch the client’s skin is sanitized properly.
Linens: Linens that are soft and free of irritating detergents are also be great for a client with psoriasis. Many detergents have heavy fragrances and alcohols, which can trigger and irritate psoriasis. Extra soft sheets, and even microfiber towels, are softer on the skin. When providing treatments, recommend to refrain from using hot towels. Rather, use linens that are lukewarm to help calm inflammation.
LED Therapy: Both blue and red LED exposure have been shown to have a positive effect on inflamed skin. The blue light works on antibacterial issues associated with psoriasis and prevents any more bacterial skin infections for those with the condition. If a client has all-over body psoriasis, you may want to look for one of the newer LED beds on the market to get a larger body area covered.
Massage: Since stress is a trigger, it is most reasonable to expect that using massage therapy will help reduce some of the built up anxiety in the client. Many of those who suffer from psoriasis have stress from the appearance of the outbreaks, as it can be very uncomfortable both physically and emotionally. Because it can be painful at times, make sure to avoid outbreak areas when massaging. Also, consider the products that you are using in regards to fragrance and ingredients.
Products: Salicylic acid has been approved by the FDA in treating psoriasis, however estheticians must be careful to not use too strong of an acid, or leave it on the skin for too long, as it can then become irritated. Antimicrobial and antibacterial ingredients will be beneficial in preventing conditions that promote infection. Calming, hydrating and barrier function ingredients will also help with the inflammation. Ingredients that help with the itch factor, like calamine, mirabilis jalapa, and figwort, will relieve the urge to scratch. Creams with shea butter will help hydrate the skin. Sulfate free products should also be considered.
Home Care
While we de-stress and calm a client’s skin in the treatment room, we should also go over what they are dodoing at home between spa treatments. Suggest to your client that many of the same precautions you take in the treatment room should be replicated at home. Types of linens, products (ingredients), fragrance, water temperature, and relaxation methods will be helpful. If the condition is triggered by work or living environment, offer suggestions about how to protect the skin from being exposed.
The economic burden of psoriasis is approximately $35.2 billion in the United States per year. Costs are rising yearly for those suffering from this condition. Approximately 7.5 million people in the United States have psoriasis, and many of them are looking to us to help them with the symptoms. Encourage clients to get an official diagnosis from a dermatologist. Understanding your client’s medical condition will help you educate them and build a long and rewarding client/ spa professional relationship.
