Exploring Psoriasis Treatment
- Supermodel Cara Delevingne, 30, has proudly shared her psoriasis with the world. But recent photos seem to suggest she’s making progress with her management of the chronic condition.
- Psoriasis, in general, is a condition that can cause the development of red, itchy patches on the skin. The condition affects up to 3.2 percent of the U.S. population, according to the American Academy of Dermatology.
- Symptoms associated with psoriasis include red patches of skin covered with silvery scales, small scaling spots, dry, cracked skin that may bleed or itch, itching, burning, or soreness, thickened or ridged nails and swollen or stiff joints. If you ever start to notice red, scaly spots on your body, one of our experts recommends you see a dermatologist right away.
- For patients with newly diagnosed or very mild psoriasis, topical treatments (like ointments or creams you rub on your skin) may be enough to treat outbreaks. If the condition is more widespread, your doctor may recommend phototherapy (which uses light to treat the condition) or systemic treatments, which can be taken orally or through an IV and treat the body as a whole.
Looking back at pictures from the 2022 Met Gala in May, Delevingne’s psoriasis is clearly visible on her elbow area.Read More
Then, in pictures from another formal event in June, we can see more psoriasis shown on her leg by the slit of her dress.
Looking glamorous as always, it is lovely to see these examples of such a successful figure known for modeling the likes of luxury brands such as Chanel, Dior and Burberry destigmatizing the condition.
But SurvivorNet, of course, wishes Delevingne nothing but the best with her psoriasis management. And recent photos from MIPCOM Cannes – the 38th International Co-Production & Entertainment Content Market – seem to show that the British model has made remarkable progress in treating her chronic and somewhat severe psoriasis.
In pictures from the October event, Delevingne appears to have very little to no evidence of psoriasis. We do not know what her symptom management regimen looks like or what kind of treatments she’s used, but it’s important to remember there are an extraordinary number of new options for people dealing with this disease.
Understanding Cara Delevingne’s Condition: Psoriasis
Now that we’ve taken a look at Cara Delevingne’s psoriasis journey, let’s take a step back and understand the condition more fully. Psoriasis, in general, is a condition that affects up to 3.2 percent of the U.S. population, according to the American Academy of Dermatology. It can cause the development of red, itchy patches on the skin. But there are many different types of the disease with plaque psoriasis being the most common.
“Psoriasis is a chronic, auto-immune 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.”
People with psoriasis are often asymptomatic, but uncomfortable outbreaks can happen. That being said, psoriasis patches can vary in how they look on the skin. You might have a few spots with scaling similar to dandruff or rashes covering a large portion of your body. The most common places to see psoriasis patches are the lower back, elbows, knees, legs, soles of feet, scalp, face and palms.
“Some patients report itching [or a] burning sensation, but that doesn’t tend to be the norm. It certainly can happen,” Dr. Khattri explained. “Then if you have psoriasis in the genital area, it can feel uncomfortable just because it’s in a very sensitive part of the body. But for the most part, it tends to be asymptomatic.”
Symptoms associated with psoriasis include:
- Red patches of skin covered with silvery scales
- Small scaling spots
- Dry, cracked skin that may bleed or itch
- Itching, burning, or soreness
- Thickened or ridged nails
- Swollen or stiff joints
If you ever start to notice red, scaly spots on your body, Dr. Khattri recommends you see a dermatologist right away so you get get a proper diagnosis and the proper care you need.
Psoriasis is a chronic disease that does not have a cure, but there are many different ways to help manage symptoms. Treatment for the disease also varies but the three main categories include topical treatments like ointments or creams you can rub on the skin, phototherapy which uses UVB light to treat the disease and systemic treatments like drugs that target parts of the immune system you can take orally or through an IV. Like we said before, it’s unclear what kind of treatments/management techniques Cara Delevingne has turned to, but whatever they are seem to be working great!
“When I see a psoriasis patient, I first determine the extent of their condition. If it’s fairly localized, I’m able to treat the patient with topical therapy by itself,” says Dr. Linda Stein Gold, Director of Clinical Research in the Department of Dermatology at Henry Ford Health in Detroit. “But if they have a more widespread condition, topicals alone are not practical.”
Topicals are most often recommended for newly diagnosed patients, or those with mild psoriasis. This first-line treatment is applied directly to your affected skin area with either lotion, cream, or foam. They work by reducing inflammation and slowing down, or putting the brakes on excessive immune cell production.
- Topical steroids. Corticosteroid ointments or creams are the most common treatment for psoriasis flareups and can reduce swelling, redness and itching. Steroid medications come in different strengths that range from strong to less potent. Low strength versions can be bought over-the-counter (OTC), but you’ll need a prescription for stronger steroids. Since prescription-strength steroids can have side effects such as burning or thinning of your skin, you should avoid using them on sensitive areas of your body such as your face, genitals or armpits.
- Topical non-steroids. Your doctor might suggest a non-steroidal topical treatment. These medications include synthetic vitamin D3 (Calcipotriol) and Vitamin A, calcium inhibitors, retinoids, salicylic acid (scalp and shampoo solutions), as well as coal tar and anthralin. Side effects include skin drying, rash, peeling and in some cases, a worsening of your psoriasis.
Phototherapy (light therapy) will not cure your condition, but it can reduce the size, itchiness and the appearance of psoriasis. Light therapy works by exposing the skin to ultraviolet light on a regular basis and slowing down the excess growth of skin cells, which reduces plague formation. Under medical supervision, you can receive light therapy at your healthcare provider’s office, a designated phototherapy unit, or at home.
Your psoriasis should improve within two to four weeks. But keep in mind that everyone’s skin reacts differently. Although the benefit of treatment varies from patient-to-patient, average remission time is three to 12 months. The possible side effects include mild sunburn, a stinging or itching sensation, an increased likelihood of cold sores (this is more likely if you’ve had them before), as well as premature aging of the skin. Your risk of getting skin cancer also increases with long-term exposure to light therapy.
Systemic treatments may be suggested by your healthcare provider if your psoriasis is more persistent and topicals or phototherapy are not helping your condition.
Systemic treatments are not just aimed at the affected skin area, but work throughout your body and are taken orally or by injection or intravenously. “We find that systemic, particularly biologic agents are highly safe and effective,”
says Dr. Stein Gold.
Oral /Intravenous or Injected Medications
- Methotrexate. (Taken orally by pills or liquid form, intravenously or by injection) Approved by the FDA more than four decades ago, this classic systemic treatment works as an immunosuppressant that inhibits fast dividing cells. It’s typically delivered as one dose or divided into three dosages over a 24-hour period. The most common side effects are fatigue, nausea, and headaches.
- Apremilast (Otezia). (Taken orally by pill or in liquid form) This medication treats psoriasis and psoriatic arthritis by regulating inflammation within the cell and inhibiting an enzyme known as phosphodiesterase 4 (PDE4). This is the enzyme that controls much of the inflammatory action within cells, which can affect the level of inflammation associated with psoriasis. Side effects include nausea, diarrhea, headache and upper respiratory tract
- Cyclosporine. (Taken orally by pill or liquid form) This fast-acting medication is aimed at severe, difficult to manage and acute flares. Because of the drug’s potential for serious side effects including kidney issues and high blood pressure, it isn’t prescribed as a long-term treatment.
- Biologics. (Administered by injection or IV transfusion) Unlike other systemic medications, biologics only target specific parts of the immune system and are exclusively injected or delivered through transfusion. The biologics used to treat psoriasis work by blocking the action of a specific type of immune cell called a T-cell. Or, they block proteins in the immune system that play a big part in psoriasis. Although biologic medications are administered either intravenously or by injection, they are not a one-shot deal. Treatments often need to continue as long as the medication is working. Biologics have another downside: they can increase your risk of infection such as a fever, cough, or flu-like symptoms. If you’re taking a biologic and you are experiencing a side effect, contact your healthcare provider right away.
“You can help your doctor make more informed decisions regarding your treatment by sharing information about your condition and your medical history,” Dr. Stein Gold said. “For example, whether you have a history of heart disease, IBS, MS or prior cancers and if you have arthritis or a history of infections including TB or hepatitis.”
Contributing: Robin Westen