Functional Medicine for Psoriasis

What is psoriasis?

Psoriasis is a chronic (long-lasting) condition driven by the immune system. Overactive immune cells cause skin cells to grow too quickly. New skin cells grow in three or four days instead of a month, so they pile up on the surface. This forms raised, scaly patches called plaques.^{1, 3, 4}

Psoriasis is not contagious. It can come and go, with flares and periods when the skin improves. Anyone can get it, and it affects men and women equally. Symptoms often begin between ages 15 and 25, but they can start at any age.^{1, 3}

The cause is not fully understood, but genes and the environment both play a part. Common triggers include stress, skin injuries, infections such as strep throat, certain medicines, smoking and alcohol.^{1, 2, 3}

Psoriasis can affect more than the skin. About 1 in 3 people with psoriasis may develop psoriatic arthritis, which causes joint pain, swelling and stiffness. Psoriasis is also linked with a higher risk of other conditions, including heart attack and stroke, depression and diabetes.^{1, 3, 4}

Common symptoms of psoriasis

There are five main types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. Plaque psoriasis is the most common, affecting about 80 to 90 percent of people with psoriasis. On lighter skin, plaques often look red with silvery-white scale. On darker skin, they may look purple, grayish or dark brown.^{1, 3, 4}

Common signs include:¹

• Raised, thick patches of skin with scale, often on the scalp, elbows, knees or lower back⁴
• Itching, burning or stinging^{1, 3}
• Dry, cracked skin that may bleed^{1, 3}
• Smooth, red patches in skin folds, such as the armpits or groin (inverse psoriasis)¹
• Small, scaly spots that appear suddenly, often after an infection such as strep throat (guttate psoriasis)^{1, 4}
• Nail changes, such as tiny dents, discoloration, crumbling or a nail lifting away⁴
• Poor sleep¹
• A swollen, tender joint, heel pain or morning stiffness, which can be signs of psoriatic arthritis^{1, 4}

How psoriasis is diagnosed and treated

A doctor usually diagnoses psoriasis by examining your skin, scalp and nails. They may ask about itching, recent illness or stress, medicines you take, family history and joint pain. If the diagnosis is unclear, a small skin sample (biopsy) may be checked under a microscope.^{2, 3}

There is currently no cure, but treatments have improved. Treatment aims to control symptoms so you can carry on with daily life and sleep better. The choice depends on the type of psoriasis, how severe it is, where it is on the body, and possible side effects.^{2, 3}

Mild psoriasis is often treated with creams or ointments, such as corticosteroids or vitamin D-based medicines. Moderate to severe psoriasis may need light therapy (phototherapy), pills, or injected medicines such as biologics.^{1, 2}

Dermatologists, who specialize in skin, hair and nail conditions, treat psoriasis. If you have joint symptoms, a rheumatologist may also be part of your care. Ongoing care with your dermatologist matters, so keep up with regular visits.²

How our care fits alongside your dermatologist

Avicenna Functional Medicine does not replace your dermatologist or the treatment they prescribe. Our role is to add to your care, not to take its place.

In a functional medicine visit, we look at factors that may contribute, such as gut health, nutrition, environmental exposures, sleep, stress and immune regulation, alongside the care you already receive. Our aim is to understand the whole picture of your health and to support your overall wellbeing.^{1, 2}

Please do not stop or change any prescribed medication without talking to the doctor who prescribed it. If you are curious about supplements or other complementary approaches, talk with your dermatologist before you start.³

What to expect at Avicenna

All visits are by telehealth, for patients located in Florida and Texas. We are a cash-pay practice, and we accept HSA and FSA. Care usually follows these steps:

• A free, 30-minute discovery call to talk about your health and whether our approach is a good fit for you
• A full intake visit with our health coach, under clinician supervision, covering your history, symptoms, current treatment and goals
• Testing chosen for you, where it is likely to be useful
• A personalized plan, with follow-up visits to review how you are doing and adjust the plan as needed

When to get urgent care

See your doctor soon if you notice joint pain, swelling or stiffness, because untreated psoriatic arthritis can cause lasting damage. Also tell your dermatologist if your psoriasis is getting worse or stops responding to treatment.^{1, 4}

Two rare types, erythrodermic psoriasis and generalized pustular psoriasis, can be life-threatening and need medical care right away. Warning signs include skin over most of your body that is red or looks burned, or pus-filled bumps covering most of your skin. These skin changes may come with fever, chills, headache, a rapid pulse, muscle weakness, severe itching, or feeling extremely ill.^{1, 4}

Telehealth visits with our team are not for emergencies. Call 911 right away if you have warning signs of a medical emergency, such as:⁵

• Chest pain or pressure that lasts two minutes or more⁵
• Trouble breathing or shortness of breath⁵
• Sudden confusion, unusual behavior or trouble waking up⁵
• Fainting or passing out⁵
• Sudden dizziness, weakness or changes in vision⁵
• Being unable to speak⁵
• Severe belly pain, or sudden severe pain anywhere in the body⁵
• Coughing up or vomiting blood⁵
• Thoughts of suicide or of harming someone else (you can also call or text 988)^{5, 6}