Psoriasis: Frequently Asked Questions

Here are some frequently asked questions related to psoriasis.

Q: If I have psoriasis, will my children get it?

A: Psoriasis is not contagious, so you cannot “give” it to your children or to anyone else. However, in about one third of cases, psoriasis is inherited. It is estimated that if a child has one parent with psoriasis, the child’s chances of getting the disease are between one in 10 and one in four. If both parents have psoriasis, a child’s chances of getting the disease are about 50-50.

Q: Is there a special diet that will help to clear psoriasis?

A: Various diets, including the use of fish oil supplements, have not been proven to help psoriasis.

Q: The steroid cream that my dermatologist prescribed does a good job of clearing the psoriasis on my hands and arms, but my dermatologist has told me not to use it on my face. Why not?

A: Dermatologists generally tell their patients not to use topical steroid medications on the face because-especially when used for a long time-these medications can produce side effects such as stretch marks, thinning and reddening of the skin, and the appearance of small blood vessels through the skin.

Q: The steroid cream that my dermatologist prescribed worked well for a while but now my psoriasis has come back. Why?

A: Topical steroid medications can lose their effectiveness if they are used repeatedly for a long time. This is called resistance. Ask your doctor about other medications for psoriasis that are applied to the skin. Two relatively new medications are calcipotriene, which is chemically related to Vitamin D, and tazarotene, which is chemically related to Vitamin A. These medications may be used on their own or in combination with a steroid cream.

Q: My doctor is suggesting cortisone shots to treat my psoriasis. Is this worth a try?

A: Cortisone is a type of steroid. Dermatologists do not recommend steroids that are taken internally (in the form of pills or shots) to treat psoriasis. Although they clear the disease temporarily, it often comes back worse than ever when treatment stops. In addition, steroid pills and shots can have serious long-term side effects, including high blood pressure, diabetes, cataracts, weight gain, and thinning of the bones.

Q: How effective are the new biological therapies that are advertised today?

A: In January 2003, the U.S. Food and Drug Administration approved Amevive (alefacept), the first biological therapy for psoriasis. Amevive, delivered through injection, treats plaque psoriasis through a unique immunosuppressive mechanism of action. Specifically, Amevive is believed to work by simultaneously blocking and reducing the cellular component of the immune system that is thought to play a significant role in the disease process.

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