Psoriasis is a chronic autoimmune skin disorder affecting millions worldwide, characterized by red, itchy, and painful scaly patches. The immune system mistakenly attacks healthy skin cells, leading to accelerated skin cell production. While conventional topical treatments exist, they often suffer from low skin penetration efficacy and off-target adverse effects, highlighting unmet medical needs in psoriasis management.
The exact cause of psoriasis remains unclear, but it is believed to be influenced by a combination of genetic and environmental factors. A family history of psoriasis significantly increases an individual's risk of developing the condition.
Understanding Psoriasis and Its Management
Psoriasis is an autoimmune skin disorder where the immune system mistakenly attacks healthy skin cells, triggering an accelerated skin cell production cycle. This results in the characteristic red, scaly patches that can be itchy, painful, and emotionally distressing.
Current Treatment Modalities
Mild to moderate cases of psoriasis are often managed with topical treatments prescribed by a doctor or dermatologist. These can include:
- Vitamin D Analogues: These synthetic forms of vitamin D are known to slow down skin cell renewal.
- Phototherapy: This involves exposing the affected skin to specific wavelengths of ultraviolet (UV) light under medical supervision.
In more severe cases, where topical treatments and phototherapy prove ineffective, oral or injectable medications may be prescribed by a dermatologist.
Skincare for Psoriasis
When dealing with psoriasis, it is essential to use skincare products that are gentle and do not exacerbate inflammation or interfere with prescription topicals. Beneficial ingredients include:
- Jojoba Oil: Being non-comedogenic, it moisturizes without clogging pores and helps reduce scaling.
- Glycerin: Known for its skin-soothing properties, glycerin can draw more moisture into the skin.
The Importance of Professional Consultation
While not every individual with psoriasis requires immediate professional attention, consulting with a dermatologist or doctor is highly advisable if you suspect you have psoriasis or experience concerning symptoms. A dermatologist can provide:
- Accurate Diagnosis: Psoriasis can sometimes be mistaken for other skin conditions like eczema or fungal infections.
- Personalised Treatment Plan: A dermatologist can assess the severity of your psoriasis and recommend the most effective, tailored treatment options.
- Monitoring and Management: Psoriasis is a chronic condition with fluctuating severity, requiring ongoing professional guidance for effective management and improved quality of life.
For ongoing support alongside prescribed treatments, a dedicated aesthetician can help build a gentle skincare routine to best support the skin.
Your guide to psoriasis
Hyaluronic Acid: A Natural Compound with Therapeutic Potential
The body naturally produces hyaluronic acid (HA), also known as hyaluronan. This clear, viscous substance is crucial for lubricating tissues and plays a role in skin health, wound healing, bone strength, and various other bodily functions. The largest amounts of HA are found in the skin, connective tissue, and eyes. Its primary function is to retain water, thereby keeping tissues lubricated and moist.
Hyaluronic acid has a variety of uses. It is commonly taken as a supplement and is also incorporated into topical serums, eye drops, and injections.
Scientifically Backed Benefits of Hyaluronic Acid
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Promotes Healthier, More Supple Skin
Hyaluronic acid supplements can enhance skin suppleness and appearance. As a compound naturally present in the skin, HA binds to water to retain moisture. However, aging and exposure to environmental factors like UV radiation, tobacco smoke, and pollution can decrease its levels. Supplementing with HA can help counteract this decline by providing the body with additional amounts. Studies indicate that daily doses of 120-240 mg for at least a month can significantly increase skin moisture and reduce dryness. Hydrated skin also reduces the appearance of wrinkles, making skin appear smoother. When applied topically, HA serums can reduce wrinkles, redness, and dermatitis. Dermatologists also use HA injections as fillers to maintain firm and youthful-looking skin.
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Can Speed Wound Healing
Hyaluronic acid plays a key role in wound healing. Its concentrations increase in the skin when damage occurs, helping to regulate inflammation and signal the body to build more blood vessels in the damaged area. In some studies, topical application of HA to skin wounds has shown to reduce wound size and decrease pain more rapidly than a placebo or no treatment. HA also possesses antibacterial properties, potentially reducing the risk of infection in open wounds. Furthermore, it has shown effectiveness in reducing gum disease, accelerating healing after dental surgery, and eliminating ulcers when used topically in the mouth. While research on HA serums and gels is promising, it remains unclear if oral supplements offer the same benefits, though they may boost HA levels in the skin.
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Relieve Joint Pain by Keeping Bones Lubricated
HA is also found in the joints, where it lubricates the spaces between bones, preventing them from grinding against each other and causing pain. Hyaluronic acid supplements are particularly beneficial for individuals with osteoarthritis. Daily intake of 80-200 mg for at least two months has been shown to significantly reduce knee pain in individuals with osteoarthritis, especially those aged 40-70. HA can also be injected directly into joints for pain relief, although an analysis of over 21,000 adults found only a small reduction in pain and a higher risk of adverse effects with injections. Combining oral HA supplements with injections may help extend pain-relieving benefits and increase the time between shots.
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Soothe Acid Reflux Symptoms
When acid reflux occurs, stomach contents regurgitate into the throat, causing pain and damaging the esophageal lining. Hyaluronic acid may help soothe this damaged lining and speed up recovery. A test-tube study found that a mixture of HA and chondroitin sulfate applied to acid-damaged throat tissue healed it faster than untreated tissue. Human studies have also shown benefits, with one study indicating that a HA and chondroitin sulfate supplement, along with an acid-reducing medication, decreased reflux symptoms 60% more than the medication alone. Another study showed this combination was five times more effective at reducing acid reflux symptoms than a placebo. While more research is needed, these outcomes are promising.
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Relieve Dry Eye and Discomfort
Approximately 11% of older adults experience dry eye symptoms due to reduced tear production or rapid tear evaporation. Given HA's excellent moisture-retaining properties, it is often used to treat dry eye. Eye drops containing 0.2-0.4% HA have demonstrated a reduction in dry eye symptoms and improved eye health. Contact lenses containing slow-release HA are also being developed. HA eye drops are frequently used during eye surgery to reduce inflammation and speed wound healing. While topical application effectively reduces dry eye symptoms, the effects of oral supplements are less clear. One small study suggested that combining topical and oral HA was more effective than topical HA alone, but larger studies are needed.
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Preserve Bone Strength
Emerging animal research is investigating the effects of HA supplements on bone health. Older studies in rats with osteopenia (an early stage of bone loss) found that HA supplements could slow the rate of bone loss. Test-tube studies have also indicated that high doses of HA can increase the activity of osteoblasts, the cells responsible for building new bone tissue. While more human research is required, these early findings are promising.
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Could Prevent Bladder Pain
Interstitial cystitis, or painful bladder syndrome, affects 3-6% of females, causing abdominal pain, tenderness, and a frequent urge to urinate. While the causes are unknown, HA inserted directly into the bladder via a catheter has been found to relieve pain and urinary frequency associated with the condition. Researchers hypothesize that HA may help repair bladder tissue damage, reducing sensitivity to pain. It is unclear whether oral HA supplements can increase bladder HA levels sufficiently to produce similar effects.
Hyaluronic Acid Nanoparticles (HA-NPs) for Psoriasis Treatment
Hyaluronic acid nanoparticles (HA-NPs), formed by the self-assembly of HA-hydrophobic moiety conjugates, have been extensively studied as nanocarriers for targeted drug delivery due to their excellent physicochemical and biological characteristics. Recent research identifies HA-NPs as promising topical therapeutics for psoriasis treatment.
In Vivo Efficacy of HA-NPs
In vivo skin penetration studies and psoriasis animal models demonstrated that transcutaneously administered HA-NPs accumulate and associate with pro-inflammatory macrophages in the inflamed dermis of psoriasis mouse models. Importantly, HA-NPs exhibited potent therapeutic efficacy against psoriasis-like skin dermatitis in a size-dependent manner. This efficacy was achieved by suppressing innate immune responses and restoring skin barrier function, with no overt signs of toxicity.
The therapeutic effect of HA-NPs on psoriasis-like skin dermatitis was attributed to the outermost hydrophilic HA shell layer of the nanoparticles. This effect was independent of the molecular weight of HA and the hydrophobic moiety. The efficacy of HA-NPs was comparable to that of conventional psoriasis therapeutics widely used in clinical settings.
Other Acids in Skincare
While the term "acid" might sound harsh, certain types of acids are highly beneficial for the skin. These include alpha-hydroxy-acids (AHAs) and beta-hydroxy-acids (BHAs), which act as exfoliants. AHAs are water-soluble and exfoliate the surface layer for a brighter complexion, with examples like glycolic acid and lactic acid. BHAs, on the other hand, are oil-soluble and penetrate pores to remove buildup and excess sebum, making them ideal for acne-prone skin.
Salicylic acid is a beta-hydroxy acid (BHA) traditionally derived from white willow bark, possessing a chemical structure similar to aspirin. It offers anti-inflammatory, anti-microbial, and sebum-regulating benefits. As an oil-soluble BHA, it penetrates the skin more deeply. While initial dryness and irritation can occur, prolonged irritation may necessitate adjustments to the skincare routine. Salicylic acid is highly effective at decongesting follicles and pores, which can lead to a temporary "purging" period, especially in cases of acne. This purging phase, depending on acne severity, can last for several weeks. Salicylic acid is contraindicated only in cases of aspirin allergy, pregnancy, and breastfeeding.
Hyaluronic acid (HA) is a sugar molecule naturally produced by the body, often referred to as a "moisture magnet" or humectant. Its production naturally slows with age. HA helps lubricate and hydrate joints and tissues, maintains skin health, accelerates wound healing, and can reduce scarring. As a skincare ingredient, HA is safe for daily use, even on oily skin. It is found in various products like toners, moisturizers, and masks. Some formulations are clinically proven to increase the skin's natural HA production, offering both immediate and long-term benefits.
Synthetic HA is also a widely used ingredient in dermal fillers, approved by the FDA for temporarily restoring volume to lines and wrinkles and augmenting areas like lips, cheeks, and chin. However, their use is not recommended for individuals under 23, and safety for pregnant or breastfeeding women is not established. Potential side effects of HA filler treatments include bruising and swelling, which can often be minimized by discontinuing blood-thinning medications (with physician approval), alcohol, and certain supplements prior to the procedure. Reducing intake of high-sodium foods pre- and post-treatment is also advised.
HA is considered beneficial for specific skin types, particularly those that are oily and blemish-prone yet dehydrated. A professional skincare consultation is recommended to tailor routines to individual needs.
Possible Side Effects and Precautions of Hyaluronic Acid
Hyaluronic acid is generally considered very safe with few reported side effects. Allergic reactions are rare as the body naturally produces HA. A study involving 60 individuals with osteoarthritis who took 200 mg daily for a year reported no negative side effects. However, its effects during pregnancy or breastfeeding have not been thoroughly studied, so caution is advised for these groups. There is also some evidence suggesting that cancer cells may be sensitive to HA, and supplementation could potentially accelerate their growth. Therefore, individuals with cancer or a history of cancer are generally advised to avoid HA supplements.
Hyaluronic acid injections into the skin or joints carry a higher risk of side effects compared to oral or topical applications.
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