Psoriasis is a chronic immune-mediated inflammatory skin condition in which an overactive immune system causes the body to make new skin cells in days rather than weeks. The overgrowth of cells does not shed; instead the overgrowth piles up on the skin’s surface and causes thick white scale to appear. These resulting plaques can itch, sting or burn. In addition to the skin, psoriasis can involve the scalp and nails. However, it most commonly involves bony surfaces such as elbows, knees and ankles. Psoriasis is not contagious. It can flare from numerous factors including stress, skin injury, certain medications, streptococcal infections, cold weather and excessive alcohol consumption. Psoriasis cannot be cured; it typically waxes and wanes throughout life.

Treatment is dictated by the severity of one’s psoriasis, its location on the body and how much of the body surface area is affected. For mild psoriasis, topical therapy is most common and options include emollients, compounds containing tar, salicylic acid, steroids, Vitamin D analogues, calcineuron inhibitors or a combination of some of the aforementioned medications. An effective treatment for moderate to severe psoriasis is phototherapy. Phototherapy is UV radiation often given alone or in combination with a topical or systemic compound. The mechanism of action of phototherapy is not completely understood. However, it is believed that ultraviolet radiation plays a role in immunosuppression and cell cycle interruption in the skin. For severe psoriasis, treatment is often systemic. There are numerous, highly effective systemic medications including certain retinoid compounds, immunosuppressants such as Methotrexate and Cyclosporin and immunotherapy with “biologic” medications which are targeted therapies that can either amplify or suppress an immune response in a person’s body.

To treat an AK, your dermatologist will take into consideration several factors including how many AK’s you have, where they are on your body, their size and your medical history. Treatment options include cryotherapy (liquid nitrogen), chemical peels, photodynamic therapy, laser resurfacing, as well as topical medications such as imiquimod (Aldara/Zyclara) and 5-fluorouracil (5FU/Efudex).