Ask Dr Colin Theng: Psoriasis

Eczema and psoriasis share many similarities. They are both chronic skin rashes and present with itchy red rashes. However, have differences in their presentation and have different underlying pathology. Atopic eczema is a form of eczema that often occurs from infancy and childhood. It presents with itchy red rashes that affects mainly the flexural areas, like the elbow and knee bends and neck. In acute eczema, the rash can be weepy and oozy. However, in chronic eczema, the rash is raised and thick and this can resemble psoriasis.

Firstly, I think it is important to try to lead a healthy and stress-free lifestyle. Stress is hard to avoid in stressful Singapore but it is a well-known trigger of psoriasis, so do not forget to minimise stress in your life. For mild psoriasis, this is usually treated with topical medications. Topical steroids, coal tar and vitamin D analogues creams are commonly prescribed. They are effective in controlling psoriasis when there is a limited area of involvement.

Hi, Evening primrose oil is a common supplement advocated for treating eczema. However, robust scientific data is lacking and in real life, many eczema sufferers derive no benefits from taking this or any other supplements. This seems to be what my patients tell me as well. The key preventive measures lie with the avoidance of known aggravating factors such as stress, heat, sweating, friction, etc and to diligently repair/maintain the skin barrier using mild cleansers and regular use of moisturizers.

Hello Yang, Thanks for the D2D. Heat and sweat can make a person feel more itchy. With psoriasis, your skin may be more sensitive to extremes of temperature. However, this is not true of all people with psoriasis and many are able to continue to exercise and lead a healthy lifestyle. In fact, psoriasis has been linked with an increase risk of heart disease, obesity, diabetes and hypertension. It is therefore important to exercise regular and maintain a healthy lifestyle.

Thanks for the question. If you have a diagnosis of psoriasis, there is a possibility that certain treatments can aggravate it. With psoriasis, damage or injury to the skin can cause psoriasis to develop at the site of the injury. This is know as the Koebner phenomenon. Therefore, you do have to take care that the treatment is gentle and does not cause any trauma or damage to the skin. Likewise, for eczema, the skin is sensitive and more prone to external insults, so you should avoid treatment if the facial skin is still red or irritated as this can be more easily aggravate by treatment.