In recent years, there has been an increasing demand for dermatology services at Singapore's National Skin Centre (NSC).
Psoriasis is a chronic, non-contagious skin condition that occurs when your skin cells multiply and are replaced too quickly. Often, it is accompanied by inflammation. As a result, the condition appears as red scaly patches. 
DoctorxDentist invited Dr Colin Theng, a fully accredited dermatologist and the president of the Psoriasis Association of Singapore, to answer readers' questions on the causes and treatment options for psoriasis.
Genes play a very important role in the development of psoriasis
If you have a family history of psoriasis, you will have an increased risk of developing psoriasis.
The development of psoriasis depends on an interplay of genetic and environmental factors.
To illustrate the point, if one of your parents has psoriasis, the risk of developing psoriasis is about 20%. If both of your parents have psoriasis, your risk can go up to about 50%.
Does this mean that psoriasis is inevitable if multiple family members have it?
Not exactly. A 23-year-old-reader was worried about eventually getting psoriasis because she had family members who suffered from it.
Dr Theng assured her that although the risk of developing psoriasis is higher, it isn't set in stone.
Eczema is more common in children than psoriasis
When it comes to children, skin conditions are more likely to be an indication of eczema rather than psoriasis, especially if affected areas include the inner elbow area or flexural area.
On the other hand, psoriasis tends to affect the elbows. It also often starts later in life, with the peak age of onset in the late teens to early twenties. It is less common for psoriasis to occur during childhood.
Psoriasis is not conclusively linked to any foods
People often wonder if foods can trigger psoriasis. According to Dr Colin, the link between psoriasis and diet is not strong. There isn't enough medical evidence to suggest that any foods affect psoriasis or causes it to develop. Psoriasis is not caused by food allergies.
Nevertheless, he advises patients to refrain from too much alcohol and smoking as these could aggravate the condition.
Additionally, keeping a food diary might be more relevant for eczema, which may be food-related or triggered in some cases.
Eating healthily is encouraged
Dr Theng encourages people who suffer from psoriasis to eat healthily. Reason being, they have a higher risk of being overweight and developing other health-related issues such as diabetes and high cholesterol.
Minimising stress can help manage psoriasis
When it comes to managing psoriasis, it's important to lead a healthy and stress-free lifestyle. Sure, stress can seem like an inevitable part of life (especially in fast-moving urban jungles like Singapore), but keep in mind that it's a well-known trigger of psoriasis.
Mild psoriasis can be treated with topical medications
Options such as topical steroids, coal tar, and vitamin D creams work very well if you have mild psoriasis. They are commonly prescribed by doctors. As long as there is a limited area of involvement, they can effectively keep your condition under control.
If you fail topical treatment, there's phototherapy
Phototherapy is a good treatment option if your psoriasis is more extensive or if you fail topical treatment.
This involves the use of ultraviolet light. It is like going for a medical tanning session in a light booth. Here's the catch: you have to go for treatment two to three times a week. 
Oral medications need to be taken for severe cases
Oral medications such as methotrexate, acitretin, and cyclosporine can be used to treat severe psoriasis.
While these medications are effective in treating psoriasis, there are downsides to it. They suppress the immune system and affect the liver, kidneys, and blood counts.
However, with careful monitoring, they can be used safely to treat psoriasis.
New and effective treatments for psoriasis
A new method to treat psoriasis is through the use of biologic agents are given by injections. They target specific immune pathways that cause psoriasis. 
Dr Theng has seen up to 80% of his patients being clear or almost clear of the condition after this treatment. The biologic agents do suppress the immune system but have minimal impact on the liver and kidneys, unlike the traditional oral therapies.
Psoriasis treatment costs can range from $30 - $2000
Psoriasis is a chronic disease. If you suffer from the condition, you can expect to be on treatment for some time. Treatment prices vary greatly with factors such as their effectiveness as well as the specific condition.
The cost of oral medications can range from $30 - $600 a month, while the new biologic agents come with a heftier price tag; they range from $1,200 - $2,000 a month depending on the biologic that is used.
Be extra cautious when exercising
Heat and sweat can cause itchiness and discomfort. With psoriasis, there's a chance that your skin may be more sensitive to extremes of temperature.
However, this is not to say that you shouldn't exercise if you have psoriasis. In fact, psoriasis has been linked with an increased risk of heart disease, obesity, diabetes, and hypertension.
Therefore, it's important to exercise regularly and maintain a healthy lifestyle. Many of Dr Theng's patients were able to exercise and keep fit.
Tips to keep your skin fresh when you exercise
To minimize the redness and itch, try exercising in a cooler environment. Avoid exercising between 10:00am to 4:00pm when the sun is at its hottest.
Dr Theng also suggests wearing loose-fitting clothing and reminds you to wipe dry frequently.
Last but not least, have a cool shower immediately after the exercise. Moisturise right after showering to relieve dryness.
Your risk of cancer might increase slightly
According to published data, there might be a slight increase in the risk of developing certain cancers in individuals with psoriasis. Some studies have pinpointed cancers such as lymphoma, lung cancer, and skin cancer.
Possible reason for this includes chronic inflammation and impaired immune-surveillance in psoriasis individuals.
However, Dr Theng emphasized that the increase in cancer risk is small, so there's no need to worry too much about these findings.
This article is medically reviewed by Dr Colin Theng.