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36 DAYSPA | AUGUST 2014 Delicate Conditions C o n d i t i o n : Condition: PSORIASIS Occurrence: Psoriasis affects 7.5 million Americans, men and women equally, and all ethnicities (although it's more predominant in Caucasians). It's seen in people of all ages, but is more com- mon in people aged 15 to 35. Because psoriasis improves with natural sunlight, it may occur more often in extreme Northern climates. History: In years past, psoriasis— named for the Greek word psora ("to itch")—was often confused with lep- rosy; in medieval Europe, people with psoriasis were forced to warn others of their arrival with clappers. In May this year, the World Health Organization member states recognized psoriasis as a "chronic, non-commu- nicable painful, disfi guring and disabling disease for which there is no cure." Primary symptoms: Psoriasis usually presents with raised, red, scaly patches. It occurs on any part of the body—it's most common on the elbows and knees but can also be found in skin creases such as the groin and armpits and under the breasts, as well as in the center of the face, and ears, scalp and mid-chest. Possible causes: "Psoriasis occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells," explains Noe Baker, public relations manager of the National Psoriasis Foundation (psoriasis .org). "Many believe that genetics play a role; one-third of people with psoriasis report that a family member also has it," she continues. "Scientists think that at least 10% of the general population inherits one or more of the genes that make them susceptible to psoriasis, but that only 2% to 3% develops the disease. For a person to develop psoriasis, he or she must have the genes that make her predisposed to the condition and be exposed to certain external triggers." Those triggers may include stress, certain medications, injury to the skin and in- fections such as strep throat. Annet King, director of global education for Dermalogica's International Dermal Institute (dermalinstitute.com) in Los Angeles, adds diet, smoking, alcohol, low humidity, cold weather and UV exposure to the list. Treatment options: According to Dr. Michael Sha- piro, medical director and founder of Vanguard Derma- tology (vanguarddermatology.com) in New York, there has been a recent revolution in the understanding of psoriasis. "At its core, it's a disease in which individual members of the immune system are interacting with each other in erroneous ways," he notes. "Hence, up-to-date treatments for severe psoriasis target the immune system rather than treat the skin." Baker points out that treatments for psoriasis vary depending on its type (there are fi ve types in total, with the most common form—plaque psoriasis—af- fecting up to 80% of patients), as well as location and severity. However, she cites the most common recourses: topical treatments; light therapy (aka pho- totherapy or heliotherapy), in which skin is exposed to UVB light on a regular basis; systemics (prescription drugs that work throughout the entire body); and biologic drugs, or biologics, which are generally pre- scribed for moderate to severe psoriasis and psoriatic arthritis that has not responded to other treatments. King calls psoriasis "the most self-esteem-affecting disorder people are likely to have"—and because there is no complete cure, treatment involves managing the disorder. She suggests spa pros can assist clients by having them avoid artifi cial ingredients, high-foam cleansers and hot baths, and recommending measures including milky/creamy cleansers, barrier-replenishing You Should Know... "We always encourage a holistic approach when treating skin conditions. Psoriasis, rosacea and eczema can be inherited and/or caused by environmental factors. People need to start looking at their diets and stress levels and realize there is not one product out there that is going to 'cure' them. There must be a combination of products along with dietary changes and an evaluation of stress levels as a full- circle treatment approach. I always suggest that they incorporate B vitamins into their diet, which can help with stress. Light exercise, acupuncture, massages, getting enough sleep, using fragrance-free detergent and eating less spicy foods are also lifestyle changes I recommend. The use of light serums with simple formulations containing liposomes, sphingolipids and glycolipids work best, and light hydrating sun protection products with SPF is also very helpful." —LORI TERWILLIGER, SENIOR EDUCATOR, WILMA SCHUMANN SKIN CARE LIGHT THERAPY MAY HELP EASE SYMPTOMS OF PSORIASIS. © AMANA PRODUCTIONS INC/GETTY