Understanding clients who have psoriasis

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					Understanding clients
 who have psoriasis
    What is psoriasis?

• Common, chronic, inflammatory disease of
  skin and joints

• Complex genetic disease of the immune
  system with environmental triggers

• Immune system malfunctions and makes the
  skin grow too quickly, creating a build up of
  skin cells causing plaques
    What is psoriasis?

• Researchers believe that psoriasis is genetic
  and can be passed down from generation to

• Not contagious
     Types of psoriasis

• Plaque
  – Patches of raised, red skin
    covered by flaky, white buildup
    called scale(s)
  – Most common form
  Types of psoriasis

• Guttate
  – Small, red dots on the skin
  – Usually on the arms, legs, chest and back
  Types of psoriasis

• Inverse
  – Smooth, dry patches that are red and inflamed
  – Often found in folds or creases of the skin (e.g.
    armpits, groin)

  Types of psoriasis

• Erythrodermic
  – Intensely bright red skin that looks like a bad
  Types of psoriasis

• Pustular
  – Blister-like spots filled with fluid and
    surrounded by red skin
  What is psoriatic arthritis?

• Inflammatory joint disease found in ten
  percent to 30 percent of patients with

• Stiffness, pain, swelling and tenderness of the
  joints and surrounding ligaments and tendons

• Skin symptoms usually appear before joint
  symptoms, but not always
 How common is psoriasis?

• Affects 2 percent to 3 percent of the
  population worldwide
  – According to the National Institutes of Health,
    as many as 7.5 million Americans have psoriasis
• Occurs nearly equally in men and women
  across all socioeconomic groups
• Present in all racial groups but in varying
   When does psoriasis emerge?

• Can develop psoriasis at any age
   – Commonly appears between the ages of 15 and 25
• Is a lifelong condition
   – Tends to wax and wane
  What are symptoms of

• Psoriasis can make the skin itch, burn, sting
  and/or bleed
• Flaking and scaling are most common
• Constant itching is often described as the
  most frustrating symptom
    Specific skin sites

• Scalp
   – Powdery scales with silver sheen around the scalp
     line, forehead, ears, and back of neck
   Specific skin sites

• Nails
   – Pitting, deformation,
     discoloration, thickening
     and/or separation of the
     nail from the nail bed
  Specific skin sites

• Palms of hands and soles of feet
  – Cracks, blistering, swelling
  – Very difficult and painful to walk when soles of the feet are
  Specific skin sites

• On the face, around the eyes, ears, nose and
  – When psoriasis affects the eyelids, lashes may become
    covered with scales, and the edges of the eyelids may be red
    and crusty.
  – Psoriasis in the ears can cause scale buildup that blocks the
    ear canal, leading to temporary hearing loss.
• Genitals
  – The most common type of psoriasis in the genital region is
    inverse psoriasis, which first shows up as lesions that are
    very red in the folds of the skin.
 Fact or fiction?

Psoriasis is contagious and can be spread by
using the same comb from another person
who has it.
 Fact or fiction

FICTION: Psoriasis is not
contagious. No one can “catch” it
from another person.
   Fact or fiction?

Psoriasis can develop from poor hygiene
Fact or fiction?

FICTION: Cleanliness has nothing to do
with having psoriasis. Psoriasis
symptoms are visible on the skin, but
the disease starts below the skin’s
surface in the immune system.
   Fact or fiction?

Psoriasis is a cosmetic skin rash
 Fact or fiction?

FICTION: Psoriasis is not a
“superficial” disease. People with
psoriasis are affected emotionally as
well as physically.
  Fact or fiction?

Psoriasis is temporary and untreatable
Fact of fiction?

FICTION: Psoriasis is a chronic and
lifelong disease.

FICTION: There is no cure for
psoriasis but there are many
treatment options.
  Psoriasis carries an emotional

• The emotional toll of psoriasis can be just as
  much of a burden as the physical aspects.
  People with the disease may feel hopeless,
  helpless, depressed and isolated.
• People with psoriasis can become frustrated,
  self-conscious and embarrassed because of
  the physical appearance of the disease.
People with psoriasis
experience discrimination

                  National Psoriasis Foundation
                  2005 Fall Survey Panel n=428
  Living with psoriasis –blogger
             Psoriasis and the fear of
             going to the hairdresser

I didn’t go to a hairdresser until just before my
 wedding. My wife insisted on it. I rehearsed my
 explanation to the hairdresser for my scaly scalp
 over and over in my mind. When I finally sat down in
 the chair and had the chance to share my condition,
 the hairdresser just shrugged it off and said it
 wasn’t that bad. But I felt like I was having a root
  What can you do?

• Help educate others that psoriasis is not
• Show compassion to someone with psoriasis.
• If you know someone with psoriasis who
  hasn’t been to a doctor in a while, encourage
  them to see a dermatologist.
• Reach out to someone with psoriasis.
  Encourage them to visit
  for support and education.
  Clients with scalp psoriasis

• What should you do if your client has scalp
  psoriasis and wants chemical treatments
  (permanent, color) for his/her hair ?

  – First have them talk with their health care
  – Conduct a patch test
   Clients with scalp psoriasis

Heat from hair dryers can dry the skin and
  cause scalp psoriasis to get worse.

– Use lower heat setting
– Don’t dry as long a time
  Clients with nail psoriasis

• Symptoms of nail psoriasis include:
  – Deformation, separation of the nail from the nail
    bed, discoloration (yellow-brown in color),
    thickening of the nail and pitting
Clients with nail psoriasis

     Pitting of the nail
  Care for nail psoriasis

• Natural nail manicures should be safe*
• Nails should be trimmed back to the point of
  firm attachment
• Be careful when cleaning nails, vigorous
  cleaning and scraping under the nails may
  break the skin where the nail is attached and
  lead to more psoriasis development
  Nail enhancements

• Can a person with nail psoriasis get nail
  enhancements? (acrylic, gel, etc.)
  – Typically, this should not be a problem
  – Severe nail psoriasis (extremely fragile, crumbling
    nails) may not be good candidates for nail
  – A health care provider’s opinion should be
    considered in these types of cases
  – Proper care of artificial nails is essential to
    prevent damage to underlying nails
Benefits of nail enhancements

Artificial nails are less traumatic to the skin
given the thickness.

Again, make sure if your client has nail psoriasis,
that she has discussed using acrylic nails with her
medical provider.
   Tips for working with clients
   who have psoriasis
• Have a basic knowledge of the disease
• Show compassion and understanding
• Don’t treat them differently from your other
• Don’t offer treatment or medical advice, but
  you can recommend they seek medical care if
  they are not in treatment
• Refer them to the National Psoriasis
  Foundation for more information and support
Clients for life!

If you have a client with psoriasis
 and you provide them with great
 service – chances are they will be
 your client for life!
  Play it safe

• Stay on the safe side: have your client consult
  a health care provider whenever you see signs
  that a health condition exists before working
  on them. Be sure never to diagnose a problem
  and always follow your client’s doctor’s

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