HealthBauer XcelDr Trisha

Ask Dr Trisha: Psoriasis

HealthBauer XcelDr Trisha
Ask Dr Trisha: Psoriasis

Psoriasis can develop at any age but we often think of it as a problem for younger people because the average age of onset is 15-20. However, some people can develop psoriasis for the first time later in life, usually around 55-60.

With this condition, your skin produces cells too fast and they are made and replaced every few days, instead of every few weeks, which causes them to build up and form scales. Doctors aren’t sure exactly what causes psoriasis, but it’s thought to be driven by abnormalities in your immune system.

Symptoms may wax and wane over the years and flare-ups tend to come on more quickly and be less predictable as you get older. Illness, stress, environmental changes, dry skin and some medications could trigger a flare-up. It can be difficult to spot if medication is causing trouble as skin problems may not appear until several weeks after starting a new drug and if you suddenly stop taking a steroid drug it may trigger certain types of psoriasis.

Psoriasis looks like patches of thickened scaly skin or ‘plaques’ and is common over elbows, knees, scalp and the palms or soles of your feet. Some people have just a few small patches while others have extensive, severe scales. The scaly areas may be itchy or burn, and the thickened skin may crack open, with a risk of infection.

Psoriasis often flares up in relation to stress or illness, so the usual advice about sleep, relaxation, a good diet and stress management is a good starting point. Keep your skin well moisturised and ask your doctor or pharmacist to check any medication you may be taking.

Your GP can prescribe various drug treatments to help. In very mild cases, creams such as Vitamin D cream or steroids applied to the skin may control the condition. If these aren’t enough, treatments using ultraviolet light (phototherapy) may help.

If it’s very severe you may be offered tablets and other medicines including drugs which suppress your immune system, such as methotrexate. There is no cure for psoriasis but most people can control it with careful treatment. But this does take time and you may have to change your medication regularly.

Q. At 67 I’ve been told I’ll no longer be called for a cervical screening test – am I no longer at risk of cervical cancer?

Dr Trisha says: If you have reached 65 with normal results on cervical screening tests then the chance of developing cervical cancer in the next couple of decades is extremely small. Currently the NHS do not screen every woman in later life in order to search for the small number who will develop abnormal tests. However, as the risk is not zero and climbs slowly after about 15 years since the last negative screening, there is some debate among researchers that, as life expectancy increases, the age for stopping routine screening should be made later than 65.

If you’ve had an abnormal result in any of the last three tests before reaching 65, or if you’re high risk for any other reason, such as previous cervical cancer, then you may need to be screened past 65.  If you have any abnormal symptoms, such as vaginal bleeding, after the menopause, see your doctor immediately.

  • Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing