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How Can It Be Psoriasis? It Doesn’t Itch!
from Brenda C.

Hi Ed. Am waiting to see a dermatologist but meanwhile my regular doctor has diagnosed my skin problem as psoriasis because I told him my grandfather had it. I have red scaly patches on my elbows and one wrist. They came on pretty fast. I’ve had them for about 8 weeks, now, and have just started applying a prescription cream. My problem with my doctor’s diagnosis is that these patches don’t itch at all. My grandfather’s patches drove him crazy with itching. Couldn’t I have something else? Maybe eczema?

-Brenda C.

*****

Ed’s Response: It probably IS possible that you have some other dermatitis, even eczema, but your doctor probably took that into consideration before diagnosing psoriasis. Unfortunately, the fact that your lesions aren’t itching (right now) isn’t an indicator one way or the other.

For many of us, the worst symptom of our psoriasis isn’t the appearance of the lesions or the flaking; it’s the seemingly constant itch. But for others among us, the lesions simply don’t itch, or don’t always itch. Nobody really understands why this is. If the sensation of itching is, in fact, an immune system response, then it’s not difficult to rationalize why flakers may or may NOT have problems with it. The lesions themselves are a misfiring of immune systems responses. The immune system is behaving in our lesions as though we have sustained an injury to the skin; new cells are being generated up to 14 times faster than normal; the area becomes thick with too many skin cells, inflamed as more blood rushes in to feed all those cells, and flakes form as the uppermost layer of cells is sloughed off. The drive-us-crazy itching might be interpreted as one more “accident” in this litany of immune system malfunctions.

I’ve personally learned that responding to the itch by scratching is always a mistake. It might quiet the itch for a few minutes, but it gives the lesion a reason to exist; it traumatizes the skin and spawns more frantic behavior inside the lesion. If I dare extrapolate, I’d suggest you do everything in your power to ensure your lesions stay itch-free — keep them moist with lotion — and prevent yourself from even casually scratching them.

In the meantime, it won't hurt if your Dr. prescribes for psoriasis for a few months. If it does nothing to help in that time frame, revisit the possibility, with your doctor, that your condition is something else.

Good luck to you, Brenda.  -Ed

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