Hormonal Changes Increase Women's Risk of Psoriasis

Patient Expert

The hormonal changes that come with menopause can trigger lots of changes in the body. While women often expect drier skin, they may not be expecting other skin conditions to develop.

One of those is psoriasis, which is caused by problems with the immune system and can be triggered by a number of factors, including the hormonal changes of menopause as well genetics. Other common triggers for psoriasis include a stressful event, strep throat, smoking, heavy alcohol consumption, certain medications, cold and dry weather, a cut or scratch, or a bad sunburn. While this condition can begin at any age, most people will get psoriasis by the age of 40. However, another common time when psoriasis tends to show up is between the ages of 50-60. Approximately 7.5 million Americans are estimated to have psoriasis, which is caused by overproduction of skin cells.

This condition, which is not contagious, develops when your immune system sends incorrect signals that tell the skin cells to grow in days, instead of weeks. The body doesn't shed these excess cells, thus causing the cells to pile on the surface of the skin and forming patches. Psoriasis differs from eczema in several ways. For instance, psoriasis plaques are well-defined while eczema has less well-defined edges and tends to be flatter. Furthermore, eczema and psoriasis typically occur in different places. Psoriasis is most often identified on the outside of the knees and elbows, the scalp, the lower back, the face, the palms of your hands and the soles of your feet. It also may show up on the fingernails, toenails, genitals and inside the mouth.

About 30 percent of people who have this condition will later develop psoriatic arthritis. People who have severe cases of psoriasis also may be at an increased risk for cardiovascular disease, hypertension, diabetes, depression, cancer, obesity and other conditions related to the immune system, such as Crohn's disease.

There are multiple treatments for psoriasis, including topical treatments, light therapy and medications that are taken orally of by injection. Additionally, researchers have announced that they've developed a new drug, secukinumab, that has shown great promise in two clinical trials.

The first trial involved 738 patients who had psoriasis. Doctors randomly gave secukinumab to two-thirds of the participants.   This group was subdivided with one group receiving 300 milligrams weekly of the medication for five weeks, following by the same dosage given every four weeks thereafter. The other subgroup was given a 150-milligram dosage of the drug for the same time interval. The remaining one-third of the patients received a placebo.   The researchers' analysis found that within 12 weeks, 80 percent of the patients who received the 300-milligram dosage had a 75-percent improvement in their condition. In comparison, one in 20 patients who received the placebo had similar results. Slightly less than 60 percent of participants who received the larger dosage had a 90-percent improvement while almost 30 percent reported that their psoriasis was gone. Furthermore, the researchers found that over 25 percent of the study participants didn't have any signs of psoriasis at the end of the study while more than 50 percent had a 90-percent improvement in their condition.

A second trial involved 1,306 patients. Half of this group received either 300 milligrams or 150 milligrams of secukinumab. About one-fourth of the participants were given Enbrel, currently one of the top treatments for this skin condition. The remaining participants were given a placebo.

In this study, 77 percent of the participants who received the highest dose had a 75-percent improvement in their condition within 12 weeks. Similar strides were seen in 44 percent of people who received Enbrel and five percent of people who took the placebo. Furthermore more than half of the patients who took secukinumab had a 90-percent improvement in their symptoms; only 20 percent of the people taking Enbrel had similar progress. Twenty-five percent of the participants said their psoriasis had been eliminated after taking secukinumab, as compared to one out of 20 participants taking Enbrel. The only side effect reported was increased risk of infection.

While these studies are definitely encouraging, you'll still have to wait to get your hands on it because it's awaiting approval by the U.S. Food and Drug Administration. However, you may want to ask your doctor to prescribe one of the other treatments. Additionally, lifestyle changes may improve skin's appearance and feel, although they won't cure psoriasis. These changes include taking daily baths, using moisturizer, getting small amounts of sunlight, avoiding psoriasis triggers and avoiding alcohol. Additionally, using aloe vera cream or Oregon grape (barberry) cream or consuming fish oil supplements may help.

Primary Sources for This Sharepost:

Allen, P. Y. & Paget, S. A. (2013). Dr. Pat consults: The heartbreak of psoriasis. Women's Voices for Change.org.

Mayo Clinic. (2014). Psoriasis.

MedlinePlus. (2014). New psoriasis drug shows promise in trials.

National Psoriasis Foundation. (ND). Symptoms and diagnosis.

Seaman, B. & Eldridge, L. (2008). The no-nonsense guide to menopause. Simon & Schuster.