Daily Archives: January 29, 2021

Like most drugs, Otezla may cause mild or serious side effects. The lists below describe some of the more common side effects that Otezla may cause. These lists dont include all possible side effects.

Your doctor or pharmacist can tell you more about the potential side effects of Otezla. They can also suggest ways to help reduce side effects.

Heres a short list of some of the mild side effects that Otezla can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Otezlas prescribing information.

Mild side effects of Otezla can include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. If they become bothersome, talk with your doctor or pharmacist.

Serious side effects from Otezla can occur, but they arent common. If you have serious side effects from Otezla, call your doctor right away. If you think youre having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

* For more information about this side effect, see the Side effect focus section below.

You can read below to learn more about some of the side effects Otezla may cause.

You may lose your appetite while youre taking Otezla. You may also lose some weight.

Be sure to tell your doctor if you lose three pounds (1.4 kilograms) or more in 7 days or less. Changes that may occur with weight loss include having:

What might help

While youre taking this drug, your doctor may monitor your weight. They might ask you to check your weight at home.

If you notice that youre losing weight without trying, talk with your doctor. Tell your doctor if your weight loss is happening because of severe nausea, vomiting, or diarrhea.

In some cases, your doctor may have you stop taking Otezla. Dont stop taking Otezla without first talking with your doctor.

To help manage weight loss, your doctor may recommend that you eat plenty of nutritious calories every day. To regain weight that youve lost, try to avoid eating unhealthy empty calories. Instead, choose foods that are high in calories and nutrients. If you have trouble choosing nutritious foods to eat, talk with your doctor.

Some people may have changes in mood or depression while taking Otezla. This may be more common in people whove had depression in the past.

If you have depression or youve had it in the past, let your doctor know before you start taking Otezla.

Be sure to monitor your moods while youre taking Otezla. Talk with your doctor right away if you have any changes in mood, feelings of depression, or suicidal thoughts.

What might help

If youve had depression in the past, your doctor will consider the risks and benefits of prescribing Otezla for you. If the benefits of using Otezla outweigh the risks, your doctor will likely prescribe the drug. Theyll monitor your moods regularly.

Its important to identify depression early. Doing so can help reduce the harmful effects of depression.

If you have depression thats related to using Otezla, your doctor may prescribe counseling or medications to treat the depression. If needed, your doctor may have you stop taking Otezla. Dont stop taking Otezla without first talking with your doctor.

If you think someone is at immediate risk of self-harm or hurting another person:

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

You may have diarrhea while youre taking Otezla. In fact, the most common side effect of Otezla is diarrhea. With diarrhea, you may have more frequent, loose, or watery stools.

Some people may have severe diarrhea while taking Otezla. With severe diarrhea, you can have:

Tell your doctor if you have diarrhea, or any of these other symptoms, during treatment.

You may have a higher risk of complications because of severe diarrhea if you:

What might help

If you have diarrhea while youre taking Otezla, youll need to replace fluid and electrolytes that your body is losing. When you lose fluid and electrolytes through diarrhea, you can get dehydrated. (With dehydration, you have a low fluid level in your body.)

For diarrhea thats not severe, you can rehydrate by drinking diluted fruit juice or electrolyte drinks. Eating foods that are low in fiber may help. Some foods that may help improve diarrhea include:

Certain over-the-counter medications may also help treat diarrhea. Be sure to talk with your doctor before taking any medications with Otezla.

If you have severe diarrhea with Otezla, call your doctor. They may lower your dosage of the drug. If needed, your doctor may even have you stop taking Otezla. Dont stop taking the medication without first talking with your doctor.

Sometimes, for severe diarrhea, you may need intravenous (IV) fluids and electrolytes. (Youll get IV fluids as an injection into your vein thats given over a period of time.)

Some people may be allergic to apremilast or any of the other ingredients in Otezla.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Otezla. If you think youre having a medical emergency, call 911 or your local emergency number.

View original post here:
Otezla: Side Effects, Cost, Uses, What to Consider, and More - Healthline

Introduction

Psoriasis is a chronic, immune-mediated disease that affects the skin and exerts multiple systemic effects.1 Increasing evidence suggests that disturbances within the gut microbial composition, their metabolic products and intestinal permeability may exacerbate pathophysiologic pathways in a number of inflammatory disorders.2,3 An altered gut barrier allows the translocation of luminal contents into the underlying tissues and then into the circulation.4 An increased passage of bacterial components (lipopolysaccharide, DNA, toxins), which are potent pro-inflammatory triggers, results in local and (or) systemic immune response with potential clinical implications.5 Emerging data indicated that such a chronic low-grade inflammation was the hallmark of psoriasis and its related comorbidities, such as obesity, insulin resistance, atherosclerosis and nonalcoholic fatty liver disease.6,7

Gut microbiota profiling in psoriasis confirmed significant alterations in its biodiversity and composition.8 Several studies assessed the intestinal barrier in psoriasis by measuring the plasma concentrations of intestinal fatty acid-binding protein (a marker of enterocyte damage),9,10 zonulin (a protein that specifically and reversibly regulates intestinal permeability),11,12 claudin-3 (a component of tight junctions),13,14 lipopolysaccharide (a bacterial endotoxin)12,15 and bacterial DNA.16,17 However, the results were heterogeneous, with some patients presenting significantly affected intestinal integrity, and others showing a properly functioning gut barrier.

Therefore, the aim of our study was to compare those two groups of patients in order to establish the clinical significance of altered intestinal barrier in psoriasis. The specific objectives were as follows: (a) to determine whether there are differences in disease activity between psoriatic patients with a normal and damaged intestinal barrier, (b) to investigate the presence and severity of gastrointestinal symptoms among psoriatic patients with altered gut integrity, (c) to evaluate the blood concentration of trimethylamine N-oxide (TMAO), a gut microbiota-associated metabolite, depending on the function of the intestinal barrier.

A prospective cohort of 120 patients between 18 and 60 years of age, with chronic plaque psoriasis qualified for systemic treatment or phototherapy, was enrolled in the study between January 2018 and December 2018 in a tertiary referral dermatological center (Department of Dermatology, Medical University of Warsaw, Warsaw, Poland). The exclusion criteria were as follows:

The patients underwent a thorough physical examination, whole blood count, C-reactive protein, lipid profile, liver and kidney function tests. Disease severity was determined with the Psoriasis Area Severity Index score (PASI).

Endoscopy, abdominal ultrasonography, computed tomography, serum or fecal analyses were performed to exclude an organic disease of the gastrointestinal tract, if indicated.

The blood was collected once after an overnight fast. Blood samples were centrifuged at 4000 rpm (1500 g) for 10 min. within 15 min. of sample collection. The plasma was subsequently collected and frozen at 80C to be analyzed later.

Gastrointestinal barrier integrity was assessed via the measurement of serum claudin-3 (CLDN-3) and intestinal fatty acid-binding protein (I-FABP) with the use of the commercially available enzyme-linked immunosorbent assay (ELISA) kits (EIAab, Wuhan, China).9,13,14

Based on biomarker concentrations, the participants were allocated into two groups: with disrupted gut barrier and with properly functioning gut barrier. Patients were considered as having a disrupted gut barrier with CLDN-3 over 49.4 ng/mL and I-FABP over 412.3 pg/mL. Those cut-off values were defined as the mean concentration with two standard deviations and based on the results of healthy subjects published in our previous studies.9,13,14

The blood plasma concentration of TMAO was determined using liquid chromatography coupled with triple-quadrupole mass spectrometry as previously described.36,37 The limit of quantification for TMAO was 20.3 ng/mL.

The occurrence of gastrointestinal symptoms was evaluated with the Gastrointestinal Symptoms Rating Scale (GSRS). The GSRS is a reliable and validated questionnaire that utilizes a seven-level Likert scale (17), depending on the intensity and frequency of symptoms experienced during the previous week. A higher score mainly indicates inconvenient symptoms. Sixteen questions are clustered into five domains: reflux, abdominal pain, indigestion, diarrhea and constipation.38,39 Patients completed the questionnaire before blood collection. By the time of the final analysis, the results of the questionnaire were blinded to the investigators.

All participants gave their written informed consent before entering the study. The study was conducted in accordance with the Helsinki declaration and the protocol approved by the institutional Ethics Committee (Medical University of Warsaw, Warsaw, Poland).

The ShapiroWilk test was used to assess the normality of distribution. The categorical variables were summarized as frequencies and percentages and were compared with a chi-square test. The continuous variables were not normally distributed. Therefore, they were presented as medians with interquartile ranges (IQR). The non-parametric MannWhitney U-test was applied to compare differences between the groups.

All statistical analyses were performed with STATISTICA 13 software (StatSoft, Inc., USA). The p value of <0.05 was considered statistically significant.

One hundred and fifty patients with psoriasis were initially included in the study. According to the exclusion criteria, 24 of them could not participate. The subjects were 20- to 60-year-old (mean age 43.714.1) men (n=87) and women (n=39) with the disease duration ranging from 6 months to 35 years. Based on the adopted cut-off values for CLDN-3 and I-FABP, 68 patients were qualified to the group with an altered intestinal barrier and 46 to the group with a properly functioning intestinal barrier. Twelve patients were excluded due to the inconsistent result of gut integrity biomarkers.

Table 1 describes the anthropometric characteristics, clinical data and laboratory findings of the psoriatic patients with an altered and normal gut barrier. No statistically significant differences were observed for age, sex and BMI between the groups. The patients with psoriasis and an altered intestinal barrier demonstrated a higher disease activity assessed with the PASI score (19.7 [16.721.1] vs 10.3 [6.312.7]; p<0.001). Compared to the patients with a normal barrier, those with altered intestinal integrity also had the higher values of systemic inflammation biomarkers, i.e. neutrophil-to-lymphocyte ratio; NLR (2.86 [2.204.42] vs 1.71 [1.472.04]; p<0.001) and C-reactive protein (CRP) concentration (3.76 [2.355.67] vs 1.92 [0.703.60]; p<0.05).

Table 1 Anthropometric, Clinical and Laboratory Data of Patients with Psoriasis According to Normal and Altered Intestinal Barrier

As for the GSRS scores, both groups showed significant differences (Table 2). The patients with an altered gut barrier had a higher total score in the GSRS (3.20 [2.533.67] vs 1.46 [1.071.67]; p<0.001), as well as in individual values for particular sections.

Table 2 Gastrointestinal Symptom Rating Scale (GSRS) in Patients with Psoriasis According to Normal and Altered Intestinal Barrier

Figure 1 presents TMAO concentration in the serum of psoriatic patients with a normal and altered gut barrier. The latter group had a significantly higher circulating level of this bacterial metabolite (375.751.9 vs 119.427.5 ng/mL; p<0.05).

Figure 1 Plasma concentration of trimethylamine N-Oxide (TMAO) in psoriatic patients with normal and altered gut barrier (*p<0.05).

Several studies previously revealed increased intestinal permeability in patients with psoriasis.12,14 However, the clinical significance of this phenomenon still remains unclear. To our knowledge, it is the first study that evaluates disease activity, self-reported gastrointestinal symptoms and TMAO concentration in patients with psoriasis according to the presence of a normal or altered gut barrier.

We found that psoriatic patients with an altered gut barrier experienced gastrointestinal symptoms much more frequently and intensely. Their results obtained in the GSRS were significantly higher in the total score as well as for individual symptom domains. Gastrointestinal symptoms are quite common among patients with psoriasis. Feldman et al conducted an online-based survey and found that several gastrointestinal signs and symptoms (pain, abdominal bloating, diarrhea, mucus in stool, blood in stool, and unintentional weight loss) were more prevalent in the respondents with moderate-to-severe psoriasis.18 However, literature sources regarding the relationship between gastrointestinal symptoms and increased gut permeability are scarce. So far, gastrointestinal symptoms have been found to be associated with the biomarkers of a disrupted gut barrier in the elderly,19 after intensive exercise20 and in patients with irritable bowel syndrome.21 Impaired gut integrity may facilitate the translocation of luminal content to the inner layers of the intestinal wall and lead to a local immune response. The low-grade inflammation in the intestinal mucosa alters gastrointestinal reflexes and activates the visceral sensory system, subsequently promoting the occurrence of gastrointestinal symptoms.22 Patients with psoriasis and psoriatic arthritis presented the signs of subclinical gut inflammation reflected by an increased fecal calprotectin concentration, without the clinical and endoscopic features of inflammatory bowel diseases.23

A higher disease activity and systemic inflammation are other characteristic features of an altered intestinal barrier in patients with psoriasis. It is unknown whether increased gut permeability is an early event in the pathogenesis of psoriasis or the consequence of the disease. Previous findings indicated a correlation between intestinal integrity biomarkers and the PASI score or an inflammatory state, reflected by an increased CRP concentration and neutrophil-to-lymphocyte ratio.9,13 The loss of barrier function allows the translocation of bacterial antigens into the circulation, where they may contribute to immune activation and act as a trigger of psoriasis exacerbation. The increased blood concentration of lipopolysaccharide, an endotoxin derived from Gram-negative bacterial cell walls and a strong proinflammatory molecule, was confirmed in psoriatic patients.12,15 Cell-free bacterial DNA was also identified in the blood of patients with psoriasis.16,17 Nucleotide sequencing indicates that the detected DNA fragments correspond to the microbiota commonly found in the gastrointestinal tract.

Not only antigens but also bacterial metabolites translocating to the systemic circulation might be crucial in the interactions between gut microbiota, a compromised intestinal barrier, gastrointestinal symptoms and psoriasis activity. Trimethylamine N-oxide is one of the most intensively studied gut-microbiome-derived metabolite in the recent years.24 Dietary L-carnitine, choline and lecithin are metabolized by the intestinal microbiome to trimethylamine (TMA), which is subsequently absorbed and converted into TMAO in the liver by flavin-containing monooxygenase 3.25 An increased circulating TMAO concentration was demonstrated to activate pro-inflammatory signaling pathways and positively correlate with cardiovascular risks.26,27 A high TMAO concentration was linked to several psoriasis comorbidities, i.e. obesity,28 hypertension,29 metabolic syndrome,30 nonalcoholic fatty liver disease31 and insulin resistance.32 Before our study was conducted, TMAO levels had not been assessed in psoriasis, although its concentration correlates significantly with skin and joint involvement in patients with psoriatic arthritis.33 According to some authors, it was not TMAO itself, but rather its precursor TMA which was responsible for the observed disorders and TMAO as the product of oxygenation was a biomarker of the increased intestinal translocation of TMA.34,35

We hypothesize that TMAO or TMA translocation in the presence of an altered intestinal barrier is a potential mechanism linking gut dysbiosis to the immune activation, influence on disease activity and/or the development of psoriasis comorbidities. The modulation of the gut microbiota, the reinforcement of the intestinal barrier or direct TMAO inactivation may thus become an important target in the prevention and treatment of psoriasis.

In the present paper, we demonstrated that an altered gut barrier in psoriasis is associated with gastrointestinal symptoms, systemic inflammatory profile and the increased blood concentration of gut microbiota-derived metabolite TMAO. The findings provide an important basis for future studies to investigate how to optimally modify the gut microbiome and intestinal barrier in order to beneficially influence psoriasis with its comorbidities.

TMAO, trimethylamine N-oxide; PASI, Psoriasis Area Severity Index score; CLDN-3, claudin-3; I-FABP, intestinal fatty acid-binding protein; ELISA, enzyme-linked immunosorbent assay; GSRS, Gastrointestinal Symptoms Rating Scale; IQR, interquartile ranges; BMI, Body Mass Index; NLR, neutrophil-to-lymphocyte ratio; CRP, C-reactive protein; TMA, trimethylamine.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

The authors thank Prof. Robert Gniadecki for his critical comments on the manuscript. The authors would also like to thank AstraZeneca for permission to use Polish adaptation of the Gastrointestinal Symptom Rating Scale.

This research was funded by the Polish Ministry of Science and Higher Education, grant number MNiSW/2020/220/DIR/NN4.

The authors report no conflicts of interest in this work.

1. Korman NJ. Management of psoriasis as a systemic disease: what is the evidence? Br J Dermatol. 2020;182(4):840848. doi:10.1111/bjd.18245

2. Tong Y, Marion T, Schett G, Luo Y, Liu Y. Microbiota and metabolites in rheumatic diseases. Autoimmun Rev. 2020;19(8):102530. doi:10.1016/j.autrev.2020.102530

3. Tajik N, Frech M, Schulz O, et al. Targeting zonulin and intestinal epithelial barrier function to prevent onset of arthritis. Nat Commun. 2020;11(1):1995. doi:10.1038/s41467-020-15831-7

4. Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019;68(8):15161526. doi:10.1136/gutjnl-2019-318427

5. Gomez-Hurtado I, Gallego-Duran R, Zapater P, et al. Bacterial antigen translocation and age as BMI-independent contributing factors on systemic inflammation in NAFLD patients. Liver Int. 2020. doi:10.1111/liv.14571

6. Tilg H, Zmora N, Adolph TE, Elinav E. The intestinal microbiota fuelling metabolic inflammation. Nat Rev Immunol. 2020;20(1):4054. doi:10.1038/s41577-019-0198-4

7. Prussick RB, Miele L. Nonalcoholic fatty liver disease in patients with psoriasis: a consequence of systemic inflammatory burden? Br J Dermatol. 2018;179(1):1629. doi:10.1111/bjd.16239

8. Sikora M, Stec A, Chrabaszcz M, et al. Gut microbiome in psoriasis: an updated review. Pathogens. 2020;9(6):463. doi:10.3390/pathogens9060463

9. Sikora M, Stec A, Chrabaszcz M, et al. Intestinal fatty acid binding protein, a biomarker of intestinal barrier, is associated with severity of psoriasis. J Clin Med. 2019;8(7). doi:10.3390/jcm8071021

10. Stehlikova Z, Kostovcik M, Kostovcikova K, et al. Dysbiosis of skin microbiota in psoriatic patients: co-occurrence of fungal and bacterial communities. Front Microbiol. 2019;10:438. doi:10.3389/fmicb.2019.00438

11. Gerdes S, Osadtschy S, Buhles N, Mrowietz U. Zonulin may not be a marker of autoimmunity in patients with psoriasis. Acta Derm Venereol. 2012;92(2):171172. doi:10.2340/00015555-1208

12. Richetta AG, Grassi S, Moliterni E, et al. Increased intestinal barrier permeability in patients with moderate to severe plaque-type psoriasis. J Dermatol. 2020;47(10). doi:10.1111/1346-8138.15361

13. Sikora M, Chrabaszcz M, Waskiel-Burnat A, Rakowska A, Olszewska M, Rudnicka L. Claudin-3 - a new intestinal integrity marker in patients with psoriasis: association with disease severity. J Eur Acad Dermatol Venereol. 2019;33(10):19071912. doi:10.1111/jdv.15700

14. Sikora M, Chrabaszcz M, Maciejewski C, et al. Intestinal barrier integrity in patients with plaque psoriasis. J Dermatol. 2018;45(12):14681470. doi:10.1111/1346-8138.14647

15. Romani J, Caixas A, Escote X, et al. Lipopolysaccharide-binding protein is increased in patients with psoriasis with metabolic syndrome, and correlates with C-reactive protein. Clin Exp Dermatol. 2013;38(1):8184. doi:10.1111/ced.12007

16. Codoner FM, Ramirez-Bosca A, Climent E, et al. Gut microbial composition in patients with psoriasis. Sci Rep. 2018;8(1):3812. doi:10.1038/s41598-018-22125-y

17. Ramirez-Bosca A, Navarro-Lopez V, Martinez-Andres A, et al. Identification of bacterial DNA in the peripheral blood of patients with active psoriasis. JAMA Dermatol. 2015;151(6):670671. doi:10.1001/jamadermatol.2014.5585

18. Feldman SR, Srivastava B, Abell J, et al. Gastrointestinal signs and symptoms related to inflammatory bowel disease in patients with moderate-to-severe psoriasis. J Drugs Dermatol. 2018;17(12):12981308.

19. Ganda Mall JP, Ostlund-Lagerstrom L, Lindqvist CM, et al. Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress? BMC Geriatr. 2018;18(1):75. doi:10.1186/s12877-018-0767-6

20. Karhu E, Forsgard RA, Alanko L, et al. Exercise and gastrointestinal symptoms: running-induced changes in intestinal permeability and markers of gastrointestinal function in asymptomatic and symptomatic runners. Eur J Appl Physiol. 2017;117(12):25192526. doi:10.1007/s00421-017-3739-1

21. Linsalata M, Riezzo G, DAttoma B, Clemente C, Orlando A, Russo F. Noninvasive biomarkers of gut barrier function identify two subtypes of patients suffering from diarrhoea predominant-IBS: a case-control study. BMC Gastroenterol. 2018;18(1):167. doi:10.1186/s12876-018-0888-6

22. Akiho H, Ihara E, Nakamura K. Low-grade inflammation plays a pivotal role in gastrointestinal dysfunction in irritable bowel syndrome. World J Gastrointest Pathophysiol. 2010;1(3):97105. doi:10.4291/wjgp.v1.i3.97

23. Adarsh MB, Dogra S, Vaiphei K, Vaishnavi C, Sinha SK, Sharma A. Evaluation of subclinical gut inflammation using faecal calprotectin levels and colonic mucosal biopsy in patients with psoriasis and psoriatic arthritis. Br J Dermatol. 2019;181(2):401402. doi:10.1111/bjd.17745

24. Nowinski A, Ufnal M. Trimethylamine N-oxide: a harmful, protective or diagnostic marker in lifestyle diseases? Nutrition. 2018;46:712. doi:10.1016/j.nut.2017.08.001

25. Ufnal M, Zadlo A, Ostaszewski R. TMAO: a small molecule of great expectations. Nutrition. 2015;31(1112):13171323. doi:10.1016/j.nut.2015.05.006

26. Farhangi MA, Vajdi M. Novel findings of the association between gut microbiota-derived metabolite trimethylamine N-oxide and inflammation: results from a systematic review and dose-response meta-analysis. Crit Rev Food Sci Nutr. 2020;60(16):28012823. doi:10.1080/10408398.2020.1770199

27. Yang S, Li X, Yang F, et al. Gut microbiota-dependent marker TMAO in promoting cardiovascular disease: inflammation mechanism, clinical prognostic, and potential as a therapeutic target. Front Pharmacol. 2019;10:1360. doi:10.3389/fphar.2019.01360

28. Dehghan P, Farhangi MA, Nikniaz L, Nikniaz Z, Asghari-Jafarabadi M. Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) potentially increases the risk of obesity in adults: an exploratory systematic review and dose-response meta- analysis. Obes Rev. 2020;21(5):e12993. doi:10.1111/obr.12993

29. Ge X, Zheng L, Zhuang R, et al. The gut microbial metabolite trimethylamine N-oxide and hypertension risk: a systematic review and dose-response meta-analysis. Adv Nutr. 2020;11(1):6676. doi:10.1093/advances/nmz064

30. Papandreou C, More M, Bellamine A. Trimethylamine N-oxide in relation to cardiometabolic healthcause or effect? Nutrients. 2020;12(5):1330. doi:10.3390/nu12051330

31. Leon-Mimila P, Villamil-Ramirez H, Li XS, et al. Trimethylamine N-oxide levels are associated with NASH in obese subjects with type 2 diabetes. Diabetes Metab. 2020. doi:10.1016/j.diabet.2020.07.010

32. Roy S, Yuzefpolskaya M, Nandakumar R, Colombo PC, Demmer RT, Hu C. Plasma trimethylamine-N-oxide and impaired glucose regulation: results from the Oral Infections, Glucose Intolerance and Insulin Resistance Study (ORIGINS). PLoS One. 2020;15(1):e0227482. doi:10.1371/journal.pone.0227482

33. Coras R, Kavanaugh A, Boyd T, et al. Choline metabolite, trimethylamine N-oxide (TMAO), is associated with inflammation in psoriatic arthritis. Clin Exp Rheumatol. 2019;37(3):481484.

34. Jaworska K, Bielinska K, Gawrys-Kopczynska M, Ufnal M. TMA (trimethylamine), but not its oxide TMAO (trimethylamine-oxide), exerts haemodynamic effects: implications for interpretation of cardiovascular actions of gut microbiome. Cardiovasc Res. 2019;115(14):19481949. doi:10.1093/cvr/cvz231

35. Jaworska K, Hering D, Mosieniak G, et al. TMA, A forgotten uremic toxin, but not TMAO, is involved in cardiovascular pathology. Toxins (Basel). 2019;11(9):490. doi:10.3390/toxins11090490

36. Ufnal M, Jazwiec R, Dadlez M, Drapala A, Sikora M, Skrzypecki J. Trimethylamine-N-oxide: a carnitine-derived metabolite that prolongs the hypertensive effect of angiotensin II in rats. Can J Cardiol. 2014;30(12):17001705. doi:10.1016/j.cjca.2014.09.010

37. Wolyniec W, Kasprowicz K, Giebultowicz G, et al. Changes in water soluble uremic toxins and urinary acute kidney injury biomarkers after 10- and 100-km runs. Int J Environ Res Public Health. 2019;16(21):4153. doi:10.3390/ijerph16214153

38. Kulich KR, Regula J, Stasiewicz J, et al. Psychometric validation of the polish translation of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in patients with reflux disease. Pol Arch Med Wewn. 2005;113(3):241249.

39. Kulich KR, Madisch A, Pacini F, et al. Reliability and validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: a six-country study. Health Qual Life Outcomes. 2008;6(1):12. doi:10.1186/1477-7525-6-12

Link:
[Full text] Clinical Implications of Intestinal Barrier Damage in Psoriasis | JIR - Dove Medical Press

Psoriasis is often perceived as just a skin problem by many.

This chronic condition, which causes red, flaky and crusty patches covered with silvery scales on the skin, is usually considered a cosmetic or aesthetic issue.

However, consultant dermatologist Dr Chng Chin Chwen says: It can be disfiguring and disabling.

Even if it is just on the skin, for some people, it can affect their palms and soles.

If this is severe and the skin cracks, it can affect how a person walks and works, especially for those people who need to work with their hands, e.g. bakers and nurses.

She notes that for patients whose nails are significantly affected, it can even affect their ability to pick up things as their nails can be too painful to do so.

And not to mention that psoriasis can also affect the genitals of a patient you can imagine how this can affect a male patient in their marriage and their social life, she adds.

While some psoriasis patches cause no additional sensation or feeling, some can be very itchy, and even painful as mentioned above.

Some patients may also bleed easily after scratching their affected skin.

This, in addition to the constant shedding of skin flakes with uncontrolled or untreated psoriasis, can cause the patient embarrassment and might lead to stigmatisation.

Other than skin

Present at the official launch of Tremfya was (from left) Janssen senior product manager Seri Naga Leong, Dr Chin Chwen, Dr Peter and Janssen marketing head Sophia Lim.

Consultant dermatologist Dr Peter Chng points out that psoriasis is a systemic, immune-mediated, inflammatory disease.

This means that we know it is due to our immune system and it causes inflammation.

It predominantly affects the skin and joints, he says.

Psoriasis in the joints known as psoriatic arthritis can occur before skin symptoms for some patients.

Dr Chin Chwen shares: There is an old study done in 1987, which shows that one in five patients with psoriatic arthritis will have significant deformity affecting their daily function.

And if you follow up patients for 10 years, more than half of them will have five or more deformed joints.

In addition, psoriasis is associated with abdominal obesity, high cholesterol and triglyceride levels, high blood pressure, diabetes, inflammatory bowel disease (especially ulcerative colitis), cancer and venous thromboembolism, as well as lung and kidney disease.

As some of these conditions are risk factors for heart disease and stroke, this means that psoriasis patients are also at higher risk for these two conditions.

Mental health is another aspect that can be significantly impacted, potentially affecting a persons social and working or schooling life.

The visibility of the condition and public ignorance can combine to create stigmatisation of the patient.

This can in turn lead to depression, social isolation, and even suicidal tendencies, as well as seriously impacting on the patients career or studies.

The stigmatisation, the loss of work, and also schooling etc, will affect the patients heath significantly, notes Dr Chin Chwen.

Diagnosed by sight

Psoriasis is often diagnosed by examination alone.

It is actually based on, number one, appearance; number two, distribution, which means which part of the skin is involved; and also, a lot of the time, progression we need to ask the patient what the skin looked like before and after, and even better if there are photos, she explains.

Psoriasis can appear anywhere on the body, although it commonly affects the scalp, ears, elbows, knees, umbilicus, back and areas of friction like the waist where a belt rests against.

It can be classified into a number of types according to appearance.

The most common types include plaque psoriasis, which appears as thick scaly patches on the skin; erythrodemic psoriasis, which can cover up to 90% of the body in red patches; pustular psoriasis, where the affected areas are covered with pus-filled blisters or pustules; and guttate psoriasis, which appears as multiple teardrop-shaped patches.

The problem is, patients arent confined to one type of psoriasis, says Dr Chin Chwen, adding that psoriasis can change from one type to another over time.

While psoriasis can occur at any age, it typically manifests in adulthood.

Sometimes, the symptoms are triggered by a particular incident, such as stress, trauma, an infection, or overindulgence in alcohol or tobacco.

Guttate psoriasis, for example, typically occurs after an episode of streptococcal throat infection.

She adds: There are many environmental factors that can worsen psoriasis, e.g. trauma sometimes patients can have a fall and then they will develop psoriasis plaques on the site of trauma.

It is not uncommon for a patient to go for surgery and subsequently develop psoriasis plaques on the site of surgery.

Any form of stress, whether it is mental or physical, can trigger the onset of psoriasis.

She notes that while psoriasis is gene-related, the method of inheritance is complex with multiple genes involved.

The (method of) inheritance is not completely understood up to today, as every now and then, scientists discover a new gene that is associated with psoriasis.

Lifestyle and medication

While there is no cure for psoriasis, it can be controlled.Chin notes that the PsO Much More campaign is aimed at helping psoriatis patients realise they can effectively manage their disease with lasting efficacy, thus regaining their self-esteem and leading quality lives.

According to Dr Chin Chwen, the first priority is to live healthily.

Generally, a healthy lifestyle helps to control the psoriasis better.

Stop smoking; reduce or even stop alcohol; eat a better diet; do regular exercise; manage the weight, especially for those who are overweight; and wherever possible, try various methods whether its music or yoga or whatever to reduce stress.

And of course, see your dermatologist, discuss your problems and take the recommended treatments, she says.

She notes that treatment is usually tailored to each patient based on their condition and circumstances.

Individualised treatment is very important.

So we will actually treat each person based on the severity of the disease, the type of psoriasis, when the patient presented, their general health status whether the patient has diabetes, high blood pressure, etc and of course, how much the psoriasis burdens a person, she says.

She notes that: Psoriasis can burden everyone differently.

For example, a person who needs to go out, socialise and meet clients in their workplace, psoriasis involving their hand is important to them, because they have to take it out to shake hands.

For an influencer or celebrity, even a small psoriasis plaque on the face or a visible area will impact the person very much, because it will affect their work.

Treatment for psoriasis consists of topical agents, phototherapy and systemic treatments.

Topical agents are creams, ointments, soaps and shampoos, which are all applied directly onto the psoriasis patches.

According to Dr Chin Chwen, these include tar, steroids, acids, calcipotriol (vitamin D) and calcineurin inhibitors.

Meanwhile, phototherapy utilises UVA (ultraviolet A) and UVB (ultraviolet B) light, and is usually administered two to three times a week.

For systemic therapy, she shares that there are standard immunosuppressants such as methotrexate, acitretin and cyclosporine, which are given to patients with severe disease; small molecules, which are not yet available in Malaysia; and biologics.

A targeted approach

Biologics are medicines made from whole or parts of living organisms, which target a specific part of the immune system.

There are just under a dozen biologics on the market for the treatment of psoriasis, with the majority available in Malaysia.

One of the latest to be introduced here is the monoclonal antibody Tremfya, also known by its generic name guselkumab.

Tremfya is the first biologic to target and block interleukin-23 (IL-23), and is approved for use in adult patients with moderate to severe plaque psoriasis.

IL-23 is a cytokine a small protein involved in cell signalling that is involved in inflammation (to help fight invading microorganisms) and the formation of blood vessels.

Dr Peter explains that our immune system is like an army, with IL-23 being one of the messenger soldiers.

In psoriasis, he says: This IL-23 goes crazy when theres nothing and its very peaceful, it suddenly goes and tells the general that there are enemies coming and that the army needs to fight.

So the general will start asking all the soldiers to get ready and start to fight, causing a lot of inflammation.

Thus, blocking this messenger soldier will help decrease unnecessary inflammation in the body that results in psoriatic symptoms.

He notes that a number of studies have already been done on the effectiveness of Tremfya.

One study known as Voyage 1, looked at the Psoriasis Area and Severity Index (Pasi).

The results showed that 84.3% of participants had a Pasi score of 90 for up to about four years.

This means that over four out of five patients in the phase 3 clinical trial had 90% of their psoriatic patches cleared after taking the biologic.

And this was maintained for about four years with regular administration of the injectable drug.

In fact, 57.1% of patients had a Pasi score of 100, meaning that they were totally cleared of their symptoms up to four years after they first started taking the biologic.

However, Dr Peter notes that Tremfya is not a cure for psoriasis as IL-23 is only one soldier.

We know that you can capture one, but after some time, there may be another crazy soldier, so you have to continuously capture all these problematic soldiers, he says.

He adds that Tremfya has a good safety profile, especially when it comes to opportunistic diseases like tuberculosis that were a concern with older psoriasis biologics.

And one advantage to the targeted approach is that our immune system as a whole is still functional.

Which means that if a real enemy comes, you can still fight the enemy, the infection, he says.

Another advantage to Tremfya, he points out, is that it only needs to be injected once every eight weeks.

Like other recent biologics, it can also be self-administered.

As biologics are generally the most expensive of all psoriasis treatments, Johnson & Johnson Malaysia has a patient access programme to help make Tremfya more accessible to psoriasis patients.

Patients can utilise the programme via their dermatologist.

The company, which owns Janssen Pharmaceuticals that produces the biologic, has also launched the Pso Much More patient awareness programme.

Says Johnson & Johnson Malaysia managing director Chin Keat Chyuan: Through this programme, we seek to help patients better understand their medical condition and know how they may effectively manage it with clinically-proven treatment options.

The awareness programme is themed PsO Much More because psoriasis is so much more than a skin disease.

It also affects patients wellbeing from a social and psychological aspect, which is beyond skin deep.

Both Dr Chin Chwen and Dr Peter were speaking to the media at the virtual launch of Tremfya in Malaysia.

Original post:
Psoriasis Is More Than Skin Deep - The Star Online

Keep your skin moisturized throughout the day to help prevent a post-workout psoriasis flare-up.

Image Credit: FreshSplash/E+/GettyImages

Working up a good sweat during an intense bout of exercise can feel cleansing and invigorating. But if you're living with psoriasis, that post-workout endorphin rush can be overshadowed by an uncomfortable flare-up.

While you'll want to follow the specific recommendations of your doctor, you probably shouldn't cut exercise out of your day-to-day routine. After all, regular workouts can bust stress and keep your weight in check, both of which may help control psoriasis. Indeed, an October 2018 review in Cureus recommends exercise as an adjunct treatment for the skin condition.

To combat exercise-related psoriasis irritation, stick to a post-workout routine that can help soothe your sensitive skin.

How Exercise Affects Psoriasis

Generally, psoriasis shows up as dry, red patches on the skin that may itch, burn or hurt, according to Harvard Health Publishing. Like many other skin conditions, though, the severity of psoriasis varies from person to person.

It can also show up nearly anywhere on the body, including the torso, arms, legs, elbows, knees and even nails, depending on the type of psoriasis you have.

As a result, the type of exercise you do can be more or less painful for your skin, depending on where your psoriasis is located on your body, Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, tells LIVESTRONG.com.

For instance, the chlorine in a pool can dry your skin, making it more prone to flare-ups, while running or jogging can cause your skin to rub together, causing chaffing and inflammation, particularly on your inner thighs and underarms, Dr. Zeichner says.

"When you exercise, blood vessels dilate, allowing for greater circulation of oxygen and nutrients to your muscles and skin," he says. "This may lead to redness of the skin and, in some cases, can make psoriasis more itchy."

However, that doesn't mean people with psoriasis should skip their favorite swimming or running workouts. Actually, vigorous exercise might actually help reduce the risk of psoriasis, according to an August 2012 study in JAMA Dermatology.The thinking is that people who exercise this way have less overall inflammation.

So, how can you counteract the drying effects of some workouts? The answer lies in a diligent post-workout skincare routine. Follow these three steps after each sweat session to help soothe your psoriasis flare-ups.

Your 3-Step Post-Workout Routine to Manage Psoriasis Flares

Step 1: Take a Warm Shower, and Keep It Brief

Showering too often can cause skin dryness. But if you exercise every day, that's kind of inevitable, right? Luckily, there are a few shower guidelines you can follow to help prevent your psoriasis from feeling painful, itchy or dry.

While you may love a super-hot shower after a grueling workout, keep the water lukewarm, Dr. Zeichner says. Keeping steam in the bathroom will help prevent dryness, too, so keep your bathroom door closed and avoid using a fan, recommends the American Academy of Dermatology (AAD). Also, limit your shower to five or 10 minutes.

Afterward, avoid rubbing your skin dry with your towel, Dr. Zeichner says. Instead, pat or blot your skin gently with a clean towel to avoid extra friction on your skin, especially in the areas you may have itchy or painful psoriasis patches.

Step 2: Use a Gentle Body Wash

While you're in the shower, avoid harsh cleansers, soaps or body wash products, Dr. Zeichner says. If you have any doctor- or dermatologist-recommended products, you'll definitely want to use those on your psoriasis.

If not, choose cleansers that don't dry your skin. Avoid ingredients like alcohol, alpha-hydroxy acid (AHA), retinoids and fragrance, per the AAD. These ingredients can dry out your skin's natural oils, causing more itchiness, redness or a burning feeling.

"Make sure to use a gentle, hydrating cleanser that won't strip the skin or disrupt the outer skin layer," Dr. Zeichner says.

When searching for a cleanser, look for products that have the National Psoriasis Foundation's Seal of Recognition. These cleansers have been tested and are safe to use on psoriasis.

Step 3: Apply a Hydrating Moisturizer ASAP

Once you've stepped out of the shower and dried off, apply a hydrating moisturizer on your psoriasis (and whole body, if you'd like) within five minutes post-shower, Dr. Zeichner says. This will help lock in hydration and prevent dryness.

Avoid moisturizers with fragrance or other harsh ingredients, like those noted above for body wash. Prioritize products your dermatologist or doctor recommends, then supplement with psoriasis-friendly products at your local drug store if you wish.

Look for lotions or creams that help prevent itching and repair skin, recommends the National Psoriasis Foundation. Some brands even make psoriasis-specific moisturizers that are free of harmful or harsh ingredients.

Read more:
How to Treat and Prevent a Post-Workout Psoriasis Flare-Up - LIVESTRONG.COM

What is light therapy?

Pills, creams, and invasive treatments arent the only answer to health problems. Whether youre dealing with depression or skin disorders, migraines or other chronic pain, sometimes you just need to turn to the light. Depending on the condition, there may be something along the colorful spectrum of light therapy to alleviate your symptoms and give you relief.

As anyone whos ever used a prism or looked at a rainbow knows, white light isnt really white at allits all colors of the rainbow, from red to violet. Each color is determined by the wavelength of the light, and there are even some wavelengths that arent visible to the human eye.

Some wavelengths can be damaging to human healthlike ultraviolet (UV) waves, which can harm your skin and eyeswhile others may actually be good for your health.

For example, green light therapya type of LED, or light emitting diode therapy, that doesnt contain UV raysis thought to help migraine and other chronic pain. Blue light therapy can be prescribed for acne. Red light is thought to help rejuvenate skin by minimizing wrinkles, fine lines, and other signs of aging.

Dermatologists treat skin conditions like psoriasis, eczema, and rosacea with different types of light. And light without harmful UV rays can be used to help treat seasonal depression.

Heres a look at the types of light therapy and what the science says about how they work.

When winter sets in and the days get shorter, it can feel as if someones turned the lights out on your happiness. Just convincing yourself to go out, talk to your friends, or take care of yourself in ways that would benefit your well-being can be a challenge.

If this sounds like you, its possible you might find reliefand a new energy for the seasonwith light therapy for depression.

Light therapy involves the use of light, either from sunlight or an artificial UV light source, such as a light box or therapy lamp. (Here are the 10 best light therapy lamps on Amazon.)

Also known as light treatment, phototherapy, or heliotherapy, light therapy is often used in the treatment of seasonal affective disorder (SAD). If your mood and behavior change significantly with the change in seasons, you may have SAD. A type of depression, it most often strikes in the late fall or early winter, and then lifts again with the arrival of spring. It can also happen in the reverse pattern, with depression in the summertime.

You may suspect you have winter SAD if, in addition to depression symptomslike low energy, loss of interest in activities, and feelings of hopelessness or worthlessnessyou also begin to oversleep, overeat, gain weight, and avoid social situations. Experts believe that winter SAD is brought on, in part, by reduced exposure to natural light as the days grow shorter, which may affect mood-regulating neurotransmitters like serotonin.

About one in 20 Americans get depressed in winter, says Michael Terman, PhD, professor of psychiatry at Columbia University in New York City and president of the Center for Environmental Therapeutics. Another three [in 20] feel lousy in winter but not at clinical severity. And many more feel symptoms associated with SAD, like overeating with significant weight gainwithout any decline in mood.

During light therapy, youre exposed to a bright light box daily for 30 to 45 minutes in the morning starting in the fall and continuing into the spring.

There is a wealth of research showing that people with SAD feel better with light therapy. In fact, this is the first-line treatment for SAD. Thats because light stimulates nerve fibers along the optic nerve (located in the back of your eye) and activates a particular part of your brain called the lateral habenula, which directly elicits mood elevation, says Terman.

Terman says that theyve seen rapid results in patients.

If the timing and dosing are correct from the start and do not require adjustment, we have seen relief from deep depression in just a couple of days, and most often within a week, he says. That is far quicker than antidepressant medication, which can take weeks or months to show similar results.

Light therapy might also treat non-seasonal depression. Terman points to a randomized, placebo-controlled clinical trial, published in JAMA Psychiatry in 2016. The study compared light therapy for 30 minutes per day in the early morning plus a placebo pill; fluoxetine (Prozac), an SSRI antidepressant alone; a combination of the two; or a placebo in the treatment of major depressive disorder.

Light therapy outperformed the drug by a mile, says Terman. The drug did no better than an inactive placebo. However, when the light was combined with the drug, the improvement in depression was greatest of all.

There is also evidence that bright white light therapy can help treat bipolar depression, according to a randomized double-blind placebo-controlled trial, published in 2017 in The American Journal of Psychiatry. Researchers found that nearly 70 percent who were treated with bright white light for four to six weeks experienced remission in symptoms, a reality for just 22 percent of the placebo light group. The bright light group also had lower depression scores compared to the placebo.

In addition, light therapy is also tapped to treat circadian rhythm disorders. Thats when your sleep-wake cycle is out of sync with your environment. For instance, you might go to sleep at an extremely late hour or wake up at an unusually early time. And, as a result, your daily functioning is affected.

Circadian rhythm disorders are partially treated with light exposure in the morning or at night to shift your clock, notes Lawrence Jay Epstein, MD, clinical director of the division of sleep and circadian disorders at Brigham and Womens Hospital in Boston.

The most potent form of light is sunlight, but if you need to deliver light at times when the sun is not available, then you can use a light box, he says.

Its possible to do light therapy at home, as long as you follow the rules for timing, dosing, and light box design, says Terman. There are so many products on the market, but not all will be effective. The Center for Environmental Therapeutics, which provides light box selection guidelines, suggests looking for the following: a high dosage (10,000 lux) that remains effective at a comfortable seating distance (so you dont have to put your face extremely close to the device); transparency on product specifications; and a polycarbonate UV filter, to protect eyes and skin.

A miniature light box is unlikely to be effective. These devices have not been clinically tested, says Terman.

Light therapy is not regulated by a medical society or federal standards, he adds. So unfortunately, anything goes.

The Center for Environmental Therapeutics also recommends placing the box directly in front of you and making sure the light is coming from above eye level to limit glare. The center also advises reading or eating breakfast when using the light box, which helps you keep your eyes open enough to make treatment effective.

The risks of bright light therapy include skin and eye damage. If you have preexisting medical conditions of your eyes and skin (such as diabetic retinopathy) or are taking certain photosensitizing medications, you should talk to your doctor before using light therapy.

In order to make sure that youre doing light therapy correctlywith the right dose, at the right timeits best to talk to your physician first rather than trying to determine this for yourself. You also dont want to stop medication youre currently taking to treat depression. Ask your doctor about how light therapy might fit in with your current treatment plan.

Sometimes topical creams arent enough to heal stubborn acne. Blue light therapy may be able to kill several types of common bacteria responsible for causing acne. The blue light wavelength also can slow down oil production in the sebaceous glands. Oil plugs the hair follicles, which can cause acne.

In one study published in the Journal of Drugs in Dermatology, 33 people with mild to moderate acne received blue light therapy treatment twice a day for eight weeks. They also used a cleanser before treatments and a serum each evening. More than 90 percent of participants reported improvements in their skins appearance, clarity, tone, texture, and smoothness after treatment.

Another study in the journal Drug Resistance Updates found that 77 percent of people with acne who had five weeks of blue light therapy treatment saw improvements in their skin.

Rarely is light therapy the only thing youll need to clear acne however, according to the American Academy of Dermatology (AAD). It usually works best along with a topical cream or some other treatment. Youll usually need several applications to see results.

Side effects can include temporary redness and swelling, stinging and burning. Long-term pain, blistering, and scarring is rare, but possible.

Blue light therapy typically isnt helpful for blackheads, whiteheads, acne cysts, or nodules, according to the AAD.

Red light therapy can be used on its own or in conjunction with blue light to treat acne, according to the AAD. Its not as common, however, as blue light as a solo therapy for acne.

Red light is believed to act on skin cells called fibroblasts, which help produce collagen. Collagen is the supportive protein structure in the skin that plays a role in aging.

Because of this connection, red light therapy is sometimes used in an attempt to rejuvenate skin. It can target wrinkles, fine lines, roughness, and other signs of aging.

In a study published in the Journal of Photochemistry and Photobiology B: Biology, people with facial wrinkles received varying wavelengths of red light therapy or no treatment twice a week for four weeks. Those who received red light therapy had improved measures of elasticity and fewer visible wrinkles.

In another study, published in Photomedicine and Laser Surgery, people receiving red light therapy had visible changes in wrinkles and skin roughness.

Red light therapy can also cause temporary redness, swelling, and burning. Long-term pain and scarring is also possible, but rare.

Green light therapy shows some promise for easing the pain of migraines and some chronic conditions.

In a small study published in Cephalgia in 2020, researchers recruited 29 patients with chronic or episodic migraines and exposed them to white light for two hours daily for 10 weeks as a control. After a two-week break, they exposed them to two hours of green light daily for 10 weeks.

During green light therapy, episodic migraines decreased from 7.9 to 2.4 headaches monthly and chronic migraines from 22.3 to 9.4 headache days each month.

But its not just headaches. In another study, published in Pain Medicine in 2020, 21 adults with fibromyalgia were exposed to white light daily for 10 weeks, then exposed to green light therapy. Fibromyalgia is a condition characterized by overall pain, fatigue, and sleep issues. During green light treatment, patients reported a significant reduction in pain intensity.

Studies in rats found that exposing the animals to green light seemed to decrease their levels of pain, according to a study in a 2017 issue of Pain. Researchers discovered that enkephalinsa molecule that acts as a natural pain reliever in the bodyincreased by three times in the rats when exposed to green light.

Rosacea is an inflammatory skin condition characterized by facial redness. Doctors sometimes suggest light therapy for rosacea to help ease some of the symptoms. Targeted light therapy decreases inflammation on a cellular level by promoting healing.

According to the AAD, light therapy may be an option, especially if you have visible blood vessels. Most patients see a 50 percent to 75 percent decrease in visible blood vessels after one to three treatments. Results typically last three to five years.

Theres typically redness or a rash immediately after treatment that usually fades within two weeks. You may also have pain, itching, or tightness during treatment.

In a study, published in 2020 in the journal Lasers in Surgery and Medicine, people with rosacea who had facial redness were given a form of light therapy and/or a prescription cream. Those who were treated with both the light therapy and the cream saw the greatest improvement in their redness.

Light therapy may not be as effective if your rosacea symptoms are primarily pimples or pustules (papulopustular rosacea), thickening of the skin (phymatous rosacea), or a bulbous growth around the nose (rhinophyma).

There are different types of laser therapy for rosacea including pulsed dye lasers and intense pulsed light (IPL) therapy, which use several colors of light at once.

Different wavelengths of UV light may be a treatment for eczema and psoriasis. Eczema is an umbrella term for a group of skin conditions noted for itchiness, redness, and rashes. Psoriasis is a common skin condition that causes scales and itchy, dry patches.

Phototherapy uses different wavelengths of UV light targeted to treat itchiness and redness and other symptoms. Because UV rays can be harmful to skin, its important that you follow a short-term treatment plan under the care of a health care professional.

For eczema, dermatologists most commonly will use narrowband ultraviolet B (NB-UVB) light, according to the National Eczema Association. Other options may include ultraviolet A (UVA) light.

Researchers arent sure exactly how UV therapy works but it reduces inflammation in the skin, having an impact on the immune system, reports the National Eczema Society. To have an effect, it takes several weeks of treatments at least 2-3 times per week to show an improvement. Once your skin is nearly clear and/or itching has stopped, your dermatologist will reduce the frequency of treatments gradually.

Phototherapy is used with adults or children who have moderate to severe eczema that isnt responding to standard treatments like steroids and topical creams. Side effects may include temporary redness and dryness. Long-term use can result in accelerated aging and an increased risk of skin cancer and cataracts.

UV light therapy can be prescribed by dermatologists for psoriasis to slow skin cell growth, reduce inflammation, ease itching, and suppress immune system activity, according to the AAD. The excimer laser, which offers narrowband UVB light, has been approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques, reports the National Psoriasis Foundation. It may be safely used on many parts of the body including elbows, knees, scalp, ears, armpits, and the groin.

Phototherapy is typically given 2-3 times a week for several weeks in order to be effective. UV therapy is most often prescribed for mild to moderate psoriasis and has been found to be particularly effective for scalp psoriasis.

It can cause short-term redness, burning, and itching. Long-term use can lead to aging, cancer, and freckles.

Here are stories of people who used light therapy to treat a variety of conditions:

Avoid Seasonal Affective Disorder

Signs of Seasonal Affective Disorder

I Used a Light Therapy Lamp

The post What Is Light Therapy? How Light Can Heal a Variety of Health Problems appeared first on The Healthy.

Go here to see the original:
What Is Light Therapy? How Light Can Heal a Variety of Health Problems - AOL