1 00:00:01,840 --> 00:00:07,720 Speaker 1: Welcome to Brainstuff, a production of iHeartRadio. Hey brain Stuff, 2 00:00:07,800 --> 00:00:12,360 Speaker 1: Lauren Vogelbaum here. You may have heard that your body 3 00:00:12,400 --> 00:00:16,000 Speaker 1: replaces and replenishes all of its cells every seven years. 4 00:00:17,079 --> 00:00:21,440 Speaker 1: This isn't quite true. It's catchy, but our bodies are complicated, 5 00:00:21,760 --> 00:00:24,960 Speaker 1: and your rate of cellular renewal depends person to person 6 00:00:25,079 --> 00:00:29,320 Speaker 1: and organ to organ. Your skeletal cells might change out 7 00:00:29,320 --> 00:00:32,040 Speaker 1: every ten to fifteen years or so. Some of the 8 00:00:32,080 --> 00:00:34,239 Speaker 1: cells in your brain and heart will stay with you 9 00:00:34,280 --> 00:00:38,000 Speaker 1: for your entire life. On the flip side, the cells 10 00:00:38,000 --> 00:00:40,879 Speaker 1: in your liver get replaced every three years, and the 11 00:00:40,920 --> 00:00:44,400 Speaker 1: ones in your gut turnover within a few months. But 12 00:00:44,520 --> 00:00:48,280 Speaker 1: if it were a race, your skin would win. Under 13 00:00:48,280 --> 00:00:52,160 Speaker 1: normal conditions, the cells in your epidermis, your skin's outermost layer, 14 00:00:52,479 --> 00:00:56,920 Speaker 1: replace themselves in just four weeks. That's because the outer 15 00:00:57,000 --> 00:00:59,720 Speaker 1: layer of the epidermis is actually made up of tough, 16 00:00:59,760 --> 00:01:03,400 Speaker 1: dead cells that help protect us from germs and rough 17 00:01:03,400 --> 00:01:07,360 Speaker 1: surfaces and everything else in the world around us. We're 18 00:01:07,440 --> 00:01:10,679 Speaker 1: constantly sloughing off the old ones as they wear out. 19 00:01:11,080 --> 00:01:14,440 Speaker 1: We shed some forty thousand dead skin cells every minute. 20 00:01:15,360 --> 00:01:17,360 Speaker 1: That adds up to about one and a half pounds 21 00:01:17,360 --> 00:01:22,280 Speaker 1: of skin around seven hundred grams shed every year, but 22 00:01:22,520 --> 00:01:27,759 Speaker 1: that's assuming that everything is working properly. Sometimes, for reasons 23 00:01:27,760 --> 00:01:31,839 Speaker 1: that we don't entirely understand, your skin can go into overdrive. 24 00:01:33,080 --> 00:01:36,360 Speaker 1: In a condition called psoriasis, your skin tries to replace 25 00:01:36,360 --> 00:01:41,240 Speaker 1: its outermost layer every four days or so. This leads 26 00:01:41,240 --> 00:01:44,280 Speaker 1: to a build up of skin cells that can cause discolored, 27 00:01:44,440 --> 00:01:48,160 Speaker 1: uncomfortable patches on your skin that are annoying at best. 28 00:01:48,920 --> 00:01:52,480 Speaker 1: It's caused by your immune system being way overactive. So 29 00:01:52,680 --> 00:01:57,400 Speaker 1: it's not contagious, but there's no cure, not yet anyway. 30 00:01:58,680 --> 00:02:01,640 Speaker 1: But what's going on here? How could a process that's 31 00:02:01,640 --> 00:02:04,480 Speaker 1: supposed to be good, the maintenance of our body's first 32 00:02:04,560 --> 00:02:09,120 Speaker 1: line of defense turn against us today? Let's talk about 33 00:02:09,160 --> 00:02:14,320 Speaker 1: what we know and don't know about psoriasis. First off, 34 00:02:14,639 --> 00:02:18,640 Speaker 1: not allsrisis looks the same. The symptoms and their severity 35 00:02:18,760 --> 00:02:21,839 Speaker 1: can really differ, and they come and go over time 36 00:02:21,960 --> 00:02:27,560 Speaker 1: in flares. Very basically, soriasis usually manifests as patches of 37 00:02:27,600 --> 00:02:32,320 Speaker 1: irritated skin that are tender, itchy, or even painful. The 38 00:02:32,360 --> 00:02:35,840 Speaker 1: patches are often reddish or purplish in color, sometimes with 39 00:02:35,960 --> 00:02:39,519 Speaker 1: scales or flakes coming off. They could occurb anywhere on 40 00:02:39,560 --> 00:02:42,520 Speaker 1: the body, though they're most common around the elbows and knees, 41 00:02:42,680 --> 00:02:45,800 Speaker 1: hands and feet, around the torso and scalp, and anywhere 42 00:02:45,800 --> 00:02:49,880 Speaker 1: the skin folds, like under the arms. The finger and 43 00:02:49,919 --> 00:02:53,799 Speaker 1: toenails can also be effected, showing pitting, discoloration, or other 44 00:02:53,840 --> 00:02:58,600 Speaker 1: deformation of the nail, along with pain or tenderness. Psorisis 45 00:02:58,680 --> 00:03:02,359 Speaker 1: can pop up in anyone at any age. People usually 46 00:03:02,360 --> 00:03:04,520 Speaker 1: see their first flare between the ages of fifteen to 47 00:03:04,560 --> 00:03:08,600 Speaker 1: twenty five, but it can happen earlier or later. We 48 00:03:08,639 --> 00:03:11,040 Speaker 1: know that genetics has something to do with it. You're 49 00:03:11,080 --> 00:03:13,720 Speaker 1: more likely to develop psoriasis if someone in your family 50 00:03:13,800 --> 00:03:18,000 Speaker 1: has it. Researchers are investigating a number of associated genes 51 00:03:18,040 --> 00:03:21,760 Speaker 1: but haven't really pinned any down yet. About a tenth 52 00:03:21,800 --> 00:03:26,040 Speaker 1: of the population may be genetically predisposed to psoriasis, but 53 00:03:26,120 --> 00:03:30,080 Speaker 1: only two to three percent of people will actually develop it. 54 00:03:30,080 --> 00:03:32,880 Speaker 1: It seems that something has to trigger your immune system 55 00:03:32,960 --> 00:03:36,440 Speaker 1: to start acting up. That something might be an injury 56 00:03:36,440 --> 00:03:39,880 Speaker 1: to the skin or a seemingly unrelated illness like a 57 00:03:39,880 --> 00:03:43,040 Speaker 1: strep infection. It can be a change in the weather 58 00:03:43,440 --> 00:03:47,680 Speaker 1: or just stress, and once a flare happens, the condition 59 00:03:47,920 --> 00:03:52,240 Speaker 1: is chronic, meaning it'll usually keep recurring and resolving and 60 00:03:52,400 --> 00:03:59,080 Speaker 1: recurring throughout your life. And unfortunately, researchers aren't exactly sure 61 00:03:59,160 --> 00:04:03,560 Speaker 1: why this happened. It seems like a combination of genetic 62 00:04:03,640 --> 00:04:08,680 Speaker 1: predisposition and some environmental trigger causes your skin to stress out. 63 00:04:09,560 --> 00:04:11,800 Speaker 1: Your skin and your immune system try to work together 64 00:04:11,880 --> 00:04:14,880 Speaker 1: to protect you, which is good, but in this case, 65 00:04:15,040 --> 00:04:18,520 Speaker 1: researchers think that some kind of feedback loop happens, a 66 00:04:18,560 --> 00:04:21,719 Speaker 1: sort of perfect storm where your skin produces more and 67 00:04:21,760 --> 00:04:25,159 Speaker 1: more replacement cells and your immune system is really gearing 68 00:04:25,240 --> 00:04:28,280 Speaker 1: up for a fight, getting extra blood flow and defensive 69 00:04:28,279 --> 00:04:31,840 Speaker 1: cells to the area, and nothing comes of it, so 70 00:04:32,040 --> 00:04:37,080 Speaker 1: you're left with patches of flaky, inflamed skin. It doesn't 71 00:04:37,160 --> 00:04:40,360 Speaker 1: help that this perfect storm that is psoriasis can present 72 00:04:40,480 --> 00:04:43,760 Speaker 1: in a number of ways. Let's talk more about those 73 00:04:43,760 --> 00:04:48,680 Speaker 1: different symptoms. Researchers divide them into five basic types of psoriasis. 74 00:04:49,839 --> 00:04:53,040 Speaker 1: The most common by far is called plaque soriasis because 75 00:04:53,120 --> 00:04:57,039 Speaker 1: it causes raised scaly patches on the skin known as plaques. 76 00:04:58,240 --> 00:05:01,359 Speaker 1: On light colored skin, they often look red with white scales. 77 00:05:01,600 --> 00:05:04,960 Speaker 1: On darker colored skin, they often look purple with gray scales. 78 00:05:06,080 --> 00:05:09,239 Speaker 1: They usually appear on the elbows, knees, torso, and scalp, 79 00:05:09,480 --> 00:05:12,440 Speaker 1: but can show up anywhere and can be puffy and 80 00:05:12,760 --> 00:05:17,400 Speaker 1: itchy or painful. Plaques show up on about eighty percent 81 00:05:17,480 --> 00:05:22,280 Speaker 1: of people with psoriasis. What's called inverse psoriasis is a 82 00:05:22,279 --> 00:05:26,400 Speaker 1: little less common. It causes dark red to purple, sort 83 00:05:26,440 --> 00:05:30,320 Speaker 1: of shiny patches in places where our skin folds, like 84 00:05:30,400 --> 00:05:33,200 Speaker 1: under the arms, around the groin, and under the breasts. 85 00:05:34,400 --> 00:05:37,320 Speaker 1: The patches aren't usually scally, but they can be really 86 00:05:37,360 --> 00:05:40,680 Speaker 1: itchy and tender. Around twenty five percent of people with 87 00:05:40,839 --> 00:05:46,080 Speaker 1: riasis experience these more rarely, like less than ten percent 88 00:05:46,120 --> 00:05:48,880 Speaker 1: of the time. The condition can cause what's called gut 89 00:05:48,920 --> 00:05:52,839 Speaker 1: tape csoriasis, which is sort of like plasoriasis, but the 90 00:05:52,880 --> 00:05:56,800 Speaker 1: scally spots are smaller and more numerous, often spread over 91 00:05:56,839 --> 00:06:01,440 Speaker 1: the entire arms, legs, or torso. It's a lot of small, 92 00:06:01,600 --> 00:06:04,720 Speaker 1: thin patches of irritation rather than a few big ones. 93 00:06:05,560 --> 00:06:09,799 Speaker 1: This one often shows up in adolescence rarely, in about 94 00:06:09,839 --> 00:06:13,520 Speaker 1: three percent of cases. Psoriasis can cause pustules to develop 95 00:06:13,960 --> 00:06:17,640 Speaker 1: a rash of painful, pus filled bumps across the palms 96 00:06:17,680 --> 00:06:21,280 Speaker 1: or souls, or sometimes other areas. Of the body. That's 97 00:06:21,400 --> 00:06:26,719 Speaker 1: called pustular psoriasis. Also, rarely, in about two percent of cases, 98 00:06:27,000 --> 00:06:31,680 Speaker 1: you find really widespread discoloration and irritation over large areas 99 00:06:31,720 --> 00:06:35,800 Speaker 1: of the body. This is called erythrodermic psoriasis, and it's 100 00:06:35,839 --> 00:06:38,520 Speaker 1: a more severe version that can be accompanied by flu 101 00:06:38,680 --> 00:06:43,039 Speaker 1: like symptoms like fever, chills, and fatigue. If this happens 102 00:06:43,040 --> 00:06:45,359 Speaker 1: to you or a loved one, definitely call a doctor 103 00:06:45,440 --> 00:06:50,160 Speaker 1: right away because it counts as a medical emergency. Generally speaking, 104 00:06:50,240 --> 00:06:52,960 Speaker 1: if you have any of these symptoms, getting in touch 105 00:06:53,000 --> 00:06:55,440 Speaker 1: with a healthcare professional is the best thing to do 106 00:06:55,720 --> 00:07:00,560 Speaker 1: because well, a, you're probably uncomfortable, and b they'll be 107 00:07:00,600 --> 00:07:03,080 Speaker 1: able to help with the diagnosis and figure out from 108 00:07:03,120 --> 00:07:06,280 Speaker 1: there how best to manage and reduce those symptoms and 109 00:07:06,520 --> 00:07:10,640 Speaker 1: any others that may come up. All forms of psoriasis 110 00:07:10,680 --> 00:07:14,320 Speaker 1: are tricky to treat because, again, it's not caused by 111 00:07:14,360 --> 00:07:17,560 Speaker 1: some germ that medicine can help you fight. It's an 112 00:07:17,560 --> 00:07:21,560 Speaker 1: instance of your own body turning against you. A healthcare 113 00:07:21,600 --> 00:07:25,040 Speaker 1: provider will evaluate your symptoms and do a skin biopsy, 114 00:07:25,480 --> 00:07:27,440 Speaker 1: that is, take a small sample of skin to look 115 00:07:27,480 --> 00:07:31,040 Speaker 1: at under a microscope to tell whether you're experiencing psoriasis 116 00:07:31,160 --> 00:07:34,760 Speaker 1: or a different condition. Well, once you have a diagnosis, 117 00:07:34,800 --> 00:07:38,040 Speaker 1: there are lots of treatment options for relieving discomfort and 118 00:07:38,120 --> 00:07:42,800 Speaker 1: reducing the severity and occurrence of skin patches. There are 119 00:07:42,920 --> 00:07:46,480 Speaker 1: topical treatments, creams, and other products that you apply directly 120 00:07:46,520 --> 00:07:49,360 Speaker 1: to your skin. Some can be bought over the counter 121 00:07:49,400 --> 00:07:52,640 Speaker 1: from drug stores or grocery stores, but others, like topical 122 00:07:52,640 --> 00:07:58,080 Speaker 1: steroids and some strong alternatives, need a prescription. Topicals are 123 00:07:58,080 --> 00:08:01,360 Speaker 1: great because, depending on the product, they're non invasive ways 124 00:08:01,400 --> 00:08:05,760 Speaker 1: to reduce inflammation, or control skin growth or smooth rough patches. 125 00:08:07,080 --> 00:08:11,160 Speaker 1: Then there's phototherapy. This is a category of also non 126 00:08:11,160 --> 00:08:14,960 Speaker 1: invasive treatments that use ultraviolet light to slow down skin 127 00:08:15,000 --> 00:08:20,280 Speaker 1: growth on an ongoing basis. Basically, a dermatologist will prescribe 128 00:08:20,320 --> 00:08:23,080 Speaker 1: a consistent schedule for you to either go into a 129 00:08:23,080 --> 00:08:26,320 Speaker 1: medical office or use a machine at home that exposes 130 00:08:26,360 --> 00:08:29,200 Speaker 1: affected areas of your skin to a specific amount of 131 00:08:29,320 --> 00:08:34,480 Speaker 1: ultraviolet light for a specific amount of time. Consistency is key, 132 00:08:34,840 --> 00:08:37,880 Speaker 1: but home photo therapy especially can be a convenient and 133 00:08:37,920 --> 00:08:42,040 Speaker 1: affordable treatment. Those are the first two categories of treatment 134 00:08:42,080 --> 00:08:46,040 Speaker 1: that healthcare providers will usually try, but if they're not 135 00:08:46,200 --> 00:08:50,120 Speaker 1: working or for whatever reason you need something different. There's 136 00:08:50,160 --> 00:08:55,280 Speaker 1: what's called systemic treatments. They're called systemic because they're not 137 00:08:55,440 --> 00:09:00,000 Speaker 1: applied to a particular topical area. Instead, these are prescripts 138 00:09:00,320 --> 00:09:05,240 Speaker 1: medications that help control immune or skin activity throughout your body. 139 00:09:05,520 --> 00:09:08,200 Speaker 1: Some can be taken orally and work to moderate your 140 00:09:08,200 --> 00:09:12,120 Speaker 1: immune response or your skin growth in specific ways. Others, 141 00:09:12,320 --> 00:09:15,400 Speaker 1: called biologic drugs, have to be given by either injection 142 00:09:15,640 --> 00:09:19,960 Speaker 1: or IV. Biologics are super targeted drugs that block particular 143 00:09:20,000 --> 00:09:25,719 Speaker 1: activity in your immune system. Systemics are powerful tools against soriasis. 144 00:09:26,440 --> 00:09:29,360 Speaker 1: All of these treatments can come with risks and side effects. 145 00:09:29,720 --> 00:09:31,640 Speaker 1: A health care provider can help you figure out which 146 00:09:31,679 --> 00:09:34,120 Speaker 1: ones are right for you and manage any side effects 147 00:09:34,120 --> 00:09:38,679 Speaker 1: that do occur. And it is important to treat psoriasis 148 00:09:38,920 --> 00:09:43,120 Speaker 1: because first of all, it is uncomfortable and having skin 149 00:09:43,280 --> 00:09:46,120 Speaker 1: problems can be embarrassing and you don't need to live 150 00:09:46,160 --> 00:09:50,640 Speaker 1: with that. But also, untreated csoriasis is associated with greater 151 00:09:50,760 --> 00:09:54,640 Speaker 1: risk of what's called comorbidities, which are other conditions that 152 00:09:54,720 --> 00:09:58,839 Speaker 1: often occur alongside a health issue. In the case of psoriasis, 153 00:09:58,880 --> 00:10:02,760 Speaker 1: they're often inflamma related and can include things like diabetes, 154 00:10:02,840 --> 00:10:08,720 Speaker 1: inflammatory bowel disease and cardiovascular disease. It also includes a 155 00:10:08,800 --> 00:10:13,520 Speaker 1: real specific one called syriatic arthritis. Around a third of 156 00:10:13,559 --> 00:10:17,320 Speaker 1: people with psoriasis will experience this. It's a condition that 157 00:10:17,400 --> 00:10:20,800 Speaker 1: causes swelling and stiffness or pain in the joints and 158 00:10:21,000 --> 00:10:24,600 Speaker 1: places where connective tissues attached to the bones, but especially 159 00:10:24,679 --> 00:10:28,400 Speaker 1: in the outer joints of the fingers and toes. As 160 00:10:28,440 --> 00:10:32,360 Speaker 1: with psoriasis, the symptoms really vary. They can be mild 161 00:10:32,480 --> 00:10:36,360 Speaker 1: or severe, and can flare up, then resolve, then flare 162 00:10:36,440 --> 00:10:40,199 Speaker 1: up again over time. It's distinct from other kinds of 163 00:10:40,280 --> 00:10:43,920 Speaker 1: arthritis for a few reasons, including where it occurs, and 164 00:10:44,120 --> 00:10:47,800 Speaker 1: because it's often accompanied by the nail symptoms of psoriasis. 165 00:10:49,080 --> 00:10:52,800 Speaker 1: Researchers aren't exactly sure what's going on here either, but 166 00:10:52,960 --> 00:10:56,720 Speaker 1: it seems that the inflammation from that overactive immune system 167 00:10:56,840 --> 00:11:01,200 Speaker 1: you see in psoriasis isn't just skin deep. If that 168 00:11:01,280 --> 00:11:06,920 Speaker 1: inflammation reaches the joints, you get discoloration and discomfort there too. 169 00:11:07,200 --> 00:11:10,160 Speaker 1: This can also damage the joints over time, so it's 170 00:11:10,240 --> 00:11:12,920 Speaker 1: especially important to talk to a healthcare professional if you 171 00:11:13,000 --> 00:11:17,960 Speaker 1: experience these symptoms. They might use different tests like X rays, MRIs, 172 00:11:18,120 --> 00:11:21,440 Speaker 1: ultrasounds and blood tests to help rule out other conditions 173 00:11:21,480 --> 00:11:24,000 Speaker 1: and make sure that you get the right diagnosis and treatment. 174 00:11:25,000 --> 00:11:28,080 Speaker 1: Those treatments include the systemics we talked about a minute ago, 175 00:11:28,679 --> 00:11:32,280 Speaker 1: oral medications or biologics that help control your immune system 176 00:11:32,480 --> 00:11:37,880 Speaker 1: unlessen inflammation throughout your body. I don't have personal experience 177 00:11:37,920 --> 00:11:41,600 Speaker 1: with psoriasis, but just as a human whose job it 178 00:11:41,679 --> 00:11:45,000 Speaker 1: is to explain how things work, it's frustrating that this 179 00:11:45,120 --> 00:11:48,480 Speaker 1: is such a complex condition that we don't entirely understand 180 00:11:48,520 --> 00:11:53,079 Speaker 1: it and can't cure it. But research is ongoing and 181 00:11:53,120 --> 00:11:57,480 Speaker 1: the treatments available are improving all the time. Our bodies 182 00:11:57,520 --> 00:12:01,160 Speaker 1: are weird and wonderful. They can do amazing things and 183 00:12:01,320 --> 00:12:05,800 Speaker 1: can also behave in very strange ways. Please take care 184 00:12:05,840 --> 00:12:13,600 Speaker 1: of yours. Today's episode is an original written by me. 185 00:12:14,200 --> 00:12:16,560 Speaker 1: Brain Stuff is production of iHeart Radio and is produced 186 00:12:16,559 --> 00:12:19,440 Speaker 1: by Tyler Klang. For more podcasts from my heart Radio, 187 00:12:19,679 --> 00:12:22,920 Speaker 1: visit the iHeartRadio app, Apple Podcasts, or wherever you listen 188 00:12:22,960 --> 00:12:24,000 Speaker 1: to your favorite shows.