Psoriasis

What it is

Psoriasis is a long-term immune condition where skin cells build up quickly, causing thick, scaly plaques, often on the elbows, knees, scalp and lower back. It is not contagious. It can also affect nails and joints.

How it works

Psoriasis is an immune-driven condition in which skin cells are produced in days instead of weeks, so they pile up as thick plaques with silvery scale. It is linked to inflammation elsewhere in the body, including the joints.

Why it matters on darker skin

On darker skin plaques often look purple, grey or dark brown rather than pink, and scale may be thicker, so it can be mistaken for eczema or fungal infection. It often leaves dark or light patches after healing.

Causes and triggers

Genetics, stress, infections such as strep throat, skin injury, smoking, alcohol, some medicines and stopping strong steroids suddenly.

What helps — and why it works

Moisturise daily and use prescribed treatments consistently. Many effective options exist, from creams and medicated shampoos to light therapy and modern medicines for more severe disease. Healthy weight, not smoking and limiting alcohol help control it. Emollients daily: soften scale and reduce itch. Expected timeline: days. Doctor-prescribed treatment: vitamin D creams, steroids, phototherapy or tablets/injections calm the immune drive. Expected timeline: 2–8 weeks depending on treatment. Look after general health: psoriasis raises heart and joint risk; not smoking helps. Expected timeline: long term.

What to avoid and why

Avoid picking scales and harsh scrubs. Do not stop prescribed treatment suddenly, and avoid self-treating with strong steroid creams long term.

Common mistakes

• Picking scale.
• Thinking psoriasis is contagious.
• Using strong steroid creams continuously without review.

Building a routine that lasts

Most skin problems improve with a short routine used every day rather than many products used occasionally. A practical base is a gentle cleanser, a fragrance-free moisturiser and a broad-spectrum sunscreen in the morning, with one targeted treatment at night. Introduce one new product at a time and give it two weeks before adding another, so that if your skin reacts you know the cause. Patch-test on the inner arm or behind the ear for a few days first. Skin renews itself roughly every four to six weeks, so most treatments need two to three cycles — eight to twelve weeks — before you can judge them fairly. Photographs taken in the same light every four weeks are more reliable than memory. In the Nigerian climate, heat, humidity and harmattan all change what your skin needs: lighter gels in the humid season and richer creams in dry months are both reasonable. If a product stings for more than a few minutes, causes swelling, or leaves new dark patches, stop it. Buy from registered pharmacies or official stockists, and use the Authenticity Check if you are unsure whether a product is genuine.

Reading labels and choosing products

On the label, look first for the active ingredient and whether the product is fragrance-free and non-comedogenic. Ingredients are listed in order of amount, so an active at the end of a long list may be present only in a small quantity. Be wary of products that promise results in days, that list no ingredients, or whose label is a sticker or handwritten. Words such as 'natural', 'herbal', 'organic' and 'dermatologist-inspired' are marketing terms, not safety standards. Hydroquinone, mercury compounds (sometimes listed as calomel or mercurous chloride) and strong steroids such as clobetasol do not belong in an over-the-counter cosmetic. A real NAFDAC registration number should be printed on the pack and should match the product on the official Greenbook register. Price is not proof: counterfeiters copy expensive brands. When in doubt, ask a pharmacist, keep your receipt, and use Melanin & Me's Authenticity Check and barcode scanner as a first screen.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.