Education is King

Ignorance may be bliss but it is also very dangerous and can be the cause of great pain. This applies to so many situations in life. We do or say something that is terribly stupid simply because we do not know any better. The best way to prevent this from happening is to know everything about absolutely everything, so that we can always act and talk from an enlightened position.

This is, of course an impossible goal. We cannot possibly reach that level of knowledge, so we bumble along in life, tripping over situations that result from limited knowledge.

There is a way around this. It is to make no assumptions about anyone with whom we come into contact but to get to know them and their situation before we make up our minds about them as people. That needs us to keep an open mind about people and their situations, rather than to jump to conclusions then act stupidly.

I was on the committee of the Cape Psoriasis Association in Cape Town, South Africa, for a long time. I was also chairman of that body for a few years. During those years we on the committee came to learn of and meet various people who had psoriasis and who were very badly treated by friends, family, colleagues and people on the street. They were treated this way because those people did not know how to process what they saw in front of them.

There was a gentleman who came to our public meetings regularly. He told us that at the office where he worked, his colleagues refused to have lunch with him and would not even use the same telephone that he did. They were petrified that they would catch psoriasis from him.

He was no better off in his own home. His wife would not allow him to share a bed with her. She did not like to be near him with his flaking skin, nor to have the tiny flakes of skin that he had shed in the bed in which she was sleeping. She also would not tolerate the stains on the bedsheets that were left by the moisturisers and medicated creams that he applied to his skin to ameliorate his condition. She kept a special set of crockery and cutlery to be used only by him, he was not allowed to use the same as used by the rest of the household.

We also came to learn of a teenage boy who was ostracised by his family because of his psoriasis. They would not allow him to live in the family home, not to sleep or even to take his meals inside. Year round he lived in a tiny shed in the back yard of the home, in intolerable conditions, through summer heat and winter storms.

These situations exist because of closed minds and ignorance. The more educated a person, the more open their mind is likely to be and the more tolerant they are likely to be to others less fortunate than them. Those of us with psoriasis must appreciate how we appear to others who do not understand the condition. The worse the condition, the stronger the reaction that there is likely to be from other people and the more important knowledge about psoriasis becomes. Educating ourselves about the condition does two things.

First, it allows us to take whatever steps are needed to improve our skin. In the process we will become more healthy overall and improve our lives in general. Improving our psoriasis also reduces the visible impact when we are seen by others, so they will have less reason to be put off by what they see.

Second, it empowers us to spread the education wherever we go, into everyone with whom we come into contact. It equips them to interact with us with more confidence, in the knowledge that they and their families are not at any risk of breaking out all over with spots and scales. When they have that knowledge in their heads, they will pass it on to others, so the knowledge will spread.

There will be people who will not want to listen, not want to learn about psoriasis. Personally, I have never discussed psoriasis with anyone who did not want to learn more about it. If you do come across anyone who does not want to listen, who insists on treating you badly, move on and leave them behind. They are not worthy of wasting your time.

In your own interest, as well as of everyone else who has psoriasis, try to educate your family, friends and colleagues about the causes and results of psoriasis. I allow psoriasis to have minimal impact on my life and most of this is a result to educating myself and those around me about the condition.

Plastics and you

In recent posts I have mentioned the dangers of chemicals migrating out of polyester clothing and plastic liquid containers and onto or into your body. The dangers of plastics go further than that though.

We don't know which plastics present the most danger of leaching plasticisers into what we eat and drink. The plastics manufacturers aren't going to give us a straight answer, their business success depends on selling as much as possible of their product. The food manufacturers aren't necessarily going to tell us the truth either until they know that their packagings are truly safe because a bad answer will knock their sales.

We have to depend on government or independent testing laboratories, with no ties to the plastics or food processing industries, to supply honest answers. The testing that they have done has shown that there are chemicals that escape from the plastics, particularly under elevated temperatures and that this applies to many types of food packaging. Some of these chemicals are proven carcinogens, i.e. they cause cancer. Carcinogens in the digestive system are bad news, resulting in cancers of the various parts of the digestive system, most importantly the colon. This is where the bad chemicals are likely to spend the most time before being eliminated from your system.

The chemicals in the colon also affect the immune system, putting it out of balance. This can result in all sorts of autoimmune conditions, including psoriasis and arthritis. It is worthwhile to improve this situation by:-

1) Minimising the intake of chemicals out of food packaging

2) Getting them out of your body as fast as possible by ensuring that your digestive system is working properly

These chemicals may come out of any plastic containers that you use to cook or heat food in your microwave. That includes plastic packaging containing TV meals and other frozen pre-prepared meals that you either cook or heat in the microwave. Carcinogens have also been identified in coatings used to preserve the inside surfaces of food cans and have been proven to migrate into the food.

The problem is that we don't know fully which packaging does this and which doesn't. Until the food packaging industry cleans up its act this danger will exist. In the meantime I try to minimise consuming products that have been both in contact with plastics and at elevated temperatures. Many of these products are over-processed and bad for health anyway, so minimising them can only be a benefit.

Drink Pure Water

One of my tactics for clearing my psoriasis has been to try to eliminate any potential sources of unhealthy chemicals or products that might have been entering my body. I am quite diligent about reading any material that comes into my hands about things that are good and bad for health. I try to maximise the good things and minimise the bad stuff. You cannot do that without knowing which is good and which is bad, as well as what makes them good or bad.

One tends to believe that the water in USA is top class and that in Africa it is very suspect. My experience from living in Cape Town and Virginia Beach has been that the water in Cape Town is probably of more consistent high quality than in Virginia Beach. Here the water taste varies considerably from month to month. Sometimes it tastes muddy and other times it has a strong chlorine taste. I have little confidence in it being free of bad stuff.

We investigated a whole-house filtration system but it was very costly. We tried a small filter that attaches to the outlet of the faucet, which helped but is lacking in the number of heavy metals and other contaminants that it removes. Eventually we changed to an under-sink two-stage filter that removes a wide range of particles, chemicals and heavy metals and I use that for all drinking water, even if it is to be boiled. I think that the only way to get water that is more pure would be to distill it myself or buy distilled water.

Filtering your own domestic water from the city or county water supply is much cheaper than buying bottled water. It also gives more confidence about the source of the water that I am drinking. There have been a few TV programs and reports of investigations into the sources of some of the brands of bottled water sold in stores. Some of them are suspect or are just water bottled by a small supplier from the public water supply and fraudulently sold as spring water.

The other concern is that plasticisers in the plastic containers will contaminate the liquids that they contain, particularly if the bottle is heated in any way. This may be due to the bottle being inside a hot vehicle or lying on your towel on a hot beach. The toxic chemicals will migrate into the liquid that you will drink, which enables those chemicals to enter your digestive system and then every cell in your body. You can keep your bottled liquids cool to prevent this happening but it might be a long journey from the bottling factory to your mouth. If any supplier in that path is less than careful in storing the cases of bottles in cool areas and out of direct sunlight then the chemicals might have been in the liquids for days or weeks before you even buy the bottle.

Heavy metals and toxic chemicals can show in the human body in many different forms, from psoriasis to cancer or Alzheimer's and Parkinson's. There is no guarantee that any person will not contract those conditions anyway but it is worthwhile to minimise the chances by drinking good clean water, without dangerous contaminants.

Wear Natural Fibres

Have you ever noticed how plastic items that are new are generally flexible but old plastic items break easily because they have become hard and brittle? You may also remember vinyl tile flooring of a few decades ago that shrank as it aged, so that the once tight joints gradually became larger and larger. New clothes made with man-made fabrics are strong, soft and flexible but as they age they become more stiff and are much easier to rip.

This is because plastic contains plasticisers and those plasticisers gradually migrate to the surface and evaporate off into the air. The plasticisers are chemicals that are included in the mix when making plastic raw materials for processing into all manner of objects for use in modern life. This includes a wide range of fibres that are further processed into threads to be woven into fabric to make clothing.

The plasticisers are chemicals that are good for plastic but bad for any living body. Man-made fibres put those fabrics on the outside of your body. On cool days this may not do you much harm, if any. Any plasticisers that are released might simply evaporate off into the air. In hot weather this changes because you will start to perspire. The warmer temperature will also increase the rate of release of the plasticisers from your clothing. Your skin becomes moist with sweat, which absorbs plasticiser from the fabric and you soon have a chemical solution on your skin.

Imagine that you are out jogging, cycling or exercising at the gym, in sexy tight stretch clothing made from man-made fabrics. Everything that you are wearing is pulled tight against your skin and is flexing with every movement of your body, like a second skin. Your own skin is oozing salty liquid in the form of sweat. Your second skin is soaked in that liquid and is itself releasing chemical plasticisers into that liquid, helped by the increasing temperature both from your body and from the environment. The water evaporates off but the salt and chemicals stay behind, gradually strengthening the mix until you have a concentrated salty chemical soup being rubbed against your skin by the fabric.

With psoriasis (and many other skin conditions) your skin is affected by what is contacting it from the outside. It is adversely affected by many chemicals. In the scenario described above you have toxic chemicals that are not only in contact with the psoriasis but they are being artificially held there by the fabric and the fabric is also rubbing it into the surface. This is a bad situation for any skin problem.

Here are clothing principles that help to keep psoriasis to a minimum.

1) Check the labels before buying any item of clothing. Stay with natural fibres wherever possible. That means buying mostly cotton or wool articles. Some fabrics are a combination of polyester and cotton, try to keep the polyester to a very small percentage.

2) Make sure that any underwear worn is cotton and not polyester.

3)Loose underwear is less likely to aggravate perspiration than tight-fitting versions. Your skin needs to breathe so that it is cooler and perspires less.

4) Loose outer garments are also better, for the same reasons. They are not held against the skin to trap moisture but allow it to evaporate off.

5) If you must wear man-made fabrics for some reason, such as a sports uniform, get out of it as soon as you can, shower to wash away any perspiration and dress in natural fibre clothes.

Eat Natural

The most healthy way to nourish your body is to give it food that is as close to its natural form as possible. This does not imply that you must eat anything raw that should be cooked but it does mean that you should try to minimise the amount of processing that happens to that food between the time that it is reaped or killed and when it enters your mouth.

Keep in mind that the manufacturers are in the business of feeding the masses for their own benefit, not yours. They exist primarily to make a profit. If there are ways for them to make that profit by using inferior produce or by using a cheaper alternative that will taste as good, they may well do so. Even when reading the list of ingredients and nutrition information you cannot be sure exactly what is in that can of soup or frozen meal because low levels of additives don't have to be reported. You can be sure of what is in your meal if you prepare it yourself.

The food manufacturers add all manner of additives to their products and not all of them are good for your health. Some are added to maximise taste, for example salt and sugar. Personally, I find most prepackaged American foods much too salty for my palate. I think that they have progressively added more salt to their recipes over the decades to keep ahead of the American palate becoming accustomed to it, so their product always seems flavourful to taste buds that have already been sensitised by too much salt. Read the information labels on your cans to see the high salt content of some of these products. Salt absorbs water from its surroundings, so too much salt makes your body hold excess water. It also increases bad cholesterol levels in your blood. Not good for your health.

Various manufacturers have heeded the call from health authorities to reduce salt content but some of them have replaced it with more sugar, to enhance the flavour. The are compensating for lost saltiness by increasing sweetness. That is also bad for your health, the extra sugar translates into more calories, which make more fat if you don't burn them off. Also, read in an earlier post Watch What You Mix what the effects are of combining excessive sugars with proteins in your meals.

Bread choice is somewhere that you can improve the amount of processing in what you eat. Many of the choices are little more than air and highly processed white flour. They are not even tasty or pleasant to eat and they are awful toasted. The packaging tells that it is enriched with various vitamins and minerals. Frankly, it has to be enriched because so much natural goodness has been removed in the processing that it has little nourishment left in it. This stuff also has preservatives to stop it from going stale. You can forget a few slices in a packet in the back of your bread bin and it will still be soft 2 weeks later. You will have better digestion if you choose wholewheat and multi-fibre breads ahead of white air bread. It is also more filling, so you will feel that you have eaten something more substantial.

Salads made from fresh ingredients are always nice in hot weather. They are filling, have lots of fibre and the colourful ingredients are full of antioxidants. The fibre will improve your digestion and the antioxidants will help to ward of cancer by getting rid of free radicals in your system. The same applies to lightly steamed vegetables.

Food cooked at home from fresh is far more healthy than buying prepared frozen dinners from the supermarket. Many chain restaurants are just as guilty of over-salting their food as the manufacturers of canned of frozen dinners. You can continue eating this way out of convenience but think about what it is doing to your health.

Hair Washing thoughts

There is a variety of shampoo options available for treatment of psoriasis and it is up to you to find which products work best for you.

I settled on two types. One is a tar shampoo and the other is a salicylic acid shampoo. I find it best to alternate between the two for best results, using one the one day and the other the next day.

Years ago I was having a haircut and my hairdresser told me that I should rinse my hair more thoroughly because she could smell the chemicals on my hair and she thought that was bad. A few months later we had a Psoriasis Association public meeting and the speaker was a leading Cape Town dermatologist. I asked her how thoroughly the shampoo should be rinsed out and she said that it is more beneficial to rinse very briefly than to rinse thoroughly. She said that keeping some of the chemicals on the scalp makes it work better.

There are a few other points that I have learned over the years to help keep the psoriasis on my scalp under control. So, here are points in no particular order of importance.

1) Medicated shampoos need to be on the scalp for awhile to work, so it helps to wet the hair and rub in the shampoo a few minutes before getting into the shower. Maybe lather up, then brush your teeth, shave etc before entering the shower.

2) The shampoo is needed on your scalp rather than in your hair. No problem if your hair is short but if it is very long then you can lose a lot of beneficial shampoo in your hair. Concentrate on massaging the shampoo into your scalp with your finger tips.

3) Don't overdo the rinse. A quick rinse with warm water is all that it needs. Don't make the water too hot, excessive heat will aggravate your psoriasis and also remove more of the chemicals than warm water.

4) Salt water helps my skin. If I have been in the ocean then I don't rinse with fresh water when I leave the beach but rather allow the salt water to air-dry. I don't wash my hair the next day but leave the salt on my scalp for another 24 hours.

5) It helps for the sun to get to my scalp, so I seldom wear any sort of headgear unless I will be in strong sunlight for many hours. I want the sun to penetrate through my hair. I keep a cap handy to wear if I feel that my scalp has had enough sun.

6) Being somewhat of a skinflint, I don't like to have my hair cut too often. When I have it cut, it is with a razor and #4 or #5 attachment. That is short, so it lets the sun through. When it grows to about 50mm (2") I have it cut back again.

Using these methods, my scalp is generally pretty good. It is still worthwhile to wear mostly light coloured clothing to be sure that there are no flakes of skin showing on my shoulders. Black is out, charcoal is OK, grey is good and white is great.

Don't hide away

When I was diagnosed with psoriasis I was very aware of how ugly it made my skin look. My immediate reaction was to hide it.

My first reading about the condition was in encyclopedias and medical books because there was no Internet yet. All of my reading described how people felt ashamed of it and hid it away with long sleeve shirts and long pants. I also read that it benefits from exposure to UV rays.

I came to the conclusion that hiding it away is the worst thing that can be done because it will reduce exposure to sunlight and aggravate rather than help. So, I quickly went back to my customary shorts and T-shirts or shorts only. My wife asked if i wasn't worried about what my friends would think or say. I said that I was not concerned and would educate them about psoriasis if needed. I had decided that if any friend objected to seeing my skin then they were not worthy of my friendship. As I expected, nobody objected and all wanted to know more about it.

I continued to spend lots of time on the beach and in the ocean. If anyone asked about my blotchy skin I politely explained that psoriasis is non-contagious and benefits from exposure, so should not be hidden away. Nearly 30 years later I still hold the same opinions and follow the same habits as I did then, they have proven to work.

I believe that it is very important for everyone with whom you are regularly in contact, i.e. family, friends, co-workers etc, to understand what psoriasis is and that it has no detrimental effect on anyone else. They must understand that you cannot harm them, there is no need for them to feel afraid that they or anyone else will catch psoriasis from you. As long as you have people around you who don't understand this you will experience incidents when they don't want to be near to you or to touch something that you have touched.

Psoriasis is no more contagious than a broken leg but can be much more debilitating in your daily life if you come into contact with people who want to persecute you because they do not understand what they see. A broken leg they can understand but red and silver blotches on the skin can conjure up images of all sorts of tropical or other contagious diseases that they don't understand.

So, my advice is to wear light and comfortable summer clothing that lets the sun get to your skin. Take every opportunity to educate those around you about psoriasis, so that they know exactly what it is and can easily accept it, rather than preferring to exclude you from their circle of contact. Your skin will improve from the exposure and you will feel better for not being a hermit.

Anti-Inflamatory Drugs

In the 90s I was on my boat and the crew were packing away sails. I stepped on a sail on the foredeck, not realising that they had not closed the hatch over which they had spread the sail. I fell through the hatch, with my fall broken by my elbows hitting the deck. Aside from the inevitable painful joints, I also had a massive swelling that developed rapidly overnight on an elbow and was extremely painful.

Next day I went to the doctor and was diagnosed with bursitis and given a prescription of anti-inflammatory tablets that lasted for 2 weeks. The tablets worked a treat in sorting out the problem and I was all set for the Cape to Rio trans-Atlantic yacht race that was to start a few weeks later.

A few days after I started the anti-inflammatory treatment I noticed that I was starting a flare-up in my psoriasis. No-matter what I did to improve it, the flare-up just grew worse. It continued a few weeks after the course of tablets was completed, then slowly tapered off back to normal.

Next visit to the doctor, I mentioned the psoriasis flare-up and she said that it could well be a side-effect of the drugs. That put me on notice to watch it in the future. Next time that I had a bursitis problem I was again prescribed anti-inflammatories and again experienced a flare-up. Both times the drug used was ibuprofen.

Since proving that I have this reaction to ibuprofen, I have tried to minimise my use of the drug. I prefer to use an aspirin or two for pain instead of ibuprofen but don't know if it is as effective as an anti-inflammatory treatment for injuries. If I have sports injury then I still use ibuprofen but at a minimal level to minimise the aggravation.

I expect that most people who have psoriasis will have a similar reaction to anti-inflammatory drugs. Millions of people take these drugs for pain relief from arthritis and other painful conditions. If you are one of those people and you have psoriasis that you can't seem to improve then it is very possible that the anti-inflammatory drugs are aggravating your psoriasis. In that case it will be worthwhile to do some testing to find the answer one way or the other.

Speak to your doctor about it. My doctor changed me to another drug when we realised that I had a problem but I don't remember what the new drug was. We have both emigrated, to opposite sides of the world, so I can't call her to ask what it was. Your doctor should be able to advise a suitable alternative.

This problem will also apply to other medications. The important thing is to discover whether or not you are adversely affected by the medications that you take. If you find that they are aggravating your psoriasis then you should try to find an alternative that will not affect you or to use the medication at the lowest level that you can.