Psoriasis and the Older American

Learn how to limit the effects of psoriasis in older years

Psoriasis and the older American

Our American society is growing older at a rapid rate, primarily due to longer and longer lifespans. The 2010 US Census showed that the population 65 and older was growing faster than the US population overall. Since psoriasis is a lifelong disease, it affects many older Americans; some who have had it since childhood and others who developed it later in life. The number of people dealing with psoriasis in their older years is clearly only going to rise.

There are several special considerations regarding older patients with psoriasis. Different treatments may be appropriate as arthritis and back problems may make applying topical creams more difficult. Other health conditions like heart disease, diabetes, and cancer may make certain treatments riskier or even dangerous. Drug interactions are a larger risk in the elderly since older patients often take more medications. As we all age or care for our older loved ones, keeping good communication with your doctor is critical to make sure your treatment is targeted help achieve the most benefit with the least amount of risk.

Certain medications may cause psoriasis to start or worsen. These can include beta-blockers (a heart and blood pressure medicine), lithium (for bipolar disorder), quinidine (for heart arrhythmias), and indomethacin (for pain and arthritis). Since older patients tend to take more medications, it is important to let your doctors and your pharmacist know that you have psoriasis when you are getting any new medicine.

Also, always talk to your doctor before stopping any medication.

A recent large study from Spain found that patients over 65 did not have an overall risk of side effects from systemic medications for psoriasis, but did have an increased risk of the more severe or potentially dangerous side effects. Guidelines for treatment from the Medical Board of the National Psoriasis Foundation indicate that older patients should be treated with topical treatment for milder psoriasis, but for more severe disease that aggressive treatments like ultraviolet light and systemic medications are appropriate.

 They also stress the importance of regular follow up with your doctor and monitoring for side effects.

Certain medications, like methotrexate and cyclosporine are particularly known to have increased risks in elderly patients, who may already have some underlying trouble with their liver or kidneys from other medical conditions or medications. These treatments can exacerbate the pre-existing problems and create increased risk of more dangerous side effects. Since we have many other more targeted treatments for psoriasis now, the use of cyclosporine for older patients is decreasing.

About 30% of people with psoriasis will also have some degree of joint pain (called psoriatic arthritis), which may range from mild to very severe. Some patients may attribute their joint pain to “just getting older” and therefore go undiagnosed. As age can limit our movement and flexibility in other ways, psoriatic arthritis may contribute to patients being unable to walk, exercise, or participate in their usual activities if not treated properly.

With Americans living longer and longer, the number of us who will face psoriasis as we age is growing every day. A healthy diet, exercise, and good communication with your doctor and pharmacist can help to limit the effects of psoriasis and keep it from interfering with our “golden years.”

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