How psoriasis triggers depression – and how to stop it

Many people with psoriasis know from personal experience that depression, anxiety and other mental health issues often go hand in hand with this inflammatory disease.

For many years, explains dermatologist and psychologist Rick Fried, M.D., Ph.D., both clinicians and patients thought they understood why.

“People are living with a condition that is often very physically uncomfortable, limits physical activities and intimacy, and can result in sufferers being stigmatized, bullied, and otherwise discriminated against. So, it makes intuitive sense that the potential for anxiety and depression are much higher because of the realities of living with the social and physical burden of the illness,” says Fried, clinical director at Yardley Dermatology Associates and Yardley Clinical Research Associates in Pennsylvania.

Mounting evidence points to an additional reason, a “second hit to the psyche,” Fried says that underscores how critical it is to get adequate treatment for psoriasis, a disease in which under-treatment is “epidemic.”

Inflammation is the culprit

“In people with psoriasis, certain inflammatory cytokines, such as tumor necrosis factor and various interleukins, are elevated; we see a remarkably similar increase in these inflammatory cytokines in depression,” says dermatologist and psychiatrist John Koo, M.D., professor in the Department of Dermatology at the University of California, San Francisco Medical Center.

Cytokines are proteins involved in the inflammatory process of the immune system.

Koo and his colleagues reviewed the raft of evidence for this “cytokine theory of depression” in a 2017 Journal of the European Academy of Dermatology and Venereology (JEADV) article. They concluded that ongoing systemic inflammation likely causes physiologic and biochemical changes that drive the development of depression and other mood disorders.

“These inflammatory cytokines cross the blood-brain barrier,” explains Fried. “In the brain, they send biochemical messages that deplete neurotransmitters such as serotonin, norepinephrine and dopamine, which are intimately involved in our ability to think, to act, to feel, and to function.”

Treatment is the answer

Biologics, which target and block specific inflammatory cytokines, may have a direct biochemical effect on depression.

“By blocking these inflammatory cytokines and calming inflammation, you are changing the cytokine profile for the better – not just in the skin, but in the brain,” says Koo. “In clinical trials of biologics, investigators commonly report that participants with severe psoriasis often experience significant improvements in mood even before you can see any visible difference in their skin.”

A 2015 JEADV review found treatment with biologics significantly decreased depressive symptoms in people with moderate to severe psoriasis. Similarly, a study published in Medicine in 2016 found people with psoriasis experienced lowered rates of depression and insomnia after treating with biologics. Participants also decreased their rate of antidepressant use by 40 Percent after two years.

Therapies such as phototherapy and conventional systemic medications also decrease body-wide inflammation.

“As long as the treatment is adequately treating the person’s psoriasis – so that they have minimal to no symptoms – it should help the mind as well as the body,” says Koo. “When people are treated adequately and aggressively for psoriasis, their depression often goes away.”

Treating “adequately and aggressively” is the goal of NPF’s Treat to Target initiative, which aims to reduce psoriasis to no more than 1 percent of body surface area after three months of treatment. But this goal remains a challenge for far too many.

“Topicals are overused for psoriasis patients, many of whom need potent systemic therapies, not only to treat their skin disease, but also to lower the risk for the many conditions that occur more often in people with untreated chronic inflammation, including diabetes, cardiovascular disease, heart attack, stroke, and obesity, as well as depression,” says Koo.

Koo and Fried advise psoriasis patients who aren’t satisfied with their treatment to discuss more aggressive therapeutic options with their dermatologist. “Many dermatologists are still uncomfortable using biologics despite their effectiveness and safety. If you encounter this, you should seek a second opinion,” says Koo.

“There are safe and effective medications for psoriasis that will make you feel and function better on a day-to-day basis and will decrease the likelihood of some of the real and potentially devastating and life-threatening effects of untreated disease,” Fried adds.

Talk to your health care provider

An open conversation will help you and your provider determine the best treatment option. To get ready, you should first assess how psoriasis impacts your life. Take our quiz to find out.

 

Here’s How Stress Actually Impacts Your Skin

Authors: Richard Fried MD Ph.D

If you’ve always suspected that stress has the power to make your skin act up, prepare to feel at least a little validated. Maybe you’ve realized your eczema flares most when your job responsibilities are spiraling out of control. Perhaps it feels like a new pimple pops up every day when your personal life is in shambles.

It’s not in your head—feeling stressed out really can affect your skin—and vice versa. Here, experts discuss the science behind how stress impacts your skin, plus what you can do about it.

The unfortunate truth is that stress can upset your skin in multiple ways. One way is when stress causes inflammation, which in turn causes your skin to freak out.

“So many [skin conditions] are related to an inappropriate release of inflammatory chemicals,” Richard Fried, M.D. Ph.D., a dermatologist, clinical psychologist, and clinical director of Yardley Dermatology, tells SELF.

Ah, inflammation, that buzziest of buzzwords. At its core, inflammation is your body’s response to a perceived threat to your health. This can be a good or bad thing. Inflammation plays a crucial role in keeping you healthy, because your body needs to to defend itself from true dangers, like flu viruses. But sometimes your body can overreact to substances that are actually harmless—hello, allergies—or something that at least doesn’t require such a disproportionate response. Sometimes, that thing is stress.

“The stress response—whether we’re being chased by a saber-toothed tiger, whether we have a deadline, whether we’re having trouble with family or love—is all the same,” Dr. Fried says. “Your immune system gets ready to do battle.” It does this by releasing chemicals like interleukins, which, in order to help protect your health, cause inflammation.

If your genetics, environment, or both make you susceptible to certain skin-related ailments, this inflammation can also make them flare up. “Stress is a general trigger that can make the skin misbehave in whatever way it’s prone to misbehaving,” Dr. Fried says.

Because of that inflammation, stress can lead to flare-ups if you already have certain skin conditions, but it can also just make your skin hypersensitive.

Let’s say you’re predisposed to eczema. Feeling overwhelmed with stress is one trigger that can make its characteristic patches of dry, itchy, inflamed skin bloom across your body, according to the Mayo Clinic. Same goes with psoriasis, a condition that causes sore, irritated, scaly blotches of skin, and rosacea, which can lead to reddened facial skin and bumps that might feel hot and tender to the touch. Of course, acne is in the mix, too.

Along with these, a few other conditions are closely linked with stress, like seborrheic dermatitis(greasy patches that show up in places like your scalp; it can also cause dandruff) and telogen effluvium (when hair sheds excessively because of severe, unusual stress). “Stress and pro-inflammatory chemicals cause the hair to transition from the growth phrase to the falling out phase all at once,” Arielle Nagler, M.D., a dermatologist at NYU Langone Health, tells SELF.

Other health conditions, like skin-picking disorder (also called excoriation disorder) or trichotillomania (also known as hair-pulling disorder), have a more obvious link to stress. Shannon Bennett, Ph.D., a psychologist at Weill Cornell Medicine and NewYork-Presbyterian, describes these as impulse-control conditions that usually get worse under stress. Since the impulsive pulling or picking can be a way of trying to cope with negative emotions, feeling stressed might make a person engage in these actions more often. These kinds of disorders can have various physical and mental ripple effects, Bennett explains, from skin infections to shame and guilt.

This doesn’t mean stress will cause these conditions if you don’t have them, just that it might make them harder to manage if you do.

Even if you don’t have an actual skin condition, dealing with way more stress than usual for a significant amount of time might make your immune system hyperirritable, so something that doesn’t normally bother your skin can make it freak out, Dr. Fried explains. It’s kind of like when you’ve had a week from hell, then someone cuts you off in traffic as you’re running late to work. You might be much more likely to let forth a stream of expletives than if the same thing happened during a week when life’s been copacetic.

“We use that conceptualization for the immune system. When your immune system’s in a good mood, whatever. When it’s not, [stress] can make your skin misbehave,” Dr. Fried says. “It could be putting your usual moisturizer on, your usual fragrance, eating the same diet, or using a hair dye that has historically not made your scalp angry.”

But there’s also a pretty huge mediating factor between stress and your angry skin, and that’s how you act when you’re stressed.

If touching your face is your go-to nervous habit and you always break out when you’re stressed, that may be less a function of your immune system, and more a result of you introducing whatever’s on your hands to your face.

Acne has a lot to do with people touching their faces,” Dr. Nagler explains. “I always talk about that with my patients.”

Stress can also make you more likely to skimp on your usual healthy habits, which can come with side effects. “Usually, when we’re experiencing a great deal of stress, we spend less time taking care of ourselves,” Bennett says. “If you’re not sleeping well, if you’re not taking the time to wash your face, if you’re not eating well or drinking enough water, that can impact your skin negatively.”

This is in part because your immune system functions best when you’re taking care of yourself, but also because neglecting these things might stress you out more. It can become a brutal feedback loop.

OK so stress is bad and screwing with our skin. So if we just de-stress we’ll have great skin, right? Not exactly.

Don’t get us wrong—having a few de-stressing techniques on hand is always a good idea, whether that’s deep breathing, practicing meditation, or whatever else works for you, Bennett says.

But that doesn’t mean tamping down on stress is the magic fix that will automatically quash your skin concerns. “It’s not that if you only handled stress better, your skin would be just fine,” Dr. Fried says. In fact, putting that pressure on yourself to eliminate your stress for better skin can just make you more stressed. See where we’re going here?

Instead, the real message to take away from this is that there are lots of ways stress and your skin can affect each other. Managing your stress (and any stress-fueled behaviors that can screw with your skin) may be one part of the puzzle that can help your skin mind its manners, and when it does misbehave, at least do so less severely—but it’s not the be-all and end-all. So in addition to taking your breakouts and flare-ups as a sign that you need to chill and take time for self-care, talk to a professional if symptoms persist.

If your stress is irritating your skin or your skin is stressing you out, check in with a medical professional for help.

Dr. Fried recommends starting with your dermatologist, explaining your problem (whether that’s acne, eczema, or something else), and seeing if they can make any recommendations for how to fix it or how to find someone who can.

And about the stress component: It couldn’t hurt to discuss your added stress levels with a health care provider or therapist if possible. While stress may have a starring role here, it probably isn’t acting alone. Approaching the issue from all angles could get you that much closer to no longer wearing your stress on your skin.

The Emotional and Functional Benefits of Poly-L-Lactic Acid 

Authors: Richard Fried MD Ph.D, W. Phillip Werschler, MD, Judith Cenci, MD, Lauren Sternberg MD,  Priya Dhanaraj MD, Dara Tolas MA, Suzanne Withrow MA

Facial volume loss can substantially impact both self-perception of the affected individual and their social/professional interactions and opportunities. Persons who are perceived as more youthful and attractive are rated as nicer, more energetic, healthier, and more likely to be productive than those perceived to be older and unattractive.

The observed facial changes that result from underlying volume loss associated with age and photodamage often produce an older and less attractive appearance. Loss of facial volume often produces a sad, sunken, deflated, dull, tired, and lackluster appearance. These changes can be interpreted as evidence of aging and loss. In addition, some may consciously or subconsciously see these changes as harbingers of their own progressive deterioration and decline. Injection of approved fillers into the upper face, mid face, and lower face can create a more youthful, better rested, and kinder appearance. Randomized controlled trials (RCT’s) demonstrating the effectiveness of injectable fillers in improving emotional and functional status remain scarce.

It’s About Time

A hallmark of hyaluronic acid and calcium hydroxyl appetite filler products is their ability to produce immediately apparent volumetric changes. The recent proliferation of technologically improved hyaluronic fillers has dramatically enhanced the armamentarium available to active clinicians. Claims of anatomic regional superiority and longer duration are enticing. The early days of fillers characterized by “briefly there till completely gone” are being supplanted by “there now, persistently there, and stimulatory for a reasonable period of time.” This is a meaningful step forward; persistence of filler presence with enhancement of collagen production. It can be argued that this represents a true slowing of the facial aging process. Understandably, “filler wars” abound with manufacturers claiming product superiority and battling for dominance in the hands of clinicians.

In contrast to the immediate deposition of hyaluronic acid or calcium hydroxyl appetite, another option exists for enhancement of collagen production and persistence of benefit. Poly-L Lactic Acid is an extremely effective stimulator of collagenases and fibroplasia that produces gradual volumization of the treated areas. While there is apparent immediate volume repletion with PLLA injection, it is mostly from the sterile water and lidocaine commonly used to prepare the product and thus largely dissipates soon within days after injection. The subsequent enhancement in collagen production and facial volumization occur gradually over the 1-3 months following each injection. Optimal correction usually occurs 1-3 months after 3-4 monthly injections of a full vial of PLLA. While the exact dilution of PLLA varies among injectors, 6-7cc’s of sterile water with 2 ccs of lidocaine are frequently reported.
Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For its use in soft tissue augmentation, it is supplied as a lyophilized powder containing PLLA microparticles, the size and chemical attributes of which are tightly controlled. As a biocompatible material, PLLA generates a desired subclinical inflammatory tissue response that leads to encapsulation of the microparticles, stimulation of host collagen production, and fibroplasia. Over time, the PLLA degrades, the inflammatory response wanes, and host collagen production increases. This response leads to the generation of new volume and structural support that occurs in a gradual, progressive manner, and which can last for years.

Timing is everything; In life, in love, in business, in theatre, and in fillers. More information is needed to assess whether the delayed onset of clinically evident volumization produced by PLLA injection will still deliver patient satisfaction and favorable changes in emotion and function.

Purpose of the present study

A consideration among some clinicians is the “delayed gratification” aspect of poly L-Lactic Acid.  While the efficacy, safety, and duration of PLLA injection benefits are well supported by the literature, its mechanism of action as a strong biostimulator that produces gradual tissue augmentation over several months is unique. Many clinicians wonder whether patients will objectively “remember” their baseline appearance and subsequently be satisfied with their ultimate cosmetic outcome.  Is the immediate “correction” provided by hyaluronic acid and calcium hydroxyl appetite fillers, available to all who see (including and especially the recipient), a stellar positive or a potential negative? Is it possible that some individuals might be embarrassed or self-conscious about the sudden change in their appearance? Might the gradual changes and equal or better volumization with greater duration produced by PLLA injection produce a more psychologically comfortable transition in appearance with equal or greater satisfaction in outcome?

The goal of this study was to assess the changes in emotional and functional status of subjects treated with 2-4 monthly PLLA injections to the upper, mid, and lower face.

The Study

50 subjects were recruited from 2 community US based dermatology centers (Bucks County Pennsylvania and Spokane, Washington). 50 were eligible and enrolled according to protocol inclusion and exclusion criteria, 49 females and 1 male. 58% of subjects were age 45-60, 33% 60-75, and 8% 35-45. The protocol was approved by a central IRB and full informed consent provided.

Two patient self-report measures were utilized, The Facial Volume Restoration Outcome Questionnaire (Table 1) and the Rosenberg Self Esteem Scale (Table 2). The Facial Volume Restoration Outcome Questionnaire is a 35-item patient self-report Likert scale based instrument. Subjects self-report and self-rate selected areas of their emotional and functional status. The Rosenberg Self Esteem Scale is also a Likert scale based instrument measuring overall self-esteem. Subject self-report measures were completed at baseline and 6 months after their first injection. Facial volume loss was assessed on a 0-4 scale (Table 3) pre-treatment and post-treatment by the principle investigator or a Sub-Investigator.

Subjects were injected monthly with one full diluted vial of PLLA over 3 or 4 consecutive months.

Subjects received 1 full vial of poly L Lactic acid at each treatment visit.  The PLLA was reconstituted with 7cc of sterile water and 2cc of lidocaine without epinephrine.  The contents of the vial were injected in areas deemed appropriate by the certified injector and agreed upon by the study subject. Approximately 4-6 weeks later, a second vial was reconstituted as above and injected according to the above parameters. Finally, approximately 4-6 weeks later (12-16 weeks after the first injections), subjects were evaluated and a decision was jointly made with the injector regarding whether a third vial was desired and appropriate. All 50 subjects were injected at week 1, 49 subjects were injected at second visit, and 35 were injected at the third visit.

Results

Pre-and post-assessments were completed on 41 subjects. The remaining 9 were lost to follow-up or withdrew and did not complete the post filler instruments or return for investigator evaluation. None failed to return due to known AE’s. Approximately 30% of subjects who completed pre-and post-injection instruments reported increased confidence, increased sense of control, increased productivity, increased comfort with others, feeling more attractive, increased happiness when looking in the mirror, more happiness when their faces were touched, healthier eating, increased contentment, beliefs that they were seen as less stressed by others, they were happier with their bodies, they are exercising more, and that their lives were better. 43% felt more optimistic and 33% felt less anxious (Table 4). The changes in self-esteem self-reported on the Rosenberg scale were very modest but also favorable. IGA of facial volume loss improved from 2.2 at baseline to1.2 at 6-month follow-up assessment (lower score suggesting less volume loss).

Discussion

Injection of PLLA is a safe and effective method for facial volume and contour restoration. A potential “draw-back” or “negative” of PLLA injection is the delay in clinically evident volume repletion. The improvements are gradual as enhanced endogenous collagen production and fibroplasia replenishes volume depleted areas. In the present study, we essentially assessed the following question; “Can patients “be patient”, objectively remembering their previous appearance sufficiently to appreciate the improvements in their appearance provided by their own enhanced collagen production and fibroplasia. The present data suggest that the answer is “yes they can”. Many subjects did indeed perceive favorable emotional and functional improvements at 6 months after their first PLLA injection. Clinicians should consider “growing younger gradually” is a palatable option for patients. More gradual clinical change may evoke fewer comments, questions, and stares while delivering the desired cosmetic, emotional, and functional results. Buttressing and clarifying the data on the emotional and functional benefits of facial volume restoration can further “legitimize” treatment with poly L-Lactic Acid as an effective and meaningful medical procedure. Dissemination of data substantiating that volume restoration is more than simply a vanity intervention can serve as a compelling “recruitment tool” for the growing number of “maturing persons” struggling with the deflation and lackluster appearance that accompany the volume loss associated with aging, medications, stress, and illness.

Perhaps the “slow and steady wins the race” adage remains valid!

Limitations of the study include recognition that the favorable changes reported may not be a direct result of their filler experience and lack of quantification of Likert Scale gradations.

 

Investment versus Indulgence?

Few will argue the short and long-term benefits of a truly good investment. A good investment can yield greater security, stability, confidence, freedom, and pride. These benefits can motivate and facilitate actions and interactions that enhance and expand our opportunities.

Investing in our skin health and appearance can indeed be a shining example of a truly good investment. In contrast to an indulgence, which may be defined as a fleeting consumption, dalliance, immersion, or sensory experience, the good investment usually has longer lasting and demonstrably beneficial results. Please don’t misunderstand my message, indulgence absolutely has an essential place and high priority in our day to day existence (please pass the dark chocolate).

Skin enhancement and rejuvenation treatments at the right place delivered with knowledge and skilled hands can bestow a more youthful, fresher, friendlier appearance. People who invest wisely in their skin look better rested, healthier, and more energetic. They look and feel less stressed and are perceived as “nicer”. Healthier eating and more regular exercise are other additional benefits reported by those who invest wisely in their skin.

Interestingly, not only do people feel better, but their skin “feels better” too. Our patients relate that their skin feels less sensitive, less irritable, and has more uniform tone and texture.

So, feel free to take a good look in the mirror and see how good you can feel about making a truly good investment in your skin. We at Yardley Dermatology think “you are worth it!

NPF Experts Discuss World Psoriasis Day Impact

10/30/2017

World Psoriasis Day, an awareness day dedicated to the 125 million people diagnosed with psoriasis around the world, was created by The International Federation of Psoriasis Association and recently took place on October 29, 2017. The theme this year was Psoriasis Inside Out.

Members of the National Psoriasis Foundation’s medical board recently spoke with The Dermatologist to discuss the importance of the awareness day and its impact, as well as what patients and dermatologists can take away from the event.

Increasing Awareness

Having a recognition day such as this provides a global spotlight on this important public health issue of psoriasis, noted Lawrence J Green, an assistant clinical professor of dermatology at George Washington University School of Medicine.

“World Psoriasis Day helps to increase awareness for both people living with psoriasis and their loved ones and also for people who know little about psoriasis. It’s about recognition. Recognition demonstrates to people with psoriasis and their loved ones that the world is listening to them. It raises awareness about the condition to those who know little about psoriasis, hopefully encouraging them to learn more about this disease that is about inflammation occurring throughout the body, not just on the skin,” he said.

Ron Prussick, MD, assistant clinical professor, department of dermatology at George Washington University and medical director, Washington Dermatology Center explained, “This is a very important day for people with psoriatic diseases because it is an opportunity to educate the public. As this is a visible disease, the public needs to understand this is a disease of the immune system and it not infectious or contagious. The goal is to develop a cure but until then, with better knowledge about the disease there will be more tolerance and understanding in the future.”

Impact and Treatment

One goal of the awareness day is to help communicate that psoriasis is a common, important medical condition that can impact the quality and quantity of a patient’s life, according to Richard G.B. Langley MD, FRCPC, a professor of dermatology, division of dermatology, department of medicine, at Dalhousie University.

“Specifically, psoriasis has a profound negative impact on the quality of life for patients and their families, and has a number of significant comorbidities that can cause disabilities and can impact the life expectancy of certain patients,” he said. “With the advent of newer targeted therapies, there is reason for significant hope. However, there is a significant work that needs to be done to provide access of these therapies for this important medical condition and the more awareness raised around this condition, the better.”

Rick Fried, MD, PhD, a dermatologist and clinical psychologist and clinical director Yardley Dermatology Associates/Yardley Clinical Research Associates, noted the day of recognition is an opportunity to discuss and appreciate the psychosocial impact of the disease. “I believe that World Psoriasis Day legitimizes the feelings, physical and emotional burdens, and systemic comorbidities of psoriasis…. a skin, body, and mind inflammatory disease,” he said. “This is a sunset of hope and opportunity. Today there are numerous elegant treatments that can liberate psoriasis sufferers allowing them to live full and unencumbered lives.”

By recognizing that they are not alone, patients can seek treatment and support through the health care community. “World Psoriasis Day encourages patients and dermatologists to make a change today so that those dealing with psoriasis in the future may not be so heavily impacted,” said Jashin J. Wu, MD, director, clinical dermatology research, associate director, the Dermatology Residency Program Kaiser Permanente, Los Angeles Medical Center.

“I would hope that patients take away that professional organizations around the world, like the National Psoriasis Foundation are advocating for them. I would hope that professionals see that patients are not giving up on their disease and continue to be active despite the psoriasis,” he said.

Jerry Bagel MD, MS, director, Psoriasis Treatment Center of Central New Jersey, and senior attending physician, University Medical Center, agreed. “I hope patients and professionals recognize that today there are extremely effective, relatively safe treatments that can effectively treat psoriasis.”

Community for a Cure

“By increasing awareness of this disease throughout the world we hope to let patients and professionals know our goal is to study the cause and develop a cure. We want people with psoriasis to know there is support for them from both the public and medical professional community,” said Dr Prussick.

View Article

Bellies, Bulges and Love Handles. What can we do?

by Richard Fried, MD PhD

Why are they so bothersome? What can we do?

Our satisfaction with the appearance of our bodies is largely determined by societal norms. Currently, these suggest that our stomachs should be firm and flat. Similarly, our hips should be smooth, tight, and gradually sloping. These “rules” are imprinted into our brains via numerous teaching tools such as television, movies, magazines, and social media. The beautiful people and their perfect bodies are in our faces almost at every turn.

Enter “the evil mirrors” – those nasty tormentors that are constantly reminding most of us that we fall short of these ideal proportions. The reality is, that attaining and maintaining the “ideal body” is phenomenally difficult and for most of us, not realistically possible even if we subsisted on salad greens eaten after 7 hour daily visits to the gym. For those lucky people who were born with that perfect body, fear not, time will win! With a bit of maturity (defined as age, childbirth, menopause, andropause, life’s demands, trials, and tribulations), the bellies, bulges, and love handles will make their unwelcome appearance. None of us are immune – they will come.

Simply and sadly stated, bellies, bulges, and love handles “violate” the societal rules of proportion. Our negative self-talk about these unwanted body contours can make us feel badly. Sometimes, these unwanted body contours can be subject to or cause friction resulting in skin discomfort and/or rashes that “feel bad”. Many patients have told us that the belly, bulge, or love handle is a source of self consciousness and preoccupation. Internal dialogues such as “I hate these”, “I can’t stand it”, “this makes me feel old” can be ever present intrusions, distracting us from fully enjoying the present. If only we had the perfect body, all would be well and our lives would be perfect. NOT SO!

Please don’t let this get you down – this is about to get cheerier!

Perfection does not exist! One of the keys to happiness is accepting and embracing our imperfections (and we all have a big bunch of them!). Acceptance of the fact that imperfection defines the human experience can lead to great emotional relief. Acceptance of imperfection can allow us to exhale and stop trying so furiously to “be perfect”.

Good enough can be great. Accepting that perfection is unattainable and probably emotionally unhealthy, we can talk about what actually appears to make people happy. Improvement! Better appearance, less bulge, and less belly.

Good enough or modest improvement can be EXTREMELY SATISFYING and LIBERATING. Looking in that same mirror and seeing a smaller belly, bulge, or love handle can help to decrease self-consciousness and diminish intrusive and upsetting “self talk”. Positive change that we associate with attractiveness and health is empowering.

Call us for a free consultation. Yardley Dermatology is a cutting-edge laser and skin rejuvenation center. We have the gentle and safe laser and radio frequency technologies proven to reduce the burden of unwanted bulges, bellies, and love handles.

Click here to learn more about our Vanquish technology.

Uncovering the Emotional Impact of Psoriatic Disease

WASHINGTON, April 19, 2016 /PRNewswire-USNewswire

To ensure that people living with psoriasis and psoriatic arthritis have access to the treatments needed to manage their disease, the National Psoriasis Foundation (NPF) will hold a congressional briefing today to address the emotional and mental implications of psoriatic disease.

This briefing will include Cyndi Lauper, pop icon and spokeswoman for “I’m PsO Ready,” a national initiative driven by NPF and Novartis Pharmaceuticals Corporation to highlight the physical, emotional and social challenges of psoriasis. The briefing will also include NPF medical board member, board-certified dermatologist and clinical psychologist Dr. Richard Fried of Yardley Dermatology and Yardley Clinical Research Associates.

Dr. Richard Fried, NPF medical board member, Cyndi Lauper, pop icon and “I’m PsO Ready” spokeswoman, and Randy Beranek, president of the National Psoriasis Foundation conduct congressional briefing on the emotional and mental impact of psoriatic disease.
In addition to dealing with the physical suffering and an increased risk of comorbidities, such as cardiovascular disease and diabetes, many patients struggle with depression and a reduced quality of life due to the social stigma associated with psoriatic disease.

Recent studies have found that those living with psoriasis have a 39 percent increased risk of being diagnosed with depression than those without the disease. Those with a combination of both psoriasis and psoriatic arthritis suffer higher rates of anxiety and depression than those with psoriasis alone.

For many, treating their disease is the first step in reducing the risk of depression and improving overall quality of life. However, lack of access, lack of appropriate diagnosis, and lack of resources to get medication limit many patients from treating their disease. Congress can help address these issues by removing barriers that are making it hard for patients to treat their disease.

“The goal of this briefing is to ask Congress to support initiatives that provide better access for patients to effectively treat their disease, said Randy Beranek, president of the National Psoriasis Foundation. “By addressing the significant impact psoriatic disease has on patients’ overall quality of life, we are getting closer to achieving our goal of dramatically improving health outcomes for all with psoriatic disease.”

For more information about psoriatic disease, visit www.psoriasis.org and http://www.moretopsoriasis.com/index.jsp

About the National Psoriasis Foundation

National Psoriasis Foundation (NPF) is the world’s largest nonprofit dedicated to people with psoriasis and psoriatic arthritis. Our priority is to provide the services people need to take control of their condition, while increasing research to find a cure. In addition to serving more than 2.1 million people annually through our health education and advocacy initiatives, NPF has funded more than $13 million in research grants and fellowships. Learn more about the Psoriasis Foundation at www.psoriasis.org or call 800-723-9166. Follow us on Facebook and Twitter.

Read Original Article

Reveal Skin Analysis Advanced Technology

Reveal looks deep in the skin’s layers to assess:

• Brown Spots
• Fine Lines and Wrinkles
• Acne
• Enlarged Pore Size
• Skin Tone and Texture
• UVA Sun Damage
• Laxity of the Skin
• Enlarged Pore Size
• Diffuse Redness

The Reveal Skin Analysis is an advanced technology that allows us to get a baseline of your current skin condition to formulate a customized treatment plan for you. This in-depth analysis will give you a well-educated foundation towards achieving healthy, glowing, younger looking skin. Contact us today for more information.