Have you noticed thick scales building up on your elbows, knees, or scalp recently, or red patches that won't go away?
This might not be simple dry skin—it could be a chronic scaling skin condition (psoriasis).
This chronic scaling condition is a non-contagious skin disorder in which skin cells are produced much faster than normal, leading to abnormal scale buildup.
It appears as white scales with red patches on the surface, and it's caused by immune system dysfunction. The main symptoms include heat, pain, or itching.
Overactive Immune System Creates Chronic Skin Scaling
Chronic skin scaling has multiple causes: family history, genetics, dry climate, stress, and lack of sleep. Stress is often identified as the biggest trigger. 💢
Immune System's Misreading of the Situation
Skin cells normally divide and create new cells in regular cycles (4-6 weeks). When cells complete their lifecycle, they naturally shed as dead skin scales.
The process affecting this skin cell growth involves T cells, which are key cells that control our body's immune response.
Among the various T cell types, Th17 (Helper T cell-17) is the main driver of chronic skin scaling. When Th17 becomes excessively activated, the following happens in our body:
- Excessive deployment of neutrophils (immune soldiers) 🪖
- Overproduction of skin scales
The Illusion of 'Infection' Triggers Scale Production
Neutrophils make up the largest number among our immune system cells. They're the first responders deployed when external threats invade, and when these immune cells die during battle, they become pus. They primarily evolved to fight fungal infections and other pathogens.
The problem with chronic skin scaling is that the immune system mistakenly thinks "a major threat has invaded" when there's actually no infection.
This results in unnecessary immune warfare, appearing as inflammation on the skin surface.
Symptoms Worsen in Winter
Chronic skin scaling symptoms tend to worsen in winter when UV exposure decreases.
Korea's particularly dry winters are also contributing factors to symptom aggravation.
Treatment Approaches for Psoriasis
This condition isn't just a 'cosmetic' issue.
While chronic skin scaling(psoriasis) can cause itching, it can sometimes cause severe heat sensation and pain that significantly impacts daily life, making treatment necessary.
Conventional Medicine Approach: 'Immune Control'
Since it's an immune disorder, medications that control the immune response are primarily used:
- Initial stage: Topical steroids
- Moderate cases: Immune-modulating drugs like MTX, cyclosporin
- Severe cases: Biologics (advanced medications like Cosentyx, Tremfya that target specific immune pathways)
Korean Medicine Approach: 'Personalized Treatment'
Korean Medicine considers not only current skin symptoms but also the patient's overall health condition. Treatment approaches differ for acute phases (red, severely inflamed skin) and chronic phases (dark red, dry skin).
Most importantly, the patient's overall constitution determines the treatment approach:
- For patients with excess heat and high energy → Herbal formulas focused on cooling skin inflammation
- For patients with a cold constitution and low energy → Herbal formulas focused on strengthening overall health
Even when skin conditions appear identical, prescriptions vary—this is the key characteristic of Korean herbal medicine. The range of treatment options for chronic skin scaling is particularly comprehensive.
If you're struggling with chronic skin scaling, the following methods can help alongside treatment:
- Get adequate sunlight exposure (natural light is beneficial)
- Create a stress-reducing environment
Most importantly, it's okay to distance yourself from people and situations that drain your energy. Your health comes first.
Dr. Oh Chul
| HJM Korean Medicine Clinic
