Psoriasis

Flaky scales are the most common disorder of the skin. Scales that consist of keratinocytes or horn cells, come lose and fall away during the regeneration cycle of the skin. In skin disorders associated with inflammatory reactions, an increased number of horn cells is generated and consequently accumulates, forming scales. These scales pose an aesthetic problem for patients and may also cause stigmatisation, which is a psychological burden. Furthermore, the scaly patches make it more difficult for active agents to penetrate the skin and should therefore be removed as part of topical treatment.

LOYON® allows a gentle, purely physical removal of scales and crusts of the skin in scaly skin disorders such as psoriasis. The gentle lifting of scales avoids bleeding which can occur as a result of mechanical removal (e.g. scratching). Scale removal makes it easier to apply subsequent topical therapies or is even required to make these possible, as active agents applied to the skin are better absorbed following scale removal. UV-rays also penetrate thick plaques only to a limited extent, hence keratolysis is very frequently carried out prior to phototherapy.

Removal of psoriasis scales also removes active inflammatory mediators, which are bound in the scaly skin layer and further contribute to the inflammatory reaction. Removal of the scaly skin has an important psychological effect and lessens the mental burden. LOYON® can be used in conjunction with systemic psoriasis therapy, especially when plaques remain on the skin despite internal therapy.

How is Loyon applied?

APPLY LOYON® ONTO DRY SKIN AND GENTLY MASSAGE IN.

The liquid consistency of LOYON® makes it easy to spread it on the dry skin, even on very rough scaly areas of the skin. The keratolytic agent is pleasant to apply: it doesn’t sting or stick, is free from odour and colour and leaves a pleasant feeling on the skin.

DEPENDING ON THE LOCATION OF THE SCALES, YOU CAN USE THE PIPETTE OR THE SPRAY NOZZLE TO APPLY THE LIQUID.

With the aid of two application devices LOYON® can be applied very individually. Depending on the part of the body where LOYON® is being applied, the pipette or the spray nozzle can be used. Both can be easily screwed on to the bottle. With the help of the pipette and thanks to the liquid consistency of LOYON® it can be easily applied to hairy areas of the body or onto the scalp. The pipette is also very suited for applying LOYON® specifically to confined or smaller areas of scaly skin. The spray nozzle on the other hand is especially suited for the fast and efficient coverage of larger skin areas.

TO ACHIEVE EFFECT, LEAVE ON FOR 3 HOURS OR LONGER, E.G. OVERNIGHT.

Keep in mind that LOYON® is very efficient and start off using only a small amount. The liquid absorbs quickly and after a few minutes, no residues are noticeable. LOYON® should be left on for around three hours. It can also remain on the skin overnight.

WASH OFF WITH A MILD SHAMPOO OR A GENTLE WASH LOTION.


REPEAT APPLICATION AS REQUIRED.

LOYON® can be applied as often as desired. Even application on large areas of the skin or repeated use, e.g. when scales appear anew during a psoriasis flare-up, is not a problem. LOYON® can also be used by pregnant women, infants with cradle cap or elderly patients with liver or kidney damage. An improvement should be noticed after one week’s daily treatment.

Frequently asked questions

1What is psoriasis?
Psoriasis is a non-infectious inflammatory disease of the skin, in which inflammatory reactions affect the whole body. This is called a systemic disease. In addition to the visible affection of skin and nails, joints can be affected as well. This is known as psoriatic arthritis and occurs in every fifth psoriasis patient. Further associated diseases are adipositas, diabetes and an increased risk of depression.
2How do I recognise psoriasis?
Typical symptoms of psoriasis are: - Candle wax phenomenon: When scraping off the skin cells in the area of a plaque, the scales become easily detached and resemble candle wax. - Last membrane phenomenon: Upon continued scraping, a lamella-like thin membrane can be removed. - After removal of this membrane, pin point bleeding occurs in this area (‘bloody dew’, also called Auspitz’s sign).
3How is psoriasis treated?
Depending on the area of the skin affected and the severity of the psoriasis, several options are available. It has to be kept in mind that psoriasis cannot be cured. However, treatment can reduce symptoms or help to remain symptom-free for as long as possible. Still, in many cases the disease will reappear in regular intervals (psoriasis flare-up). As a general rule, treatment begins with external (topical) therapy. This uses, for example, substances which remove scales (keratolytic agents) such as LOYON® as well as the active ingredients salicylic acid or urea. Keratolytic agents loosen the firmly adherent scales and expose the skin underneath. This makes the application of further external medications easier. These medications can be cortisone-containing preparations, vitamin D derivatives, retinoids, dithranol or other substances. These act mainly by inhibiting the underlying inflammatory reaction and by reducing excessive cell growth. Phototherapy and climate therapy as well as psychosomatic treatment are further options. In severe forms of psoriasis, systemic therapies such as methotrexate, fumaric acid esters or biologic medications may be used. These interfere with the body’s immune system and inhibit inflammatory reactions. During symptom free intervals, urea-based creams care for and protect the skin.
4How does psoriasis develop?
Typical for psoriasis vulgaris are psoriasis plaques which are plate-like raised patches of silvery to yellow scales which are firmly attached. The skin underneath is inflamed and strongly reddened. In the area of the plaques, an excessive number of horn producing cells (keratinocytes) is formed, and at a rate around six times faster than normal. In a healthy person, it takes around 28 days from the formation of the horn cells in the epidermis until they reach the surface and are shed off. When a person has psoriasis, this process takes only five days. In addition, the maturation process which the keratinocytes undergo in order to become dead horn cells (corneocytes) is altered. Consequently, incompletely matured horn cells accumulate at the skin’s surface and become visible as psoriasis plaques. Increased inflammatory reactions take place in the skin layers underneath this area as well as within the scaly patches.
5How common is psoriasis?
Around 1.8 million* people in the United Kingdom have psoriasis. The prevalence is around 2%** in adults, with both women and men affected equally. It occurs significantly less frequently in children and young people up to 18 years. * Source: https://www.psoriasis-association.org.uk/pages/view/about-psoriasis ** Source: http://www.nhs.uk/conditions/Psoriasis/Pages/Introduction.aspx
6How do scaly skin disorders develop?
Scaly skin disorders can have many causes. This may be increased dehydration of the skin, or insufficient lipid production. A hornification disorder of the skin may also be the reason. Two different forms are distinguished according to their underlying cause: Retention hyperkeratosis: The skin cells are formed at a normal rate; however, the horn layer adheres more firmly and for longer and therefore becomes thicker. This is the case e.g. in fish scale disease (ichthyosis vulgaris). Proliferation hyperkeratosis: The skin cells and therefore also the scales are formed and shed at an increased rate. For example, psoriasis or eczema. There are many different scaly skin disorders of varying causes, as shown by the following examples: Psoriasis Infections (e.g. fungal skin infections) Chronic eczema, non-infectious inflammatory diseases such as atopic eczema, contact dermatitis, seborrhoeic eczema Infantile seborrhoeic eczema (cradle cap) Hereditary conditions (ichthyoses) Seborrhoeic keratosis (senile warts)
7How do scales form?
The skin contains stem cells (keratinocytes) which divide throughout their life span. These cells divide every 28 days and migrate through the different layers of the epidermis to the surface. In the process they progressively lose the characteristics of living cells. Eventually, they do not possess a nucleus anymore and lose their cohesion to neighbouring cells. In the end they are shed off as ‘dead horn cells’ (corneocytes), or scales.
8What is the structure of our skin?
The skin consists of three layers: The top layer (epidermis) is only 0.03 to 0.3 mm thick and does not contain any blood vessels. In the palms of the hands and the soles of the feet, the epidermis can be up to 2 mm thick. The increased mechanical strain in this area leads to an increased production of skins cells. This results in a thicker, tougher area of the skin which is noticeable as callus. The most common cells of the epidermis are the keratinocytes (horn cells). They are formed in the basal layer of the epidermis and are pushed upward by the formation of new cells. During their migration to the surface of the skin, they mature and change their shape. After around 28 days they arrive in the stratum disjunctum as dead horn cells (corneocytes) and are shed off. In addition, special receptors for the detection of pressure and melanin-producing pigment cells (melanocytes) are found in the epidermis. Melanin protects from UV rays and is responsible for the tanning of the skin. The next layer is the dermis, which is 0.5 to 1.5 mm thick and consists mainly of connective tissue. A system of many tiny blood vessels is intertwined through this layer and supplies the skin with oxygen and nutrients. Together with smooth muscle, the blood vessels are involved in temperature regulation. In the dermis originate sebaceous glands and sweat glands as well as hair follicles. Also located in this layer are numerous pain, thermal and stretch receptors. The hypodermis (subcutis) consists of fat tissue and connective tissue, and varies in thickness between 0.5 mm and 3 cm. Larger blood vessels and nerves are found here. Special mechanoreceptors such as the lamellar or Pacinian corpuscles detect vibrations and deep pressure sensations.
9What function does our skin have?
The skin is our largest organ. With a surface area of nearly 2m2, it covers our body and forms a barrier to the outside world. The skin protects us from damaging environmental factors such as UV rays, mechanical strain, varying temperatures or germs. Our skin also fulfils social and communicative functions: with the aid of special receptors in the skin we sense different stimuli and are able to distinguish warm from cold as well as a gentle touch from greater pressure or pain. Just how important our skin is for our physical and mental wellbeing becomes clear when skin diseases occur.