Detox and revitalise your body workshop: Saturday 21 June, 1-4pm

 

Detox and revitalise your body workshop

 

Saturday 21st June 2014, 1-4pm

Yoga teacher, Cherie Lathey, and Nutritionist, Fleur Borrelli, will be holding an afternoon detox workshop on Saturday 21st June from 1-4pm.

A detox awakens the body’s powerful cleansing and healing abilities, helping to cure and prevent disease, restore health, balance emotions and prolong life.

A juice detox with yoga helps eliminate toxins by producing internal heat and massaging the internal organs, whilst boosting the immune system, restoring the body’s natural healing power. It is a great kick-start to a healthier, more positive, lifestyle.


The afternoon will include:

• "Why detox" with Fleur Borrelli: Understanding why the mind and body benefits from gentle detoxifying.
• Vinyasa flow yoga with Cherie Lathey: Focusing on breath, movement, twisting, and heat producing poses.
• Refreshing detoxifying fresh juices / smoothies prepared by Fleur.
• Discussion and recipes on superfoods & smoothies. Learn how to prepare for the best detox results.

Both Fleur and Cherie believe in a gentle and safe detox approach.

Cost: £45

Early bird offer: £40 (if booked before 15 June)

 

More information and booking 

For more information or to book your place on this course, please call The Putney Clinic of Physical Therapy reception on 020 8789 3881 or send an email to info@putneyclinic.co.uk, quoting Detox and revitalise your body workshop as the subject.

Psoriasis: what treatments are currently available

There is no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of the affected skin patches. In most cases, the first treatment used will be a topical treatment, such as vitamin D analogues or topical corticosteroids. Topical treatments are creams and ointments applied to the skin.

If these are ineffective or your condition is more severe, a treatment called phototherapy may be used. Phototherapy involves exposing your skin to certain types of ultraviolet light. In the most severe cases where other treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body.

Treatments are determined by the type and severity of your psoriasis and the area of skin affected. Your doctor will probably start with a mild treatment, such as topical creams (which are applied to the skin), and then move on to stronger treatments if necessary.

A wide range of treatments are available for psoriasis, but identifying which treatment is most effective can be difficult. Talk to your doctor if you feel a treatment is not working or you have uncomfortable side effects.

Topical treatments

Topical treatments are usually the first treatments used for mild to moderate psoriasis. These are creams and ointments you apply to affected areas. They are all that some people need to control their condition. If you have scalp psoriasis, a combination of shampoo and ointment may be recommended.

Topical corticosteroids

Topical corticosteroids are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces the symptoms of itching. Topical corticosteroids range in strength from mild to very strong. Only use topical corticosteroids when recommended by your doctor. Stronger topical corticosteroids can be prescribed by your GP and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.

Vitamin D analogues

Vitamin D analogue creams are commonly used along with, or instead of, topical corticosteroids for mild to moderate psoriasis affecting areas such as the limbs, trunk or scalp. They work by slowing the production of skin cells. They also have an anti-inflammatory effect. Types of vitamin D analogues include calcipotriol, calcitriol and tacalcitol. There are very few side effects, as long as you do not use more than the recommended amount.

Calineurin inhibitors

Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are medicines that reduce the activity of the immune system and help to reduce inflammation. They are sometimes used to treat psoriasis affecting sensitive areas (such as the scalp, the genitals and folds in the skin) if topical corticosteroids are ineffective.

These medications can cause skin irritation or a burning and itching sensation when they are started, but this will usually improve within a week.

Coal tar

Coal tar is a thick, heavy oil and is probably the oldest treatment for psoriasis. How it works is not exactly known, but it can reduce scales, inflammation and itchiness. It may be used to treat psoriasis affecting the limbs, trunk or scalp if other topical treatments are ineffective. Coal tar can stain clothes and bedding and has a strong smell. It can be used in combination with phototherapy (see below).

Dithranol

Dithranol has been used for over 50 years to treat psoriasis. It has been shown to be effective in suppressing production of skin cells and has few side effects. However, it can burn if too concentrated.

It is typically used as a short-term treatment for psoriasis affecting the limbs or trunk under hospital supervision as it stains everything it comes into contact with, including skin, clothes and bathroom fittings. It is applied to your skin (while wearing gloves) and left for 10 to 60 minutes before being washed off. Dithranol can be used in combination with phototherapy.

Phototherapy

Phototherapy uses natural and artificial light to treat psoriasis. Artificial light therapy can be given in hospitals and some specialist centres, usually under the care of a dermatologist. These treatments are not the same as using a sunbed.

UVB phototherapy

Ultraviolet B (UVB) phototherapy uses a wavelength of light invisible to human eyes. The light slows down the production of skin cells and is an effective treatment for some types of psoriasis that have not responded to topical treatment. Prior to treatment starting, you will have a short test to ascertain your skin type. Treatments are generally administered twice a week over a period of 15 weeks (maximum 30 sessions), with the dosage being gradually increased with each session. Goggles must be worn while in the UVB chamber in order to protect your eyes. The nurse in charge of your treatment will check for any moles and will apply total sunblock to them.

This treatment may be used in cases in which psoriasis has not responded to topical treatments. You may continue to use topical steroid creams throughout your treatment, but you must not apply them on your treatment days (before entering the light chamber). Possible side effects of the treatment include burning, itchy or dry skin, increased light sensitivity, cold sores and folliculitis (inflammation of hair follicles).

Psoralen plus ultraviolet A (PUVA)

For this treatment, you will first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light. Your skin is then exposed to a wavelength of light called ultraviolet A (UVA). This light penetrates your skin more deeply than ultraviolet B light.

This treatment may be used if you have severe psoriasis that has not responded to other treatment. Side effects of the treatment include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts. Long-term use of this treatment is not encouraged as it can increase your risk of developing skin cancer.

Combination light therapy

Combining phototherapy with other treatments often increases its effectiveness. Some doctors use UVB phototherapy in combination with coal tar, as the coal tar makes the skin more receptive to light. Combining UVB phototherapy with dithranol cream may also be effective (this is known as Ingram treatment).

Systemic treatments

If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments are treatments that work throughout the entire body. These medications can be very effective in treating psoriasis but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.

There are two main types of systemic treatment, called non-biological (usually given as tablets or capsules) and biological (usually given as injections). These are described in more detail below.

Non-biological medications

Methotrexate

Methotrexate can help control psoriasis by slowing down the production of skin cells and suppressing inflammation. It is usually taken once a week. Methotrexate can cause nausea and may affect production of blood cells. Long-term use can cause liver damage. People who have liver disease should not take methotrexate and you should not drink alcohol when taking it. Methotrexate can be very harmful to a developing baby, so it is important that women use contraception and do not become pregnant while they take this drug and for three months after they stop. Methotrexate can also affect the development of sperm cells, so men should not father a child during treatment and for three weeks afterwards.

Ciclosporin

Ciclosporin is a medicine that suppresses your immune system (immunosuppressant). It was originally used to prevent transplant rejection but has proved effective in treating all types of psoriasis. It is usually taken daily. Ciclosporin increases your chances of kidney disease and high blood pressure, which will need to be monitored.

Acitretin

Acitretin is an oral retinoid that reduces production of skin cells. It is used to treat severe psoriasis that has not responded to other non-biological systemic treatments. It is usually taken daily. Acitretin has a wide range of side effects, including dryness and cracking of the lips, dryness of the nasal passages and, in rarer cases, hepatitis. Acitretin can be very harmful to a developing baby, so it is important that women use contraception and do not become pregnant while they take this drug and for two years after they stop taking it. However, it is safe for a man taking acitretin to father a baby.

Biological treatments

Biological treatments reduce inflammation by targeting overactive cells in the immune system. These treatments are usually used if you have severe psoriasis that has not responded to other treatments, or if you cannot use other treatments.

Etanercept

Etanercept is injected twice a week and you will be shown how to do this. If there is no improvement in your psoriasis after 12 weeks, the treatment will be stopped. The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there is a risk of serious side effects including severe infection. If you had tuberculosis in the past, there is a risk it may return. You will be monitored for side effects during your treatment.

Adalimumab

Adalimumab is injected once every two weeks and you will be shown how to do this. If there is no improvement in your psoriasis after 16 weeks, the treatment will be stopped. Adalimumab can be harmful to a developing baby, so it is important that women use contraception and do not become pregnant while they take this drug and for five months after the treatment finishes. The main side effects of adalimumab include headaches, a rash at the injection site and nausea. However, as adalimumab affects the whole immune system, there is a risk of serious side effects including severe infections. You will be monitored for side effects during your treatment.

Infliximab

Infliximab is given as a drip (infusion) into your vein at the hospital. You will have three infusions in the first six weeks, then one infusion every eight weeks. If there is no improvement in your psoriasis after 10 weeks, the treatment will be stopped. The main side effect of infliximab is a headache. However, as infliximab affects the whole immune system, there is a risk of serious side effects including severe infections. You will be monitored for side effects during your treatment.

Ustekinumab

Ustekinumab is injected at the beginning of treatment, then again four weeks later. After this, injections are every 12 weeks. If there is no improvement in your psoriasis after 16 weeks, the treatment will be stopped. The main side effects of ustekinumab are a throat infection and a rash at the injection site. However, as ustekinumab affects the whole immune system, there is a risk of serious side effects including severe infections. You will be monitored for side effects during your treatment.

Why we need to help our detoxification systems

by Fleur Borrelli, Nutritionist at The Putney Clinic of Physical Therapy

It is a relatively unknown fact that our body produces its own toxins as part of our normal metabolism. Our intestinal bacteria may also release by-products from metabolism that can be damaging to our health. This is before we even consider the toxins that come in from the environment.

Fortunately we have evolved a complex network of systems to get rid of toxins that have been created internally. The antioxidant system cleverly destroys free radicals during chemical reactions in our cells before they can damage the cell itself.

The liver, amongst its multitude of tasks, will take a toxic molecule which is generally fat soluble and transforms it into a water soluble molecule to be excreted out of the body in urine via the kidneys. Even fat soluble molecules can be shifted into bile which is then squirted into the intestine and ejected from the body in faeces. Sweating can lose any heavy metals lurking about, not to mention the shedding of toxins via skin, hair and nails.

This is what happens when all is working well... But we now live in a modern environment where we are being overloaded with toxins We have plastics in our toothpaste, heavy metals in our deodorant, herbicides in the air we breathe, additives in our foods, synthetic hormones in our drinking water, harmful electromagnetic radiation in our homes and the list goes on.

We may reach a point where we have adapted to this environment of chemicals that are foreign to our body but we haven’t got there yet. We are succumbing more and more to symptoms produced by compromised detoxification systems such as poor digestion, headaches, depression and chronic fatigue.

'Tired all the time' (TATT) is one of the major reasons why people visit their doctor... We need to help our detoxification systems. We can do that by consciously reducing our toxin exposure, being mindful of everything we put into our mouth or on our skin. Indeed a good rule of thumb would be not to put anything onto our skin that we are not prepared to put into our mouth! Nourishing the body as well will provide those systems with the raw materials they need to perform their tasks. Food is our medicine.

Fleur will holding a detox and revitalise your body workshop along with Cherie Lathey of Yoga Mama on Saturday 21 June, from 1-4pm. Early bird offer of £40, if booked before 15 June (normal price £45).


For appointments with Fleur at The Putney Clinic of Physical Therapy, call  020 8789 3881 or send an email to info@putneyclinic.co.uk.



Fleur Borrelli (Nutritionist)
W:Nutrition and superfood
N: Nutrition and superfood newsletters
T: 07766 88 35 22
E: fleur@nutritionandsuperfood.co.uk

Psoriasis: types and triggers

Some facts about psoriasis

• It's estimated that at least 2% of the world's population has psoriasis.
• Psoriasis is a systemic disease.
• People who get psoriasis exhibit a wide range of symptoms that vary in severity.
• Psoriasis goes through cycles: sometimes better, at other times worse.
• No single treatment works for everyone.
• A form of arthritis, called psoriatic arthritis, affects up to 42% of the people who have psoriasis.
• Poor diagnosis and treatment means that many people with psoriasis and psoriatic arthritis suffer in silence.
• There is no cure for psoriasis or psoriatic arthritis.

What are the symptoms?

Normally there is a constant shedding of dead skin cells. However, due to the acceleration of the replacement process, both dead and live cells accumulate on the skin surfce. Often this causes red, flaky, crusty patches covered with silvery scales that shed easily. It can occur on any part of the body, although it is most commonly found on the elbows, knees and the scalp. It can also cause intense itching and burning.

Who is at risk?

Psoriasis affects approximately 2% of people globally, and up to 4% in some countries. It can start at any age. The condition is not contagious and many people only have small patches of their skin affected. There is a genetic link and psoriasis tends to run in families. About 30% of people with one first degree relative with psoriasis develop the condition. This genetic tendency appears to be triggered by infection; certain medicines (including ibuprofen and lithium); psychological factors (including stress), or skin trauma. There is no way of predicting who will develop psoriasis. 50-60% of people who first experience it do not know of anyone else in their family who has had it.

Genetics

Psoriasis runs in families. One in three people with psoriasis has a close relative with the condition. However, the exact role that genetics plays in causing psoriasis is unclear. Research studies have shown many different genes are linked to the development of psoriasis. It is likely that different combinations of genes may make people more vulnerable to the condition. However, having these genes does not necessarily mean you will develop it.

Common types of psoriasis

Plaque psoriasis

This is the most common form, accounting for about 90% of cases. Its symptoms are dry, red skin lesions, known as plaques, which are covered in silver scales. They normally appear on your elbows, knees, scalp and lower back but can appear anywhere on your body. The plaques can be itchy, sore or both. In severe cases, the skin around your joints may crack and bleed.

Scalp psoriasis

This can occur on parts of your scalp or on the whole scalp. It causes red patches of skin covered in thick silvery-white scales. Some people find scalp psoriasis extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, although this is usually only temporary.

Nail psoriasis

In about half of all people with psoriasis, the condition affects the nails. Psoriasis can cause your nails to develop tiny dents or pits, become discoloured or grow abnormally. Often nails can become loose and separate from your nail bed. In severe cases, your nails may crumble.

Guttate psoriasis

Guttate psoriasis causes small (less than 1cm or 1/3 inch) drop-shaped sores on your chest, arms, legs and scalp. There is a good chance that guttate psoriasis will disappear completely after a few weeks, but some people go on to develop plaque psoriasis. This type of psoriasis sometimes occurs after a streptococcal throat infection and is more common among children and teenagers.

Less common types of psoriasis

There are less common types of psoriasis:  Inverse (flexural) psoriasis, pustular psoriasis, Generalised pustular (von Zumbusch) psoriasis, Palmoplantar pustular psoriasis and acropustulosi. In very rare cases, erythrodermic psoriasis may develop.

What triggers the disease?

Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger. Knowing your triggers may help you to avoid a flare-up. Common triggers include:

• An injury to your skin such as a cut, scrape, insect bite or sunburn (this is known as the Koebner response)
• Drinking excessive amounts of alcohol
• Smoking
• Stress
• Hormonal changes, particularly in women (for example during puberty and the menopause)
• Certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, ACE inhibitors (used to treat high blood pressure) and beta blockers (used to treat congestive heart failure)
• Throat infections - in some people, usually children and young adults, a form of psoriasis called guttate psoriasis (which causes smaller pink patches, often without a lot of scaling) develops after a streptococcal throat infection, although most people who have streptococcal throat infections do not develop psoriasis
• Other immune disorders, such as HIV, which cause psoriasis to flare up or to appear for the first time

Myths and misconceptions about psoriasis

Unlike other ailments, psoriasis can be seen on the skin and often people guess at what is wrong. They wonder if the lesions might be contagious, which they are not, or that the person who has the psoriasis is unclean, overly nervous or high-strung, which they may be, but that is not the reason they have psoriasis. Sometimes they may believe the person who has the skin disorder did something to cause psoriasis to appear, but that, too, is also false.

Psoriasis is a disorder stemming from a physical defect just like other disorders, such as arthritis, asthma, diabetes or nearsightedness. It is very important to educate the public about psoriasis and not allow myths to spread.

Common myths about psoriasis

Myth: "Psoriasis is contagious"

Fact: Psoriasis, especially in moderate or severe forms, is highly visible. Because of the abnormal growth of skin cells, thick red scaly inflamed patches of skin appear. However, psoriasis is not contagious.. You can't "catch" the disease from another person and you can't pass it on to someone else by touching them or having close contact. Actually, psoriasis is as contagious as freckles!

Myth: "Psoriasis is just a skin disease. A cosmetic problem."

Fact: Psoriasis is a chronic disease of the immune system that causes the abnormal growth of skin cells. While a normal skin cell matures in 28 to 30 days and is shed from the skin's surface unnoticed, a psoriatic skin cell takes only 3 to 4 days to mature and move to the surace, resulting in cells piling up and forming the scaly lesions. Psoriasis lesions can be painful and itchy, and they crack and bleed.

About 30-50% of all people with psoriasis also develop psoriatic arthritis which causes pain, stiffness and swelling in and around the joints.

Skin inflammation in psoriasis is just the tip of the iceberg. There is increasing evidence suggesting links with serious health concerns such as cardiovascular disease, diabetes, liver disease, depression and obesity.

Myth: "Psoriasis only affects patients physically."

Fact: Aside from the physical burden of the disease, there is also a significant psychological and emotional impact experienced by psoriasis sufferers. People with psoriasis often report feelings of helplessness, hopelessness, anger, frustration and even depression related to the appearance of their skin and how others react to their condition. Some patients with severe psoriasis have even experienced thoughts of suicide.

Many individuals react to their condition by wearing concealing clothing, curtailing everyday activities such as swimming or going to the gym if it means they will attract stares or negative comments. Psoriasis sufferers often compare the dysfunction and disability of the condition to that experienced by people with other chronic conditions such as diabetes or heart disease.

Myth: "Psoriasis is caused by poor hygiene."

Fact: Psoriasis is a disease of the immune system and has nothing to do with poor hygiene. Triggers that can influence the course of psoriasis include infections, stress or worry, hormonal changes, injury to the skin, alcohol, obesity, poor diet and certain medicines.

Myth: "Psoriasis can be cured"

Fact: Psoriasis is a chronic, life-long disease. There is no known cure yet, but with new options and improved exisiting treatments, people have a wide variety of ways to help manage the the symptoms of psoriasis. Until a cure for psoriasis is found, pharmaceutical research continues to hold the best hope for increasingly more effective therapies, leading to a better overall management of psoriasis. Research into the immune system has led to the development of new biological drugs that target the underlying causes of the condition.

Myth: "Psoriasis is easily diagnosed"

Fact: Many conditions affecting the skin look alike. For example, some early symptoms of psoriasis, such as itching and redness, look the same as eczema or atopic dermatits. This can sometimes make the disease difficult to diagnose. It is important to see a doctor who can do the necessary tests to make a proper diagnosis.

Myth: "Psoriasis cannot be inherited"

Fact: While many patients with no family history of the disease develop psoriasis, there is a gentic link in approximately 40-60% of patients with the condition. Numerous studies point to a genetic predisposition, or inherited tendency, for these patients to develop psoriasis. Having the genetic predisposition, however, does not necessarily mean that individuals will develop the disease. Other contributing factors, such as injury or infection, may act in conjunction with several genes, or specific patterns of genes, to set in motion the chain of events resulting in psoriasis.