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Psoriasis

Medically reviewed by Drugs.com. Last updated on Feb 7, 2024.

Overview

Psoriasis is a skin disease that causes a rash with itchy, scaly patches, most commonly on the knees, elbows, trunk and scalp.

Psoriasis is a common, long-term (chronic) disease with no cure. It can be painful, interfere with sleep and make it hard to concentrate. The condition tends to go through cycles, flaring for a few weeks or months, then subsiding for a while. Common triggers in people with a genetic predisposition to psoriasis include infections, cuts or burns, and certain medications.

Treatments are available to help you manage symptoms. And you can try lifestyle habits and coping strategies to help you live better with psoriasis.

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How psoriasis develops

In psoriasis, the life cycle of your skin cells greatly accelerates, leading to a buildup of dead cells on the surface of the epidermis.

Symptoms

Common signs and symptoms of psoriasis include:

There are several types of psoriasis, each of which varies in its signs and symptoms:

When to see a doctor

If you suspect that you may have psoriasis, see your health care provider. Also seek medical care if your condition:

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Plaque psoriasis

Plaque psoriasis is the most common type of psoriasis. It causes dry, raised skin patches (plaques) covered with scales.

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Guttate psoriasis

Guttate psoriasis, more common in children and young adults, appears as small, water-drop-shaped spots on the trunk, arms or legs. These spots are typically covered by a fine scale.

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Inverse psoriasis

Inverse psoriasis causes smooth patches of inflamed skin in the folds of the skin. It usually appears under the breasts and around the groin and buttocks.

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Nail psoriasis

Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration.

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Pustular psoriasis

Pustular psoriasis generally develops quickly, with pus-filled blisters appearing just hours after the skin becomes inflamed and tender. It usually appears on the palms or the soles.

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Erythrodermic psoriasis

The least common type of psoriasis, erythrodermic psoriasis can cover the entire body with a peeling, itchy rash.

Causes

Psoriasis is thought to be an immune system problem that causes skin cells to grow faster than usual. In the most common type of psoriasis, known as plaque psoriasis, this rapid turnover of cells results in dry, scaly patches.

The cause of psoriasis isn't fully understood. It's thought to be an immune system problem where infection-fighting cells attack healthy skin cells by mistake. Researchers believe that both genetics and environmental factors play a role. The condition is not contagious.

Psoriasis triggers

Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor. Common psoriasis triggers include:

Risk factors

Anyone can develop psoriasis. About a third of instances begin in childhood. These factors can increase the risk of developing the disease:

Complications

If you have psoriasis, you're at greater risk of developing other conditions, including:

Diagnosis

Your health care provider will ask questions about your health and examine your skin, scalp and nails. Your health care provider then might take a small sample of skin (biopsy) for examination under a microscope. This helps determine the type of psoriasis and rule out other disorders.

Treatment

Psoriasis treatments aim to stop skin cells from growing so quickly and to remove scales. Options include creams and ointments (topical therapy), light therapy (phototherapy), and oral or injected medications.

Which treatments you use depends on how severe the psoriasis is and how responsive it has been to previous treatment and self-care measures. You might need to try different drugs or a combination of treatments before you find an approach that works. Even with successful treatment, usually the disease returns.

Topical therapy

Light therapy

Light therapy is a first line treatment for moderate to severe psoriasis, either alone or in combination with medications. It involves exposing the skin to controlled amounts of natural or artificial light. Repeated treatments are necessary. Talk with your health care provider about whether home phototherapy is an option for you.

Oral or injected medications

If you have moderate to severe psoriasis, or if other treatments haven't worked, your health care provider may prescribe oral or injected (systemic) drugs. Some of these drugs are used for only brief periods and might be alternated with other treatments because they have potential for severe side effects.

Treatment considerations

You and your health care provider will choose a treatment approach based on your needs and the type and severity of your psoriasis. You'll likely start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy). Then, if your condition doesn't improve, you might move on to stronger treatments.

People with pustular or erythrodermic psoriasis usually need to start with stronger (systemic) medications.

In any situation, the goal is to find the most effective way to slow cell turnover with the fewest possible side effects.

Alternative medicine

Alternative medicine

Some studies claim that alternative therapies (integrative medicine) — products and practices not part of conventional medical care or that developed outside of traditional Western practice — ease the symptoms of psoriasis. Examples of alternative therapies used by people with psoriasis include special diets, vitamins, acupuncture and herbal products applied to the skin. None of these approaches is backed by strong evidence, but they are generally safe and might help reduce itching and scaling in people with mild to moderate psoriasis.

If you're considering alternative medicine to ease the signs and symptoms of psoriasis, talk with your health care provider about the pros and cons of these approaches.

Lifestyle and home remedies

Try these self-care measures to better manage your psoriasis:

Coping and support

Coping with psoriasis can be a challenge, especially if the affected skin covers a large area of your body or is visible to other people. It can cause discomfort and embarrassment. The ongoing, persistent nature of the disease and the treatment challenges only add to the burden.

Here are some ways to help you live with psoriasis and feel more in control:

Preparing for an appointment

You'll likely first see your primary care provider. In some cases, you may be referred directly to a specialist in skin diseases (dermatologist).

Here's some information to help you prepare for your appointment and know what to expect from your health care provider.

What you can do

Make a list of the following:

For psoriasis, some basic questions you might ask include:

What to expect from your doctor

Your health care provider is likely to ask you several questions, such as:

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