Psoriasis – signs to look out for and how to treat it

Have you noticed patches of flaky, dry skin on your body? This could be a sign of psoriasis. Here’s how to get it treated.


Different types of psoriasis

What causes psoriasis and who’s most affected?

When to see a doctor

How is psoriasis diagnosed?

Treatment for psoriasis

How to manage psoriasis with self-care

Psoriasis can make you feel self-conscious, affect your productivity at work, your relationships, and your sleep. It can even prevent you from wearing some of your favorite clothes. But it doesn’t have to stop you from living the life you want. Here’s how to get the condition under control.


Do you have dry, cracked skin and a raised, patchy rash that’s formed scales? You might have psoriasis. It’s a chronic skin condition that affects around 2-3% of people in the world.

While it may not have a huge impact on life for some people, for others it may feel painful, sore, and itchy, making it difficult to concentrate at work – and even get enough sleep at night. 

Because psoriasis is a visible condition, you might also feel very down and self-conscious about your body.

## Different types of psoriasis

There are many different types of the condition, each with unique symptoms.

It’s possible to have one type of psoriasis, or you might have more than one form, or one could progress into another.

Types include:

- __plaque psoriasis__ – the most common type, causing raised and itchy skin patches covered with scales. You might have a few or many of these, developing on your elbows, knees, lower back and scalp (scalp psoriasis is a specific type of plaque psoriasis)
- __inverse psoriasis__ – affects the skin around your groin, bottom and breasts, where smoother patches of red and inflamed-looking skin get worse with sweating and friction
- __guttate psoriasis__ – small, scaling spots on the body, arms, and legs that look drop-shaped. It usually affects children and young adults 
- __nail psoriasis__ – when the nails on your fingers and/or toes grow abnormally and look discolored. Your nails might also separate from the nail bed
- __pustular psoriasis__ – a rare type causing small or large areas of pus-filled blisters on the palms, or soles of your feet
- __erythrodermic psoriasis__ – another rare type, where an itchy, peeling rash covers the whole body
- __[psoriatic arthritis](https://www.livehealthily.com/health-library/conditions/psoriatic-arthritis)__ – a complication of psoriasis, which causes stiffness, pain and swelling around your joints.

The color of your psoriasis will vary depending on the color of your skin. On black, white, and brown skin, the patches may look pink or red, with scales turning white or silvery. But patches can also go purple or dark brown on brown and black skin, with scales looking gray.

The severity of psoriasis varies from person to person, but most forms come and go in cycles – flaring up for a few weeks or months to cause more severe symptoms, then settling down to mild or no symptoms. 


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## What causes psoriasis and who’s most affected?

The condition is thought to be caused by a problem with the immune system, which triggers skin cells to grow faster than normal.

Skin cells are usually produced and replaced every 3 to 4 weeks, but if you have psoriasis, this process speeds up and can take just 3 to 7 days. Over time, this leads to a build-up of skin and the rise of scaly patches. 

While anyone can develop psoriasis, you could be more likely to get the condition if it runs in your family. 

Certain triggers also increase the likelihood of psoriasis developing, including:

- a recent skin injury, such as a cut, insect bite, sunburn, or scrape
- smoking, or being around secondary smoke
- living in a cold, dry climate
- going through hormonal changes, particularly in women such as during the menopause 
- stress
- being between the ages of 20 and 30, or 50 and 60
- drinking a lot of alcohol
- a recent infection, such as [strep throat](https://www.livehealthily.com/health-library/conditions/streptococcal-infections) or skin infections
- taking certain medicines like lithium, high blood pressure medication, and antimalarials.

Psoriasis is not contagious, so it can’t be spread from person to person.

## When to see a doctor

If you think you have [psoriasis symptoms](https://www.livehealthily.com/health-library/conditions/psoriasis#types-of-psoriasis), see a doctor. You should also book an appointment if you already have psoriasis and it’s:

- getting worse or spreading to more of your body
- causing you pain
- making you feel down about your skin and your body
- not getting better with treatment.

Psoriasis may raise your risk of other conditions such as [high blood pressure](https://www.livehealthily.com/health-library/conditions/blood-pressure-high), cardiovascular disease, and [diabetes](https://www.livehealthily.com/health-library/conditions/diabetes). 

This is thought to be due to inflammation caused by psoriasis, or because these types of health issues have similar risk factors. Your doctor can help you assess your risk and give you advice to help.


## How is psoriasis diagnosed?

A doctor can usually tell if you have the condition by looking at your skin, but they may refer you to a dermatologist if they aren’t sure. 

In some cases, you might need to have a skin biopsy – when a small sample of skin is taken and examined under a microscope. 

You may need a blood test and X-ray if other conditions, such as [rheumatoid arthritis](https://www.livehealthily.com/health-library/conditions/rheumatoid-arthritis), are suspected. 

You may be referred to an arthritis specialist (rheumatologist) if it’s thought you’ve developed psoriatic arthritis. 

## Treatment for psoriasis

It’s a chronic condition, which means there’s no cure, but the symptoms can be well managed with medication. 

Treatments aim to stop skin cells from producing so fast, and to improve the appearance of skin patches.

Exactly which treatment you’ll be recommended depends on how severe your psoriasis is, but you might be prescribed more than one type, to be used in combination with another.

They include:

- __topical creams, ointments, and emollients__ – common first-line treatments, such as vitamin D analogues and topical steroids. They can take up to 6 weeks to work
- __light therapy (phototherapy)__ – used if topical medicine doesn’t work, or your psoriasis is more severe. It uses ultraviolet light, set at specific wavelengths, to reduce inflammation
- __systemic medications__ – such as steroids and retinoids taken orally, or injected, to work throughout your entire body. They’re only used if your psoriasis is severe, or if other treatments haven’t worked because they carry side-effects. 

## How to manage psoriasis with self-care

Looking after yourself at home, alongside medicines prescribed by a doctor, will help you to manage the condition. You could try to: 

- __keep up with your treatment plan__ – to help manage your condition
- __avoid scratching your skin__ – especially psoriasis patches or scales. Medicated shampoo or ointment-based moisturizers can help – speak to your doctor
- __manage stress__ – have a go at deep breathing exercises, yoga or meditation
- __stop smoking__ – and avoid secondhand smoke
- __talk to your employer__ – this can help you feel more confident at work and manage your psoriasis at the same time. It might look like working flexible hours for doctor’s appointments, or wearing protective clothing (eg gloves) to stop patches from getting worse 
- __stay away from psoriasis triggers__ – such as infections, injuries to the skin, harsh soaps, and too much sunlight
- __lose weight, if you are overweight or obese__ – people with psoriasis are slightly more at risk of developing diabetes and cardiovascular disease, so this helps lessen risk
- __connect with others__ – through support groups, such as [The National Psoriasis Foundation](https://www.psoriasis.org/support-and-community/), [the psoriasisSPEAKS group on Facebook](https://www.facebook.com/PsoriasisSpeaks) or the [Psoriasis Support Group UK on Facebook](https://www.facebook.com/groups/486402214847452/).


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References

Amelia Glean

Jo Wheatley

Dr Ewan O'Farrell

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Have you noticed patches of flaky, dry skin on your body? This could be a sign of psoriasis. Here’s how to get it treated.