Plaque psoriasis; Psoriasis vulgaris; Guttate psoriasis; Pustular psoriasis
Psoriasis is a skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales.
Psoriasis is very common. Anyone can develop it, but it most often begins between ages 15 to 35.
Psoriasis isn't contagious. This means it doesn't spread to other people.
Psoriasis seems to be passed down through families. Health care providers think it may be an autoimmune condition. This occurs when the immune system mistakenly attacks and inflames or destroys healthy body tissue.
Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in 2 weeks rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin's surface, forming the patches of scales.
The following may trigger an attack of psoriasis or make it harder to treat:
Psoriasis may be worse in people who have a weak immune system. This may be due to:
Some people with psoriasis also have arthritis (psoriatic arthritis).
Psoriasis is a common skin condition that causes skin redness and irritation. Most people with psoriasis have thick, red skin with flaky, silver-white patches called scales. Psoriasis may affect you at any age, but it usually begins between the ages of 15 and 35. You can't spread this disorder to others, but it does seem to be passed down through families. We think it probably occurs when your immune system mistakes healthy cells for dangerous substances. Skin cells grow deep in your skin, normally rising to the surface about once a month. But, in people with psoriasis, this process occurs too fast, usually happening in only about 2 weeks, and dead skin cells build up on your skin's surface. Many factors can trigger psoriasis, or make it more difficult to treat, including bacterial or viral infections, dry air or skin, injuries to your skin, some medications, stress, too much or too little sunlight, and even too much alcohol. In general, psoriasis may be very bad in people who have a weakened immune system. Psoriasis can appear suddenly or it can appear slowly. Often, it goes away and then flares up again, time after time. If you have psoriasis, you'll probably have irritated patches of skin on your body, often on your elbows and knees. But it can show up anywhere on your body, even your scalp. The skin patches may be itchy, dry and covered with silver, flaky scales. They may be pink in color and raised and thick. So, what do you do about psoriasis? Well, your doctor will need to look at your skin to make a diagnosis. Sometimes the doctor will take a skin sample, or a biopsy, to rule out other possible problems. Your treatment will focus on controlling your symptoms and preventing infections. In general, you have three options: topical medications like lotions or creams, pills or injections that affect your whole body, and therapy that uses light to treat psoriasis. But most people tend to use creams or ointments they place directly on their skin. Psoriasis is a life-long condition you can control with treatment. It may go away for a long time and then suddenly return. Fortunately, with the right treatment, it usually does not affect your general physical health.
Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back.
The main symptom of the condition is irritated, red, flaky patches of skin. The medical term for the patches is plaques. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, and soles of the feet.
The skin may be:
Other symptoms may include:
There are 5 main types of psoriasis:
Your provider can usually diagnose this condition by looking at your skin.
Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your provider may order x-rays.
The goal of treatment is to control your symptoms and prevent infection.
Three treatment options are available:
TREATMENTS USED ON THE SKIN (TOPICAL)
Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include:
SYSTEMIC (BODY-WIDE) TREATMENTS
If you have very severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids can also be used.
Newer drugs called biologics are used when other treatments do not work. Biologics approved for the treatment of psoriasis include:
Some people may choose to have phototherapy:
If you have an infection, your provider will prescribe antibiotics.
Following these tips at home may help:
Some people may benefit from a psoriasis support group. The National Psoriasis Foundation is a good resource:
Psoriasis can be a lifelong condition that can be controlled with treatment. It may go away for a long time and then return. With proper treatment, it will not affect your overall health. But be aware that there is a strong link between psoriasis and other health problems, such as heart disease.
Call your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.
Tell your provider if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.
There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups.
Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.
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Lebwohl MG, van de Kerkhof PCM. Psoriasis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 203.
Menter A, Korman NJ, Elmets CA, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy. J Am Acad Dermatol. 2011;62(1):114-135. PMID: 19811850
Last reviewed on: 7/23/2015
Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.