Psoriasis Symptoms and Treatment Options

Psoriasis affects the skin, but it can also interfere with sleep, emotional well-being, and other areas of daily life. It’s a chronic immune-mediated condition characterized by itchy, burning skin and emotional stress. Flares of psoriasis typically occur over weeks or months and may go into remission or subside for an extended period. Understanding how psoriasis forms, what can trigger a flare, and what treatment options exist helps patients make informed healthcare decisions. A dermatologist must also rule out similar conditions, as psoriasis can look like eczema, fungal infections, and other types of skin diseases.

Estimated reading time: 7 minutes

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What Is Psoriasis?

In psoriasis, the immune system causes skin cells to grow faster than normal, accumulating on the skin’s surface in raised areas called plaques. These plaques may itch, burn, crack, and bleed. On lighter skin, these plaques may appear red or pink with silvery scales. On brown or black skin, plaques may look purple, dark brown, or gray. Psoriasis is not contagious, and it cannot spread from person to person via touch, shared items, or proximity. It can occur on any part of the skin, including the scalp, elbow, knee, lower back, palm, sole, and nails.

Common Types of Psoriasis

A dermatologist can identify the type of psoriasis you have and recommend treatment based on its location, severity, symptoms, and effect on your quality of life. The main types of psoriasis include:

Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis, characterized by raised patches of dry, flaky skin covered by silvery scales. It tends to appear in areas like the scalp, elbows, knees, and lower back.

Guttate Psoriasis

Guttate psoriasis is characterized by small, drop-shaped spots and often occurs across the trunk, arms, and legs. It may appear after a streptococcal infection and is commonly seen in younger people, particularly children.

Inverse Psoriasis

Inverse psoriasis appears in skin folds, including areas under the breasts, around the groin, or in the armpit. These patches tend to look smooth and shiny rather than scaly and may be worsened by heat, sweat, and friction.

Pustular Psoriasis

Pustular psoriasis is marked by small bumps filled with pus and surrounded by red, irritated skin. It is often confined to the hands or feet, or it may appear on larger areas. This type of psoriasis needs prompt medical treatment if it covers extensive parts of the body.

Erythrodermic Psoriasis

Erythrodermic psoriasis is a less common and potentially serious form of psoriasis that may lead to generalized redness and skin peeling, severe itching and pain, and a shift in body temperature. Those with widespread erythrodermic psoriasis should seek immediate medical attention.

How Common Is Psoriasis?

Approximately 8 million people in the US live with psoriasis, with the National Psoriasis Foundation estimating that about 3% of American adults have the condition. It can develop at any age and affect people of all skin tones. If the plaques are visible, they may draw unnecessary notice and cause embarrassment, social isolation, and decreased self-esteem. Psoriasis can cause pain and itching and interfere with sleep, work, exercise, and the ability to perform daily activities.

Resource: psoriasis.org

What Causes Psoriasis?

The specific cause is not yet known, and most experts believe psoriasis is caused by a mix of genetic and environmental triggers related to immune system activity.

Genetics

Psoriasis often occurs in families. Having a parent or close relative with the disease raises the chances that you will develop it. However, genes alone do not explain all cases, because environmental factors may also be involved.

Immune System Activity

Immune cells normally defend our bodies from bacteria, viruses, and other invaders. In psoriasis, the immune system becomes overactive, triggering a cascade of events that cause skin inflammation and rapid skin cell production.

Common Psoriasis Triggers

A trigger does not cause psoriasis, but it may prompt a flare or worsen symptoms in someone who is already prone to the condition. Triggers can differ from one patient to another.

These are common triggers:

• Emotional stress
• Strep and other infections
• Injury to the skin, e.g., cuts, scrapes, burns, bug bites, tattoos, or severe sunburn
• Cold, dry weather
• Smoking and secondhand smoke
• Excessive alcohol
• Certain medications including lithium, some anti-malaria drugs, and some blood pressure medications
• Rapid withdrawal from oral or injected corticosteroids

Never stop a prescribed medication without first speaking with the clinician who prescribed it. A dermatologist and prescribing clinician can explore more appropriate options for patients whose medications appear to impact psoriasis.

Resource: health.harvard.edu

Psoriasis Treatment Options

While there is no cure for psoriasis, treatment can improve symptoms, reduce skin inflammation, slow the growth of skin cells, and help prevent future flare-ups. The treatment option that’s best for each patient will depend on the type and severity of the psoriasis, the areas of skin involved, the response to past treatment, and a patient’s medical history.

Topical Medications

Applied to the skin, these are commonly used to treat mild or localized psoriasis. Examples include:

• Corticosteroid creams, gels, and ointments
• Vitamin D analogs
• Retinoids
• Calcineurin inhibitors
• Salicylic acid
• Coal tar products
• Moisturizers and keratolytic products that soften scales

Some topical medications are associated with side effects if used too frequently or over extended periods of time. Always follow the directions provided by your dermatologist, and consult with your dermatologist or primary care clinician before using prescription topical medications on sensitive skin areas such as the face or body folds.

Phototherapy

This treatment involves exposing the skin to precisely measured doses of natural or artificial ultraviolet light in a dermatologist’s clinic. This option may be suggested to treat moderate-to-severe psoriasis or plaques resistant to topical treatment. Phototherapy is available for qualified patients through Colorado Springs Dermatology Clinic, PC. The treatment schedule and safety measures will depend on the light treatment being used, the patient’s skin type, and medical history.

Oral and Injectable Medications

If you have moderate psoriasis, a provider might recommend taking medication that works throughout your whole body, sometimes called systemic medications. These are newer oral treatments or biologic drugs that act on specific parts of the immune system response. If you take any systemic or biologic medication, your treatment must be managed by your physician. Your dermatologist may request blood tests or other forms of monitoring depending on what medication you are taking.

Daily Skin Care and Healthy Habits

Don’t make significant changes to your diet or take supplements as a substitute for medical treatment. If you’re thinking about making dietary changes or adding vitamins or other dietary supplements to your treatment, talk to your dermatologist first, especially if you’re taking other prescribed medications.

Psoriasis and Other Medical Conditions

Psoriasis also may be related to other medical conditions that require health care beyond your dermatologist. A patient with psoriasis may develop psoriatic arthritis and have symptoms such as swollen, stiff, sore, or painful joints. Psoriasis is associated with some mental health conditions such as depression and with medical conditions such as metabolic syndrome and cardiovascular disease. Report any symptoms such as joint pain, stiffness, or swelling, as well as emotional changes such as anxiety, irritability, and depression, to your dermatologist. Prompt medical attention can help ensure a timely diagnosis and treatment.

Resource: mayoclinic.org

When Should I Visit a Dermatologist?

See a dermatologist right away when you have a rash that won’t go away or is causing you pain, itching, or discomfort and has become a rash that has scales or flaking, has patches of skin that have peeled, blisters that are oozing or covered with pus, or symptoms accompanied by fever, fatigue, or other changes in body temperature. You should also see a dermatologist if your rash is affecting your sleep, your ability to work, your physical movement, or your self-confidence.

Final Thoughts

Even though your psoriasis is a chronic condition, it doesn’t have to rule your life. You can reduce discomfort, prevent skin infection, and address psoriasis’ impact on your physical and emotional health by getting an accurate diagnosis and a treatment plan that’s just for you. Contact Colorado Springs Dermatology Clinic, PC to help diagnose and treat your psoriasis at our offices.