What is Psoriasis? Causes, Symptoms, and Treatment

August 2021

How to Identify and Manage this Common, Inflammatory Skin Disease

There can be many causes of itchy, red, burning or stinging skin, but if it is persistent and won’t go away on its own, you may have psoriasis. What is psoriasis? It’s a chronic skin disease that can affect any part of the body, but is often found on the knees, elbows, or scalp.

The National Psoriasis Foundation explains that psoriasis is caused by an overactive immune system in which the growth of skin cells occurs very quickly. It takes about a month for normal skin cells to finish growing and be shed from the body. With psoriasis, skin cells finish growing every few days, and instead of shedding, they pile up on the surface of the skin.

In most cases, psoriasis is characterized by raised areas, or plaques, on the skin that are typically red, itchy, and can burn or sting.

Psoriasis is not contagious, and is not always hereditary. It can be difficult to pinpoint exactly what causes psoriasis in a certain individual, but we do know that it occurs when the immune system is reacting to a triggering event, which can include illness, stress, exposure to hot or cold temperatures, contact with an allergen, or even trauma to the skin, such as a burn or scrape.

Do I Have Psoriasis?

If you are experiencing itchy, red, burning or stinging skin, always contact your dermatologist for a clear diagnosis. Individuals who suffer from psoriasis describe it as a persistent burning, stinging itch; different from something more benign like a rash or irritation.

There are actually five primary types of psoriasis that can all affect different parts of the body. Some individuals have more than one type of psoriasis. 

Plaque Psoriasis: This most common type affects 80-90 percent of individuals diagnosed with psoriasis. Plaque psoriasis manifests as raised patches of skin called plaques, which are itchy, red, inflamed, and often appear to have silvery scales or even a dark coloration, depending on skin type.

Inverse Psoriasis: Affecting about 25% of those living with psoriasis, inverse psoriasis is most commonly identified by the lack of scales on the skin that are so common with plaque psoriasis. It is also most often found within skin folds – under arms, under the breasts, or in the genital or buttocks areas.

Guttate Psoriasis: Slightly different in appearance from other types of psoriasis, guttate psoriasis typically manifests as small red spots, and is frequently found on the arms, legs, chest, stomach, or back. Guttate psoriasis is less common, affecting about 8 percent of those living with psoriasis.

Pustular Psoriasis: A far smaller population of people (about 3 percent) are affected by this type of psoriasis, which is characterized by pus-filled bumps that are painful and irritated. While it is most commonly found on the hands and feet, it can also appear on any area of the body.

Erythrodermic Psoriasis: Very rarely, individuals with psoriasis may develop erythrodermic psoriasis, which causes redness and excessive shedding of skin layers. About 2 percent of people with psoriasis suffer from erythrodermic psoriasis, and it can be severe enough to be life threatening. Symptoms include itching and pain, an almost burned appearance of the skin, as well as more serious conditions such as changes in heart rate or dehydration.

In some cases, psoriasis can lead to other health conditions, including psoriatic arthritis, which can cause symptoms of arthritis in the joints, and affects about 30 percent of individuals with psoriasis. Psoriasis can also affect fingernails and toenails, causing pain, pitting of the nail, separation of the nail from the nail bed, or coloration changes.

While these types of psoriasis vary widely in how they affect people, and can be more mild or more severe depending on the flare-up and other physical or environmental factors, you should always contact your healthcare provider or dermatologist to ensure a proper diagnosis and treatment.

Eczema vs. Psoriasis: What’s the Difference?

Like psoriasis, eczema is a very common skin condition that causes red, itchy, and sometimes flaky patches on the skin. While individuals with psoriasis report more burning and stinging associated with their flare-ups, eczema can look and feel very similar, making it difficult to self-diagnose.

Ultimately, your dermatologist needs to make the final call, but there are a few characteristics of eczema that set it apart from psoriasis.

  • While eczema can cause a very intense and unrelenting itch, it does not typically burn or sting the way psoriasis does.
  • Eczema and psoriasis both cause red, inflamed patches of skin that can be flakey or scaly. However, skin affected by psoriasis tends to be more inflamed, with raised areas that may appear swollen.
  • Because everyone is different, there are no definitive locations on the body where eczema or psoriasis exclusively appear. Speaking strictly in terms of the most commonly observed cases of each skin condition, eczema typically affects parts of the body that bend, like behind your knee, as well as on the neck, wrists, and ankles. Psoriasis is common in skin folds, and on the elbows, knees, scalp and parts of the face, hands, feet, lower back, and fingernails or toenails.

When considering eczema vs. psoriasis, there are almost more similarities than differences, which underscores the need to consult your doctor for an accurate diagnosis.

Psoriasis Treatment: How to Manage Symptoms

About 7.5 million Americans, and 125 million people worldwide, are living with psoriasis. Psoriasis currently has no definitive cure, and because it’s a chronic disease, those who have it will have it for life. While psoriasis can occur at any age, it first appears most commonly in individuals between the ages of 15 and 35.

The symptoms of psoriasis do come and go, and the onset of symptoms, or flare-ups, can vary in severity. The goals of psoriasis treatment are to reduce the occurrence of flare-ups, and to reduce the severity of those flare-ups when they happen.

There are a few different ways to manage psoriasis. Patients may try multiple approaches before finding one or more that make a difference.

  • Corticosteroids and other topical treatments: Corticosteroid creams, ointments, or sprays can relieve the discomfort of a psoriasis flare-up by reducing inflammation and soothing irritation.These treatments are typically prescribed by your primary care doctor or your dermatologist.There are also many other topical treatments available, including coal tar, Vitamin D analogues, or salicylic acid.
  • Diet: While there is currently no evidence pointing to diet as a trigger for psoriasis,    many psoriasis patients notice a correlation between certain foods they eat and their flare-ups. Because psoriasis is an inflammatory disease, foods that reduce inflammation, such as those high in Omega-3 fatty acids, are thought to be helpful.
  • Weight: Obesity has been shown to correlate with psoriasis, and can make psoriasis more difficult to treat. Weight management has far-reaching benefits for individuals struggling with any autoimmune disease, and for psoriasis patients, it can help mitigate those triggers that may bring on flare-ups, such as high blood pressure, high cholesterol, or other metabolic conditions.
  • Meditation, Exercise, and Lifestyle Improvements: Because stress is thought to be a trigger for psoriasis, patients who focus on stress relieving activities like meditation or exercise, or make lifestyle changes to reduce day-to-day stressors, may see improvements to their flare-ups.
  • Light Therapy: In some cases, your dermatologist may prescribe ultraviolet light therapy. With this treatment, UVB rays applied over a consistent period of time penetrate the skin and can slow the growth of affected skin cells.

Within the last few years, different prescription drug treatments, or biologics, have come onto the market to help people manage their psoriasis, and have been found to be highly effective in treating psoriasis symptoms. However, individuals should consult with their doctor prior to taking a biologic, as these drugs can suppress the immune system in ways that can lead to serious infections, such as tuberculosis.

Biologic treatments are often considered for individuals who are not responding to any other type of psoriasis treatment, but there are other medications available that can be used when other drugs can’t be given.

These drugs can be administered orally in liquid or pill form, or through an injection or intravenous infusion. It is best to speak with your dermatologist about the right medication to treat your psoriasis.

Creating Greater Awareness Around Psoriasis

Finding a treatment is important for reducing the discomfort that can come with psoriasis flare-ups, but for many individuals suffering from psoriasis, there is an emotional impact as well. Even mild psoriasis can make individuals feel self-conscious or lead to social and mental health consequences. With stress being considered a trigger for psoriasis, it can create a challenging cycle for individuals feeling anxious about the appearance of their psoriasis when in public settings.

Fortunately, awareness about psoriasis has grown exponentially. The month of August is National Psoriasis Month, helping to spread information about this disease and make those who suffer from it feel less isolated. Coupled with television commercials for psoriasis drug treatments and billboards and other advertising highlighting the challenges of psoriasis, there is far more acceptance and hope for people with psoriasis than ever before.

At Optima Dermatology, we are committed to helping our patients find the right psoriasis treatment. Our goal is to give you power over your psoriasis so you can manage your flare-ups and get back to your life.

Book a free consultation with our board-certified dermatologists at one of our locations in Indiana, Maine, New Hampshire, or Ohio for a diagnosis and to begin conquering your psoriasis.