Psoriasis Signs, Symptoms, and Treatment

August 2023

August is Psoriasis Awareness Month, so we’re speaking with Dr. Jennifer Stead, a Board-Certified Dermatologist at our Bedford, NH practice (Manchester area), to learn about the signs, symptoms, and treatments for this persistent skin condition. Psoriasis is a chronic disease marked by itchy, red, and sometimes burning skin. Understanding and managing it is crucial, whether you suspect you have psoriasis or have been diagnosed with it.

Understanding and Managing this Chronic Skin Condition

Psoriasis is a chronic skin disease that is primarily identified by itchy, red, burning, or stinging skin that won’t go away on its own. If you think you have psoriasis or have been diagnosed with it, it’s important to understand this condition and how to manage it. 

Signs, Causes, and Symptoms of Psoriasis

Psoriasis is most often found on the knees, elbows, or scalp, and is characterized by raised areas, or plaques, on the skin that are typically red, itchy, and can burn or sting. 

It’s important to understand that psoriasis is not contagious, and is not necessarily hereditary. While psoriasis can occur at any age, it first appears most commonly in individuals between the ages of 15 and 35.

The National Psoriasis Foundation states that psoriasis is caused by an overactive immune system in which the growth of skin cells occurs very quickly. 

Normal skin cells take about a month to finish growing and be shed from the body. However, skin cells impacted by psoriasis finish growing every few days, and instead of shedding, they pile up on the surface of the skin.

Psoriasis can flare up when the immune system reacts to a trigger, such as illness, stress, exposure to hot or cold temperatures, contact with an allergen, or even trauma to the skin, such as a burn or scrape. 

Are There Different Types of Psoriasis?

Yes! In fact, there are five types of psoriasis that can affect different parts of the body in different ways, and you can have more than one type of psoriasis.  

Here are the five types of psoriasis and their characteristics to help you understand which type you may have. 

Plaque Psoriasis: This most common type affects 80-90 percent of individuals who have psoriasis. Plaque psoriasis manifests as raised patches of skin called plaques, which are itchy, red, and 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. 

Psoriasis can lead to other health conditions, including – but rarely – psoriatic arthritis, which can cause symptoms of arthritis in the joints. Psoriatic arthritis 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 milder 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.

How to Manage Psoriasis Flare-Ups in the Warmer Months

The symptoms of psoriasis can come and go, but the onset of symptoms, or flare-ups, can vary in severity and be triggered by different things. One common trigger is hot temperatures, such as warm weather in the summer months. Individuals with psoriasis often experience flare-ups when they’re exposed to the sun or from the friction and sweat caused by exercise or summer activities like swimming and hiking. 

But don’t worry – there’s no need to stay inside and shelter from the sun if you have psoriasis. Many individuals can take some basic precautions before engaging in summer activities to prevent or at least minimize psoriasis flares. 

Here are a few “hot tips” for managing psoriasis in the summer. 

  1. Wear broad-spectrum sunscreen with an SPF of 30 or more. Sunscreen is always recommended regardless of skin conditions, but for those with psoriasis, it provides a valuable barrier between the sun and potential skin irritation. To further help prevent a psoriasis flare-up, choose a sunscreen that is fragrance-free and designated for sensitive skin. 
  2. Allow your skin to “breathe” by avoiding fabrics that hold moisture. Even if you’re not doing a vigorous outdoor activity, clothing that doesn’t wick away sweat from the skin will create irritation and cause your psoriasis to flare up. Light, breathable, wicking fabrics make a big difference in any warm weather activity. 
  3. Embrace a swim in the ocean or in a saltwater pool. Saltwater can help wash away dead skin and improve the look of your psoriasis. However, because salt water can also dry out the skin, it’s important to clean off and moisturize well afterward. 
  4. Grab a spot in the shade, in front of a fan, or in an air-conditioned room whenever you can, as refreshing temperatures help cool down the skin and reduce the chance of flare-ups or additional irritation. 

And we know the summer is the most popular time to travel, but you don’t have to worry if you have psoriasis – you just have to be prepared. Make sure to bring appropriate clothing for the activities you’ll be doing, as well as enough medication if you’re using any prescription or over-the-counter topical or oral treatments for your psoriasis. 

Psoriasis Treatment: Managing and Reducing Symptoms 

About 7.5 million Americans, and 125 million people worldwide, are living with psoriasis. Psoriasis is a chronic skin disease with no definitive cure, so those who have it will have it for life. However, there are ways to manage symptoms with the right treatments. 

There are a few different ways to manage psoriasis, and it’s common for patients to try multiple approaches before finding one or a combination that makes a difference. 

Prescription medications that can help include 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 analogs, or salicylic acid. 

There are also different prescription drug treatments, or biologics, that have come onto the market to help people manage their psoriasis and have been found to be effective. However, you should consult with your doctor or dermatologist before 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. Further, biologics 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. 

There are several non-medication treatments you can consider. 

Other non-medication treatments you can try include adjustments to diet, weight loss, or a focus on lifestyle improvements that reduce stress and anxiety. 

While there is currently no evidence pointing to diet as a trigger for psoriasis, some patients do notice a correlation between certain foods they eat and their flare-ups, which could be a result of a food allergy or the inflammatory nature of psoriasis. Eating foods that reduce inflammation, such as those high in Omega-3 fatty acids, may be helpful. 

Obesity has been shown to correlate with psoriasis, as it can cause some of the triggers that may bring on flare-ups, such as high blood pressure, high cholesterol, or other metabolic conditions. Weight management is beneficial for any individual, especially those struggling with an autoimmune disease.

Finally, starting a meditation routine, exercising regularly, or adjusting your lifestyle to reduce day-to-day stresses can help reduce psoriasis triggers as anxiety and stress are thought to contribute to psoriasis flare-ups.

Light Therapy for Psoriasis Treatment

At Optima Dermatology, we offer ultraviolet light therapy, or phototherapy, in which UVB rays are applied over a consistent period of time to penetrate the skin and help slow the growth of affected skin cells. We offer this treatment at our Mentor, Macedonia, Salem and Bloomington clinics with our Houva device, and will soon also be offering it at our Stratham, NH location. 

There are two types of UVB therapy – narrowband and broadband. The primary differences are that narrow-band UVB rays release a smaller range of ultraviolet light, may produce more effective and longer-term results, and may require fewer treatments. 

An excimer laser, which emits a high-intensity beam of UVB light, is often used to treat chronic, localized psoriasis plaques as it can target specific areas of the skin, particularly on the scalp.

Light therapy has been found to be effective in treating psoriasis, but the type and duration of this phototherapeutic treatment varies from patient to patient depending on the severity of your psoriasis. 

In many cases, there is simply not enough long-term data available to indicate for how long patients will experience reduced symptoms or overall improvements following a course of light therapy treatment. 

The Good News: There Is Help Out There for Your Psoriasis!

Psoriasis is a challenging skin disease that not only causes physical discomfort but can have an emotional impact as well. Even mild psoriasis can leave people feeling self-conscious and can even cause social and mental health issues. And because stress and anxiety are considered triggers for psoriasis, patients can often become “stuck” in a difficult cycle that can feel impossible to get out of. 

Fortunately, psoriasis awareness has grown significantly. In 1997, the National Psoriasis Foundation designated August as National Psoriasis Month, which has helped spread information about the disease and create a community for those suffering from it to feel less isolated. 

We are all now also exposed regularly to ads and commercials for psoriasis drug treatments highlighting the challenges of the disease and treatment options. While the month of August is a great time to focus on awareness around this skin disease, we offer more acceptance and hope year-round for people suffering from 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. 

Request an appointment today for a diagnosis and to begin conquering your psoriasis.