How to Identify, Treat, and Manage Psoriasis

We’re back with another Derm Deep Dive, a series where we provide expert advice from our board-certified dermatologists about common skin conditions or treatments. August is Psoriasis Awareness Month, and this month we sought input from our team of expert dermatologists to share information and guidance about psoriasis treatment and awareness.

What is Psoriasis?

Psoriasis is a chronic skin disease that can affect any part of the body but is most often found on the knees, elbows, or scalp. This skin condition is thought to be 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, but psoriasis causes skin cells to finish growing every few days, and instead of shedding, they pile up on the skin’s surface and cause irritation.

In most cases, psoriasis is characterized by raised areas called plaques on the skin that are typically red, itchy, and can burn or sting. It is a lifelong disease that causes flare-ups of inflammation affecting the skin, but it can also affect the joints and other organs in the body.

Who Most Commonly Suffers from Psoriasis?

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.

About 8 million people in the U.S. suffer from psoriasis, and 125 million globally, according to the National Psoriasis Foundation. While psoriasis can occur at any age, it first appears most commonly in individuals between the ages of 15 and 35.

There are five different types of psoriasis, and many individuals suffer from more than one; however, the 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.

What are Different Types of Psoriasis, and Which is the Most Common?

The most common form of psoriasis is plaque psoriasis, which 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.

Other types of psoriasis include:

• Inverse psoriasis, which manifests within skin folds – under the breasts, armpits, or in the genital or buttocks areas – and lacks the scales that are so common with plaque psoriasis.
• Guttate psoriasis, which manifests as small red spots and is most frequently found on the arms, legs, chest, stomach, or back. Usually after a strep infection in psoriasis prone individuals.
• Pustular psoriasis, which is characterized by pus-filled bumps that are painful and irritated and is most commonly found on the hands and feet.

Less common forms:

• Erythrodermic psoriasis, which is very rare and causes excessive shedding of the skin’s layers. It can be severe enough to be life-threatening as it can affect heart rate and cause dehydration. 
• Generalized Pustular psoriasis, which are pustules affecting the whole body.

Additionally, psoriasis can affect your joints:

Psoriatic arthritis, which can occur as a result of having any type of psoriasis and causes symptoms of arthritis in the joints. This affects about 30% of patients.

What Does Psoriasis Treatment Look Like?

Psoriasis is a chronic skin disorder, so the goals for psoriasis treatment are to reduce the occurrence and minimize the severity of flare-ups.

Psoriasis treatment includes:

• Corticosteroids, Vitamin D analogues and other topical treatments
• UVB light therapy, which penetrates the skin over time and can slow the growth of affected skin cells.

Within the last few years, different systemic  drug treatments have come available to help people manage their psoriasis and psoriatic arthritis when topicals and other lifestyle changes are not controlling the condition. New oral medications and injectable medications, called biologics, are available with very good success.

Treatment options that are also beneficial:

• Dietary changes to increase the consumption of foods that can reduce inflammation
• Weight loss to help mitigate triggers that can cause psoriasis flare-ups, such as high blood pressure, high cholesterol, or other metabolic conditions
• Stress relief through meditation, exercise, and lifestyle changes as stress is thought to be a trigger for psoriasis

What are Some First Steps For Someone Newly Diagnosed with Psoriasis?

The most important step is to work with your dermatologist on a skincare plan to manage your psoriasis. Getting to the bottom of what may be causing your psoriasis flare-ups is essential for managing this condition.

Additionally, keep an open mind about your psoriasis management. This is a chronic and often lifelong condition, and while there are treatment options, it may take time to find the right one for you. If you’re working with the right dermatology professional, you will feel confident that your symptoms are being treated as effectively as possible.

What is the Biggest Misconception About Psoriasis?

Psoriasis is often confused with eczema, another 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, and emphasizing the importance of seeking a diagnosis from your board-certified dermatologist.

Additionally, we find that the emotional impact for individuals with psoriasis – and really any skin condition – is often misunderstood. Those who struggle with visible skin issues, or experience painful flare-ups, often experience significant emotional impacts such as depression, anxiety, self-consciousness, and difficulty being in public. These conditions can be extremely disruptive to everyday life, so we work with every patient to help manage symptoms and get them back to feeling confident. 

Think You Have Psoriasis? Have a Dermatologist Take a Look.

Psoriasis can cause significant discomfort but can be controlled through a skincare routine developed between you and your board-certified dermatologist.

Schedule an appointment today with an expert Optima Dermatology provider to begin your path to psoriasis management.