Psoriasis is a long-term skin condition that causes patches of thick, red, scaly skin. It’s not contagious, but it can be frustrating, painful, and even embarrassing for some people. While psoriasis mostly affects the skin, it’s actually an immune system problem that causes the body to produce skin cells too quickly. These extra skin cells build up on the surface, leading to the noticeable symptoms.
This condition affects millions of people in the United States and can start at any age, though it often appears between the ages of 15 and 35. Psoriasis can range from mild and manageable to more severe cases that make daily life difficult. Even though there is no cure yet, there are many treatment options that can help control symptoms and improve quality of life.
In this article, we’ll explain what psoriasis is, what causes it, the different types, what symptoms to look for, and how doctors diagnose and treat it.
What Psoriasis Really Is
Psoriasis is a chronic autoimmune disease. In people with psoriasis, the immune system mistakenly attacks healthy skin cells. Normally, new skin cells grow deep in the skin and slowly rise to the surface, replacing old cells. This process usually takes about a month. But with psoriasis, the process speeds up dramatically—sometimes taking just a few days. This causes skin cells to pile up on the surface, forming dry, red, itchy patches.
The most common areas affected by psoriasis include the scalp, elbows, knees, and lower back, but it can show up anywhere on the body. The symptoms often come and go, with periods of flare-ups followed by times when the skin clears up or improves. These cycles can be unpredictable and are often affected by things like stress, illness, or cold weather.
Causes and Different Types of Psoriasis
Doctors don’t know exactly what causes psoriasis, but it’s believed to be a mix of genetics and environmental factors. If someone in your family has psoriasis, your risk of getting it is higher. But not everyone with the gene will develop the condition. Some things may trigger psoriasis in people who are already at risk.
Common triggers include infections (like strep throat), skin injuries (such as cuts or sunburns), stress, certain medications, and cold weather. Smoking and heavy alcohol use can also increase the risk or make the condition worse.
There are several types of psoriasis, and each one looks and feels a little different:
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Plaque psoriasis is the most common form. It causes raised, red patches covered with silvery-white scales. These patches can be itchy and painful.
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Guttate psoriasis usually appears after an infection and causes small, drop-shaped spots on the skin.
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Inverse psoriasis affects areas where skin touches skin, like the armpits, groin, or under the breasts. The skin is red and smooth but not scaly.
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Pustular psoriasis causes white pus-filled bumps surrounded by red skin. It’s less common and can be serious.
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Erythrodermic psoriasis is rare but very serious. It causes widespread redness, scaling, and skin that peels off in sheets. This type needs immediate medical attention.
Some people with psoriasis also develop a related condition called psoriatic arthritis, which causes joint pain and swelling. It can be mild or severe and may show up before or after the skin symptoms appear.
Symptoms of Psoriasis
The symptoms of psoriasis can be different for everyone, depending on the type and how severe it is. The most common signs include:
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Raised red patches of skin covered with thick, silvery scales
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Dry or cracked skin that may bleed
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Itching, burning, or soreness in the affected areas
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Thickened, pitted, or ridged nails
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Pain or stiffness in the joints (in psoriatic arthritis)
Some people may have just a few small patches, while others have large areas of affected skin. Psoriasis may appear in the same place every time it comes back, or it may show up in new spots. The symptoms can also get worse during flare-ups, especially when triggered by stress, illness, or other factors.
While the condition mostly affects the skin, its emotional impact is real too. People with psoriasis may feel self-conscious or frustrated, and in some cases, the stress of dealing with the disease can lead to anxiety or depression.
How Psoriasis Is Diagnosed
To diagnose psoriasis, a doctor will start by looking at your skin and asking about your symptoms and medical history. Since psoriasis can look like other skin conditions, such as eczema, a skin biopsy might be needed. This involves removing a small piece of skin and looking at it under a microscope to confirm the diagnosis.
If you have joint pain or swelling along with skin symptoms, your doctor may also check for psoriatic arthritis. This might include blood tests or imaging tests like X-rays to look for signs of joint damage.
It’s important to see a dermatologist (a skin doctor) for an accurate diagnosis and to figure out the best treatment plan for your needs.
Treatment Options for Psoriasis
Although there is no cure for psoriasis, many treatments can help manage symptoms and reduce flare-ups. The right treatment depends on how severe your symptoms are and how much of your body is affected.
For mild cases, over-the-counter creams and lotions that contain ingredients like salicylic acid or coal tar can help reduce scaling and itching. Prescription topical treatments like corticosteroids or vitamin D creams are also common.
If psoriasis is more widespread or doesn’t respond to topical treatments, light therapy may be used. This involves exposing the skin to natural or artificial ultraviolet (UV) light under medical supervision.
For moderate to severe psoriasis, oral medications or injections may be needed. These include drugs that affect the immune system, like methotrexate, cyclosporine, or newer biologic medications that target specific parts of the immune system. These treatments can be very effective, but they also come with potential side effects and need to be monitored closely.
Lifestyle changes can also play a big role. Managing stress, avoiding known triggers, keeping the skin moisturized, and avoiding smoking or heavy alcohol use can help reduce flare-ups and improve how you feel.
