Overview
Psoriasis affects countless people around the world. Approximately 3% of the U.S. population suffers from psoriasis, and numerous have no idea how to manage the condition. This article discusses in depth the symptoms, triggers, treatment and prevention of psoriasis.
What is psoriasis?
Psoriasis is a well-known autoimmune condition that leads to the rapid buildup of skin cells. This buildup of cells causes scales to appear on the skin’s surface. In individuals with psoriasis, skin cells don’t have time to fall off, and the production occurs over a few days, leading to the buildup of skin cells.
This chronic condition causes redness around the scales and results in inflammation. Mostly psoriatic scales are whitish-silver. These scales can develop as thick red patches. However, on darker skin tones, they present as purplish, dark brown patches with grey scales. These patches tend to crack and bleed.
In normal cases, skin cells originate in the deep layer of the skin and slowly rise to the surface over one month. However, cell production occurs at a greater speed in people with psoriasis.
Scales usually develop on joints, most commonly affecting the knees and elbows, but they can occur anywhere on your body. Multiple areas of the body may be affected, including:
- hands
- feet
- scalp
- neck
- face
Psoriasis may also affect the:
- nails
- mouth
- genital region
Some other conditions that may be associated with psoriasis include:
- inflammatory bowel disease
- type 2 diabetes
- psoriatic arthritis
- anxiety
- depression
- heart disease
What triggers psoriasis?
Psoriasis outbreaks can vary from person to person. The exact causes of flare-ups haven’t yet been identified. Common psoriasis causes or triggers include:
- Emotional stress.
- Skin injury.
- Infections such as Streptococcal affect the immune system.
- Prescription medications include Lithium and beta blockers.
- Cold weather.
What are psoriasis symptoms?
Psoriasis rash is an indication of early psoriasis. Red, scaly patches follow this. Other psoriasis symptoms include:
- Cracked, dry skin.
- Itchiness.
- Shiny patch of skin.
- Scaly scalp.
- Skin pain.
- Pitted or cracked nails.
- Joint pain.
Is psoriasis contagious?
The rash is not contagious. So you can’t pass it on to another person.
What causes psoriasis?
Psoriasis results from an overactive immune response that causes inflammation and leads to new skin cells growing too fast.
The normal skin cells growth cycle lasts 28 to 30 days. However, in individuals with psoriasis, new cells grow and migrate to the skin surface every few days. The new cells form a layer at the top of the skin, giving the appearance of silvery scales.
Psoriasis usually runs in families, and parents can pass it down to their children.
Diagnosing psoriasis
Psoriasis can be diagnosed based on a physical exam. In some cases, a biopsy is required for confirmation.
Physical examination
Most doctors can reach a diagnosis after a physical exam. Symptoms of psoriasis are easily distinguishable from other conditions that may result in similar symptoms. During the examination, it is best to let your doctor look at all the affected areas.
Biopsy
However, sometimes for confirmation of the suspected diagnosis, a biopsy is done. A small sample of the affected area is taken and sent to the lab for analysis. The results can help diagnose the type of psoriasis and rule out any other conditions. Treatment options can vary according to the results.
Some common Psoriasis triggers
External factors can trigger psoriasis. However, psoriasis triggers are not the same for every individual. Common triggers that have been identified for psoriasis include:
Stress
A high amount of stress may cause a flare-up. Developing a good stress coping mechanism can, in turn, help reduce the possibility of flare-ups.
Injury
A cut or accident can trigger a flare-up. Vaccines, sunburns and injections are some other triggers.
Medications
Certain medications, such as lithium, antimalarials, and antihypertensives, can trigger an outbreak of psoriasis.
Infection
Psoriasis is a result of your immune system mistakenly attacking healthy skin cells. The immune system is a person’s first line of defence against infection. If you have an infection, your immune system, apart from carrying out its normal function, may start attacking healthy cells resulting in a psoriasis flare-up. Strep throat is considered a common trigger.
Alcohol
Excessive alcohol intake can lead to frequent psoriasis outbreaks. However, reducing alcohol intake or avoiding it entirely can help prevent flare-ups.
What are the different types of psoriasis?
There are five types of psoriasis:
Plaque psoriasis
This is the most prevalent type of psoriasis. Symptoms of early plaque psoriasis include dry, itchy, raised skin patches covered with scales. These patches are referred to as plaques. Plaques usually appear on the knees, lower back, elbows, and scalp. There may be few or many. When these patches affect the scalp only, the condition is called scalp psoriasis. The patches vary in color. Red, inflamed patches appear on light skin tones, while darker brown or purplish patches appear on darker skin tones. The overlying skin can heal with a color change, commonly referred to as post-inflammatory hyperpigmentation.
Guttate psoriasis
Guttate psoriasis mainly affects children and young adults. This psoriasis is triggered by a bacterial infection such as strep throat. Small, drop-shaped, red, or violet spots on the arms, legs, or trunk characterize the condition.
Pustular psoriasis
Pustular psoriasis affects adults resulting in white, pus-filled blisters and areas of red or violet inflamed skin, depending on the skin tone. The patches are more intense violet on darker skin tones. Psoriasis on hands or psoriasis on feet is a typical presentation of pustular psoriasis. Although pustular psoriasis can be widespread, it usually affects the hands and feet.
Inverse psoriasis
Inverse psoriasis causes inflamed skin patches and red, shiny skin to appear. Areas commonly affected include the armpits, breasts, groin, or skinfolds in the genitals region. Genital psoriasis or psoriasis penis occurs when these regions’ patches of inverse psoriasis appear.
Erythrodermic psoriasis
Erythrodermic psoriasis is considered a very severe and rare type of psoriasis. This form often affects areas of your body at the same time. The skin gives the impression of being sunburnt. Scales that have developed may slough off in large sections. It can result in an infection leading to a fever, and the person can fall ill.
This type of psoriasis can be life-threatening, so it’s essential to consult a doctor if you have any such symptoms.
Treatment options for psoriasis
Although psoriasis has no permanent cure, treatment options are available to counter inflammation, heal the skin, remove plaques, and slow down the process of the rapid buildup of skin cells. Psoriasis treatment can vary according to psoriasis type.
Psoriasis treatments can be divided into three categories:
Topical treatments
Psoriasis medication includes creams and ointments. These are applied directly to the affected skin and help manage mild to moderate psoriasis.
Topical psoriasis treatments include:
- topical corticosteroids
- moisturizer
- anthralin
- vitamin D analogs
- salicylic acid
- topical retinoids
Systemic medications
People with moderate to severe psoriasis, particularly those who have not responded well to other forms of treatment, may need to switch to oral medications or injectables for psoriasis.
However, these medications can have severe side effects, and for that reason, doctors usually prescribe them for short periods.
These medications include:
- methotrexate
- cyclosporine
- oral retinoids
- biologics
Common prescribed oral and injected medications used to treat psoriasis include:
Methotrexate
Methotrexate is used to manage several autoimmune conditions. It works by suppressing the immune system. Although it may cause fewer side effects when used in low doses, it can have serious long-term side effects. Severe side effects include liver damage and decreased red and white blood cell production.
Cyclosporine
Cyclosporine also dampens the immune system’s response, resultantly reducing symptoms of psoriasis. Although, this contributes to a weakened immune system, so you are more likely to fall sick easily. Some side effects include kidney problems and hypertension.
Retinoids
Retinoids mainly target reducing skin cell production. However, once you discontinue use, symptoms of psoriasis can return. Mucosal dryness and hair loss are the commonly reported side effects of retinoids.
Pregnant women or those planning to conceive are advised not to take retinoids because of the risk of possible congenital disabilities.
Biologics
This class of medications alters your immune response by working on specific inflammatory pathways. These medications are available as injectables or intravenous (IV) infusions.
Light therapy
UVA and UVB light has proven to help reduce symptoms of mild to moderate psoriasis. This form of psoriasis treatment uses ultraviolet (UV). Sunlight destroys the overactive white blood cells that attack healthy skin cells or cause a rapid turnover.
The type of treatment varies from person to person, and most people with moderate to severe psoriasis are provided with a combination of treatments to reduce symptoms. As a result, the condition may be well-controlled for a person on the same treatment, while others may need to change treatments in case they fail to respond to a particular treatment.
Home Remedies for psoriasis
Although food does not offer a definite cure for psoriasis, a nutrient-rich diet can help manage your symptoms and prevent a flare-up. Some measures that may help ease symptoms of psoriasis include:
Eating a healthy diet
Reducing the intake of saturated fats, specifically those found in animal products like meats and dairy, can help alleviate the inflammation and other symptoms associated with psoriasis.
A psoriasis treatment diet includes omega-3 fatty acids-rich sources such as salmon, sardines, flax seeds, or walnuts.
Avoiding trigger foods
Psoriasis leads to inflammation. Certain foods worsen inflammation, and avoiding those may help manage symptoms. Such food items include:
- refined sugar
- processed foods
- dairy products
- red meat
Reducing the consumption of alcohol
Alcohol consumption can trigger a flare-up. Reducing intake or stopping can help reduce the severity of the disease.
Take vitamins
Vitamins can be taken to supplement your diet. However, it is best to consult your doctor before starting any vitamins.
Complications of Psoriasis
Having psoriasis increases your risk of developing the following conditions:
- Diabetes.
- Obesity.
- High cholesterol.
- Heart attacks
- Strokes.
Prevention of Psoriasis
- Take medications as instructed by your doctor.
- Avoid harsh soaps and moisturize your skin.
- Discuss ways to lower your risk for related conditions, such as heart disease, depression, and diabetes, with your doctor.
- Lower your stress with exercise, meditation, or consulting a therapist.
Psoriasis and Arthritis
In some people, psoriasis affects more than just the skin. It can lead to arthritis. According to some studies, around 30 and 33 percent of people with psoriasis are diagnosed with psoriatic arthritis. This type of arthritis causes swelling, inflammation, and pain in the affected joints. Sometimes this can be mistaken for other conditions, such as rheumatoid arthritis or gout. Although, the presence of inflamed patches of skin with plaques usually helps diagnose this condition and differentiate it from other similar diseases.
Psoriatic arthritis is a chronic condition. Symptoms of psoriatic arthritis can occur intermittently with periods of flare-ups and remission. However, symptoms of psoriatic arthritis can persist as well. This condition usually affects joints in the fingers or toes. Other body areas that are affected include the wrists, knees, ankles or lower back.
Most people diagnosed with psoriatic arthritis already have psoriasis. However, it’s possible to develop joint symptoms or skin symptoms. An early diagnosis and treatment help prevent the progression of the disease and help prevent joint damage.
Psoriasis Around Eyes
Psoriasis around the eyes is a rare finding but can lead to redness, dryness, and discomfort. Additionally, it may impair your vision, and an evaluation by a healthcare professional is warranted if you have any such symptoms.
Commonly confused conditions:
Psoriasis vs. seborrheic dermatitis
The following symptoms characterize scalp psoriasis:
- Red inflamed skin that is covered with silvery scales
- Patches that may extend beyond the hairline and usually are present in other areas of the body.
- Itching
Seborrheic dermatitis of the scalp
- Red skin covered with yellowish scales
- Skin flakes (dandruff) at the base of the hair shaft
- Itching
Both scalp psoriasis and seborrheic dermatitis treatment include medicated shampoos and topical corticosteroid or antifungal solutions. Although, it is harder to treat Scalp psoriasis as it is often more persistent than seborrheic dermatitis of the scalp.
Nail psoriasis vs. nail fungus
Nail fungus and nail psoriasis may have a lot of similar symptoms, but the underlying cause is different; one is an autoimmune condition, while the other is an infection.
Nail psoriasis
This condition rarely occurs on its own. People with nail psoriasis have other areas of the body affected by psoriasis as well. Some symptoms of nail psoriasis include:
- Nail pitting
- Detachment of the nail
- Salmon patches or oil drop appearance on the nail
- Redness
Nail fungus
Usually affects a single toenail
- Discoloration of the nail
- Itching, stinging, or a rash on the surrounding skin
- Thickening of the nails
Other conditions that cause skin flaking include:
- Tinea capitis: is a fungal infection called the ‘scalp ringworm.’ This condition can lead to flaking.
- Eczema: This skin condition causes dry, red, itchy, and flaky skin and can affect different body regions.
- Contact dermatitis: Contact dermatitis on the scalp may also lead to flaking skin and result from using certain cosmetic products, shampoos, conditioners, or other products.
When to Consult a Doctor
Psoriasis is a chronic condition that can prevail throughout your life. It’s related to an overactive immune response. Although there is no permanent cure for psoriasis, the proper treatments can help improve symptoms. If you have skin patches or inflamed skin, talk with our doctor at Your Doctors Online to learn more about psoriasis and discuss your treatment options.
FAQs About Psoriasis Answered By Your Doctors Online Team
Psoriasis is an autoimmune condition that affects millions of people around the world.
Psoriasis is a chronic condition without any cure. It can cause pain and affect the quality of life. However, apart from the rare type called Erythrodermic psoriasis, the condition has no severe life-threatening implications.
A combination of environmental factors and genetics has been identified as the probable cause of psoriasis.
If you have these such issues, it could be psoriasis:
Cracked, dry skin.
Itchiness.
Shiny patch of skin.
Scaly scalp.
Skin pain.
Pitted or cracked nails.
Joint pain.
Although psoriasis has no permanent cure, treatment options are available to counter inflammation, heal the skin, remove plaques, and slow down the process of the rapid buildup of skin cells.
The type of treatment varies from person to person, and most people with moderate to severe psoriasis are provided with a combination of treatments to reduce symptoms.
Although food does not offer a definite cure for psoriasis, a nutrient-rich diet can help manage your symptoms and prevent a flare-up.
The overactive response of the immune system causes skin cells to be replaced rapidly, leading to the following symptoms:
Red inflamed skin that is covered with silvery scales
Patches that may extend beyond the hairline and usually are present in other areas of the body
Itching
Itching is a common symptom of psoriasis. The skin rashes and scaly patches cause some people with psoriasis to experience intense itching.
Conditions commonly mistaken for psoriasis include:
Eczema
Seborrheic Dermatitis
Tinea capitis
Contact Dermatitis
Fungal Infection
This is the most common type of psoriasis. Symptoms of early plaque psoriasis include dry, itchy, raised skin patches covered with scales. These patches are referred to as plaques. Plaques usually appear on the knees, lower back, elbows, and scalp.
The most prevalent type of psoriasis is plaque psoriasis.
Erythrodermic psoriasis is considered a very severe and rare type of psoriasis. This form often affects areas of your body at the same time. The skin gives the impression of being sunburnt. Scales that have developed may slough off in large sections.
Psoriasis and Eczema are both chronic conditions. Eczema causes intense itching and usually affects the skin on the inside surface of the arm, behind the knees, and on the neck. Psoriasis causes a rash or patches of red areas covered with silvery, scaly skin. Commonly affected areas include the outside of the elbows and the front of the knees, which can also affect the joints.
