What is psoriasis?

  • A skin condition that develops when the body makes skin cells too quickly (in days instead of weeks)
  • The cells pile up on the skin surface and forms thick, scaly patches
  • Plaque psoriasis is the most common type
    • Plaques are thick, scaly patches that develop on the skin
    • 80-90% of people with psoriasis develop plaques

What causes psoriasis?

  • Your chances of developing it is higher if your family member has it
  • Not contagious
  • Cells in immune system attack the body’s skin cells
  • Certain genes can cause psoriasis

What can trigger psoriasis?

  • Stress
  • Skin injury (includes a cut or bad sunburn)
  • Infection such as strep throat
  • Certain medications including lithium, prednisone, or hydroxychloroquine
  • Weather (especially cold, dry weather)
  • Tobacco
  • Heavy alcohol drinking

Triggers can cause flare ups, and they can vary for different people. It is very important to recognize your triggers and avoid them to reduce flare ups of psoriasis.

What are some signs/symptoms to look out for?

  • Dry, thick, raised patches on the skin
  • Patches covered with a silvery white scale that itch
  • Patchy rash that varies widely in how it looks from person to person
    • Ranges from dandruff like scaling to major eruptions all over the body
  • Rashes that vary in color
    • Tend to be shades of purple with gray on dark skin
    • Or pink/ red with silver on light skin
  • Dry cracked skin that may bleed
  • Itching, burning, or soreness
  • Rashes that erupt for a few weeks and then calm down

These ones are common, but it really depends on the type of psoriasis, places where it appears, and the amount of psoriasis.

Can you get psoriasis if you have colored skin?

  • Yes, people of all skin types can develop psoriasis, but there are differences in appearance on light and dark skin.
  • In light skin, it will tend to be red or pink
  • In dark skin, it is normally violet of gray

When should I see a doctor?

If you suspect that you may have psoriasis, see your doctor right away. Seek medical attention if your condition:

  • Becomes worse or widespread
  • Causes pain or discomfort
  • Causes concern about skin appearance
  • Does not improve with treatment

How can I treat my psoriasis?

Talk to your doctor about what treatment is right for you based on the type and severity of psoriasis. They will most likely prescribe you with mild therapy such as topical treatment to start and if your psoriasis does not improve your doctor can move you to stronger medications.

Topical treatment
  • Corticosteroids are used to treat mild to moderate psoriasis. They come in different forms such as ointments, oils, creams, lotions, gels, foams, sprays, and shampoo. For sensitive areas like the face, mild corticosteroids like hydrocortisone are recommended. These can also be used on patches of psoriasis that appear throughout the body. Stronger ointments like triamcinolone may be prescribed for areas that are less sensitive and harder to treat. However, using corticosteroids for a long time can make the skin thinner and less effective in managing psoriasis symptoms.
  • Salicylic acid shampoos and scalp solutions can help reduce scalp psoriasis.
  • Coal tar is available as shampoo, cream, and oil. It decreases scaling, itching, and inflammation and is available as a prescription and nonprescription. It is not recommended if you are pregnant or breastfeeding.
Oral/injected medications
  • Biologics are medications that are injected into the body to help treat psoriasis. They work by affecting the immune system. Some examples are Humira and Stelara.
  • Methotrexate is a medication you take once a week by mouth. It helps reduce the production of skin cells in psoriasis. It’s not safe to use while breastfeeding and if you plan to have a baby, you should stop taking it at least 3 months before trying to get pregnant.
  • Cyclosporine is a medication taken orally for severe psoriasis and works to suppress the immune system
Alternatives

There is not a lot of strong evidence on the effectiveness of these, but they are generally safe and can improve mild to moderate psoriasis.

  • Aloe extract cream- may reduce scaling, itching, and inflammation
  • Fish oil supplements-may improve scaling
  • Oregon grape (barberry)- may reduce severity of psoriasis
Light therapy

This is first line for moderate to severe psoriasis and can be used alone or in combination with medications.

  • Sunlight-daily exposure can improve psoriasis
  • UVB broadband-artificial light source that treats single patches of psoriasis, widespread and used if psoriasis does not improve with using topical treatment, short term side effects are inflamed itchy, dry skin
  • UVB narrowband-may be more effective than broadband, used 2-3 times a week, and more severe side effects than broadband
  • Psoralen plus ultraviolet A (PUVA)- this is when you take a light-sensitizing medication called psoralen before exposing the skin to UVA light. It penetrates the skin better than UVB, and the psoralen helps with this.

References

What is psoriasis? American Academy of Dermatology. (n.d.). https://www.aad.org public/diseases/psoriasis/what

Mayo Foundation for Medical Education and Research. (2024, May 17). Psoriasis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840