What is psoriasis?

Psoriasis is a noncontagious skin condition that can affect any area of your skin but mainly appears on your scalp, elbows, lower back, and knees. It can cause crusty, flaky red patches of skin with a silvery covering that can cause itching and discomfort. 

What is the difference between eczema and psoriasis?

Psoriasis is a skin condition caused by a quicker turn over of skin cells. It causes red skin and scaly, silver patches of skin. Eczema is a skin condition that causes the skin to become dry, itchy, or cracked. It does not cause silvery scale-like patches on the skin.

How common is psoriasis?

Psoriasis is a common skin condition affecting roughly 125 million people worldwide. It is more common in adults under 35 and can affect both women and men. Currently, around 2% of the UK population has psoriasis. 

What are the symptoms of psoriasis?

There are 5 main types of psoriasis, which have slightly different symptoms and can appear on different parts of your body. The main symptoms of psoriasis are dry, red patches of skin covered in silvery scales. The affected areas may also feel itchy or sore. Psoriasis usually comes and goes. When symptoms suddenly become worse, this is called a flare up. 

What are the early signs of psoriasis?

If you have psoriasis, you may notice red patches of skin that do not go away and become itchy or inflamed. You will start to notice silver scales forming. If you have any early signs of psoriasis, see your GP. 

What does psoriasis look like?

Each type of psoriasis can look slightly different but it usually causes red patches of skin. The affected areas will look dry and you may get silver coloured scales on your skin. If you have pustular psoriasis, you will get blisters on your skin that are filled with pus. Sometimes psoriasis can cause your skin to crack and bleed. Psoriasis can also affect your hands and feet. It can start after a sore throat and cause teardrop shaped red patches anywhere on your body. A much rarer type of psoriasis that would need treatment in a hospital causes large areas of skin on your body to become red and inflamed. 

What does psoriasis feel like?

Psoriasis feels different for everyone and you may not feel anything at all. Some patients find that psoriasis itches and is uncomfortable or sore.

Does psoriasis only affect your scalp?

No, psoriasis is most common on the scalp, elbows, lower back, and knees or behind your ears or between your buttocks. These are the main areas that plaque psoriasis forms, which affects about 90% of all psoriasis patients. However, it can affect any area of your body including your nails and joints, but this is less common. 

How long does a psoriasis flare up last?

Psoriasis flare ups can last from a few days to a few weeks. If you get a flare up, prescription treatments such as Dovonex cream can help with symptoms and lessen the time of your flare up. Which treatment is best for you will depend on the type of psoriasis you suffer with and whether you have any other medical conditions or take any other medications. 

What types of psoriasis are there?

There are 5 main types of psoriasis which are:

Plaque psoriasis

The most common type of psoriasis, this commonly affects your scalp, elbows, lower back, and knees. The main symptoms are red patches of skin with silver scales. These patches can become sore, itchy, and in severe cases, cause your skin to crack and bleed.

Guttate psoriasis

This type of psoriasis is more common in childhood and sometimes happens after a throat infection caused by a type of bacteria called streptococcus or “strep”. It causes small (1cm) sores on your scalp, arms, chest, and legs. Guttate psoriasis often goes away after a few weeks but it can develop into plaque psoriasis. 

Pustular psoriasis

Pustular psoriasis is a rare type of psoriasis that causes blisters on your skin that are filled with pus, which can look white or yellowish. There are different types of pustular psoriasis that affect different parts of your body, such as the palms of your hands, soles of your feet, or your fingers and toes. 

Flexural psoriasis

This type of psoriasis affects the natural creases or folds in your skin and can be found in areas such as your groin, buttocks, under your breasts, and armpits. It causes red, smooth patches. Flexural psoriasis usually flares up when you are sweating, causing itching and discomfort. 

Erythrodermic psoriasis

Erythrodermic psoriasis is another rare form of psoriasis and can affect your whole body. It can cause intense burning or itching. It is important you see your doctor straight away if you think you have erythrodermic psoriasis, as it can cause other problems such as heart failure, dehydration, and hypothermia (a dangerous drop in body temperature). 

Psoriasis complications

Psoriasis can sometimes cause complications, which is why it is important to get treatment and a proper diagnosis. Psoriasis can cause skin to become cracked or broken, leading to skin infections. It can also cause confidence and self-esteem issues as it affects the appearance of your skin. Some patients get pain, swelling, or tenderness around their joints, which is called psoriatic arthritis. 

What causes psoriasis?

Skin cells are usually replaced by your body every 3 to 4 weeks, but psoriasis causes new skin cells to form in 3 to 7 days. This causes a build up of cells on your skin. It is not known what causes psoriasis but it is thought to be linked to your immune system. A flare up is usually triggered by something, such as an infection or stress. 

What increases your risk of psoriasis?

Your risk of psoriasis may increase if it runs in your family, as it is sometimes caused by genetics. Psoriasis is often triggered by something and it cannot be caught from someone else. The most common triggers for psoriasis to start or flare up are:

• infection, guttate psoriasis is proven to be triggered by strep infections
• injury to skin, such as a piercing, tattoo, scratch, and rubbing from shoes or clothes
• stress is a well known trigger as it can affect your immune system
• medications, especially antimalarial drugs can cause psoriasis as it may affect how your immune system works
• diet, certain food or drinks may flare up your psoriasis but there is not enough research to prove this
• hormones, some people get psoriasis when their hormones are changing, such as through puberty
• smoking, smokers are more likely to get psoriasis and flare ups, as smoking can affect your skin, oxygen levels, and immune system 
• excessive amounts of alcohol may cause  psoriasis flare ups 

What causes psoriasis to flare up?

A flare up happens when your psoriasis starts or gets worse, usually because of a trigger. Each patient with psoriasis may have a different trigger. The above list are all triggers for psoriasis. It is helpful to start a diary when you have psoriasis, as it can help you find what triggers your flare ups. 

How is psoriasis diagnosed?

Psoriasis must be diagnosed by a doctor so you can get the right treatment. Your doctor can look at your skin and diagnose the condition. Sometimes, further tests are needed. Symptoms can be similar to other skin conditions, so it is important that you do not diagnose yourself. If your symptoms are severe, you may be referred to a skin specialist, called a dermatologist. 

How is psoriasis tested for?

Your GP will look at your skin and talk about your symptoms, which is usually enough to diagnose. Rarely, your GP or specialist may take a small skin sample, which can be tested for the type of psoriasis and rule out other conditions. 

How do I know if I have psoriasis?

If you have psoriasis symptoms, our doctors can confirm your diagnosis and recommend treatment using our photo diagnosis service. Or you can speak to your GP who will also be able to diagnose the condition. 

How is psoriasis treated?

Psoriasis cannot be cured but there are treatments that can help. Topical treatments such as Dovonex are the most common way to treat psoriasis, to reduce flare ups and ease symptoms. These are applied directly to the affected areas of your skin. You may also be given medications by mouth, phototherapy, or injections to help with your psoriasis. 

Can psoriasis be treated?

Yes, psoriasis can be treated to reduce flare ups and help with symptoms. 

Can psoriasis be cured?

No, there is currently no cure for psoriasis, but treatments can help manage symptoms and reduce flare ups. Treatment can also reduce the time it takes for flare ups to go away. 

How to treat psoriasis

Your doctor will be able to help choose the right treatment for your skin. This depends on how severe your psoriasis is, what type of psoriasis you have, and how much of your skin is affected. Your doctor will start you on a topical treatment and will add stronger treatments like tablets or injections if your symptoms are not controlled. You may use a combination of different treatments.

Dovonex

Dovonex is a topical treatment for psoriasis which can be prescribed through Superdrug Online Doctor. It contains the active ingredient calcipotriol, which helps to reduce symptoms of a flare up by reducing the amount of skin growth. This type of treatment is called a Vitamin D analogue.

Dovonex can only be used on your body, not your face. It is applied directly to the affected areas of your skin. Dovonex is an effective treatment for mild to moderate plaque psoriasis. It takes about 2 weeks to take effect and the best results are seen after 4 to 6 weeks of use. 

Other topical treatments

If Dovonex is not suitable for you, there are other topical treatments that can help, such as:

• emollients, which are moisturising treatments
• topical corticosteroids, which contain steroids
• other Vitamin D analogues, like tacalcitol 
• calcineurin inhibitors, which reduce activity in the immune system 
• coal tar, which is a heavy, thick oil

Phototherapy

Phototherapy can be used to treat psoriasis that is not going away with topical treatments. This should be done by a doctor and is not the same as a sunbed. Special light such as ultraviolet B (UVB) is used to treat affected areas of your skin. This usually lasts a few minutes and treatment can last around 6 to 8 weeks. 

Tablets and injections

If your psoriasis is severe or not managed by other treatments, you may be given tablets or injections. These include:

• oral methotrexate, which is usually taken once a week
• oral ciclosporin or acitretin, which is taken daily
• etanercept or adalimumab, which is an injection you can do at home
• infliximab, which is given through a drip directly into your vein at a hospital

How to prevent psoriasis

Psoriasis may be prevented by avoiding any triggers that could lead to an outbreak. This will be different for every person and may include avoiding certain medications, not smoking, and reducing stress levels. You can reduce flare ups by taking your psoriasis medication correctly and regularly moisturising your skin. 

Managing psoriasis symptoms

Your doctor will create a treatment plan to manage your psoriasis symptoms. The best way to manage your symptoms is by taking medication and avoiding triggers. 

How to remove psoriasis scales from scalp

If you have psoriasis on your scalp, your doctor may prescribe or recommend a specialist shampoo that can help with symptoms and remove scales. You should brush your hair gently every day, to help loosen scales. You can also get steroid treatments for your scalp. 

How to stop psoriasis spreading

If your psoriasis is spreading, this means your treatment is not working as it should. Speak to your doctor, as they may want to try a different treatment or a combination of treatments. 

How to stop psoriasis itching

Psoriasis itching can be reduced by using your treatments and moisturising every day. You should also limit the amount of time you spend in water, as this can cause dry, itchy skin. You can use over the counter painkillers to help with soreness and itching. A cold compress can also help with itching. 

How to get rid of psoriasis in hair

If you have psoriasis in your hair, make sure to brush your hair every day. Treat your scalp and speak to your doctor if symptoms do not get better after a few weeks. 

Sources

About Psoriasis (2017) The Psoriasis Association (accessed 04 February 2022)

Dovonex Ointment (2019) EMC (accessed 24 February 2022)

Evidence for a streptococcal superantigen-driven process in acute guttate psoriasis. (1995) PubMed (accessed 04 February 2022)

Psoriasis (2018) NHS (accessed 04 February 2022)

PSORIASIS – AN OVERVIEW (2005) BAD (accessed 24 February 2022)

Psoriasis and smoking: links and risks (2016) PubMed (accessed 04 February 2022)

Psoriatic arthritis (2019) NHS (accessed 04 February 2022)

Psoriasis: assessment and management (2012) NICE (accessed 24 February 2022)

Stress and quality of life in psoriasis: an update (2011) PubMed (accessed 04 February 2022)