Your Essential Guide to Psoriasis and More
Doctor’s Note
Get a bird’s eye view of psoriasis with our “Psoriasis 101” intro video. It has a little bit of everything you need to know, including causes, triggers, recommended products, prescriptions, and procedures!
Click to your right, or skim the highlights below!
What is Psoriasis?
Psoriasis is a chronic skin condition where skin cells grow too quickly, leading to the formation of thick, red patches with silvery scales. These patches can be itchy and painful and are most commonly found on the elbows, knees, scalp, and lower back.
Psoriasis occurs due to an overactive immune system, which causes inflammation and accelerates the growth of skin cells. Normally, skin cells grow and shed in about a month, but with psoriasis, this process takes only a few days, causing skin cells to accumulate on the surface.
The red patches can burn and sting, and the inflammation caused by psoriasis can also affect other parts of the body, leading to additional health issues like psoriatic arthritis. This condition causes swelling, stiffness, and pain in the joints and can go undiagnosed, especially in its milder forms. Early treatment is important to prevent permanent joint damage.
Psoriasis can begin at any age but typically starts between the ages of 15 and 25. It affects people of all genders and skin colors. While there is no cure for psoriasis, various treatments can help manage the symptoms and improve quality of life.
Psoriasis Pictures
People with psoriasis often have red patches of skin covered with thick, silvery scales. The skin might crack and bleed, and the affected areas can be very itchy and feel like they're burning. Fingernails and toenails may become thickened, ridged, or pitted. Some people also experience joint problems, a condition known as psoriatic arthritis.
Red Patches of Skin
These patches are often covered with thick, silvery scales.
Thickened Nails
Fingernails and toenails may become thickened, ridged, or pitted.
Dry, Cracked Skin
The skin might crack and bleed.
Stiff and Swollen Joints
Some people with psoriasis also have joint problems, a condition known as psoriatic arthritis.
Itching and Burning
The affected areas can be very itchy and may feel burning.
Side Note: This page will cover plaque psoriasis, which represents ~90% of all cases. There are different types of psoriasis, though. Click below to learn more!
Where Does Psoriasis Appear?
Common Psoriasis Locations
Less Common Psoriasis Locations
Psoriasis can appear on many parts of the body.
Common spots for it to show up include the elbows and knees, where thick, scaly patches often form. It frequently appears on the scalp, causing itchy, flaky skin. The lower back is another common area for psoriasis patches.
Less commonly, psoriasis can show up on the armpits, under the breasts, groin, genitals, anus, hands, and feet, making daily activities more challenging. The fingernails and toenails can also be affected, becoming pitted or discolored.
Side Note: Psoriasis is often confused with eczema. Click below to learn the difference!
What Causes Psoriasis?
The exact cause of psoriasis isn't fully understood, but it's thought to be related to the immune system. Normally, skin cells grow and fall off in about a month, but in psoriasis, the process happens in just a few days. This rapid turnover leads to the buildup of skin cells. Factors that can trigger psoriasis include:
Genetics: Psoriasis can run in families.
Immune System: An overactive immune system can cause inflammation and quick turnover of skin cells.
Environmental Triggers: Stress, smoking, heavy alcohol consumption, and certain medications can trigger or worsen psoriasis.
How Is Psoriasis Diagnosed?
A dermatologist or healthcare provider can diagnose psoriasis by looking at your skin, nails, and scalp. They'll also ask you questions about your symptoms and family history of skin conditions. Some questions they might ask include:
Do you have a history of skin conditions in your family?
When did you first notice symptoms?
What products help your skin?
Is this your first outbreak?
What types of soaps or shampoos do you use?
To confirm the diagnosis and rule out other skin conditions, they might take a small sample of your skin, called a biopsy, to examine under a microscope. This helps them make sure that psoriasis is causing your symptoms.
What Makes Psoriasis Worse?
Understanding what can trigger or worsen psoriasis is crucial for managing the condition effectively. While psoriasis is a chronic skin disease, various factors can lead to flare-ups or make symptoms more severe. Identifying and avoiding these triggers can help you better control your psoriasis and reduce the frequency and intensity of flare-ups. In this section, we'll explore common factors that can exacerbate psoriasis and provide guidance on how to minimize their impact on your skin health.
Smoking: Tobacco use increases the risk and severity of psoriasis.
Alcohol: Excessive alcohol consumption can trigger psoriasis flare-ups.
Obesity: Being overweight can increase the risk and severity of psoriasis.
Stress: Stress can trigger and worsen psoriasis symptoms.
Certain Medications: Beta-blockers, lithium, and antimalarials can trigger or worsen psoriasis.
Infections (Strep): Strep infections can trigger guttate psoriasis, especially in young people.
Injury: Injuries like cuts, scrapes, or sunburns can cause new psoriasis lesions (Koebner phenomenon).
Sunburn: Severe sunburn can trigger psoriasis flare-ups.
Winter: Cold, dry air can worsen psoriasis symptoms.
Withdrawal from Systemic Corticosteroids: Stopping corticosteroids suddenly can cause severe flare-ups.
What Makes Psoriasis Better?
Finding ways to improve psoriasis can significantly enhance your quality of life and manage symptoms more effectively. Although psoriasis is a chronic condition, certain strategies and treatments can help alleviate symptoms and reduce flare-ups. Identifying what helps soothe your skin and manage your condition is key to maintaining better control over psoriasis. In this section, we’ll explore effective methods and lifestyle changes that can help improve psoriasis, providing practical tips and recommendations to support your skin health.
Use Moisturizers: Apply a thick, fragrance-free moisturizer to keep your skin hydrated.
Apply Topical Treatments: Use prescribed creams or ointments as directed to reduce inflammation and itching.
Take Oatmeal Baths: Soak in lukewarm water with colloidal oatmeal to soothe itching.
Protect Your Skin: Avoid sunburn; use sunscreen to prevent damage.
Wear Soft Clothing: Choose loose, cotton clothing to avoid irritation.
Avoid Triggers: Identify and stay away from known triggers, like stress or smoking.
Manage Stress: Practice stress-relief techniques such as meditation or yoga.
Consider Over-the-counter Treatments: Use coal tar or salicylic acid products for mild flare-ups.
Consult Your Doctor: Seek professional advice if symptoms are severe or not improving.
Side Note: Click below to view step-by-step instructions for psoriasis flare treatment.
Are There Complications from Psoriasis?
Psoriasis is not limited to the skin. It also causes inflammation throughout the body that can impact various organs. This widespread inflammation means that patients with psoriasis are at a higher risk for several health conditions beyond just skin symptoms. For instance, they may face increased risks of developing heart disease, liver disease, and diabetes. Additionally, psoriasis can contribute to respiratory issues such as chronic obstructive pulmonary disease (COPD) and sleep apnea. It can also lead to joint problems like psoriatic arthritis and increase the risk of osteoporosis.
Furthermore, psoriasis can cause eye inflammation, including conjunctivitis, uveitis, and blepharitis, and is linked to inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. Other potential risks include celiac disease, fibromyalgia, lymphoma, erectile dysfunction, and mental health issues like depression and suicidal thoughts. Patients with psoriasis may also experience social isolation due to the visible nature of their condition and its impact on daily life.
Heart disease
Liver disease
Diabetes
COPD
Sleep apnea
Psoriatic arthritis
Osteoporosis
Eye inflammation
Inflammatory bowel disease (Crohn’s or ulcerative colitis)
Celiac disease
Fibromyalgia
Lymphoma
Erectile dysfunction
Depression
Social isolation
Therefore, it is very important for people with psoriasis to work closely with their doctors to keep track of and manage the various health risks that come with the condition. Regular visits to both dermatologists and primary care doctors can help catch any new health problems early, like heart disease or diabetes. This way, doctors can provide the right treatment and advice to help prevent these issues from getting worse. By staying in touch with healthcare providers and following their recommendations, people with psoriasis can improve their overall health and quality of life.
Psoriasis is well-known to affect emotional health and relationships. Due to the visible nature of their condition, patients with psoriasis may also experience social isolation. While living with psoriasis can be challenging, there are ways to handle these challenges and thrive.
Psoriasis Treatment - Overview
Psoriasis Treatment - Lifestyle Changes
If you have psoriasis, making certain lifestyle changes can significantly improve how you manage your symptoms and enhance your overall quality of life. Psoriasis is more than just a skin condition; it involves inflammation that can impact various aspects of your health. Adopting healthier habits and avoiding triggers can help control flare-ups and reduce their severity. By focusing on aspects like diet, exercise, stress management, and skin care, you can better manage your condition and potentially minimize its effects. Here are some key adjustments to consider:
Maintain a Healthy Weight: Stay active and eat a balanced diet to manage weight and reduce inflammation.
Eat a Balanced Diet: Focus on fruits, vegetables, lean proteins, and whole grains. Omega-3s from fish and flaxseeds may help. Consult your doctor before major dietary changes.
Exercise Regularly: Engage in regular physical activity, like walking or swimming, to manage weight and reduce inflammation.
Get Adequate Sleep: Maintain a regular sleep schedule to help manage inflammation and overall health.
Avoid Smoking and Limit Alcohol: Both can worsen psoriasis and trigger flare-ups. Avoid smoking and reduce alcohol consumption.
Manage Stress: Use stress-relief techniques such as meditation, yoga, or hobbies to prevent flare-ups.
Use Moisturizers: Apply a gentle, fragrance-free moisturizer to reduce dryness and itching, especially after bathing.
Avoid Harsh Soaps: Use mild, fragrance-free soaps and skincare products to avoid irritation.
Consider Supplements: Vitamin D or omega-3 supplements may help; consult your doctor before starting any new supplements.
Protect Your Skin: Use sunscreen to prevent sunburn and avoid skin injuries that can trigger new lesions.
Best Products for Psoriasis
Over-the-counter (OTC) treatments for psoriasis can effectively manage symptoms and improve skin health. Look for products containing active ingredients such as salicylic acid, which helps remove scales and reduce inflammation, and coal tar, which slows skin cell growth and reduces itching and scaling. Moisturizers with ingredients like urea and lactic acid can help keep the skin hydrated and soft, reducing dryness and flaking. Hydrocortisone creams can also provide relief by reducing inflammation and itching. Regular use of these OTC treatments can help manage psoriasis symptoms and improve overall skin condition.
Products to Moisturize
Look for thick, fragrance-free moisturizers. Look for urea, coal tar, lactic acid.
Products to Reduce Inflammation
Topical steroids
Products to Remove Scale
Salicylic Acid, Coal Tar, Oils
Devices to Reduce Inflammation
Phototherapy
Side Note: Check out the best psoriasis products!
Best Prescriptions for Psoriasis
Sometimes, over-the-counter creams and lotions aren't enough to handle psoriasis. When that happens, doctors often prescribe stronger medicines that you can only get with a prescription. These prescription topicals are usually more powerful and can help manage the symptoms better. If over-the-counter options aren't working, it's important to talk to your doctor about getting a prescription. The most common prescriptions we use for psoriasis include:
Topical Steroids
- Reduces inflammation and itching
- Available in various strengths
- Prolonged use can thin the skin (we try not to use steroids for too long!)
- Ex: Hydrocortisone, Triamcinolone, Betamethasone
Vitamin D
- Slows skin cell growth
- Often combined with topical steroids
- Few side effects
- Ex: Calcipotriene, Dovonex
Sotyktu
- Daily Pill
- Used if topicals are not an option
- Few side effects
- Requires monitoring
Prednisone
- Oral steroids are sometimes used for severe flares
- Short-term use only
- Not our favorite treatment: you can flare after you stop the prednisone!
Biologics
- Injections at home (it's easy!)
- Reduces skin inflammation
- Requires regular monitoring
- May have systemic side effects
- Ex: Humira, Stelara, Cosentyx, Skyrizi
Elidel + Protopic
- Reduces inflammation and itching
- Not a steroid
- Few side effects
- Used for sensitive areas like the face
Otezla
- Twice Daily Pill
- Reduces inflammation
- Common side effect: diarrhea
- Doesn’t work as well as biologics
Vitamin A
- Slows skin cell growth
- Reduces inflammation
- May cause irritation, dryness
- Ex: Tazarotene, Tazorac
Some of these medications can be expensive and insurance companies are going to try to deny you the pricier treatments. Download this FREE helpful worksheet to streamline the process of getting more advanced treatments.
Best Procedures for Psoriasis
Sometimes, even prescription treatments aren’t enough to manage psoriasis effectively. In such cases, doctors may recommend phototherapy, a more advanced treatment. Phototherapy involves exposing the skin to controlled amounts of ultraviolet (UV) light to reduce inflammation and slow down skin cell growth. This treatment is usually performed in a medical setting but can also involve home devices. If topical treatments aren't providing relief, discussing phototherapy with your doctor could be a beneficial next step. Common types of phototherapy for psoriasis include:
Over-the-Counter Phototherapy
- Can be purchased online
- Typically used a few times a week to affected areas
- Can be effective for mild to moderate psoriasis
Office Phototherapy
- Uses UVB light to reduce inflammation and itching
- Effective for moderate to severe eczema
- Administered in a clinical setting or at home with a unit
Home Phototherapy
- Prescription phototherapy, but at home!
- Similar to an office-based device
- Check your insurance coverage for “Durable Medical Equipment (DME)”
- Most popular companies: National Biologic + SolRx!
Psoriasis FAQs
Does Clinique Work with Psoriasis?
Clinique products are generally designed for sensitive skin, but they might not be specifically formulated to treat psoriasis. If you're considering using Clinique products, look for those labeled as gentle or moisturizing, and always patch test first. For psoriasis treatment, it's best to use products specifically designed for the condition.
Is Psoriasis a Microbial Infection?
No, psoriasis is not a microbial infection. It’s an autoimmune condition where the immune system mistakenly attacks the skin, leading to inflammation and rapid skin cell turnover. This results in the characteristic red, scaly patches.
Is Dandruff Spreadable?
Dandruff itself is not spreadable or contagious. It’s often caused by a reaction to a yeast-like fungus that’s naturally present on the skin, an oily scalp, or irritation from hair products.
Is Coconut Oil Good for Psoriasis?
Coconut oil can be soothing for psoriasis because it helps moisturize the skin and reduce dryness. However, it’s not a cure and should be used alongside other treatments recommended by your dermatologist.
Can Psoriasis Cause Fatigue?
Yes, psoriasis can cause fatigue, especially if it’s part of a condition called psoriatic arthritis. The chronic inflammation associated with psoriasis can also lead to feelings of tiredness.
Can Tanning Beds Help Psoriasis?
Tanning beds are not recommended for psoriasis treatment because they can increase the risk of skin cancer. UVB phototherapy, a specific type of ultraviolet light treatment, is often used under medical supervision for psoriasis.
Can You Get Psoriasis on Your Lips?
Psoriasis on the lips is rare but possible. It’s more common for psoriasis to affect other areas like the scalp, elbows, or knees. If you notice persistent dryness or scaling on your lips, it’s best to consult a dermatologist.
Is Vaseline Good for Psoriasis?
Vaseline can be helpful for psoriasis because it locks in moisture and helps protect the skin barrier. However, it’s typically used as a supplement to other treatments rather than as a standalone solution.
Can You Get Psoriasis in Your Ears?
Yes, psoriasis can affect the ears, both the outer ear and the ear canal. It can cause itching, scaling, and discomfort. If you suspect psoriasis in your ears, it’s important to seek medical advice for proper treatment.
Does Castor Oil Help Psoriasis?
Castor oil might help soothe psoriasis symptoms due to its moisturizing properties, but it’s not a cure. It’s important to use it as part of a broader treatment plan and consult with a dermatologist.