Psoriasis is a skin condition that causes skin redness, silvery scales, and irritation. Most people with psoriasis have thick, red, well-defined patches of skin with flaky, silver-white scales. This is called plaque psoriasis.
Plaque psoriasis; Psoriasis vulgaris; Guttate psoriasis; Pustular psoriasis
Psoriasis is common. Anyone can develop it, but it most often begins between ages 15 and 35, or as people get older.
Psoriasis isn't contagious. This means it doesn't spread to other people.
Psoriasis seems to be passed down through families.
Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in 14 days rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin's surface, forming the collections of scales.
The following may trigger an attack of psoriasis or make it harder to treat:
Psoriasis may be worse in people who have a weak immune system, including people with HIV/AIDS.
Some people with psoriasis also have arthritis (psoriatic arthritis). In addition, people with psoriasis have an increased risk of fatty liver disease and cardiovascular disorders, such as heart disease and stroke.
Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back.
The main symptom of the condition is irritated, red, flaky plaques of skin. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, soles of the feet, and genitalia.
The skin may be:
Other symptoms may include:
There are five main types of psoriasis:
Exams and Tests
Your health care provider can usually diagnose this condition by looking at your skin.
Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your provider may order imaging studies.
The goal of treatment is to control your symptoms and prevent infection.
Three treatment options are available:
TREATMENTS USED ON THE SKIN (TOPICAL)
Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include:
SYSTEMIC (BODY-WIDE) TREATMENTS
If you have moderate to severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids, such as acetretin, can also be used.
Newer drugs, called biologics, are more commonly used as they target the causes of psoriasis.. Biologics approved for the treatment of psoriasis include:
Some people may choose to have phototherapy, which is safe and can be very effective:
If you have an infection, your provider will prescribe antibiotics.
Following these tips at home may help:
Psoriasis can be a lifelong condition that can be usually controlled with treatment. It may go away for a long time and then return. With proper treatment, it will not affect your overall health. But be aware that there is a strong link between psoriasis and other health problems, such as heart disease.
When to Contact a Medical Professional
Call your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.
Tell your provider if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.
There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups.
Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.
Armstrong AW, Siegel MP, Bagel J, et al. From the Medical Board of the National Psoriasis Foundation: treatment targets for plaque psoriasis. J Am Acad Dermatol. 2017;76(2):290-298. PMID: 27908543 www.ncbi.nlm.nih.gov/pubmed/27908543.
Habif TP. Psoriasis and other papulosquamous diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 8.
Lebwohl MG, van de Kerkhof P. Psoriasis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 210.
Van de Kerhof PCM, Nestlé FO. Psoriasis. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 8.
Review Date: 7/13/2018
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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