Psoriasis

Overview

What is psoriasis?

Psoriasis (say "sor-eye-uh-sus") is a common chronic condition that causes thick red marks and flaky white patches that look like scales to form on the skin.

Is psoriasis contagious?

No, you cannot catch psoriasis from another person or give it to someone by touching them. You also cannot spread it to other parts of your body

Symptoms

What are the symptoms of psoriasis?

The symptoms of psoriasis may include:

The symptoms most often appear on the skin of the knees and elbows, although psoriasis may occur anywhere on the body (including the scalp, palms of the hands, soles of the feet, mouth and skin on the joints).

  • Pink or red, raised patches of scaly skin

  • Dry, cracked or flaky skin (it may also bleed at times)

  • Skin that burns, is itchy or sore

  • Thick, pitted fingernails

  • Pus-filled blisters on the red patches of skin (in more severe cases)

Causes & Risk Factors

What causes psoriasis?

Psoriasis starts with the immune system. Your immune system usually protects the body against infection and disease by attacking bacteria and viruses. However, when you have psoriasis, your T cells, a kind of white blood cells that are part of the immune system, mistakenly attack your skin cells instead. Your body then produces other immune system responses, leading to swelling and rapid production of skin cells. Psoriasis tends to run in families and it usually appears between 10 and 45 years of age.

People who have psoriasis may experience periods of time without any symptoms. Other times, psoriasis will "flare up" (get worse). Certain things that can cause the psoriasis to get worse include:

  • Infections (such as strep throat and the common cold)

  • Diseases that weaken the immune system

  • Stress

  • Certain medicines (such as beta-blockers for high blood pressure and drugs used to prevent malaria)

  • Skin irritations

  • Cold weather

  • Smoking

Treatment

How is psoriasis treated?

There are a number of treatments for psoriasis. Your doctor will help you decide which one is best for you. Keeping your skin moisturized with an over-the-counter product is a good first step. Body lotion can help keep skin from getting too dry and cracking. It can also help remove some of the scales. Bathing daily in Epsom salts, Dead Sea salts, bath oil or oatmeal can calm redness and remove scales.

Prescription creams, ointments, lotions and gels (also called topical medicines) that you put on the affected areas are often used to treat psoriasis. To help the medicine stay on the skin, you might apply it and then cover the areas with plastic wrap (such as Saran Wrap). Options include corticosteroids, a type of vitamin D and pine tar. Special shampoos are used for psoriasis on the scalp.

For more severe cases of psoriasis, your doctor may prescribe antibiotics or other medicines in pill form. Some of these medicines can cause side effects, so your doctor may prescribe these for only a short period of time before returning to another type of treatment.

Sunlight also can help psoriasis, but be careful not to stay in the sun too long. A sunburn can actually make your psoriasis worse. Talk to your doctor about how to safely try sunlight exposure as a psoriasis treatment. Light therapy may be another option for treatment of psoriasis. With this treatment, the affected skin is exposed to controlled forms of artificial sunlight, usually after using Psoralen, a light-sensitizing medicine. This is called "PUVA" treatment. Talk to your doctor about this option.

Will psoriasis go away with treatment?

While psoriasis will typically improve with treatment, it may not ever completely go away. The scales of psoriasis should improve after you begin treatment. It may take 2 to 6 weeks for the affected areas of your skin to return to a more normal thickness, and the redness may take several months to improve. Sometimes, certain scaly spots will get better at the same time that other spots get worse.

After you’ve been using a certain type of medicine for a while, your psoriasis may "get used to" the treatment. If this happens, your medicine may not be as effective as it once was. Your doctor may change your medicine. Sometimes you may need a stronger dose of medicine. Talk to your doctor if your psoriasis doesn’t seem to be getting better with treatment.

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Questions to Ask Your Doctor

  • What treatment is best for me?

  • Will I have to change medicines often?

  • Is there anything I can do at home to relieve the pain and itching?

  • If my symptoms get worse, when should I call my doctor?

  • Is there a special shampoo I should use?

  • Could you recommend a good lotion?

  • Will I have to be on medicine the rest of my life?

  • I have psoriasis. Will my children have it?

  • Should I make any changes to my skin care routine?

  • Are there any support groups in my area?