Psoriasis

What Is Psoriasis?

Psoriasis is a chronic (long-lasting) skin condition. People with psoriasis have a skin rash and, sometimes, joint problems or nail changes.

There's no cure for psoriasis, but treatment can help most people who have it control its symptoms.

What Are the Signs & Symptoms of Psoriasis?

The main symptom of psoriasis (pronounced: seh-RYE-eh-siss) is red, thickened patches of skin called plaques. These can burn, itch, or feel sore. Often, silvery scales cover the plaques.

Plaques can happen anywhere. In teens, they're most common on the:

• face
• scalp
• areas where skin touches skin (such as where the arm bends or in the armpit)

Other symptoms of psoriasis include:

• dry, cracked skin that may bleed at times
• thick, pitted nails
• arthritis (painful, stiff, swollen joints)

What Are the Types of Psoriasis?

Common types of psoriasis include:

Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.

Guttate (pronounced: GUT-ate) psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.

Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches are in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a girl's breasts.

What Causes Psoriasis?

The exact cause of psoriasis isn't known. But experts do know that the body's immune system, which fights germs and diseases, is involved. Overactive immune system cells make skin cells grow faster than the body can shed them, so they pile up as plaques on the skin.

Some genes have been linked to psoriasis. About 40% of people with psoriasis have a family member who has it.

Anyone can get psoriasis and it may begin at any age. It can't spread from person to person.

What Are Psoriasis Flare-Ups?

Symptoms of psoriasis can go away completely, then suddenly come back. When the symptoms are worse, it's called an "outbreak" or "flare-up." Symptoms of psoriasis can be brought on or made worse by:

• infections such as strep throat and colds
• some medicines, such as lithium and beta-blockers
• stress
• skin irritations
• cold weather
• drinking alcohol
• smoking

How Is Psoriasis Diagnosed?

Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They'll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.

Rarely, doctors might take a skin sample (a biopsy) to check more closely. A biopsy can tell the doctor whether it's psoriasis or another condition with similar symptoms.

How Is Psoriasis Treated?

Psoriasis is usually treated by a dermatologist (skin doctor). A rheumatologist (a doctor who treats immune problems) may also help with treatment. Treatments can include:

• ultraviolet (UV) light from the sun or from home or office treatments. But in some people, sunlight can make psoriasis worse.
• creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
• medicines taken by mouth or injected medicines

A doctor might try one therapy for a while and then switch to another. Or a doctor may combine different therapies. It's all about finding one that works for each person.

Sometimes what works for a while might stop working. This is one reason why it's important to work closely with a doctor. Trying out new treatments can get a little frustrating, but most people eventually find one that works.

What Else Should I Know?

Making healthy choices can help with psoriasis. Here are some things you can do:

• If you smoke, quit. Smoking can trigger outbreaks of psoriasis in some people.
• Avoid alcohol. It can make psoriasis treatments less effective.
• Eat healthy foods. Eating a lot of fruits and vegetables can help fend off diseases that might trigger psoriasis.
• Stay at a healthy weight. This decreases the risk of inverse psoriasis.
• Keep skin clean and well moisturized. Bathing daily with bath salts or oils and then applying moisturizer can help ease the symptoms of psoriasis.

People who have psoriasis may feel self-conscious about how it looks. That's one reason why some people turn to a therapist or join a support group of people who understand what they might be going through.

The key to psoriasis treatment is keeping up on whatever your doctor prescribes. If that means applying an ointment twice a day, then find a way to remind yourself to do it (like setting an alarm on your phone) so you don't forget. Psoriasis is one of those things that you need to stay focused on treating, even when you're feeling OK.

Whether your psoriasis is mild or severe, learn all you can about it. Talk to your doctor or check websites like:

• National Psoriasis Foundation
• TalkPsoriasis