Everything You Need to Know About Psoriasis

Skin that is flaky, dry, or itchy are all signs of psoriasis. There is no cure, but you can manage your symptoms by figuring out what sets them off, taking medicine, and making changes to how you live.

What is psoriasis?

Psoriasis is a long-term autoimmune condition that makes your skin cells build up quickly. This buildup of cells gives your skin a scaly look.

Around the scales, there is often inflammation and redness. Scales from psoriasis are usually white or silver and form in thick, red patches. But on darker skin tones, they can look more like dark brown with grey scales or even purple. These patches sometimes break and bleed.

Psoriasis happens when the process of making skin cells happens too quickly. Most of the time, skin cells grow deep in your skin and slowly make their way to the surface. They fall off in the end. A skin cell’s normal life span is one month.

People with psoriasis may go through this process in only a few days. Skin cells don’t have time to fall off because of this. Skin cells build up because skin cells are made too quickly.

Scales usually form on the elbows, knees, and other joints. But they can appear anywhere on your body, such as:

• hands
• feet
• neck
• scalp
• face

Types of psoriasis that happen less often affect:

• nails
• mouth
• area around the genitals

According to one study published in 2021, about 7.5 million American adults ages 20 and up have psoriasis, which is about 3% of the population (occurrence of a condition). By race and ethnicity, the rates of occurrence are as follows:

• 3.6 percent of white people
• 3.1 percent of non-Hispanic people, including multiracial people
• 2.5 percent of Asian people
• 1.9 percent of Hispanic people, including Mexican American people
• 1.5 percent of Black people

It is often linked to a number of other conditions, such as:

• type 2 diabetes
• inflammatory bowel disease
• heart disease
• psoriatic arthritis
• anxiety
• depression

What are the different types of psoriasis?

Psoriasis comes in five different forms:

Plaque psoriasis

Plaque psoriasis is what most people with psoriasis have.

The American Academy of Dermatology (AAD) says that between about 80 to 90 percent of people with psoriasis have plaque-type psoriasis. It makes red, inflamed patches on people with light skin, and patches that are purple, greyish, or darker brown on people with darker skin. This makes it harder to figure out what’s wrong with people with darker skin.

These patches are usually covered with silvery-white scales or plaques, and they are usually more severe on skin of color. Most of the time, these plaques show up on the elbows, knees, and scalp.

Guttate psoriasis

Guttate psoriasis commonly occurs in childhood. This kind of psoriasis causes small spots that are pink or violet. Most people with guttate psoriasis get it on their chest, arms, and legs. Unlike plaque psoriasis, these spots are not usually thick or raised.

Pustular psoriasis

Pustular psoriasis is more common in adults. It makes white blisters filled with pus and large patches of red or violet inflamed skin, depending on the colour of your skin. On darker skin tones, it can look more like a deep violet.Pustular psoriasis usually affects small parts of the body, like the hands or feet, but it can spread to other parts of the body as well.

Inverse psoriasis

Inverse psoriasis causes areas of skin that are red, shiny, and inflamed. Patches of inverse psoriasis show up under your armpits or breasts, in your groyne, or around skin folds in your genitals.

Erythrodermic psoriasis

Erythrodermic psoriasis is a severe and very rare The National Psoriasis Foundation says that this is a type of psoriasis.

Often, this form works on a lot of your body at once. The skin looks like it might be sunburned. When scales form, they often come off in large pieces or sheets. With this type of psoriasis, it’s not unusual to get a fever or feel very sick.

This kind can be life-threatening, so you need to see a doctor right away.

What are the symptoms?

The symptoms of psoriasis are different for each person and depend on what kind of psoriasis they have. Psoriasis can be just a few flakes on your scalp or elbow, or it can cover most of your body.

These are the most common signs of plaque psoriasis:

• raised, irritated patches of skin that look red on light skin and brown or purple on dark skin.
• scales or plaques of whitish-silver on the red patches or grey scales on the purple and brown patches.
• dry skin that may crack and bleed, soreness around patches, itching and burning around patches, and skin
• that may crack and bleed.
• thick, pitted nails
• painful, swollen joints

Not everyone will have all of these signs and symptoms. If a person has a less common type of psoriasis, they may have symptoms that are very different from the ones most people have.

Most people with psoriasis have symptoms that come and go. For a few days or weeks, the condition may cause severe symptoms. After that, the symptoms may go away and be hard to notice. Then, psoriasis may flare up again in a few weeks or if it is made worse by a common cause. Psoriasis symptoms can sometimes go away completely.

You may be in “remission” if there are no signs of the illness. That doesn’t mean your psoriasis won’t come back, but for now, you don’t have any signs of it.

Is psoriasis contagious?

Psoriasis is not spread from person to person. You can’t give the skin condition to someone else. If you touch a spot on someone else’s skin that has psoriasis, you won’t get it too.

It’s important to be educated on the condition, as many people think psoriasis is contagious.

What causes psoriasis?

No one knows for sure what causes psoriasis, even doctors. But decades of research have given them a general idea of two key factors:

• genetics
• the immune system

Immune system

Psoriasis is an autoimmune condition. Conditions that are caused by your body attacking itself are called autoimmune conditions. In psoriasis, white blood cells called T cells attack your skin cells by accident.
Most of the time, white blood cells are used to attack and kill bacteria that are trying to get into the body. This helps the body fight infections. This mistaken attack from the immune system speeds up the process of making skin cells. Because skin cells are made faster, new skin cells form too quickly. They get pushed to the surface of the skin, where they build up.

This causes the plaques that most people think of when they think of psoriasis. When the skin cells are attacked, red, swollen spots appear on the skin.

Genetics

Some people get psoriasis because they have genes that make them more likely to get it. According to research published in 2019, your risk of getting psoriasis goes up if you have a close relative with the skin condition.

Diagnosing psoriasis

Psoriasis may need two tests or examinations to be found.

Physical examination

Most doctors can figure out what’s wrong with a patient just by looking at them. Most of the time, the symptoms of psoriasis are clear and easy to tell apart from those of other conditions that may cause similar symptoms.
During this exam, you should show your doctor everything that worries you. Also, tell your doctor if anyone else in your family has the condition.

Biopsy

If your symptoms aren’t clear or if your doctor wants to be sure of what they think is wrong, they may take a small piece of your skin to test. This is called a biopsy.

Biopsies can be done in the office of your doctor on the same day as your appointment. Your doctor will probably give you an injection of a medicine that will numb the area to make the biopsy less painful.

The skin sample will then be sent to a lab where it will be looked at under a microscope. The test can figure out what kind of psoriasis you have. It can also rule out other diseases or infections that might be present.
When the results come back, your doctor may want to meet with you to talk about the results and possible treatments.

Psoriasis triggers: Stress, alcohol, and more

Psoriasis can be brought on by “triggers” that come from the outside. Not everyone has the same reactions to these things. They could also change for you over time.

Some of the most common causes of psoriasis are:

Stress

A flare-up could be caused by stress that is unusually high. If you learn to reduce and deal with your stress, you can cut down on flare-ups and maybe even stop them from happening.

Alcohol

Alcohol use disorder can trigger psoriasis flare-ups. If you drink too much, you may have more psoriasis flare-ups. Not drinking as much or giving up drinking is good for more than just your skin. If you need help, your doctor can help you make a plan to deal with your drinking problems.

Injury

An accident, cut, or scrape may trigger a flare-up. A new outbreak can also be caused by injections, vaccines, or sunburns.

Medications

Some medicines are thought to cause psoriasis. Among these medicines are:

• lithium
• antimalarial medications
• high blood pressure medication

Infection

At least a part of what causes psoriasis is that the immune system attacks healthy skin cells instead of the bad ones. If you’re sick, like if you have an infection, your immune system might build an immune response against itself instead of the one it needs to build to fight the infection.

This could make my psoriasis get worse again. Strep throat is a common trigger.

Treatment options for psoriasis

Psoriasis has no cure. Treatments aim to:

• reduce inflammation and scales
• slow the growth of skin cells
• remove plaques

There are three types of treatments for psoriasis:

Topical treatments

When applied directly to the skin, creams and ointments can help get rid of mild to moderate psoriasis.

Some topical treatments for psoriasis are:

• topical corticosteroids
• topical retinoids
• anthralin
• vitamin D analogues
• salicylic acid
• moisturizer

Systemic medications

People with moderate to severe psoriasis or those who haven’t gotten better with other types of treatment may need to take pills or get injections.

Many of these drugs can have very bad side effects, so doctors usually only give them for short periods of time.

Among these medicines are:

• methotrexate
• cyclosporine (Sandimmune)
• biologics
• oral retinoids

Light therapy

This treatment for psoriasis uses natural light or ultraviolet (UV) light. White blood cells that attack healthy skin cells and cause fast cell growth are killed by the sun. Both UVA and UVB light may help people with mild to moderate psoriasis feel better.

A combination of treatments will help most people with moderate to severe psoriasis. This kind of therapy uses more than one type of treatment to help reduce symptoms. Some people might always use the same treatment. Some people may need to switch treatments every now and then if their skin stops responding to what they are doing.

Medication for psoriasis

If you have moderate to severe psoriasis or if other treatments don’t work, your doctor may think about giving you a pill or an injection.

The most common medicines for treating psoriasis that are taken by mouth or injected are:

Biologics

This group of drugs changes your immune system and stops your immune system and inflammatory pathways from working together. These medicines are injected or put in intravenous (IV) infusion.

Retinoids

Retinoids stop the skin from making new cells. Once you stop using them, your psoriasis symptoms are likely to come back. Some of the side effects are hair loss and dry mucous membranes.

People who are pregnant or might become pregnant in the next 3 years shouldn’t take retinoids because there is a chance that their unborn children could have birth defects.

Cyclosporine

Cyclosporine (Sandimmune) Retinoids stop the body from making new skin cells. Once you stop using them, your psoriasis symptoms will probably come back. Some of the side effects are hair loss and dryness of the mucosa.

People who are pregnant or might get pregnant in the next three years shouldn’t take retinoids because they could cause birth defects in the baby.

Methotrexate

Like cyclosporine, methotrexate stops the immune system from working. When used in low doses, it may have less of an effect on the body. It can have bad effects on your body over time. Serious side effects include damage to the liver and less red and white blood cells being made.

Diet recommendations for people with psoriasis

Psoriasis can’t be cured or even treated with food, but a diet full of nutrients might help you feel better. These five changes to your lifestyle may help ease psoriasis symptoms and cut down on flare-ups:

Losing any excess weight

It’s not clear how weight affects psoriasis, but losing extra weight could make treatments work better. If you are overweight, trying to get to a healthy weight may make your condition less severe.

Eating a heart-healthy diet

Psoriasis can be easier to deal with if you eat less saturated fat, which is found in animal products like meat and dairy.

It’s also important to eat more lean proteins like salmon, sardines, and shrimp that are high in omega-3 fatty acids. Walnuts, flax seeds, and soybeans are all good sources of omega-3s that come from plants, especially if you want to eat more plant-based foods.

Avoiding trigger foods

Inflammation is caused by psoriasis. Some foods can also cause inflammation. If you avoid these foods, your symptoms might get better. Some of these foods are:

• red meat
• refined sugar
• highly processed foods
• dairy products

Drinking less alcohol

Having a flare-up is more likely if you drink alcohol. You can lower your risk by cutting back or giving up completely. Your doctor can help you make a treatment plan if you have an alcohol use disorder.

Considering taking vitamins

Some doctors think that getting vitamins from food is better than taking pills. But even the healthiest eaters may need help to get all the nutrients they need. Ask your doctor if you should take vitamins to add to what you’re already eating.

Living with psoriasis

Psoriasis can be hard at times, but if you take the right steps, you can cut down on flare-ups. These three things will help you deal with your situation in the short and long term:

Diet

Psoriasis symptoms can be helped a lot by losing any extra weight and getting to a healthy weight and by eating a diet full of nutrients. This means eating a lot of plants, whole grains, and omega-3 fatty acids.

Also, it’s important to avoid foods that may cause inflammation in your body. Some of these foods are refined sugars, dairy products, and foods that have been heavily processed.

Talk to your doctor to find out if an anti-inflammatory diet is right for you.

Stress

Stress can be a trigger for psoriasis.You might be able to reduce flare-ups and feel better if you know how to deal with stress. You might want to try the following to help you relax:

• meditation
• journaling
• breathing
• yoga

Emotional health

Research shows that people with psoriasis are more likely to have depression and low self-esteem. When new spots show up, you might feel less sure of yourself. It might be hard to talk to your friends and family about how psoriasis affects you. The condition’s constant cycle may also be frustrating.

All of the feelings that come with having psoriasis are real. Getting in touch with helpful resources is important for dealing with them. This could mean talking to a professional in mental health or joining a group for people with psoriasis.

Psoriasis and arthritis

Recent clinical guidelines from the AAD and the NPF say that between 30% and 33% of people with psoriasis will be told they have psoriatic arthritis.

This kind of arthritis makes the joints swell, hurt, and become inflamed. People often confuse it with rheumatoid arthritis or gout. This type of arthritis is usually different from others because it causes areas of red or purple skin that are swollen and have plaques on them.

Psoriatic arthritis is a long-term health problem. Like psoriasis, psoriatic arthritis symptoms can come and go, with flare-ups and remissions. Psoriatic arthritis can also be ongoing, with symptoms and problems that don’t go away.

Most of the time, this condition affects the joints in the fingers or toes. It could also hurt your wrists, knees, or ankles.
Most people with psoriatic arthritis have a skin condition called psoriasis. But it is possible to get the joint condition even if you don’t have psoriasis. Most people who are told they have arthritis but don’t have psoriasis have a family member who does.

Treatments for psoriatic arthritis may help ease symptoms, relieve pain, and make it easier to move the joints. As with psoriasis, losing any extra weight, eating a diet full of nutrients, and staying away from triggers may help reduce flare-ups of psoriatic arthritis.

A quick diagnosis and a treatment plan made just for you can help lower the risk of serious problems, such as damage to your joints.

Psoriasis statistics

Around 7.5 million People in the US who are 20 or older have psoriasis.

Psoriasis can start at any age, but most people are diagnosed when they are adults. Most people get it between the ages of 15 and 35.

Some studies and the World Health Organization (WHO) say that about 75 percent of people with psoriasis are diagnosed before they are 46 years old. In the late 50s and early 60s, there can be a second peak time for diagnoses.

According to the WHO, Both men and women are affected the same way. Psoriasis is diagnosed more often in white people than in other groups. Only a small number of people with psoriasis are people of colour. But because psoriasis looks different on darker skin tones, it may be missed in people of colour.

The National Psoriasis Foundation says that if someone in your family has increases, you are more likely to get it yourself. But a lot of people who have the disease have no family history of it. Even if psoriasis runs in the family, not everyone will get it.

Around one-third of the people who have psoriasis will also have psoriatic arthritis. Also, people with psoriasis are more likely to get diseases like:

• type 2 diabetes
• kidney disease
• heart disease
• high blood pressure

Though the data is not complete, Research shows that more and more people are being diagnosed with psoriasis. It’s not clear if that’s because more people have the skin condition or because doctors are getting better at diagnosing it.