Psoriasis Mate tongatonga uri

Skin cells are usually replaced every 21 to 28 days. Your body makes new skin cells just under the surface to replace the old skin cells that are dropped off (shed).

With psoriasis, you make new skin much faster — in only a few days. This causes your skin to get thicker in places, forming rough, red areas and often silvery scales known as plaques.

Although the process is not fully understood, it is caused by a problem with the immune system.

Genetics also appear to play a part in causing psoriasis because the condition can run in families.

Certain things can trigger psoriasis or cause a flare-up. These include:

• stress
• anxiety
• some skin and throat infections
• smoking
• excessive alcohol
• certain medicines.

Psoriasis is not infectious, meaning you cannot catch it from other people.

Psoriasis can appear at any age and affect anyone.

The severity of psoriasis varies. Some people have a mild form but for others it can severely impact their lives.

Symptoms include:

• patches of rough, red skin and silvery white scales called plaques that last for weeks to months — on darker skin, the patches may appear purple with grey scales
• itchy skin — this is usually mild but can be severe.

Scalp, elbows and knees are the most commonly affected places.

When psoriatic plaques clear up, they may leave brown or pale marks that usually fade over several months.

Patches can form in areas where skin has been damaged, such as on scars or burns.

Types of psoriasis

There are several types of psoriasis. They vary by the area of your body affected and the type of rash. Chronic plaque psoriasis is by far the most common, causing plaques greater then 3 cm wide.

Chronic plaque psoriasis images —DermNetexternal link  

Fingernails can also be affected. This may cause your nail to lift away from your finger, which can be painful.

Some people with psoriasis will develop joint problems. This is called psoriatic arthritis and is a type of inflammatory arthritis.

Psoriasis can come and go throughout your lifetime.

Usually, your healthcare provider will diagnose psoriasis based on the appearance of your skin. They will ask you about:

• which areas of your body affected
• how it impacts your day-to-day life
• if you have any joint pain.

They will examine your skin, scalp and nails.

If your healthcare provider is unsure of the diagnosis or if usual treatment for psoriasis doesn't seem to be working, you may need to have a biopsy. This is when a small sample of skin is taken and examined under a microscope.

Although there is no cure for your psoriasis, there are many effective treatments that can keep it under control.

You often need to try different treatments to see what works for you.

Treatments depend on your symptoms.

Topical treatments

Topical treatments are products you put on your skin. Several topical treatments may help your psoriasis including: 

• Moisturisers. These are used to help with dryness and itch, make plaques less thick and help your skin absorb other treatments. You should use them instead of soap when you wash and put them on your skin every day.
• Steroids. These help by reducing inflammation, making your skin less red and itchy. Different strengths are used depending on how bad your psoriasis is and which part of your body it is on.
• Vitamin D-like compounds such as calcipotriol and calcitriol. These creams reduce the thickness and scaliness of plaques.
  Calcipotriol — DermNetexternal link
  Calcitrol — My Medicinesexternal link
• Combination calcipotriol/betamethasone dipropionate ointment, gel or foam. This may be used if an individual cream has not worked.
• Shampoos and scalp lotion or ointment if the psoriasis is affecting your scalp. These may contain a variety of products including coconut or coal tar. You can buy them at a pharmacy or supermarket but some need a prescription. Your pharmacist can advise you on which product and how to use it.

Other treatments for psoriasis

If your psoriasis is very bad and not getting better with topical treatment, your healthcare provider may refer you to see a specialist skin doctor (dermatologist).

Your treatment may then include:

• A course of ultraviolet light treatment that works by reducing inflammation of the skin.
  Ultraviolet light treatment — DermNetexternal link
• Medicines that suppress your immune system and reduce inflammation such as ciclosporin or methotrexate.
  Ciclosporin — DermNetexternal link
  Methotrexate — My Medicinesexternal link
• Acitretin. This is a type of medicine called a retinoid, which means it is similar to vitamin A. It works by slowing down skin production. You must not take it if you are pregnant or trying to get pregnant, as it can cause serious damage to a developing baby. You cannot donate blood while taking this medication, or for 2 years afterwards.
  Acitretin — My Medicinesexternal link

Avoid putting pressure on any areas of your body affected by psoriasis. For example, if you have psoriasis on your knees, avoid kneeling.

Smoking and alcohol can make psoriasis worse. Stop smoking if you smoke and reduce how much alcohol you drink. 

Get sunshine in small doses to help clear psoriasis. Take care to avoid sunburn as this can cause flare-ups and lead to skin cancer. Avoid sun beds.

Psoriasis can have a big effect on your quality of life, causing anxiety and depression. Speak to your healthcare provider if you are concerned about the impact it is having on you.

The DermNet website has more detailed information about psoriasis including images.

Psoriasis —DermNetexternal link