Doctor’s Note: Your Essential Guide to Psoriasis and More

Get a bird’s eye view of psoriasis with our “Psoriasis 101” intro video. It has a little bit of everything you need to know, including causes, triggers, recommended products, prescriptions, and procedures!

Click the video to your right, or skim the highlights below!

What is Psoriasis?

Psoriasis is a chronic skin condition where skin cells grow too quickly, leading to the formation of thick, red patches with silvery scales. These patches can be itchy and painful and are most commonly found on the elbows, knees, scalp, and lower back.

Psoriasis occurs due to an overactive immune system, which causes inflammation and accelerates the growth of skin cells. Normally, skin cells grow and shed in about a month, but with psoriasis, this process takes only a few days, causing skin cells to accumulate on the surface.

The red patches can burn and sting, and the inflammation caused by psoriasis can also affect other parts of the body, leading to additional health issues like psoriatic arthritis. This condition causes swelling, stiffness, and pain in the joints and can go undiagnosed, especially in its milder forms. Early treatment is important to prevent permanent joint damage.

Psoriasis can begin at any age but typically starts between the ages of 15 and 25. It affects people of all genders and skin colors. While there is no cure for psoriasis, various treatments can help manage the symptoms and improve quality of life.

Psoriasis Pictures

People with psoriasis often have red patches of skin covered with thick, silvery scales. The skin might crack and bleed, and the affected areas can be very itchy and feel like they're burning. Fingernails and toenails may become thickened, ridged, or pitted. Some people also experience joint problems, a condition known as psoriatic arthritis.

Red Patches of Skin

These patches are often covered with thick, silvery scales.

Thickened Nails

Fingernails and toenails may become thickened, ridged, or pitted.

Dry, Cracked Skin

The skin might crack and bleed.

Stiff and Swollen Joints

Some people with psoriasis also have joint problems, a condition known as psoriatic arthritis.

Itching and Burning

The affected areas can be very itchy and may feel burning.

Flakes on Scalp

About 50% of people with psoriasis have it on their scalp. Learn more about scalp psoriasis here!

Side Note: This page will cover plaque psoriasis, which represents ~90% of all cases. There are different types of psoriasis, though. Click below to learn more!

Learn About 5 Types of Psoriasis

Where Does Psoriasis Appear?

Psoriasis can appear on many parts of the body.

Common spots for it to show up include the elbows and knees, where thick, scaly patches often form. It frequently appears on the scalp, causing itchy, flaky skin. The lower back is another common area for psoriasis patches.

Less commonly, psoriasis can show up on the armpits, under the breasts, groin, genitals, anus, hands, and feet, making daily activities more challenging. The fingernails and toenails can also be affected, becoming pitted or discolored.

Common Psoriasis Locations

Less Common Psoriasis Locations

Side Note: Psoriasis is often confused with eczema. Click below to learn the difference!

Psoriasis vs Eczema

What Causes Psoriasis?

The exact cause of psoriasis isn't fully understood, but it's thought to be related to the immune system. Normally, skin cells grow and fall off in about a month, but in psoriasis, the process happens in just a few days. This rapid turnover leads to the buildup of skin cells. Factors that can trigger psoriasis include:

Genetics: Psoriasis can run in families.
Immune System: An overactive immune system can cause inflammation and quick turnover of skin cells.
Environmental Triggers: Stress, smoking, heavy alcohol consumption, and certain medications can trigger or worsen psoriasis.

How Is Psoriasis Diagnosed?

A dermatologist or healthcare provider can diagnose psoriasis by looking at your skin, nails, and scalp. They'll also ask you questions about your symptoms and family history of skin conditions. Some questions they might ask include:

Do you have a history of skin conditions in your family?
When did you first notice symptoms?
What products help your skin?
Is this your first outbreak?
What types of soaps or shampoos do you use?

To confirm the diagnosis and rule out other skin conditions, they might take a small sample of your skin, called a biopsy, to examine under a microscope. This helps them make sure that psoriasis is causing your symptoms.

What Makes Psoriasis Worse?

Understanding what can trigger or worsen psoriasis is crucial for managing the condition effectively. While psoriasis is a chronic skin disease, various factors can lead to flare-ups or make symptoms more severe. Identifying and avoiding these triggers can help you better control your psoriasis and reduce the frequency and intensity of flare-ups. In this section, we'll explore common factors that can exacerbate psoriasis and provide guidance on how to minimize their impact on your skin health.

Smoking: Tobacco use increases the risk and severity of psoriasis.
Alcohol: Excessive alcohol consumption can trigger psoriasis flare-ups.
Obesity: Being overweight can increase the risk and severity of psoriasis.
Stress: Stress can trigger and worsen psoriasis symptoms.
Certain Medications: Beta-blockers, lithium, and antimalarials can trigger or worsen psoriasis.
Infections (Strep): Strep infections can trigger guttate psoriasis, especially in young people.
Injury: Injuries like cuts, scrapes, or sunburns can cause new psoriasis lesions (Koebner phenomenon).
Sunburn: Severe sunburn can trigger psoriasis flare-ups.
Winter: Cold, dry air can worsen psoriasis symptoms.
Withdrawal from Prednisone: Stopping prednisone (an oral steroid) suddenly can cause severe flare-ups.

What Makes Psoriasis Better?

Finding ways to improve psoriasis can significantly enhance your quality of life and manage symptoms more effectively. Although psoriasis is a chronic condition, certain strategies and treatments can help alleviate symptoms and reduce flare-ups. Identifying what helps soothe your skin and manage your condition is key to maintaining better control over psoriasis. In this section, we’ll explore effective methods and lifestyle changes that can help improve psoriasis, providing practical tips and recommendations to support your skin health.

Use Moisturizers: Apply a thick, fragrance-free moisturizer to keep your skin hydrated.
Apply Topical Treatments: Use prescribed creams or ointments as directed to reduce inflammation and itching.
Take Oatmeal Baths: Soak in lukewarm water with colloidal oatmeal to soothe itching.
Protect Your Skin: Avoid sunburn; use sunscreen to prevent damage.
Wear Soft Clothing: Choose loose, cotton clothing to avoid irritation.
Avoid Triggers: Identify and stay away from known triggers, like stress or smoking.
Manage Stress: Practice stress-relief techniques such as meditation or yoga.
Consider Over-the-counter Treatments: Use coal tar or salicylic acid products for mild flare-ups.
Consult Your Doctor: Seek professional advice if symptoms are severe or not improving.

Are There Complications from Psoriasis?

Psoriasis affects the entire body; it causes inflammation throughout the body, which can impact different organs. This means people with psoriasis have a higher chance of developing other health issues beyond their skin symptoms. For example, they may be at greater risk for heart disease, liver disease, and diabetes. Psoriasis can also cause breathing problems, like COPD and sleep apnea, and joint issues like psoriatic arthritis or even osteoporosis.

Psoriasis may lead to eye inflammation. It’s also linked to bowel diseases like Crohn’s disease or ulcerative colitis. Other possible risks include celiac disease, fibromyalgia, lymphoma, and mental health issues like depression. Because psoriasis is a visible condition, it can also lead to social isolation, affecting daily life and self-esteem.

Heart disease
Liver disease
Diabetes
COPD
Sleep apnea
Psoriatic arthritis
Osteoporosis
Eye inflammation

Inflammatory bowel disease (Crohn’s or Ulcerative Colitis)

Celiac disease
Fibromyalgia
Lymphoma
Erectile dysfunction
Depression
Social isolation

It’s very important for people with psoriasis to work closely with their doctors to monitor and manage the health risks that come with the condition. Regular visits to both dermatologists and primary care doctors can help catch new health problems early, like heart disease or diabetes. This way, doctors can give the right treatment and advice to help prevent these issues from getting worse. By staying connected with healthcare providers and following their guidance, people with psoriasis can improve their overall health and quality of life.

Psoriasis is well-known to affect emotional health and relationships. Due to the visible nature of their condition, patients with psoriasis may also experience social isolation. While living with psoriasis can be challenging, there are ways to handle these challenges and thrive.

Get Support

Psoriasis Treatment - Overview

We treat psoriasis in different ways based on where it appears on the body and how much of the skin it affects. For everyone with psoriasis, it’s important to focus on healthy lifestyle habits and use over-the-counter (OTC) products to help manage symptoms. If psoriasis covers less than 3% of your body, there are specific treatments for different areas. Plaque psoriasis, often found on areas like elbows, can be treated with topical steroids or Vitamin D creams. The face, armpits, and groin require gentler, non-steroidal creams like Elidel or Protopic. Scalp psoriasis can be managed with topical steroids or a medicated shampoo like ketoconazole. For psoriasis on the hands and feet, stronger topical steroids may be needed.

If psoriasis affects more than 10% of the body, causes severe issues, or has uncontrollable itching, stronger treatments might be necessary. These include injections, like Humira or Skyrizi, pills like Otezla, or phototherapy (light therapy). These stronger treatments are usually prescribed by a doctor for more serious cases to help control symptoms and improve quality of life.

Psoriasis Treatment - Lifestyle Changes

If you have psoriasis, making some lifestyle changes can really help you manage your symptoms and improve your quality of life. Psoriasis is more than just a skin condition—it involves inflammation that can affect different parts of your health. Healthy habits and avoiding triggers can help control flare-ups and make them less severe. By focusing on areas like diet, exercise, stress management, and skin care, you can better manage your psoriasis and possibly reduce its effects. Here are some key changes to consider:

Maintain a Healthy Weight: Stay active and eat a balanced diet.
Eat a Balanced Diet: Focus on fruits, vegetables, lean proteins, and whole grains. Omega-3s from fish and flaxseeds may help. Consult your doctor before major dietary changes.
Exercise Regularly: Engage in regular physical activity to reduce inflammation.
Get Adequate Sleep: Maintain a regular sleep schedule.
Avoid Smoking and Limit Alcohol: Both can worsen psoriasis and trigger flare-ups.
Manage Stress: Use stress-relief techniques such as meditation, yoga, or hobbies.
Use Moisturizers: Apply a gentle, fragrance-free moisturizer to reduce dryness.
Consider Supplements: Vitamin D or omega-3 supplements may help; consult your doctor before starting any new supplements.

Best Products for Psoriasis

Over-the-counter (OTC) treatments for psoriasis can effectively manage symptoms and improve skin health. Look for products containing active ingredients such as salicylic acid, which helps remove scales and reduce inflammation, and coal tar, which slows skin cell growth and reduces itching and scaling. Moisturizers with ingredients like urea and lactic acid can help keep the skin hydrated and soft, reducing dryness and flaking. Hydrocortisone creams can also provide relief by reducing inflammation and itching. Regular use of these OTC treatments can help manage psoriasis symptoms and improve overall skin condition.

Vaseline Petroleum Original Healing Jelly Skin Protectant

Products to Moisturize

Look for thick, fragrance-free moisturizers. Look for urea, coal tar, lactic acid.

Gold Bond Multi-Symptom Psoriasis Relief

Viva Naturals Organic Coconut Oil - Unrefined, Cold-Pressed Extra Virgin Coconut Oil

Products to Reduce Inflammation

Topical Steroids

Products to Remove Flakes

Salicylic Acid, Coal Tar, Oils

Devices to Reduce Inflammation

Phototherapy

Side Note: Check out the best psoriasis products!

Best Skincare for Psoriasis

Best Prescriptions for Psoriasis

Sometimes, over-the-counter creams and lotions aren't enough to handle psoriasis. When that happens, doctors often prescribe stronger medicines that you can only get with a prescription. These prescription topicals are usually more powerful and can help manage the symptoms better. If over-the-counter options aren't working, it's important to talk to your doctor about getting a prescription. The most common prescriptions we use for psoriasis include:

Topical Steroids

Topical steroids help reduce inflammation and itching. They come in different strengths and are often applied directly to the skin. However, using them for too long can make the skin thinner, so doctors usually limit how long they are used. Examples include hydrocortisone, triamcinolone, and betamethasone.

Vitamin D

Vitamin D creams help slow down skin cell growth, which can be useful for treating certain skin conditions. They are often used with topical steroids and have few side effects. Examples include calcipotriene and Dovonex.

Sotyktu

Sotyktu is a daily pill that’s an option if topical treatments don’t work. It has few side effects but does require monitoring by a doctor.

Prednisone

Prednisone is an oral steroid used for severe flares. It’s usually taken for a short time only, as stopping it suddenly can cause symptoms to come back. It’s not the preferred treatment for long-term use.

Biologics

Biologics are medications given by injection at home that help reduce skin inflammation. They require regular monitoring and may cause side effects. Examples include Humira, Stelara, Cosentyx, and Skyrizi.

Elidel + Protopic

Elidel and Protopic are non-steroidal creams that help reduce inflammation and itching. They have fewer side effects than steroids and are safe for sensitive areas, like the face.

Otezla

Otezla is a twice-daily pill that helps reduce inflammation. Common side effects include diarrhea. It doesn’t work as well as biologics but has fewer side effects.

Vitamin A

Vitamin A creams, like Tazorac, slow down skin cell growth and reduce inflammation. However, they can sometimes cause skin irritation or dryness.

BEFORE YOU GO TO THE DERMATOLOGIST: Some of these medications can be expensive, and insurance companies may deny the more expensive treatments. Download this FREE worksheet to make it easier to get approved for advanced treatments:

Streamline Psoriasis Treatment

Best Procedures for Psoriasis

Sometimes, even prescription treatments aren’t enough to manage psoriasis effectively. In such cases, doctors may recommend phototherapy, a more advanced treatment. Phototherapy involves exposing the skin to controlled amounts of ultraviolet (UV) light to reduce inflammation and slow down skin cell growth. This treatment is usually performed in a medical setting but can also involve home devices. If topical treatments aren't providing relief, discussing phototherapy with your doctor could be a beneficial next step. Common types of phototherapy for psoriasis include:

Over-the-Counter Phototherapy

You can buy over-the-counter phototherapy devices online. They are usually used a few times a week on the affected areas and can be effective for treating mild to moderate psoriasis.

Office Phototherapy

Office phototherapy uses UVB light to reduce inflammation and itching. It’s effective for moderate to severe eczema and is given in a clinical setting or with a unit at home.

Home Phototherapy

Home phototherapy is a prescription treatment you can do at home. It’s similar to an office-based phototherapy device. Check if your insurance covers "Durable Medical Equipment (DME)" to help with costs. Popular companies for home phototherapy devices include National Biologic + SolRx!

Psoriasis FAQs

Is castor oil good for psoriasis?
Castor oil may help with psoriasis by hydrating and soothing dry, flaky skin. Its anti-inflammatory properties can alleviate irritation, but it is not a primary treatment for psoriasis.

Where to buy UVB lamp for psoriasis?
UVB lamps for psoriasis can be purchased online through retailers like Amazon, specialized medical supply stores, or directly from manufacturers that offer FDA-approved phototherapy devices.

Does Clinique work with psoriasis?
Clinique products are generally gentle and fragrance-free, which may make them suitable for psoriasis-prone skin. However, individual results can vary, so patch testing is recommended.

Is triple antibiotic ointment good for psoriasis?
Triple antibiotic ointment is not a treatment for psoriasis. It is intended for bacterial infections and may not address the underlying causes of psoriasis.

Does psoriasis make you tired?
Yes, psoriasis can make you feel tired, especially if associated with systemic inflammation, pain, or comorbidities like psoriatic arthritis or depression.

Can you get psoriasis on your lips?
Psoriasis on the lips is rare but possible. It may appear as dry, scaly patches or cracking on or around the lips.

Is coconut oil good for psoriasis?
Coconut oil is often used to moisturize and soothe psoriasis-affected skin. Its anti-inflammatory and antimicrobial properties can help reduce discomfort, but it is not a standalone treatment.

Is psoriasis a microbial infection?
No, psoriasis is not a microbial infection. It is an autoimmune condition where the immune system triggers an overproduction of skin cells.

Can you have psoriatic arthritis without psoriasis?
Yes, it is possible to have psoriatic arthritis without visible psoriasis. This occurs in a small percentage of cases and is typically diagnosed through symptoms and family history.

Can you get psoriasis in your stomach?
Psoriasis typically appears on the skin, including areas like the scalp, elbows, and knees. Psoriasis on the stomach is rare but possible.

Which comorbidity is associated with psoriasis?
Common comorbidities associated with psoriasis include psoriatic arthritis, cardiovascular disease, metabolic syndrome, and depression.

Is plaque psoriasis deadly?
Plaque psoriasis itself is not deadly, but severe cases and associated comorbidities, such as cardiovascular disease, can pose health risks if left unmanaged.

Can psoriasis cause baldness?
Psoriasis on the scalp can lead to temporary hair loss due to inflammation, scratching, or treatments. Hair typically regrows once the condition is managed.

Is psoriasis hereditary?
Yes, psoriasis can be hereditary. It often runs in families, with genetic factors contributing to an increased risk of developing the condition.

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