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What is psoriasis?

Psoriasis is a long-term disease of the skin resulting in skin that is red and scaly. Psoriasis is common and affects up to 1.8 million people in the U.K. Psoriasis is equally common in men and women and tends to be more common from late teens to early 30’s and then strikes again between 50-60. Psoriasis can come and go and can really affect some people’s quality of life. Any part of the skin can be affected but is most common on the lower back, elbows, knees and scalp.

What causes psoriasis?

The main cause of psoriasis is unknown, though it is believed to be hereditary and so you are more likely to get it if another member of your family has it. Psoriasis is believed to be an immune condition, which means there is a problem with the immune system and it is not working as it should. The immune system accidentally attacks healthy skin cells. Psoriasis occurs when skin cells multiply too fast, skin cells usually renew every 3 to 4 weeks but in people who suffer with psoriasis the process is much quicker and renews every 3 to 7 days. The skin cells build up to form raised plaques on the skin.

Is psoriasis contagious?

No, psoriasis is not contagious and cannot be spread across the body.

What are the symptoms of psoriasis?

Symptoms of psoriasis affect people differently and can vary greatly in severity. There are different types of psoriasis the most common is called plaque psoriasis, which can be alone or with another type. The symptoms of plaque psoriasis is itchy skin which looks red and inflamed, it is usually covered by loose, silvery scales (plaques) that are rough to the touch. Psoriasis makes the skin very itchy and can sometimes crack and bleed. Some people might just have a few plaques but in people with severe psoriasis, plaques can cover large areas of the body.

Pustula psoriasis is a more severe form of psoriasis with pus filled spots (pustules) developing on your skin. This condition can affect just the palms of your hands and soles of your feet or the whole body called generalised pustular psoriasis, you may also feel very unwell and experience fever, headaches and extreme tiredness. If generalised pustular psoriasis develops it usually requires hospital treatment, however this type is very rare.

If psoriasis affects the nails it can cause the nails to look dented and they can crumble or loosen from the nail bed. If psoriasis affects the scalp it can cause a scaly, itchy rash. This rash can be limited to one patch or can spread across the whole scalp and even to the forehead, ears and neck. It looks like severe dandruff and can also cause a temporary hair loss.

If psoriasis affects the palms of the hand and soles of the feet, painful cracks can develop which might affect people carrying out day to day activities like working or walking. This psoriasis is called palmoplantar psoriasis.

Guttate psoriasis is a form of psoriasis in which an inflamed drop shaped rash can appear all over the body, it is normally triggered by a bacterial streptococcal throat infection.

If psoriasis affects the creases or folds of the skin, such as those in the armpit, groin, under the breasts or under the bottom then it is called flexural psoriasis. This type of psoriasis is not scaly and is smooth and so is often misdiagnosed. This type of psoriasis is more common in people who are overweight due to it being present in skin folds.

What is the diagnosis for psoriasis?

Your doctor will normally be able to diagnose psoriasis on its appearance alone, though your doctor might arrange for a skin biopsy to help determine the type. Your doctor might then refer you to a dermatologist.

What is the treatment for psoriasis?

The symptoms of psoriasis can make people very self conscious and the constant itching can lead to fatigue. There is no cure for psoriasis so the first step in treating psoriasis is to keep the skin moisturised, for some people with mild psoriasis this might be the only treatment required. There are plenty or treatments available to help ease symptoms and limit flare-ups and the treatment you receive will depend on the severity of symptoms. As psoriasis affects people differently, treatments which work for one person might not work for another so finding the right treatment can be a case of trial and error. You might need to try various combinations to find the best one for you.

The first step in treating psoriasis is with topical treatments, these are creams or ointments applied to the skin this might need to be applied a few times per day. Topical treatment includes emollients (moisturisers), lotions or shampoo that contains coal tar or creams containing vitamins may also be recommended. Steroid creams are sometimes recommended for a short period. For more information on this cream or to purchase please click here.

For severe psoriasis, your doctor may suggest a UV light therapy treatment or prescribe drugs.

How can I avoid a flare up?

Psoriasis can flare up for different reasons, a psoriasis outbreak can be triggered by a number of factors such as :

  • Smoking excessively
  • Weather, cold dry weather can dry out your skin
  • Drinking alcohol excessively
  • Stress
  • Infections such as the common cold or sore throats.
  • Cut or any type of injury to the skin
  • Certain types of medication, such as beta blockers taken for high blood pressure.
  • Hormones, particularly during pregnancy, puberty or the menopause 

What is the long-term effects of psoriasis?

Around 1 in 3 people with psoriasis will develop psoriatic arthritis, this affects your joints causing inflammation, stiffness and pain. It is not clear why some people go on to develop this arthritis and some don’t. Having psoriatic arthritis might put you at risk of cardiovascular disease, further studies are being carried out on the reasons for this link.