Psoriasis is a chronic skin condition caused by an immune system dysfunction. Psoriasis is characterized by periods of flare-ups and remissions, and the unique and intense nature of its symptoms often causes stress and significant emotional burden. However, with available treatment options and in collaboration with a dermatologist, managing psoriasis helps maintain the patient's quality of life.
Medically reviewed by: Loizidis Christoforos, Dermatologist - Venereologist — Last reviewed: January 28, 2025
What is Psoriasis? Psoriasis is a chronic skin condition caused by an immune system dysfunction. Psoriasis is an autoimmune disease that manifests with skin lesions but sometimes also affects the joints. Psoriasis is a disease caused by the immune system itself when it 'instructs' skin cell acceleration. Thus, instead of the cell growth and shedding cycle lasting approximately one month, the process is completed in a few days, resulting in dead cells accumulating on the skin's surface, forming the scaly patches that are characteristic manifestations of psoriasis. The skin lesions appear as pink plaques with white scales on them. Although psoriasis is not contagious, the condition is hereditary and appears to 'run' in families. It is generally accepted that while there is a genetic predisposition, it does not mean that the offspring of an individual suffering from psoriasis will definitely develop the disease. It is not an allergic reaction, nor is it due to dietary habits. It manifests at all ages, although to a much lesser extent in elderly individuals. It has been observed that the appearance of psoriasis is more intense in people with limited sun exposure and usually appears in areas of the body that the sun does not frequently reach.
Who does Psoriasis Affect? Psoriasis affects men and women of any ethnicity. Symptoms can initially start from 15 to 25 years of age, without meaning that they cannot appear at any age. Men and women appear to have the same chances of developing psoriasis, which also affects children. Psoriasis Symptoms & Types Psoriasis can 'come and go,' bringing more severe or milder symptoms each time. The five main types of psoriasis, according to the symptoms they cause, are as follows: Plaque Psoriasis The most common type of psoriasis, affecting approximately 80% of patients. It produces scaly patches, erythematous plaques with silvery scales, and appears mainly: on the elbows on the knees on the lower back on the scalp Symptoms may also appear on the face, hands, feet, and genitals. Guttate Psoriasis Guttate psoriasis appears as tiny, drop-shaped red bumps, mainly covering large areas of the arms and legs. Guttate psoriasis tends to appear in children and young adults who have experienced an upper respiratory infection (strep throat) and may progress or never appear again. Inverse Psoriasis Inverse psoriasis appears in sensitive skin areas that rub against each other, such as: the armpits the buttocks the genitals It appears as intensely red, smooth patches. Inverse psoriasis does not exhibit scaly plaques like other types of psoriasis, presumably because it develops in moist areas of the body. Pustular Psoriasis Pustular psoriasis manifests with pustules, white pus-filled painful, non-infectious bumps, which may be surrounded by red inflamed skin. This form of psoriasis can be localized, affecting the palms of the hands and soles of the feet, or generalized, in which case immediate medical attention is required. Erythrodermic Psoriasis A rarer, severe form of psoriasis, erythrodermic psoriasis can cause intense redness or peeling of the skin, as well as more serious symptoms such as dehydration, fever, and heart rate disturbance, thus requiring hospitalization.
Psoriasis: Manifestation Sites
Psoriasis on the Head Psoriasis can appear anywhere on the skin and scalp. Scalp psoriasis typically occurs along the hairline and forehead, extending down to the ears and the back of the neck. Your dermatologist may recommend topical treatments such as medicated shampoos, creams, etc., oral medication, or phototherapy. Since every patient responds differently to psoriasis treatments, it may take time to find the ideal therapy for each case. Psoriasis on the Face Approximately half of all psoriasis patients experience symptoms on their face. Facial psoriasis primarily appears between the eyebrows, on the skin between the nose and upper lip, on the forehead, and at the hairline. Additionally, psoriasis can occur inside and around the ear and in the ear canal, in the mouth (internally and externally), and less commonly around the eyes. Psoriasis on the face requires careful treatment as the skin is particularly vulnerable. Psoriasis on Hands & Feet More than 1 in 10 patients with psoriasis experience manifestations on their hands and feet. In fact, symptoms can sometimes be so severe that they affect their quality of life, mobility, work, and various daily tasks. Topical treatments are a common option for psoriasis on the hands or feet, and there are also specialized phototherapies designed for hands and feet. Oral medication is administered when the condition is more severe or when there is no response to other treatments. Nail Psoriasis In many psoriasis patients, the disease can also affect the nails of their hands or feet. Most patients with plaque psoriasis are estimated to also develop nail psoriasis. In this specific form of psoriasis, the nails develop small pits on their surface, crumble, have a white, yellow, or brown discoloration, or lift from the nail bed. If you observe any of the above symptoms, you should consult your dermatologist. Nail psoriasis does not resolve without treatment; on the contrary, it may worsen.
It also appears to be linked to psoriatic arthritis.
Psoriasis: Photos Psoriasis symptoms manifest as psoriatic plaques with white scales and are the result of accelerated skin cell proliferation.
Psoriatic Arthritis A percentage of patients with psoriasis develop psoriatic arthritis, a chronic inflammatory condition that affects the joints of the upper and lower limbs and/or the spine. If psoriasis is not diagnosed early and the appropriate treatment is not applied, the patient is at risk of joint deformities and severe irreversible lesions.
Anxiety-related Psoriasis Psoriasis flare-ups are 'triggered' by various factors. One of the most common is stress, as confirmed by scientific studies and patient testimonies in the dermatologist's office. Learning to manage your stress and adhering consistently to your treatment regimen contributes to reducing psoriasis flare-ups.
Psoriasis: Exacerbating Factors Other factors that may be associated with psoriasis flares include: Vitamin D deficiency Certain medications Infections Injury Intense stress Smoking Obesity Alcohol Dry, cold weather
"Discuss with your dermatologist if you want to get a tattoo or body piercing, as these are considered injuries and can trigger a psoriasis flare-up."
Psoriasis & Diagnosis The diagnosis of psoriasis by a dermatologist is based on clinical examination, as well as the patient's complete medical history, and a skin biopsy may be required to confirm the diagnosis. A visit to the dermatologist is essential as sometimes the initial stages of the condition can resemble inflammatory skin diseases, such as eczema.
"Collaboration with your dermatologist is essential if you suffer from psoriasis, as the disease is chronic and is controlled with treatment."
Psoriasis Treatment How is Psoriasis Treated? It should be noted that psoriasis is currently not definitively curable. However, with the help of your dermatologist, you can achieve satisfactory management, which offers long periods without relapses and with clear skin. The therapeutic approach, which is individualized for each patient, includes two main options: topical treatment and systemic therapy (pills), which can be applied kombiniranly. Topical Pharmaceutical Preparations Vitamin D analogs, topical corticosteroids, topical calcineurin inhibitors, with moisturizing and keratolytic action. Systemic Therapy Antimetabolites, retinoids, immunosuppressants-immunomodulators, and biological agents.
"The sooner you talk to your dermatologist about psoriasis symptoms, the better for its management and control."
"Combining medication to treat psoriasis with the help of a specialized psychologist can improve the disease's symptoms, as stress is a significant exacerbating factor."
Seek professional help. Mental health is just as important as physical health, and they are directly linked. The onset of psoriasis can cause psychological disturbances in affected individuals, so psychological support from a specialist is essential. Do not scratch skin lesions. This habit, besides generally provoking a continuous desire for itching, worsens the lesions even more, thus delaying their remission. Enjoy the sun! The sun can help manage the disease, so you should try to be in the sun, always with the necessary protection using sunscreen.
Bibliography https://www.ncbi.nlm.nih.gov/books/NBK448194/#article-27961.s7 https://www.aad.org/public/diseases/psoriasis/what https://www.hopkinsmedicine.org/health/conditions-and-diseases/psoriasis https://www.cdc.gov/psoriasis/index.htm https://my.clevelandclinic.org/health/diseases/22852-inverse-psoriasis https://www.psoriasis.org/psoriasis-statistics/
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Is psoriasis contagious?
No, it is an autoimmune disease that is not contagious, but primarily manifests in individuals with a genetic predisposition, meaning it is hereditary.
Are there foods forbidden for psoriasis?
Some foods such as dairy products, citrus fruits, gluten-containing products, vegetables like tomatoes and peppers, as well as alcohol, can contribute to flare-ups of plaque psoriasis. In any case, it is advisable to discuss with your dermatologist any changes you make to your diet.
I feel tired. Could it be psoriasis?
Yes, psoriasis can be the culprit for the fatigue you're feeling. Talk to your doctor, who may adjust your treatment and provide advice for a healthy lifestyle, which contributes to managing fatigue.
How does psoriasis eventually go away?
With the treatment recommended by your doctor, psoriasis symptoms will "disappear," but they may return. By knowing and avoiding what triggers a psoriasis flare-up, you can achieve long periods of remission.
Are psoriasis and scabies the same?
Psoriasis and scabies are two completely different conditions, and they arise from different causes. Scabies is a parasitic contagious disease, while psoriasis is an autoimmune disease that is not contagious and has a hereditary basis.
Does psoriasis affect the patient's sexual life?
Directly no, indirectly yes. It is an autoimmune disease, so it does not affect the body's functions, and therefore not sexual performance either. The only way psoriasis can affect sexual life is through the negative impact it has on the patient's psychology (low self-esteem, reduced desire for sexual activity, etc.).
