Psoriasis is a common, often lifelong, skin condition that affects about 2% of the entire US population. Though prevalent, psoriasis often goes unrecognized, unaddressed, or misdiagnosed. Beyond its physical manifestations, psoriasis can take a toll on mental and emotional well-being. The visible nature of the condition can lead to self-consciousness, social isolation, and lowered self-esteem. Many patients grapple with feelings of frustration and anxiety due to the chronic nature of the disease and its unpredictable flare-ups. In honor of August being Psoriasis Awareness Month, here are some helpful facts to help you know more about this common skin condition.
1. What is psoriasis?
Psoriasis is a skin condition in which the body’s immune system becomes overactive, leading to inflammation and the production of new skin cells in a matter of days rather than weeks. These rapidly produced cells pile up on the skin surface, producing a thick, scaly rash called a plaque.
2. What causes psoriasis?
It is unknown what exactly triggers or causes psoriasis, but it is thought to be possibly related to a combination of factors like genetics, the environment, and at times other variables like obesity, certain medications, infections, injury, and/or stress. Psoriasis can start at any age and is not contagious or infectious.
3. Are there different types of psoriasis?
Yes. While psoriasis can show up anywhere on the skin, there are certain types of psoriasis that can be categorized by specific clinical characteristics.
- Plaque psoriasis is the most common type, making up about 80%-90% of psoriasis cases. This type is characterized by thickened plaques with a silvery-white scale, most commonly found on the knees, elbows, lower back, and/or scalp.
- Guttate psoriasis is characterized by small scaly pink bumps that appear on the torso, arms, and legs rather suddenly, but can even involve the face, ears, and scalp. This type of psoriasis will sometimes clear within weeks to months (particularly in children and young adults who have had a recent strep throat infection), but it is difficult to predict if it (or another type of psoriasis) will re-occur at some point later on.
- Inverse psoriasis develops in skin folds (armpits, genitals, crease of buttocks) and can have a raw or shiny red look to the skin.
- Pustular psoriasis can cause pus-filled bumps and redness on the hands and feet. It can be very painful and difficult to treat.
- Erythrodermic psoriasis is a life-threatening, very serious form of psoriasis that requires immediate medical intervention. People with this form of psoriasis will be ill with fever, chills, weakness, a rapid pulse, diffusely red skin, and severe itching.
4. Can psoriasis affect other parts of the body besides the skin?
Yes. Psoriasis can manifest in other areas of the body, including the nails and joints.
- Nail psoriasis shows up in approximately half of people with plaque psoriasis at some point in life. Nail changes that are common in psoriasis include “pitting” (tiny indentations in the nail), discoloration, texture alteration, buildup of skin cells under the nails, and/or nail lifting.
- Psoriatic arthritis occurs in approximately 1 out of every 3 people with psoriasis. Signs of psoriatic arthritis include joint swelling, stiffness, and pain. The earlier psoriatic arthritis symptoms are addressed, the more likely permanent joint damage can be prevented. If you suspect you may have psoriatic arthritis, discuss your symptoms with your dermatology provider, and they may recommend evaluation with a rheumatologist.
5. How is psoriasis diagnosed?
Psoriasis can often be diagnosed by a dermatology provider based on the description of your symptoms and clinical exam. That being said, sometimes it can be difficult to distinguish between psoriasis and other skin conditions, so it may be necessary to do a skin biopsy to confirm the diagnosis.
6. How do lifestyle and diet affect psoriasis?
While there are no specific diets proven to improve psoriasis, generally healthy habits can provide major benefits to psoriasis patients. The following lifestyle changes can reduce frequency of psoriasis flares and associated complications.
- Quit smoking
- Limit alcohol consumption
- Maintain a healthy weight through a healthy, balanced diet and regular exercise
- Consistently keep check ups with your primary care clinician and dermatology provider to ensure optimal management of symptoms and to detect any changes in your psoriasis symptoms
7. Can sunlight help psoriasis?
Limited exposure of affected skin to ultraviolet light (15 minutes during non-peak sunlight hours- before 10 AM and after 4 PM) produced by the sun’s rays can be beneficial for some people with psoriasis. Keeping this in mind, it’s still extremely important to protect your skin from sunburn during peak sunlight hours by wearing sunscreen daily.
8. What are the treatment approaches?
North Metro Dermatology’s approach to treating psoriasis involves tailoring the treatment plan to the individual patient’s needs. Here are some common treatment options:
NON-PRESCRIPTION RECOMMENDATIONS: Lifestyle modification (diet and activity) may help control flares if triggers are known. Sunlight exposure, while protecting against sunburn, may improve symptoms. Over-the-counter moisturizers such as petroleum jelly, thick creams, or certain shampoos can be used to treat mild psoriasis.
TOPICAL: Prescription corticosteroids are often first-line treatments to treat areas of psoriasis and come in various formulations and strengths. Vitamin A/Vitamin D derivatives and other prescription non-steroidal ointments/creams are alternative topical options.
UV LIGHT THERAPY: Narrowband UVB (phototherapy) is a safe and effective treatment option for widespread psoriasis. Our clinic also offers XTRAC® treatment which is often ideal for scalp involvement and other localized areas. These treatments are usually covered by insurance.
SYSTEMIC THERAPIES: For moderate to severe psoriasis, a variety of oral and injectable options are available to treat psoriasis.
9. Is there a cure for psoriasis?
Currently, there is no known cure for psoriasis. Most people with psoriasis will have it for life. However, there are many treatments available that can help reduce symptoms and appearance of psoriasis, as well as reduce associated damage from inflammation.
If you suspect you are dealing with psoriasis, it’s important to consult with a dermatology provider to ensure you are getting optimal, tailored care. Schedule an appointment with one of our dermatology providers for further evaluation and management. Happy Psoriasis Awareness Month!