A guide to psoriasis

Psoriasis is a common yet often misunderstood skin condition that affects millions of people worldwide. It can be challenging to live with, but understanding its causes, symptoms, and treatment options can help you manage it effectively.

Renowned consultant dermatologist Dr Aadarsh Shah provides an overview of psoriasis and offers practical advice for those who may be affected.

What is psoriasis, and why does it occur?

Psoriasis is a long-term skin condition characterised by the development of red, scaly patches on the skin. It is not contagious, so you cannot catch it or pass it on to someone else. Psoriasis occurs due to over activity of the immune system. This results in increased inflammation and increased production of skin cells. Normally, skin cells are replaced every few weeks, but in people with psoriasis, this happens in just a few days. As a result, these excess cells build up on the skin’s surface, leading to the characteristic plaques (thick, scaly patches). The condition often comes and goes, with periods of flare-ups and remission.

While the exact cause is not fully understood, psoriasis is thought to result from a combination of genetic and environmental factors. If a family member has psoriasis, you may be more likely to develop it. Additionally, triggers such as stress, infections, skin injuries, and certain medications can cause symptoms to appear or worsen.

What are the symptoms of psoriasis?

The most common symptom of psoriasis is the appearance of red, raised patches of skin covered with silvery-white scales. These patches, or plaques, can develop anywhere on the body but are most commonly found on the elbows, knees, scalp, and lower back. Psoriasis can also cause itching, discomfort, and, in some cases, pain, particularly if the skin cracks or bleeds.

There are different types of psoriasis, each with slightly different symptoms.

Some of the most common types of psoriasis are:

• Plaque psoriasis is the most common type and is characterised by thick, scaly patches.
• Guttate psoriasis causes small, drop-shaped spots and often appears after an infection, like streptococcal throat infection.
• Scalp psoriasis occurs on the scalp, leading to flaking, redness and sometimes severe itching.
• Nail psoriasis occurs on the nails and can cause pitting (small dots), lifting of the nail, pain and disfigurement.

Some people with psoriasis also develop psoriatic arthritis, a condition that causes joint pain, stiffness, and swelling. If you experience these symptoms alongside skin plaques, it is important to seek medical advice.

How can psoriasis be treated?

Although there is currently no cure for psoriasis, there are several treatments that can help manage the condition and reduce symptoms. The right treatment will depend on the severity of your psoriasis, the area of body affected, what treatments you can tolerate and how your body responds.

Topical treatments, such as steroid creams, vitamin D analogues, anti-inflammatory creams and moisturisers, are often the first line of defence. These can help reduce inflammation, slow down skin cell production, and relieve itching.

For more moderate to severe cases, treatments like phototherapy (light therapy) may be recommended.  This involves exposing the skin to very specific wavelength of ultraviolet (UV) light under medical supervision.

Systemic treatments, including oral or injectable medications, work on the immune system to reduce inflammation throughout the body. Biologic therapies, a newer class of drugs, specifically target parts of the immune system involved in psoriasis.

How can you manage psoriasis day-to-day?

Managing psoriasis often involves lifestyle changes and self-care strategies. Keeping the skin well-moisturised can prevent dryness and reduce scaling. Using gentle, fragrance-free skincare products is also important, as harsh products can irritate the skin further.

Avoiding known triggers, such as stress and certain infections, can help minimise flare-ups. Stress management techniques, like mindfulness, yoga, or deep breathing exercises, may be particularly beneficial.

If you are living with psoriasis, regular follow-ups with your dermatologist can ensure that your treatment plan remains effective and tailored to your needs. Remember, while psoriasis is a long-term condition, it can be managed with the right care and support.

If you are concerned about psoriasis and would like to book a consultation with Dr Shah, simply visit his Top Doctors profile today.