Psoriasis (PsO): Overview
Psoriasis (suh-rye-ah-sis) is a condition that causes the body to make new skin cells in days rather than weeks. As these cells pile up on the surface of the skin, you may see thick, scaly patches.
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Plaque PsO is the most common type of psoriasis
Those thick, scaly patches that develop on the skin are called plaques. About 80% to 90% of people living with PsO get plaques, so they have plaque psoriasis.
Plaques can appear anywhere on the skin, but you’re most likely to find them on the:
- Lower back
Plaques tend to vary in size. They may appear on the skin as a single patch or join together to cover a large area of skin. No matter the size, plaques tend to be itchy. Without treatment, the itch can become intense. Some people notice that their skin stings, burns, or feels painful and tight.
Psoriasis is often a life-long disease
Most people who get PsO have it for life. That’s true no matter what type of psoriasis you have, with one exception. Some children who have guttate (gut-tate) psoriasis see their psoriasis go away. Because psoriasis tends to be a life-long disease, it helps to learn about it and see a certified dermatologist. A bit of knowledge and help from a certified dermatologist can give you some control over PsO. By gaining control, you can see clearer (or clear) skin. Gaining control can also help you to feel better, improve your overall health, and prevent PsO from worsening.
Gaining control often involves:
- Learning (and avoiding) what triggers your PsO
- Sticking to a good PsO skincare routine
- Living a healthy lifestyle
- Using medication when necessary
Seeing a certified dermatologist has another benefit. PsO can increase your risk of developing certain diseases, such as psoriatic arthritis or diabetes. Your dermatologist can watch for early signs of disease. If you do develop another disease, early treatment helps to prevent the disease from worsening. When you see a dermatologist about psoriasis, your dermatologist may talk about the type(s) of psoriasis you have. It’s possible to have more than one type.
What causes psoriasis?
Psoriasis runs in families: If a parent, grandparent, brother, or sister has psoriasis, you have a higher risk of getting it.
Psoriasis is not contagious. Unlike chickenpox or a cold, you cannot catch psoriasis from someone.
You also CANNOT get psoriasis by:
- Swimming in a pool with someone who has psoriasis
- Touching someone who has psoriasis
- Having sex with someone who has psoriasis
While we know that psoriasis isn’t contagious, scientists are still trying to determine exactly how psoriasis develops.
Scientists have learned that a person’s immune system and genes play a role in causing psoriasis.
What can trigger psoriasis?
Plenty of everyday things can act as a trigger, causing psoriasis to appear for the first time. Common psoriasis triggers include:
- Skin injury, such as a cut or bad sunburn
- Infection, such as strep throat
- Some medications, including lithium, prednisone, and hydroxychloroquine
- Weather, especially cold, dry weather
- Alcohol (heavy drinking)
These triggers can also cause psoriasis flare-ups. Different people have different triggers. For example, periods of intense stress may trigger your psoriasis but cold weather may not.
That’s why it’s so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.
Common psoriasis triggers that can cause psoriasis flare-ups Stress
Do you get flare-ups when you’re feeling overwhelmed or stressed? Stress is a common trigger.
Reduce risk of flare-ups from stress
- Find a way to manage your stress and practice it — even when you’re feeling okay. Common stress busters include yoga, meditation, and support groups.
- Before going to sleep, write down 3 things that you’re grateful for. Do this daily.
- When you start to feel stressed, take a deep breath, hold it, and exhale slowly.
If this triggers your psoriasis, you’ll get a flare-up near (or in the same spot as) the injury or bite. This happens about 10 to 14 days after you injure your skin.
Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.
Reduce the risk of flare-ups from a skin injury
- If you injure your skin, treat it quickly.
- If your skin itches, calm the itch.
- Avoid scratching, which can trigger a flare.
- Try to avoid getting bug bites by using insect repellent and staying indoors when bugs are most active. Bugs are most active at dusk and dawn.
Drinking frequently or in excess
If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect. Even treatment that could be effective for you may not work and you’ll continue to have flare-ups.
Reduce the risk of flare-ups from drinking
- Quit drinking.
- If you continue to drink, limit how much you drink in a day. Women should stop after 1 drink. Men should limit themselves to 2 drinks per day.
- Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate.
Does your PsO flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause.
Reduce the risk of flare-ups from drinking
- Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.
- Before trying a nicotine patch, ask your dermatologist whether using it could trigger your PsO.
- Avoid being around people who are smoking.
Dry, Cold Weather
If your PsO worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.
Reduce the risk of flare-ups from dry, cold weather
- Treat your PsO.
- Limit showers and baths to 10 minutes and use warm rather than hot water.
- Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.
- Use a gentle, moisturizing cleanser instead of soap.
- Apply moisturizer throughout the day when your skin feels dry.
- Plug in a humidifier when the air in your home feels dry.
- Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.
- Sit far enough away from a fireplace, radiator, or other heat sources so that you cannot feel the heat on your skin.
- Remove wet clothes and footwear when you come in from the cold.
- If your PsO continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.
Sunshine, warm weather
During warm weather, PsO can flare if you:
- Spend time in air conditioning.
Reduce the risk of flare-ups during warm weather
- If you spend time in air conditioning, apply moisturizer immediately after showering or getting out of a bath.
- If your skin still feels dry from spending time in air conditioning, apply moisturizer throughout the day.
- Avoid sunburn by wearing sunscreen. You want to apply sunscreen to skin that clothing doesn’t cover and is free of PsO. To get the protection you need, use sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.
PsO can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.
Reduce the risk of flare-ups due to infection
- Treat the infection. This can lessen or clear PsO.
- Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some PsO treatments risky.
Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning medication.
Reduce the risk of flare-ups from medication
- If you think a medication is causing your PsO to flare, DON’T stops taking it. Ask the doctor who prescribed it whether the medicine could be causing your PsO to flare. If it could ask if you could take another medication.
- Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause PsO to flare. Medicines that commonly trigger PsO include lithium, drugs taken to prevent malaria, strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down), medicine that treats high blood pressure, problems with your heartbeat, some arthritis medications.
Tattoos and piercings
When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, PsO can flare.
Reduce the risk of flare-ups from tattoos and piercings
- Avoid tattoos and other types of body art if you have PsO.
- If you want to get any type of body art, talk with your dermatologist first. Your dermatologist may be able to offer some tips that can reduce flare-ups.
If you cut yourself while shaving, you may notice new PsO about 10 to 14 days later where you cut yourself.
Reduce your risk of flare-ups from shaving
- Take care to avoid cutting yourself while shaving.
- Dermatologists’ tip: To reduce cuts and nicks, try applying moisturizer and then shaving gel before you shave.
Should You Treat Psoriasis
Treating PsO has benefits for both your body and mind. Treatment can:
- Help you see clearer skin
- Slow PsO, reducing your risk of getting more severe (and sometimes disabling) PsO
- Reduce symptoms such as itch and pain
- Lessen the effects of related health conditions such as heart disease
Research also shows that keeping PsO under control with treatment can:
- Help you get a good night’s sleep
- Improve your self-confidence
Many treatment options
While there is no cure for PsO, there are more treatment choices than ever before. Several new treatments have become available in recent years. Researchers continue to study treatment options for PsO and make improvements.
When it comes to treating PsO, many people find that working with a doctor who has experience treating PsO helps. Dermatologists have this experience, so they understand the risks and benefits of the different treatments. They know which treatments can be safely combined and when treatment is unacceptable for a patient.
To give their patients better results and reduce side effects, dermatologists may include two or more medications in a patient’s treatment plan.
By speaking with a dermatologist, you can find what type of treatment can help ease your discomfort and lead to clearer skin.