Psoriasis is a skin disorder that occurs when new skin cells grow too quickly as the result of immune-related inflammation. It is characterized by thick patches of skin covered with white or silver scales. There are a variety of treatment approaches that help slow down the growth of skin cells and treat symptoms.
Here’s what to know about the condition’s causes, symptoms, and treatment options.
What is psoriasis?
Your body typically produces new skin cells over the course of several weeks. For those with psoriasis, new skin cells are formed in days. The excess cells accumulate on the surface of the skin, leading to the development of thick, scaly patches in most psoriasis cases.
Psoriasis scales may develop anywhere on the body. Some people have just a few small flakes on their scalp or elbow while others have larger patches covering much of their skin.
Causes and risk factors of psoriasis
Individuals of all ages, sexes, races, and ethnicities may develop psoriasis. In the U.S., roughly one-third of all psoriasis cases develop before the age of 20. It is a lifelong condition, with the exception of a type of psoriasis that resolves after childhood.
The specific causes of psoriasis aren’t fully understood, however, the immune system, genetics, and environmental factors likely all contribute to its development. If one parent has psoriasis, you are more likely to also develop the condition. If both parents have it, your risk increases further.
Smoking can increase both an individual’s risk of psoriasis and the severity of the condition.
Psoriasis is not contagious and cannot be passed from one person to another.
For most people with psoriasis, symptoms fluctuate over time. Symptoms may be severe for a few days or weeks before clearing up. Some people then go on to experience years without symptoms. The periodic flare-ups are typically triggered by environmental factors such as the following:
Infections including strep throat and skin infections
Weather, especially cold temperatures and dry air
Skin injuries including cuts, scrapes, bug bites, and sunburns
Exposure to secondhand smoke
Heavy alcohol consumption
Symptoms of psoriasis
While symptoms of psoriasis can vary significantly from one individual to another, common symptoms include the following:
Raised, inflamed patches of skin
White or silver scales, also referred to as plaques, on the inflamed patches
Dry skin that may crack or bleed
Soreness, itching, or burning sensations on or near patches of irritated skin
Thick, pitted nails
Joint pain or swelling
A basic physical exam is often sufficient in diagnosing psoriasis, as symptoms are both visible and distinct from those of other conditions.
In cases where a diagnosis is less clear, your doctor may order a biopsy, which is a small sample of your skin. Biopsies are typically performed in a doctor’s office with a local numbing agent.
Your provider may refer you to a dermatologist who specializes in the treatment of skin conditions.
While there is no cure for psoriasis, there are many treatments that lessen skin inflammation and scales, remove plaques, and slow down the turnover of skin cells. Your doctor will recommend the best approach for your needs and symptoms, typically starting with less invasive options.
Topical treatments, or medications applied to the surface of skin, are typically the frontline treatment for psoriasis. They slow down skin cell growth and reduce inflammation. There are several types of topicals:
Corticosteroids are anti-inflammatory agents that reduce swelling and redness, and the most commonly prescribed medications for mild to moderate psoriasis. They are available in many forms, including oils, ointments, creams, lotions, gels, and more. Mild corticosteroid ointments like hydrocortisone are frequently used for sensitive areas while stronger creams and ointments like triamcinolone (Trianex®) and clobetasol (Cormax®, Temovate®) may be used for less sensitive areas or patches that don’t respond to hydrocortisone.
Non-steroid topicals including synthetic forms of vitamin D such as calcipotriene (Dovonex®, Sorilux®) and calcitriol (Vectical®) may be prescribed as an alternative to steroids. Like steroids, these treatments can help control plaques. They may cause less irritation than other treatments.
There are also over-the-counter topical treatments in the form of lotions, foams, tars, shampoos, and more. The active ingredients salicylic acid and coal tar are FDA-approved for psoriasis treatment. Always consult your doctor before beginning an over-the-counter treatment.
Light therapy is often a first line treatment for moderate or severe psoriasis, alone or in tandem with medications. In this treatment, the skin is exposed to controlled amounts of natural or artificial light. There are many types of light therapy, from simple exposure to sunlight to controlled doses of UVB broadband and UVB narrowband light and more. Your doctor can help you determine if these therapies are appropriate for you.
Oral or injected medications
If your symptoms are moderate to severe, or if they haven’t responded to frontline treatments, your doctor may recommend an oral or injected medication. Since some of these medications have the potential for more severe side effects, they are used for short periods of time or alternated with other medications.
These treatments include:
Biologics, a class of medications that are derived from antibodies and act on your immune system to prevent inflammation
Retinoids, vitamin A-based treatment typically prescribed in a hospital setting for severe psoriasis. Due to the potential for birth defects, retinoids are not safe to take during pregnancy, or three years prior to pregnancy.
Cyclosporine (Sandimmune®) is an immunosuppressant medication that decreases your immune system’s response to ease psoriasis symptoms. Since it weakens your immune system, it can make you more susceptible to illness.
Methotrexate is another immunosuppressant that may be prescribed as an alternative to cyclosporine. There is the potential for serious side effects with long-term use, but when used in low doses in the short term, side effects are typically mild.
Your partner in health
Managing psoriasis is easier with a reliable pharmacy partner by your side. Our pharmacists can answer any questions you may have about treatment, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.
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This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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