When To See Your Doctor
Some psoriasis drugs, like steroid creams and ointments, can help almost right away. Other treatments, such as biologics, can take weeks to months to kick in.
Ask your doctor how long you can expect to wait to feel better. Usually, it shouldnât take more than 3 months to for your skin to look noticeably better. If it doesnât, ask your doctor about other treatment options.
National Psoriasis Foundation: âStatistics,â âWhen to talk to your doctor about changing treatments — and what to say,â âResearchers Examine Why Biologics Stop Working,â âWeight loss greatly improves psoriasis, study finds,â âStress and Psoriatic Disease,â âTreat 2 Target.â
Mayo Clinic: âPsoriasis.â
What To Do If Psoriasis Returns
When psoriasis strikes again, the best recourse is to start treating it pronto. If your previous treatment was successful, talk to your doctor about resuming the same course. But sometimes skin becomes resistant to a certain treatment, and what was once useful is no longer effective at managing psoriasis symptoms. In that case, youll need to try a new approach.
“There is no ‘one size fits all’treatment for psoriasis,” says James Swan, MD, professor of medicine in the department of dermatology at Loyola University Chicago and dermatologist at the Loyola Center for Health in La Grange Park, Illinois. “Treatment decisions are based on the type, severity and extent of the psoriasis, as well as the response or lack of response to prior treatments. There are many options, and new and fortunately very effective treatments are coming to market at a rapid pace.”
There are several treatments available for psoriasis, including:
What Are Other Types Of Psoriasis
Plaque psoriasis is the most common type. About 80% to 90% of people with psoriasis have plaque psoriasis.
Other, less common types of psoriasis include:
- Inverse psoriasis appears in skin folds. It may look like thin pink plaques without scale.
- Guttate psoriasis may appear after a sore throat caused by a streptococcal infection. It looks like small, red, drop-shaped scaly spots in children and young adults.
- Pustular psoriasis has small, pus-filled bumps on top of the red patches or plaques.
- Sebopsoriasis typically appears on the face and scalp as red bumps and plaques with greasy yellow scale. This type is a cross between psoriasis and seborrheic dermatitis.
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When To Call A Doctor
- Symptoms of psoriasis. Early treatment may help keep the condition from getting worse.
- Signs of an infection, including:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
If you are being treated for psoriasis, call your doctor if you:
- Have severe and widespread psoriasis and your skin is more irritated or inflamed than usual, especially if you have another illness.
- Are taking medicine for psoriasis and have serious side effects, such as vomiting, bloody diarrhea, chills, or a fever.
What Causes Guttate Psoriasis
- For some reason the germ group A beta-haemolytic streptococcus, which can cause a really sore throat, sometimes causes a skin reaction.
- It’s thought to be caused by your immune system going into ‘overdrive’ and accidentally reacting to your own skin.
- The throat infection is found in about 80% of cases.
- No one can quite figure out why this happens but some people seem to be more prone to it than others. It might be to do with your genetic make-up.
- In this way it’s similar to the way a throat infection can lead to rheumatic fever.
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How Is Psoriasis Treated
Psoriasis is usually treated by a dermatologist . A rheumatologist may also help with treatment. Treatments can include:
- ultraviolet light from the sun or from home or office treatments. But in some children, sunlight can make psoriasis worse.
- creams, lotions, ointments, and shampoos such as moisturizers, corticosteroids, vitamin D creams, and shampoos made with salicylic acid or coal tar
- medicines taken by mouth or injected medicines
A doctor might try one therapy and then switch to another, or recommend combining treatments. It’s not always easy to find a therapy that works, and sometimes what works for a time stops helping after a while.
Whats The Outlook Like After Having Guttate Psoriasis
- In nearly two thirds of people the spots clear up and never come back.
- Occasionally the spots turn into a more long-term type of psoriasis called plaque psoriasis. This can be treated with similar creams and light treatment.
- Once its cleared, sometimes a second outbreak of guttate psoriasis happens. This could happen if the streptococcus bug is lurking in your tonsils.
- Thankfully the guttate psoriasis never properly scars, although sometimes it can leave tiny pale marks where it used to be: these should fade with time though.
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Psoriasis Remission: How It Can Happen
No medicine will keep symptoms away forever. Recent advances have been made in the quest to isolate the part of the immune system response that causes psoriasis, resulting in an explosion of new and effective remedies. With the right treatment, you may enter psoriasis remission and have no visible symptoms for a period of time.
But the reality is that even if symptoms go away, theyre likely to come back. And when they do, you have to be ready to squelch them before your skin flares up too badly.
Articles On Types Of Psoriasis
Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis will crop up in response to a trigger.
In general, most types of psoriasis result from the same triggers:
- Diet
- Weather
Here’s how you can spot the 7 types of psoriasis and what you can do to treat them.
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Your Joints Dont Hurt
As many as 30% of people living with psoriasis experience psoriatic , a disease that causes the small and large joints in your body to become swollen and painful. This can make it difficult for you to move and can have a severe impact on your quality of life. Swollen, painful joints could be the only sign youre having a psoriasis flare-up.
Fortunately, many psoriasis treatments that exist for your skin also seem to help any arthritis symptoms you may have. If you begin to notice your joints arent as swollen and painful, or that youre having an easier time moving around, it could be a sign your psoriasis is going into remission.
Can Guttate Psoriasis Be Confused With Anything Else
- There are other conditions that give similar skin problems.
- Pityriasis rosea can look a bit like guttate psoriasis, but doesn’t follow a throat infection.
- Pityriasis lichenoides can resemble guttate psoriasis, but again doesn’t follow a throat infection. And the lesions look a bit different to guttate psoriasis.
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What Are Possible Complications Of Psoriasis
In some cases, psoriasis also causes arthritis. This is known as psoriatic arthritis. It causes pain, swelling, and stiffness in the joints. Psoriasis can raise your risk for diabetes, heart disease, and lymphoma. People with psoriasis are also more likely to have emotional stress and depression. Severe psoriasis can lead to erythroderma. In that condition, the skin all over the body is red and inflamed.
Psoriasis Triggers To Avoid
Symptoms of psoriasis, such as itchy patches of skin and thickened nails, can come and go.
However, there are common triggers that people with psoriasis may want to avoid just in case.
Theres no definitive psoriasis diet. However, people with the condition may want to consider avoiding the following:
- nightshade plants, such as tomatoes, eggplant, and white potatoes
- gluten, which is found in many grains and condiments
- foods made with white flour
- dairy products
- red meat
- high-sugar foods and fatty foods
According to the results of a 2017 national survey, people with psoriasis saw their symptoms improve or go away completely after they cut back on or eliminated these items.
People saw the most improvement after cutting back on or eliminating nightshade plants and gluten.
Research on alcohol and psoriasis is limited. However, existing studies suggest that alcohol acts as a trigger for many people, particularly women.
In a large published in 2010, researchers observed an increase in psoriasis onset in women who drank non-light beer as opposed to other alcoholic beverages. The increase was associated with five beers per week.
The researchers hypothesized that starch in the beer may have contributed to the development of psoriasis.
According to a , alcohol consumption may also trigger the production of inflammatory proteins and increase your risk of infection. Inflammation and infection can contribute to psoriasis symptoms.
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Seborrheic Dermatitis: Itchy Scaly Patches
A psoriasis skin rash tends to itch, burn, and feel sore. Patches of psoriasis commonly occur on your knees and elbows. Many people also have scalp psoriasis. The common skin rash seborrheic dermatitis also causes scaly, itchy skin patches. It can occur on your scalp, where it may be called dandruff, or on your face and chest. While doctors don’t know the exact cause of seborrhea, it occurs across the age spectrum, in babies as well as in adults, and is usually treated with creams and lotions.
How Is Psoriasis Diagnosed And Treated
Psoriasis often has a typical appearance that a primary care doctor can recognize, but it can be confused with other skin diseases , so a dermatologist is often the best doctor to diagnose it. The treatment of psoriasis usually depends on how much skin is affected, how bad the disease is , or the location . Treatments range from creams and ointments applied to the affected areas to ultraviolet light therapy to drugs . Many people who have psoriasis also have serious health conditions such as diabetes, heart disease, and depression. Some people with psoriasis also have an inflammatory condition which affects their joints, called psoriatic arthritis.
Psoriatic arthritis has many of the same symptoms as other types of arthritis, so a rheumatologist is often the best doctor to diagnose it. The treatment of psoriatic arthritis usually involves the use of drugs .
Psoriatic disease may be treated with drugs or a combination of drugs and creams or ointments.
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What Else Should I Ask My Healthcare Provider
If you have psoriasis, ask your healthcare provider:
- How can I prevent outbreaks and control symptoms?
- What medication will work best for me?
- What else should I do to improve symptoms?
- What are my options if creams dont work?
- Will psoriasis ever go away?
A note from Cleveland Clinic
Psoriasis, an itchy skin condition, can come and go throughout your life. Its related to an overactive immune response and is not contagious. If you have skin changes that arent going away, talk to your healthcare provider. There is no cure for psoriasis, but psoriasis treatments can improve symptoms. Your provider may prescribe a special cream or moisturizer or medications. Other therapies are available if creams or medicines dont work. Maintaining your overall health will also help improve symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/17/2020.
References
Plaque Psoriasis: The Rash That Didnt Go Away
According to a study by the Journal of the American Academy of Dermatology around 7.4 million adults are affected by psoriasis in the U.S. and while there are actually five different types of psoriasis you can be affected by, we will concentrate on the most common form of psoriasis, known as plaque psoriasis. The AAD estimates that about 80% of people with a psoriasis condition experience plaque psoriasis.
Just what exactly is plaque psoriasis though?
Plaque Psoriasis is a chronic autoimmune disease which causes your skin production to speed up faster than old skin can slough off. This causes your skin to start building up as scales, adding layer upon layer on your skins surface. For someone without the disease, skin cells normally grow deep within your skin, rise slowly to the surface of your skin, and then slough off ,with a typical life cycle being about a month. But if you have psoriasis, the production occurs in just a few days, which doesnt give the skin cells time to fall off, and thats what leads to the build-up of skin cells, or psoriatic scales, which are whitish-silver in color on Caucasian skin, and develop in thick red patches that are typically inflamed and sometimes will crack and bleed . These plaques are often very itchy and sometimes painful.
What areas does plaque psoriasis affect?
Whos at risk?
Noticing the symptoms
The symptoms of plaque psoriasis are different for everyone, but have some common signs you can look for. These include:
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What Are The Signs & Symptoms Of Psoriasis
The main symptom of psoriasis is red, thickened patches of skin called plaques. These can burn, itch, or feel sore. Often, silvery scales cover the plaques.
Plaques can happen anywhere. In children, theyre most common on the:
- face
Other symptoms of psoriasis include:
- dry, cracked skin that may bleed at times
- thick, pitted nails
- arthritis
What Are The Treatments For Guttate Psoriasis
The good news is, guttate psoriasis usually fades by itself within a few weeks to a few months.
It doesn’t necessarily need treating unless it’s really bothering the person. No particular treatment has been shown to work better than others.
A GP may prescribe a mild steroid cream if the lesions are itchy – although in practice it is quite hard to spread cream over such a large area of the body. It is worth nourishing the skin with simple moisturisers.
Although it is related to a bacterial throat infection, giving antibiotics doesn’t actually speed up the spots going away.
A dermatologist may use ‘light therapy’ which is where they beam UV light at you in a special box . This is a specialised treatment that isn’t available in all hospitals. It can help to clear up the guttate psoriasis a bit quicker than otherwise.
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Maintenance Of Regular Follow
According to the Arthritis Foundation, close collaboration with your dermatologist, rheumatologist, or other health care provider is one of the best ways to help achieve low disease activity. These professionals can evaluate your symptoms, examine your laboratory results, and adjust your medication if needed.
What Does Psoriasis Look Like
The skin changes of psoriasis are well defined and slightly raised pink or red areas with silvery-white scales. Many people have just a few plaques but some individuals with moderate to severe psoriasis may have several plaques covering large areas of their body.
Several patterns of psoriasis are recognised:
- Chronic plaque psoriasis is the most common type of psoriasis. Plaques of psoriasis are usually present on the knees, elbows, trunk, scalp, behind ears and between the buttocks although other areas can be involved too.
- Guttate psoriasis consists of small plaques of psoriasis scattered over the trunk and limbs. It can be caused by a bacteria called Streptococcus which can cause throat infections.
- Palmoplantar psoriasis is psoriasis affecting the palms and soles. Psoriasis may appear at other sites too.
- Pustular psoriasis is rare type of psoriasis where the plaques on the trunk and limbs are studded with tiny yellow pus filled spots. It can be localised or generalised and can flare rapidly necessitating hospital admission for treatment.
- Erythrodermic psoriasis is an aggressive rare form of psoriasis which affects nearly all of the skin and can sometimes require hospital admission for treatment.
Nail psoriasis is present in about half of people with psoriasis. The features of nail psoriasis are:
- Pitting and ridging of the surface of the nail
- Salmon pink areas of discolouration under the nail
- Thickening and yellowing of the nails.
- Complete nail destruction.
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Are There Complications Of Psoriasis
In some people, psoriasis causes more than itchiness and red skin. It can lead to swollen joints and arthritis. If you have psoriasis, you may be at higher risk of:
- Use medicated shampoo for scales on your scalp.
Other steps you should take to stay as healthy as possible:
- Talk to your healthcare provider about lowering your risk for related conditions, such as heart disease, depression and diabetes.
- Lower your stress with meditation, exercise or seeing a mental health professional.
How Is Guttate Psoriasis Diagnosed
There aren’t any particular tests for guttate psoriasis.
It’s diagnosed by the way it looks and also by finding out if there has been a throat infection a few weeks before. Occasionally a blood test can be used to detect the streptococcus germ : this is called an anti-streptolysin antibody assay.
A biopsy of the skin is not usually needed. If it isn’t quite clear what the skin condition is, a specialist skin doctor might use a small microscope to look at it more closely.
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Ready To See If Cosentyx Can Help You Feel Real Relief From Your Symptoms
Find a dermatologist in your area who has experience prescribing biologics as well as other treatments for moderate to severe plaque psoriasis.
COSENTYX® is a prescription medicine used to treat:
-
people 6 years of age and older with moderate to severe plaque psoriasis that involves large areas or many areas of the body, and who may benefit from taking injections or pills or phototherapy
-
adults with active psoriatic arthritis
-
adults with active ankylosing spondylitis
-
adults with active non-radiographic axial spondyloarthritis and objective signs of inflammation
Do not use COSENTYX if you have had a severe allergic reaction to secukinumab or any of the other ingredients in COSENTYX. See the Medication Guide for a complete list of ingredients.
COSENTYX is a medicine that affects your immune system. COSENTYX may increase your risk of having serious side effects such as:
Infections
COSENTYX may lower the ability of your immune system to fight infections and may increase your risk of infections, sometimes serious.
- Your doctor should check you for tuberculosis before starting treatment with COSENTYX.
- If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with COSENTYX and during treatment with COSENTYX.
- Your doctor should watch you closely for signs and symptoms of TB during treatment with COSENTYX. Do not take COSENTYX if you have an active TB infection.
Before starting COSENTYX, tell your doctor if you: