What Kind Of Doctor Treats Psoriasis
There are several types of doctors who may treat psoriasis. Dermatologists specialize in the diagnosis and treatment of skin disorders, including psoriasis. Rheumatologists specialize in the treatment of joint disorders, including psoriatic arthritis. Family physicians, internal medicine physicians, rheumatologists, dermatologists, and other medical doctors may all be involved in the care and treatment of patients with psoriasis.
What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
Causes And Risk Factors
While there is no specific guttate psoriasis cause, most will develop the condition after experiencing an infection, like strep throat or tonsillitis. The link between this type of psoriasis and upper respiratory infections is so strong that physicians recommend visiting your doctor for a strep throat test if you notice the appearance of guttate psoriasis symptoms.
Stress, injury to the skin, and some types of drugs, like antimalarials and beta blockers, can also trigger guttate psoriasis. Additionally, a genetic predisposition, hormonal disorders, and excessive alcohol consumption can also play a role in the conditions development.
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Moisturize At Least Twice A Day
Using emollients especially creams with exfoliating acids such as lactic, glycolic, or salicylic acid is key to reducing itching and scaling. It should be done in addition to whatever therapy is prescribed by your doctor, Dr. Pelle says. Apply moisturizer twice a day for the best results. You can also use it to soothe itchiness and help you resist the urge to scratch.
Are There Any Natural Treatments Or Home Remedies For Guttate Psoriasis
You may want to try natural treatments or lifestyle approaches to manage your guttate psoriasis. These may be especially helpful if youre having your first outbreak or your symptoms are mild.
You might try natural treatments along with standard treatments or by themselves. Be sure to check with your doctor before beginning any new treatments.
Some natural treatments you may consider include:
- Sunlight. Exposure to short periods of sunlight may help reduce your symptoms.
- Bath salts. Soaking in a bath with Epsom or Dead Sea salts may help reduce inflammation and wash away dead skin cells.
- Coconut oil.Coconut oil can soften the scales on your lesions and make it easier for topical medications to get to the skin below.
- Vitamin D.Vitamin D may help reduce inflammation and improve the health of your skin. Its usually applied topically.
Avoid using soaps and other personal care products that may irritate the skin. Soaps with added fragrances, dyes, or chemicals can be potential problems.
Healthy lifestyle approaches can sometimes help you manage your guttate psoriasis. These might include:
- A nutritious diet. Eating nutritious food may diminish guttate psoriasis symptoms. But no diet can cure the condition. Be sure to talk with a medical professional before making any big changes in your diet.
- Daily exercise. Its important to keep up an exercise regimen when you have psoriasis, especially for your cardiovascular health. According to a
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What Are The Symptoms Of Psoriasis
The following are the most common symptoms of psoriasis. Psoriasis comes in several forms and severities. Symptoms may include:
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Plaque psoriasis. This type of psoriasis is the most common. Symptoms may include patches of red, raised skin on the trunk, arms, legs, knees, elbows, genitals, and scalp. Nails may also thicken, become pitted, and separate from the nail beds.
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Guttate psoriasis. This type of psoriasis affects mostly children. Symptoms may include many small spots of red, raised skin. A sore throat usually proceeds the onset of this type of psoriasis.
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Pustular psoriasis. Symptoms may include small pustules all over the body or just on the palms, soles, and other small areas.
The symptoms of psoriasis may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.
Can Psoriasis Be Treated
Yes, there are many forms of treatment for psoriasis, which range from those you apply to the skin to tablets, and more recently injectable therapies, See Treatments for Psoriasis.
Many people who have psoriasis find that the sun and artificial ultraviolet light helps to improve their skins appearance. For some the change is dramatic. Be aware that exposure to the sun and artificial UV therapy can cause damage to the skin. See Psoriasis and the sun and Psoriasis and phototherapy
For some people, talking therapies such as cognitive behaviour therapy can also help them understand the psychological impact of psoriasis and provide a safe therapy which may help them cope with psoriasis. See our free online CBT programme
Your general practitioner or dermatologist will be best placed to advise you and keep you informed of all current and new treatments available and to recommend the best treatment programme for you personally.
Remember: Your treatment can only be as good as you allow it to be – that means if the treatment takes six weeks, you have to follow it as instructed for six weeks and no ducking out! Adherence to treatment instructions is an essential part of managing your psoriasis.
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What Are The Types Of Psoriasis
Common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches are in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a girl’s breasts.
Past Research And Achievements In This Area
In 2015, research led by our centre for genetics and genomics at the University of Manchester identified genetic variants associated with psoriatic arthritis, but not with psoriasis or rheumatoid arthritis. This helped to establish psoriatic arthritis as a condition in its own right. The findings could lead to the development of drugs specifically for psoriatic arthritis.
Later in the same year, our TICOPA trial looked at the benefits of early aggressive drug treatment for people with psoriatic arthritis followed by an increase in drug dosage if initial treatment isnt working. The trial found that patients treated this way, required fewer hospital- and community-based services than patients receiving the standard care.
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Problems With The Immune System
Your immune system is your body’s defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell.
T-cells normally travel through the body to detect and fight invading germs, such as bacteria. But in people with psoriasis, they start to attack healthy skin cells by mistake.
This causes the deepest layer of skin to produce new skin cells more quickly than usual, triggering the immune system to produce more T-cells.
It’s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.
What Can I Do To Help Treat My Psoriasis
There may not be a cure yet but there is much you can do to help maintain and control your psoriasis. Psoriasis, regardless of location or type, is often irritated by contact, particularly tight clothing such as elasticated waistbands, socks, tights, and underwear. It may be useful to wear looser clothing where psoriasis is likely to be irritated either when flaring or during periods of treatment. Identifying factors that may cause your psoriasis to flare, using a diary, can be helpful.
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What Is Psoriatic Arthritis Video
Psoriatic arthritis can cause pain, swelling and stiffness in and around your joints.
It usually affects people who already have the skin condition psoriasis . This causes patches of red, raised skin, with white and silvery flakes.
Sometimes people have arthritis symptoms before the psoriasis. In rare cases, people have psoriatic arthritis and never have any noticeable patches of psoriasis.
Psoriatic arthritis and psoriasis are autoimmune conditions. Our immune system protects us against illness and infection. In autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body.
Both conditions can affect people of any age.
Its estimated that around one in five people with psoriasis will develop psoriatic arthritis.
People with psoriasis are as likely as anyone else to get other types of arthritis, such as osteoarthritis or rheumatoid arthritis. These conditions are not linked to psoriasis.
Psoriatic arthritis is a type of spondyloarthritis. These are a group of conditions with some similar symptoms.
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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Stages Of The Disease In Children
As in adults, the development of childhood illness is divided into 3 stages. Let us consider them in more detail.
At a progressive stage, the child appearssmall itchy papules that surround the red rims of peripheral growth. At the same time, most children have lymph nodes thickened and enlarged, which sometimes become painful.
When moving to a stationary stage, the growth of the peripheral rims stops, after which the flattening of the infiltrate, as well as the reduction of the scaling, occurs in the center of the plaque.
Regressive phase, hecharacterized by resorption of all elements of the rash. At this stage, around the plaques, one can observe a characteristic depigmented rim. Further, the areas of the rash are deprived of pigment or subjected to even more pigmentation. In this case, the lymph nodes of the child decrease in size and become soft.
Eczema: Red Itchy Irritated Skin
Like psoriasis, eczema is a chronic skin condition that often causes intense itching. Scratching causes redness and inflammation of the skin, leading to a worsening of the eczema. Scratching can also cause a secondary bacterial infection. The most common type of eczema is caused by a reaction to irritants like detergents, soaps, or household cleansers. So if you have eczema, you should be careful to use mild soap and regularly moisturize your sensitive skin. Your doctor may prescribe a steroid cream or other medications if eczema is severe.
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Guttate Psoriasis: Small Red Spots
Guttate psoriasis the second most common type of psoriasis is characterized by multiple small, round red spots on the skin, usually widespread across the trunk and limbs. Often resulting from a bacterial or viral infection in children, such as strep throat, these spots come on suddenly and sometimes require oral medication or injections. Mild cases, however, may clear up without treatment.
Continue Learning About Plaque Psoriasis
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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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:
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Stress
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Skin injury, such as a cut or bad sunburn
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Infection, such as strep throat
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Some medications, including lithium, prednisone, and hydroxychloroquine
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Weather, especially cold, dry weather
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Tobacco
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Alcohol
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.
Thats why its so important for people who have psoriasis to know what triggers their psoriasis. Avoiding triggers can reduce psoriasis flares.
Youll find common triggers and what you can do to avoid them at: Are triggers causing your psoriasis flare-ups?
If you think you have psoriasis, its important to find out. Treatment can help relieve your discomfort and lead to clearer skin. You can find out how board-certified dermatologists diagnose and treat psoriasis at: Psoriasis: Treatment.
Related AAD resources
1 Gottlieb A, Korman NJ, et al. J Am Acad Dermatol 2008 58:851-64.2 Alexis AF, Blackcloud P. J Clin Aesthet Dermatol. 2014 7:16-24.
ImageGetty Images
References Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014 7:16-24.
All content solely developed by the American Academy of Dermatology
What Does Plaque Psoriasis Look Like
About 80 to 90 percent of people with psoriasis have plaque psoriasis, according to the National Psoriasis Foundation. This makes it the most common type of psoriasis.
A plaque psoriasis rash looks like raised patches of thick, inflamed skin. On light skin, it looks red and scaly, often with a layer of silver on top. On skin with more pigment, the plaques look purple, gray, or darker brown and tend to be thicker.
Plaques can develop anywhere but are most likely to appear on your:
- scalp
- knees
- lower back
Plaques also tend to be symmetrical. For example, youre more likely to have plaques on both knees or elbows than on just one side. Other symptoms include:
- itching
2009 study of 1,593 people with psoriasis found that guttate psoriasis affects about 8 percent of people with psoriasis.
You can spot this type of psoriasis rash by small, raised round spots called papules. They sometimes have a scaly appearance. The spots might look red on light skin and purple or brown on skin with more pigment.
Guttate psoriasis can start at any age. For most people, though, it starts in childhood or adolescence. It can develop after an infection, such as strep throat or tonsillitis.
Its most likely to develop on the limbs and torso, though some people get it on the scalp, face, or ears.
Psoriasis can appear anywhere on the body. It can develop in just one area, or it can show up in several. For example, theres:
Plaque, inverse, and guttate are the most common types. Others include:
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What Does Guttate Psoriasis Look Like When It Starts
Within a short time, dozens to hundreds of small round to oval red scaly bumps or spots appear on the trunk and limbs. These spots very rarely appear on the face and scalp.
The spots are not painful and do not cause you to feel ill or feverish but sometimes cause itching.
The lesions are not as thick as those found with plaque psoriasis.
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How Do You Treat Psoriasis On Your Face
Because the skin on your face is more sensitive than other parts of your body, the treatment will most likely start out conservative. Your treatment plan will also depend on how severe your symptoms are and if you are experiencing psoriasis sores or plaques on other areas of the body.
Your healthcare provider will recommend using a quality moisturizer on your face, as dryness is a trigger for psoriasis symptoms. Other possible treatments include steroid creams, vitamin ointment, light therapy, and immune therapies.
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How Is Psoriasis Assessed
Psoriasis should be assessed at diagnosis, before your first referral to a specialist, every time you see a specialist and to assess your response to treatment. Psoriasis may be assessed by your doctors using a variety of scores which measure the severity in your skin and joints, how psoriasis is affecting your mood and your activities of daily living and whether you are at risk of heart disease.
These scores include the PASI and DLQI
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Emotional Impact Of Psoriasis
Because of the effect that psoriasis can have on physical appearance, low self-esteem and anxiety are common among people with the condition. This can lead to depression, especially if the psoriasis gets worse.
Your GP or dermatologist will understand the psychological and emotional impact of psoriasis, so talk to them about your concerns or anxieties.
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