What Is Psoriasis Caused By

Is Psoriasis Itchy And Painful

Main symptoms of psoriasis Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or soreness. There are several different types of psoriasis. Many people have only 1 form at a time, although 2 different types can occur together.

What Is Psoriasis Symptoms Causes Diagnosis Treatment And Prevention

Psoriasis is an autoimmune disease that causes plaques, which are itchy or sore patches of thick, dry, discolored skin.

While any part of your body can be affected, psoriasis plaques most often develop on the elbows, knees, scalp, back, face, palms, and feet.

Like other autoinflammatory diseases, psoriasis occurs when your immune system which normally attacks infectious germs begins to attack healthy cells instead.

Causes And Risk Factors

Although the exact cause of psoriasis is yet to be found, researchers believe a combination of genetic, environmental, and immune factors may be involved.

• The risk of getting psoriasis increases if a close biological relative has it.
• If one of your parents has psoriasis, you stand 10-25% chance of developing it.
• If both of your parents have it, your odds increase to 50%.

Obesity

• Researchers have suggested that psoriasis patients are more likely to be obese than the general population.
• Studies have shown that losing weight can help with symptoms of psoriasis and make treatments more effective.

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How Can I Be Sure That Its Psoriasis And Not Something Else

For people with plaque or nail psoriasis, a primary care doctor can diagnose and treat the condition. People with unusual symptoms may need to see a dermatologist to rule out other conditions that can be mistaken for psoriasis. These include eczema, fungal infections, drug reactions, pityriasis rubra pilaris, and a form of skin cancer called cutaneous T cell lymphoma.

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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What Increases Your Risk

Many doctors believe that psoriasis may be passed down from parents to their children . This is because certain genes are found in families who are affected by psoriasis.footnote 2 About one-third of people who have psoriasis have one or more family members with the condition.footnote 3

Other factors that can contribute to the development of psoriasis include:

• Emotional or physical stress. Stress may cause psoriasis to appear suddenly or make symptoms worse .
• Infection. Infections such as strep throat can cause psoriasis to appear suddenly, especially in children.
• Skin injuries. An injury to the skin can cause psoriasis patches to form anywhere on the body, including the site of the injury. This includes injuries to your nails or nearby skin while trimming your nails.
• Smoking. Smoking may make you more likely to get psoriasis and make the symptoms more severe.footnote 4

Who Does It Affect

It affects men, women and children alike. It can appear at any age in varying degrees but usually between the ages of 10 and 30. The extent of disease varies enormously from a minute patch to large patches covering most body areas. Psoriasis can also run in families and much research is being done into the genetics of this disease. It is known that the disease is multi genetic and therefore children may not necessarily inherit psoriasis.

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What Are The Symptoms

Symptoms of psoriasis appear in different ways. Psoriasis can be mild, with small areas of rash. When psoriasis is moderate or severe, the skin gets inflamed with raised red areas topped with loose, silvery, scaling skin. If psoriasis is severe, the skin becomes itchy and tender. And sometimes large patches form and may be uncomfortable. The patches can join together and cover large areas of skin, such as the entire back.

Psoriasis can also affect the fingernails and toenails, causing the nails to pit, change colour, and separate from the nail bed.

In some people, psoriasis causes joints to become swollen, tender, and painful. This is called psoriatic arthritis .

Symptoms may disappear , even without treatment, and then return .

Points To Remember About Psoriasis

• Psoriasis is a chronic disease in which patches of skin become scaly and inflamed.
• There are many ways to treat psoriasis, and your treatment plan will depend on the type of disease and how severe it is.
• Most forms of psoriasis are mild or moderate and can be treated with creams or ointments.
• Managing common triggers, such as stress, cold weather, and skin injuries, can also help keep the symptoms under control.

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Treatment Options For Psoriasis

There are a variety of psoriasis treatments available, and they each work in different ways to help treat psoriasis. How do you know which is right for you? Start by talking to a dermatologist who can explain how each option works. Then you can work together to choose an appropriate treatment option for you.

Is it really psoriasis? Learn more about the symptoms:

How Can Parents Help

For some children, psoriasis is just a minor inconvenience. For others, it is a difficult medical condition.

To manage symptoms and make outbreaks less likely, your child should:

• Wash hands well and often and stay away from people who are sick to prevent infections.
• Manage stress through exercise, yoga, or meditation.
• Not smoke or drink alcohol.
• Keep a healthy weight. People who are overweight tend to have more severe psoriasis symptoms.

Kids and teens with psoriasis may feel uncomfortable with the way their skin looks. Help your child understand that psoriasis is common and treatments can help.

Whether your child’s psoriasis is mild or severe, learn about the condition together. Offer to help find a therapist or join a support group if that might help. Talk to your doctor or check websites like:

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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.

How To Prevent Triggers

If you learn your individual psoriasis triggers, you can prevent and lessen most of your outbreaks.

Its not always possible to avoid every trigger, but a little planning can go a long way toward preventing an outbreak. Try these steps:

• Modify your diet to reduce or eliminate common food and beverage triggers, including alcohol.
• Carry a hat and sunscreen with you at all times. You never know when you might be sitting at a sunny table at a restaurant.
• Avoid extreme temperatures, whether hot or cold, when posssible.
• Find ways to reduce stress. Taking up hobbies such as exercise or practicing mindfulness techniques may do the trick.
• Maintain a moderate weight.
• Quit smoking, if you smoke.
• When performing any activity that may cause skin injury, be sure to take extra precautions such as wearing long sleeves, wearing gloves, and using bug spray.
• Keep your skin moisturized. Dry skin is more prone to skin injury.

Doctors continue to study the treatment and triggers for psoriasis. Some of the areas theyre pursuing for future potential treatment are:

• gene therapy

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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.

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:

• Stress

• 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

• Tobacco

• 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

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Can Diet Affect My Psoriasis

A healthy diet is important for wellbeing and can reduce your risk of many long-term illnesses. However, there is no clear link between what you eat and the severity of psoriasis symptoms.

• The British Nutrition Foundation suggests eating at least 300g of oily fish per week for general health .
• Aim to eat more green leafy vegetables, nuts, seeds and wholegrain cereals, which also contain important essential fatty acids.
• Cut back on saturated fats and vegetable oils and use more olive oil and rapeseed oil products.
• Eat fresh, homemade foods rather than pre-packaged convenience food.
• Excessive amounts of alcohol can make psoriasis worse and can also interfere with certain drug medications, for example methotrexate.

Inflammation And Psoriasis: Making The Connection

The immune system and inflammation play a role in psoriasis. Heres how theyre believed to be connected.

Think of the immune system as your bodys alarm system. When you get a cold, infection, or scrape on your knee, your immune system sends out signals that trigger inflammation in an effort to defend itself.

When you have psoriasis, your immune system is out of balance. In fact, its in overdrive. An overactive immune system can send faulty signals and mistake healthy cells for harmful ones. This results in too much inflammation. For psoriasis patients, this means the body rapidly produces more skin cells than necessary.

Luckily, some treatment options can reduce inflammation, which may help the immune system and help to slow the rapid production of skin cells.

Talk to a dermatologist to learn more about treatment options that may work for you.

How satisfied are you with your current treatment?

Im looking for better results

Im not currently treating

Thanks for answering!

Its important to work with a dermatologist when choosing a psoriasis treatment. Learn how to start that conversation.

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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

Is Psoriasis Related To Immune System

At a basic level, psoriasis is a disorder of the immune system. White blood cells called T-helper lymphocytes become overactive, producing excess amounts of cytokines, such as tumor necrosis factor, interleukin-2, and interferon-gamma. In turn, these chemicals trigger inflammation in the skin and other organs.

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An Overactive Immune System

Psoriasis is considered an autoimmune condition. This means your immune system is a bit overzealous, causing immune cells to start attacking healthy tissuein this case, your skinas if it was an invader. The attack causes an inflammatory cascade as white blood cells go to war with skin cells, causing them to grow more quickly and thickly than they should. In turn, this results in the formation of those painful psoriatic patches.

The Relationship Between Psoriasis And Psoriatic Arthritis

About 30% of people with psoriasis will also develop psoriatic arthritis , a form of inflammatory arthritis that causes joint stiffness, swelling, and pain that can become quite debilitating if left untreated. Psoriatic arthritis is also caused by a wonky immune system reaction, according to the Mayo Clinic.

Most people with Ps.A. develop psoriasis first, but some people have joint problems first, joint problems and no skin involvement, or joint problems and nail psoriasis. If you have both conditions, they wont necessarily get better or worse in tandem. Sometimes the skin can improve, but you still have joint problems and vice versa, Dr. Helfrich says.

Psoriatic arthritis can impact any joint in the body, but most commonly occurs in the spine and the joints in the hands and feet, wrists, ankles, and knees. According to the Mayo Clinic, it can also cause painful swelling in the fingers and toes, foot pain in areas where tendons and ligaments attach to bones , and a condition called spondylitis, or inflammation of the joints between the vertebrae of the spine.

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What Causes Psoriasis Outbreaks

Psoriasis outbreaks differ from person to person. No one knows exactly what causes flare-ups. Common psoriasis triggers may include:

• Skin injury .
• Streptococcal or other infection that affects the immune system.
• Certain prescription medications .
• Cold weather, when people have less exposure to sunlight and humidity and more to hot, dry indoor air.

Scratches Bites And Skin Injury

If you have a bug bite, cut, or scrape, or youve experienced any kind of skin injury, you may notice new psoriasis lesions near the affected area. These types of injuries can even occur during everyday activities, such as shaving or tending to a garden.

Skin injury can only trigger psoriasis lesions in people who already have psoriasis.

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Taking Care Of Your Skin

Injuries to the skin, such as sunburns and scrapes, can trigger psoriasis in some people. These types of injuries can usually be prevented by practicing good skin care.

When doing activities that may cause skin injury, you should always take extra precautions. Use sunscreen and wear a hat when spending time outside. You should also use caution when engaging in outdoor activities and contact sports, such as basketball or football.

Is Psoriasis Hereditary

Although psoriasis is not contagious from person to person, there is a known hereditary tendency. Therefore, family history is very helpful in making the diagnosis.

There are many effective psoriasis treatment choices. The best treatment is individually determined by the treating doctor and depends, in part, on the type of disease, the severity, and amount of skin involved and the type of insurance coverage.

For mild disease that involves only small areas of the body , topical treatments , such as creams, lotions, and sprays, may be very effective and safe to use. Occasionally, a small local injection of steroids directly into a tough or resistant isolated psoriatic plaque may be helpful.

For moderate to severe psoriasis that involves much larger areas of the body , topical products may not be effective or practical to apply. This may require ultraviolet light treatments or systemic medicines. Internal medications usually have greater risks. Because topical therapy has no effect on psoriatic arthritis, systemic medications are generally required to stop the progression to permanent joint destruction.

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How Is It Treated

Psoriasis treatment ranges anywhere from a topical treatment, to a pill, to injections, to light therapy. The dermatologist will give you a treatment plan that is suited best for you, your type of psoriasis, what skin areas are affected, and the diseases effect on your overall health. The goal of treatment is to reduce the amount of inflammation and to control the amount of skin shedding.

Moisturizing creams loosen scales and help control itching. Special diets have not been successful in treating psoriasis, except in isolated cases increasing fish in the diet and/or taking fish oil capsules may benefit some patients with psoriasis.

There still isnt a cure for psoriasis, but there are still options that can help make your skin as clear as possible.