Causes Of Psoriasis & Video
While the exact cause of psoriasis is still not completely understood, the immune system and genetics are important in its development. Environmental factors can also play a role, for example an infection or emotional stress may trigger an episode of psoriasis, or worsen an existing outbreak.
While steering clear of some triggers may not be possible, others can definitely be avoided. Being able to identify what sets off, or aggravates your symptoms, can help you find a more effective treatment plan.
You may find the talk Psoriasis in 2013 , presented by Prof. Brian Kirby, useful and help you to learn more about psoriasis.
Psoriasis With Darker Skin
You can get psoriasis with all different skin colors, but it tends to look different on darker skin.
In African Americans, psoriasis is typically purplish in color with scaling that looks gray. In very dark skin, the psoriasis may also be dark brown and so harder to see.
Slightly lighter Hispanic skin tends to produce a dark pinkish-colored psoriasis and with a scale that looks silvery-white.
In addition, after psoriasis clears on these skin types, patches that are lighter or darker than the surrounding skin may remain for some time .
These are not scars, and they will clear after some time, though it can take from a few months to a year or longer. Your skin doctor may be able to treat them so they clear more quickly. Ask about this if the appearance of the patches bothers you.
Show Sources
Jeffrey M. Weinberg, MD, director of the Clinical Research Center, St. Luke’s-Roosevelt Hospital Center, New York City assistant clinical professor of dermatology, Columbia University College of Physicians and Surgeons consultant for Amgen and Genentech.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.
American Academy of Dermatology.
Can A Diet Cure Psoriasis Naturally
- Avoiding environmental factors that trigger psoriasis, such as smoking, and stress may help prevent or minimize flare-ups of psoriasis. Sun exposure may help in many cases of psoriasis and aggravate it in others.
- Alcohol is considered a risk factor for psoriasis, even moderate amounts of beer. People should minimize alcohol use if they have psoriasis. This is especially important if they are taking medications such as methotrexate or acitretin.
- Specific dietary restrictions or supplements other than a well-balanced and adequate diet are not important in the management of plaque psoriasis.
- Recently, some data has supported that an “anti-inflammatory” diet that is high in fruits and vegetables and low in saturated and trans fats may help manage psoriasis, although the value in preventing its onset is less certain.
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Is There A Cure For Psoriasis
Unfortunately, not at the moment. Much research is being done and in the last decade great strides have been made in understanding what goes wrong in psoriasis, so there is good cause for optimism. In the meantime there are a number of treatments that are effective in keeping the problem under control. The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.
What is the history of psoriasis?
Psoriasis has a fascinating story, from ancient times, through to the modern scientific breakthroughs. Read more.
Other Treatments For Psoriasis
If you have severe psoriasis then you may need hospital-based treatment. Light therapy is one type of treatment that can be used. This may involve treatment with ultraviolet B light. Another type of phototherapy is called PUVA – psoralen and ultraviolet light in the A band. This involves taking tablets which enhance the effects of UV light on the skin. You then attend hospital for regular sessions under a special light which emits ultraviolet A .
Sometimes people with severe psoriasis are given intense courses of treatment, using the creams or ointments described above, but in higher strengths and with special dressings.
If psoriasis is severe and is not helped by the treatments listed above then a powerful medicine which can suppress inflammation is sometimes used. For example, methotrexate, ciclosporin, acitretin, etanercept, infliximab, efalizumab, secukinumab, ustekinumab and adalimumab. There is some risk of serious side-effects with these medicines, so they are only used on the advice of a specialist.
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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. One form may change into another or become more severe.
Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping.
You should see a GP if you think you may have psoriasis.
It Can Affect The Scalp Hairline Forehead Back Of The Neck And Skin Around The Ears
Did You Know?
Symptoms may include fine scaling that looks like dandruff, or appear as thick, crusted plaques that cover the entire scalp. Other skin disorders, such as seborrheic dermatitis, may resemble psoriasis. However, scalp psoriasis appears powdery with a silvery sheen, while seborrheic dermatitis looks yellowish and greasy. Scalp psoriasis is common in patients of color, but treating it can be particularly tough due to the hair type.
Scalp psoriasis may be an indicator of psoriatic arthritis , as many people have both. If you think you have scalp psoriasis, see a dermatologist to diagnose scalp psoriasis and visit a rheumatologist to screen for psoriatic arthritis.
No matter how severe your scalp psoriasis is, there are options for treating the itching and flakes â from over-the-counter shampoos and topicals to light therapy, oral treatments and biologics.
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What Does Psoriasis Look Like On Black Skin
There are seven main types of psoriasis: plaque psoriasis, scalp psoriasis, and others that present as bumps and rashes without the scales and widespread redness. The photographs in medical books, websites, and social media used to depict the different types of psoriasis usually show red spots and splotches, but you wont necessarily see that in dark skin, says Chesahna Kindred, M.D., a dermatologist in Columbia, MD. In darker skin tones, psoriasis often is hyperpigmented, she says. The lesions are purplish or brown. There may be scaling or flaking along with intense itching in both darker and lighter skin tones, but even the scaling may appear different on dark skin. Those silvery scales may appear as ashy skin, adds Corey L. Hartman, M.D., dermatologist and founder of Skin Wellness Dermatology in Birmingham, AL. It may just look like dead skin that needs to be exfoliated, he says.
To confuse matters more, psoriasis doesnt always itch on all skin tones. So, your pigmented patches may leave you scratching your head about what is going on with your skin. This could be one reason a study published in the Journal of American Academy of Dermatology found that Non-Hispanic minorities, including Black people, Asians, and Native Americans, were 40% less likely to see a dermatologist for psoriasis regardless of insurance or socioeconomic status. These patients are not seeking a physicians help because they dont suspect they have psoriasis.
What Psoriasis Medications Can I Take
Systemic Medications
Biologics for Psoriasis
The following drugs are categorized under the term biologic because they are all proteins produced in the laboratory by industrial cell culture techniques and must be given either subcutaneously or intravenously. The frequency of treatment depends on the specific drug. All of these medications are very precise in that they block only one or two parts of the inflammatory reaction and are moderately immunosuppresive.
Biologics are expensive and do not cure psoriasis but as a group are quite effective and reasonably safe. If it is decided to start a patient on a biologic drug, the choice will depend on the particular physician’s expertise, as well as insurance coverage and payment issues.
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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
What Are The Types Of Psoriasis
In children, 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 develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman’s breasts.
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Some Symptoms Associated Psoriatic Arthritis
Symptoms can vary greatly from patient to patient. Let your doctor know if you have the following symptoms which may indicate psoriatic arthritis:
- Joint pain especially with redness, swelling and tenderness.
- Dactylitis inflammation of an entire digit, either a finger or toe which swells up to a sausage shape and can be painful.
- Nail changes loosened, thickened or pitted nails .
It has been suggested that the presence of 20 nail pits distinguishes patients with PsA from those with rheumatoid arthritis and psoriasis.
- Morning stiffness/pain in the back that improves with movement.
- Pain in your heel or tennis elbow.
How Common Is Psoriasis In Black People
The chronic skin condition affects eight million Americans, but Black patients account for a much smaller percentage of that number. According to one study, the prevalence of psoriasis in Black patients is 1.3% compared to 2.5% in white patients. But that doesnt necessarily mean dark skin is less prone to it. Its likely not as prevalent because its not as diagnosed, says Dr. Hartman. This begs the question: Why? One theory is that training about psoriasis on Black skin isnt always taught in medical schools. I was fortunate to train in dermatology at Howard University we are taught dermatology–not just dermatology in lighter skin tones, says Dr. Chesahna. Other institutions are doing the same. However, many are playing catch-up, trying to supplement their curriculum with skin of color.
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Common Types Of Psoriasis
This is the most common form, accounting for about 80 to 90% of cases.
Its symptoms are dry red skin lesions, known as plaques, covered in silver scales.
They normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
The plaques can be itchy or sore, or both. In severe cases, the skin around your joints may crack and bleed.
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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What Is Scalp Psoriasis And What Causes It
Psoriasis can appear on any part of the skin, even the scalp. With scalp psoriasis, scalp plaques produce excess scales and can cause your scalp to itch.
Symptoms of scalp psoriasis appear as the following:
- A small bump, called a papule, with a scale on top.
- The plaque typically is covered by thick layers of horny scale. When the scale sheds, it can look like dandruff.
- Sometimes these plaques can itch.
- Scratching these plaques can worsen the condition and lead to what’s called the Koebner phenomenon, or isomorphic response, which can cause psoriasis to develop in areas where there’s inflammation and trauma.
The causes of scalp psoriasis, like all psoriasis, is related to genetic defects that affect the immune system. It is not known if stress causes or makes psoriasis worse.
In some severe cases, scalp psoriasis can cause alopecia, or a loss of hair, which is rare and may be controlled with treatment. Scalp psoriasis can be treated with topical medications, which can sometimes be difficult to apply when the scalp is covered with enough hair that can create a barrier.
Are There Any Other Alternative Approaches
There are a variety of alternative approaches that can be undertaken alone or in combination with conventional therapies. It is essential if you are considering any alternative approaches to please discuss this with your doctor or healthcare professional as they may be detrimental to your health.
Such alternative approaches could entail Chinese Medicine, Acupuncture, Magnatherapy, Ayurvedic Medicine, Aromatherapy, Homeopathic Medicine, Yoga, Spa Treatments, Shiatsu, and Naturopathy. It is always advisable to fully research and find a reputable qualified practitioner who follows correct protocols for their clients. There are organisations that may be useful to contact for further details and advice. With this information you and your doctor or healthcare professional will be better placed to discuss what is best for you.
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What Happens If My Gp Cannot Help
If you are referred for further treatment or advice it is likely to be to outpatients at your local hospital where a consultant dermatologist or a specialist dermatology nurse will assess you or it may be to another General Practitioner with enhanced role often referred to as GP with special interest .
It is likely that you may be offered the same treatment that your GP has already given you or other treatments that your GP is unable to prescribe.
What Type Of Psoriasis Treatment Will I Need
Several treatment options can relieve psoriasis. Creams or ointments may be enough to improve the rash in small areas of skin. If the rash affects larger areas, or you also have joint pain, you may need other treatments. Joint pain may be a sign that you have arthritis.
Your provider will decide on a treatment plan based on:
- Severity of the rash.
- Vitamin A or retinoid creams.
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Steroid Creams Or Ointments
Topical steroids are other commonly used treatments. They work by reducing inflammation. They are easy to use and may be a good treatment for difficult areas such as the scalp and face. However, one problem with steroids is that in some cases, once you stop using the cream or ointment, the psoriasis may come back worse than it was in the first place. Only milder steroid creams or ointments should be used on your face or for psoriasis affecting flexures. See the separate leaflet called Topical Steroids for more information on how to use them.
Topical Treatments For Psoriasis
These are drugs you rub directly on your skin. Along with a good moisturizer, theyâre usually the first thing your doctor will suggest, especially for mild to moderate psoriasis. There are over-the-counter and prescription options.
Topical treatments for psoriasis come as ointments, creams, or foam and include:
Steroid creams. These slow down immune cells in your skin. They can ease swelling and redness. Mild steroid creams are available over the counter. Youâll need a prescription from your doctor for something stronger. Steroids come with side effects and shouldnât be used on sensitive areas like your face or genitals. They can burn or thin the skin. Use them exactly the way your doctor tells you.
Salicylic acid. This can soften and thin scaly skin. But it can also irritate your skin if you leave it on too long. It might weaken your hair follicles and cause temporary hair loss, too. The body can absorb salicylic acid if you put it on large patches of skin.
Calcipotriol . This is a strong form of synthetic vitamin D. Itâs known to control overactive skin cells. Your doctor might pair it with a steroid cream.
Tazorac is available gel or cream and applied one and twice daily. it is ot recommended for those who are pregnant or breast-feeding or intending to become pregnant.
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Who Is Not Eligible For The Treatment
Topical creams can be had by every individual. However, for advanced medications and procedures do consult with your doctor about the type of therapy you would prefer. Also, discuss with your doctor about your allergic symptoms and get the drugs and medications that are best suited for you. Some of the drugs used can be strong. Hence it is always better to consult your doctor before taking any medications on your own.
Ingredients That Can Benefit Scalp Psoriasis
Shamban says that when looking for products, keep an eye out for gels and shampoos or pre-treatments containing salicylic acid, as it can help soften thick patches of skin on the scalp. Another good thing about salicylic acid? It penetrates into skin and pores, allowing other medications for other symptoms to get in deeper. Look for products with antibacterial, antimicrobial, and anti-fungal properties that can help treat seborrheic dermatitis and scalp psoriasis, she adds. Antifungals also inhibit yeast growth, a main factor in dandruff which is a secondary outcome with the condition.
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