Health info > Skin conditions > Psoriasis

There are different forms of psoriasis, however 90% of people have a form known as plaque psoriasis. It can occur anywhere on the body, but the most commonly affected areas are the scalp, elbows and knees.

The signs, symptoms and severity of psoriasis vary from person to person but may include one or more of the following:

• Red patches of skin covered with silvery scales. These might be small or may cover extensive parts of the body.

• Dry, cracked skin that may bleed

• Itching, burning or soreness of skin

• Thickened, pitted or ridged nails

• Swollen and stiff joints

Causes and triggers
The exact cause of psoriasis is unknown, it is believed to be related to an immune system problem. Psoriasis runs in families. Other risk factors include obesity and smoking. Psoriasis cannot be caught from person to person. Many people’s psoriasis symptoms start or worsen because of a trigger. Common triggers include infections, injury to the skin from a cut, scrape, insect bite, or sunburn, stress, cold weather, smoking, drinking excessive amounts of alcohol, certain medications and hormonal changes.

Treatment
While there is no cure for psoriasis, symptoms can often be controlled with treatment. Treatments can be divided into three main types.

Topical treatments are the most common prescribed treatments for psoriasis. Creams, ointments and lotions containing corticosteroids, vitamin D, dithranol, retinoids, coal tar and salicylic acid are applied to the skin.

Phototherapy (light therapy) is a safe and effective second line therapy, where your skin is exposed to certain types of ultraviolet light. This treatment is prescribed in a controlled environment so please don’t try at home.

Systemic treatment (oral and injected medicine) is available for people whose psoriasis does not respond to other treatments. These treatments are generally very effective, but can have potentially serious side effects so you need to discuss with your doctor whether this is the right option or you. Options include oral medicine such as acitretin, methotrexate and cyclosporine an injected medicine such as etanercept (Enbrel) and adalimumab (Humira).

Lifestyle advice

• Have a daily bath with bath oil, colloidal oatmeal or Epsom salts to help remove scales and calm inflamed skin. Hot water and harsh soaps can worsen symptoms.

• Use plenty of moisturiser to keep psoriasis soft and prevent it from cracking and becoming sore.

• Small amounts of sunlight may help clear psoriasis, but be careful as too much sun can trigger outbreaks and increase the risk of skin cancer

• Keep a diary to know what triggers your psoriasis outbreaks and take steps to avoid these triggers

• Stop smoking

• Avoid drinking alcohol

• Make sure you take time to rest to allow your body to heal and recover.

Talk to us about getting the best results from your psoriasis medicines. We can help you with quitting smoking or weight programmes, or if you have any questions about your psoriasis.