Living with psoriasis

Overview

Psoriasis is a long-term skin condition where the skin produces new cells too quickly, causing thick, red, scaly patches. It is not contagious and is not caused by poor hygiene.

Yes. Psoriasis is one of the most common immune-related skin conditions, affecting many people around the world.

It can start at any age, but it often first appears between 15 and 35. It affects both men and women and can also occur in children and older adults.

Symptoms

Common symptoms

• thick, red patches of skin with silvery scales
• dry, cracked skin that may bleed or itch
• scaly patches on the scalp, elbows, knees, or lower back
• itching, burning, or soreness around the affected areas

Symptoms in children

• smaller, softer patches that may be itchy
• scalp scaling that looks like dandruff
• irritation in the diaper area or skin folds that does not clear with usual creams

Symptoms in older adults

• patches that may be less red but more scaly
• dry, fragile skin that can crack and bleed easily
• more frequent joint pain or stiffness, as arthritis can occur alongside psoriasis

Causes

Main causes

• an overactive immune system that mistakenly attacks healthy skin cells
• rapid growth of skin cells because of this immune response
• a genetic tendency—psoriasis often runs in families

Risk factors

• a family history of psoriasis
• stress, which can trigger or worsen a flare-up
• infections such as strep throat
• skin injuries like cuts, scratches, or sunburn
• smoking and heavy alcohol use
• some medicines—ask your doctor or pharmacist about possible triggers

When to see a doctor

See a doctor urgently if:

• if you have signs of a skin infection or a severe localized flare
• if you develop sudden, severe joint pain or swelling

Book a routine appointment if:

• if skin patches bother you, spread, or do not improve with over-the-counter moisturisers
• if you notice symptoms that interfere with sleep, work, or daily life

Diagnosis

A doctor usually diagnoses psoriasis by examining your skin, scalp, and nails. They will ask about your symptoms, family history, and any triggers.

Tests that may be done

• In some cases, a small skin sample (a biopsy) is taken to confirm the diagnosis and rule out other skin conditions.

What to expect at your appointment

The examination is quick and painless. If a biopsy is needed, the area is numbed so you feel minimal discomfort. After diagnosis, your doctor will discuss treatment options tailored to the severity of your psoriasis.

Treatment

Treatment aims to slow the rapid growth of skin cells, reduce scaling, and relieve itching. Many different approaches are available, and your doctor will recommend the option that best fits your situation.

Self-care at home

• keep your skin well moisturised with thick, fragrance-free creams or ointments
• take short, lukewarm baths and gently pat skin dry
• avoid harsh soaps and tight clothing that can irritate patches
• try to identify and avoid your personal triggers, such as stress or certain foods
• protect your skin from cuts, scratches, and sunburn

Medical treatments

Depending on severity, doctors may suggest topical treatments applied to the skin, light therapy (phototherapy) using controlled ultraviolet light, or systemic treatments taken as pills, injections, or infusions for moderate-to-severe cases. Biologic therapies, which target specific parts of the immune system, are also used. Always talk to your healthcare provider about the benefits, risks, and costs of any treatment.

When is surgery considered?

Surgery is not a treatment for psoriasis itself. However, if psoriatic arthritis causes severe joint damage, an orthopedic surgeon may discuss surgical options to improve joint function. This is very individual and should be discussed with a specialist.

Living with this condition

Living with psoriasis means managing a chronic condition that can flare up and settle down. Build a simple daily skin care routine, choose comfortable clothing that does not rub, and keep moisturisers handy at home and at work.

Lifestyle tips

• manage stress with relaxation techniques such as deep breathing or meditation
• avoid smoking and limit alcohol, as both can worsen psoriasis
• keep nails trimmed and use protective gloves for tasks that may irritate your skin
• get plenty of rest so your body can recover from flares

Diet and exercise

There is no one specific diet that cures psoriasis, but eating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats can support your immune system. Regular exercise helps reduce stress and maintain a healthy weight, which may ease the strain on your joints.

Mental health and emotional wellbeing

Psoriasis can affect your emotional wellbeing. It is normal to feel embarrassed, frustrated, or anxious about your skin. These feelings are valid, and you deserve support. If you notice persistent sadness or depression, talk to your healthcare provider or a mental health professional.

Prevention

You cannot prevent psoriasis from starting, because it is linked to genes and the immune system. But you may be able to prevent flares by recognising and avoiding your personal triggers, keeping your skin moisturised, and managing stress.

Vaccines

Staying up to date with recommended vaccines is important, especially if you take medicines that affect your immune system. Ask your doctor which vaccines are right for you.

Screening programmes

Psoriasis itself is not screened for, but your doctor may check for related conditions like arthritis or cardiovascular risk factors during routine visits.

Complications

If left untreated

• psoriatic arthritis, which causes painful joint inflammation and can lead to joint damage
• skin infections from scratching or cracking
• emotional distress, including anxiety and depression
• a higher chance of other conditions like hypertension, diabetes, and cardiovascular disease

Long-term outlook

Psoriasis is a lifelong condition, but with modern treatments, most people can control their symptoms and lead full, active lives. Flares may happen, but they can be managed. Working closely with your healthcare team gives you the best chance of keeping your skin and joints healthy.

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