psoriasis after diagnosis

Overview

Psoriasis is a chronic skin condition that makes the body create skin cells much faster than normal. These extra cells build up and form red patches with silvery scales, usually on the elbows, knees, scalp, and lower back. It is not contagious, meaning you cannot catch it from someone else. Psoriasis often flares up and then calms down, sometimes going through periods where the skin looks clear.

Yes, psoriasis is common. Around 2 to 3 people in every 100 have it, which means millions of people around the world live with psoriasis.

Psoriasis can start at any age, but it often appears first in young adults or in older adults. It affects men and women equally. Some people have a family history of the condition, but others get it without any family members being affected.

Symptoms

Common symptoms

• Patches of thick, red skin with silvery white scales, often on elbows, knees, scalp, lower back, or nails
• Dry, cracked skin that may bleed
• Itching, soreness, or a burning feeling
• Thickened, pitted, or ridged nails
• Joint stiffness or swelling in some people

Symptoms in children

• Smaller patches of psoriasis, often on the scalp or in the diaper area
• More likely to appear after an infection like strep throat
• Skin may look less scaly and more red and moist

Symptoms in older adults

• Patchy skin that may be thinner and less scaly
• Psoriasis appears more often in skin folds like under the arms or in the groin
• Older adults may be more likely to have joint symptoms such as stiffness or swelling

Causes

Main causes

• An overactive immune system that mistakenly attacks healthy skin cells, speeding up skin cell production
• Genes — psoriasis can run in families
• The exact cause is not fully understood, but it is not caused by poor hygiene or something you did

Risk factors

• A family history of psoriasis
• Stress, which can trigger a flare or make it worse
• Infections, especially strep throat in children and young adults
• Skin injuries, such as cuts, scrapes, or severe sunburn
• Some medicines — ask your doctor or pharmacist which ones could trigger psoriasis
• Cold, dry weather
• Smoking and heavy alcohol use

When to see a doctor

See a doctor urgently if:

• If your psoriasis suddenly covers a large area of your body
• If you have signs of an infection like fever, spreading redness, swelling, or pain
• If you have joint pain, stiffness, or swelling that limits daily activities
• If you feel very depressed, anxious, or have thoughts of harming yourself

Book a routine appointment if:

• If you think you might have psoriasis, make an appointment with a doctor for a full skin exam
• If your usual treatments are not helping or your symptoms keep coming back
• If you need a medication review or want to talk about new treatment options

Diagnosis

A doctor usually diagnoses psoriasis by looking at your skin, scalp, and nails, and by asking about your symptoms and family history. In most cases, no tests are needed.

Tests that may be done

• A physical exam of the skin, scalp, and nails
• A skin biopsy — a small sample of skin is taken and looked at under a microscope to confirm the diagnosis
• Blood tests may be done to rule out other conditions that look like psoriasis
• If you have joint symptoms, the doctor may examine your joints and sometimes order imaging tests, like X-rays, although this is not routine

What to expect at your appointment

Your doctor will look at the affected skin and ask questions about how long you have had it, what triggers it, whether it itches or hurts, and if you notice joint problems. If you need more specialized care, you may be referred to a skin specialist called a dermatologist. The diagnosis is usually made at your first appointment.

Treatment

There is no cure for psoriasis, but there are many safe and effective treatments that can help clear the skin, reduce symptoms, and prevent flares. Your doctor will choose a treatment plan based on how much skin is affected, where it is, and your overall health.

Self-care at home

• Moisturize your skin every day with a thick, unscented cream or ointment to reduce dryness and itching
• Take lukewarm baths or showers, and gently pat your skin dry — do not rub
• Use mild, fragrance-free soaps and cleansers
• Wear loose, soft clothing to avoid irritating your skin
• Get a little sunlight in moderation, but avoid sunburn — ask your doctor about safe sun exposure
• Find healthy ways to manage stress, like deep breathing, walking, or talking with a friend

Medical treatments

There are several types of treatment doctors use for psoriasis. Topical treatments are creams, gels, or lotions applied directly to the skin. Light therapy uses controlled ultraviolet light under medical supervision. Systemic medicines are pills or injections that work throughout the body to calm the immune system. Biologic therapies are a type of systemic medicine that target specific parts of the immune system. Your doctor will discuss the best option for you. Always follow your doctor’s advice and never change a treatment without talking to your healthcare team.

When is surgery considered?

Surgery is not a routine or standard treatment for psoriasis. Surgery may sometimes be used for psoriatic arthritis to repair severely damaged joints, but this is only considered after other treatments have been tried and only in specific cases.

Living with this condition

Living with psoriasis means building a simple skin care routine and staying aware of what triggers your flares. With good habits and the right treatment, most people manage psoriasis very well and can do their usual activities. It may take time to find the treatment that works best for you, so be patient and keep in touch with your healthcare provider.

Lifestyle tips

• Use moisturizer after washing your hands and after bathing
• Keep your skin cool and avoid overheating
• Do not scratch or pick at the affected skin
• Avoid stress by making time for rest and relaxation
• Quit smoking and limit alcohol, as both can worsen psoriasis
• Protect your skin from cuts, bites, and sunburn

Diet and exercise

A healthy, balanced diet can support your overall wellbeing. Eating plenty of fruits, vegetables, whole grains, and fish may help reduce inflammation. Regular exercise, like walking, swimming, or cycling, is good for your joints and mood. There is no special diet that cures psoriasis, but a healthy lifestyle can make it easier to manage.

Mental health and emotional wellbeing

Psoriasis can affect how you feel about yourself, especially when the symptoms are visible. It is normal to feel frustrated, embarrassed, or anxious. These feelings can come and go. If you notice low mood, trouble sleeping, or losing interest in things you used to enjoy, talk to your doctor. It is important to take care of your mental health just as much as your skin. If you ever have thoughts of self-harm or suicide, reach out to a crisis support line immediately.

Prevention

Psoriasis cannot be prevented or cured, but you can reduce the chance of a flare. Learn what triggers your symptoms and try to avoid those triggers. Managing stress, not smoking, limiting alcohol, and taking good care of your skin can make a big difference.

Vaccines

There is no vaccine to prevent psoriasis. However, keeping your routine vaccinations up to date is important for your overall health. Some vaccines may need special consideration if you take certain medicines for psoriasis, so talk to your doctor before getting any vaccine.

Screening programmes

There is no routine screening test for psoriasis. But if you have psoriasis, your healthcare provider will regularly check for related conditions, such as psoriatic arthritis, high blood pressure, or heart disease. If you notice new joint pain or swelling, tell your doctor.

Complications

If left untreated

• Psoriatic arthritis — joint pain, stiffness, and swelling that can develop in some people with psoriasis
• Skin infections from scratching or cracking open the skin
• Emotional distress, including low self-esteem, anxiety, or depression
• A higher risk of heart disease, high blood pressure, type 2 diabetes, and other conditions

Long-term outlook

Most people with psoriasis are able to manage their symptoms and lead full, active lives. With the right treatment and self-care, many achieve clear or nearly clear skin. Other health conditions can often be prevented or detected early. You can live well with psoriasis, and your healthcare team is there to help you every step of the way.

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