Psoriasis in adults

Overview

Psoriasis is a long-lasting skin condition where the body makes new skin cells too quickly. This causes thick, red, scaly patches on the skin. It is not contagious, so you cannot catch it from another person.

Yes, psoriasis is common. About 2–3% of people worldwide have it.

Psoriasis can affect adults of any age. It often first appears between ages 15 and 35, but it can start at any time. Men and women get it about equally.

Symptoms

Common symptoms

• Red, raised patches of skin covered with silvery-white scales (plaques)
• Itching, burning, or soreness on the skin
• Thickened, pitted, or ridged nails
• Dry, cracked skin that may bleed
• Stiff, swollen joints (a sign of psoriatic arthritis)

Symptoms in children

• Similar patches, but often smaller and less scaly
• Commonly affects the scalp, elbows, and knees
• May be mistaken for diaper rash or cradle cap in babies

Symptoms in older adults

• Patches may be larger and longer-lasting
• Higher risk of joint problems (psoriatic arthritis)
• Skin may become thinner and more fragile with age

Causes

Main causes

• An overactive immune system that attacks healthy skin cells by mistake
• Genes – psoriasis often runs in families
• Skin cells being replaced too quickly (every few days instead of weeks)

Risk factors

• Having a family member with psoriasis
• Stress
• Infections, especially strep throat
• Injury to the skin (like a cut, scrape, or sunburn)
• Smoking and heavy alcohol use
• Certain medications (talk to your doctor about risks)

When to see a doctor

See a doctor urgently if:

• If you have joint pain, stiffness, or swelling that lasts more than a few days
• If your skin becomes very red, hot, and painful over a large area
• If you develop a fever with widespread skin changes

Book a routine appointment if:

• If you have a persistent rash that does not go away with over-the-counter moisturisers
• To discuss treatment options and get a proper diagnosis
• If psoriasis affects your nails or scalp and is hard to manage

Diagnosis

Your doctor or a skin specialist (dermatologist) will usually diagnose psoriasis by looking at your skin, scalp, and nails. They will ask about your symptoms and family history.

Tests that may be done

• Physical exam – checking the skin, nails, and joints
• Skin biopsy – taking a small sample of skin to look at under a microscope (rarely needed)

What to expect at your appointment

The diagnosis is often quick and straightforward. Your doctor will ask questions and examine your skin. If needed, a biopsy is a simple, low-risk procedure done in the clinic.

Treatment

Treatment aims to slow skin cell growth, reduce inflammation, and clear plaques. The choice depends on how severe your psoriasis is and where it appears. Many people use a combination of treatments over time.

Self-care at home

• Keep skin moist with fragrance-free creams or ointments
• Avoid triggers like stress, smoking, and heavy alcohol use
• Use gentle, non-irritating soaps and warm (not hot) water for bathing
• Protect skin from cuts, scrapes, and sunburn

Medical treatments

Doctors may prescribe topical creams or ointments applied to the skin, light therapy (phototherapy) using ultraviolet light, or oral or injected medicines that work throughout the body. The specific treatment plan is tailored to each person. Your doctor will explain the options and potential side effects.

When is surgery considered?

Surgery is rarely needed for psoriasis itself. In rare cases, it may be used to treat joint damage from psoriatic arthritis, such as joint replacement.

Living with this condition

Living with psoriasis means managing flare-ups and taking care of your skin. Keep up with your treatment plan, moisturise regularly, and note what makes your symptoms worse so you can avoid those triggers.

Lifestyle tips

• Find healthy ways to manage stress, such as meditation, exercise, or talking to a counsellor
• Quit smoking and limit alcohol
• Get enough sleep – fatigue can worsen symptoms

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and healthy fats may help reduce inflammation. Regular exercise can help you stay at a healthy weight, which may improve symptoms. Talk to your doctor before starting a new diet or exercise programme.

Mental health and emotional wellbeing

Psoriasis can affect your self-esteem and cause anxiety or depression. It is normal to feel frustrated or upset. Do not hesitate to seek support from a mental health professional. If you are having thoughts of harming yourself, contact your local crisis service immediately.

Prevention

There is no known way to prevent psoriasis because it is partly caused by genes. However, you may be able to reduce how often flare-ups happen by avoiding your personal triggers and taking good care of your skin and health.

Vaccines

There are no vaccines to prevent psoriasis. Stay up to date with recommended vaccines (like flu and pneumonia) to avoid infections that could trigger a flare.

Screening programmes

There is no routine screening for psoriasis. If you notice skin changes, see your doctor.

Complications

If left untreated

• Psoriatic arthritis – joint pain, stiffness, and swelling that can lead to permanent damage
• Skin infections from scratching or cracked skin
• Emotional problems like low self-esteem, anxiety, and depression

Long-term outlook

Psoriasis is a long-term condition, but most people can manage it well with treatment. Flare-ups may come and go, but there are many effective ways to keep symptoms under control and maintain a good quality of life.

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