psoriasis risk reduction

Overview

Psoriasis is a long-term skin condition where the immune system becomes overactive and makes skin cells grow faster than normal. This causes thick, scaly patches on the skin, which can be itchy, sore, or uncomfortable. It is not an infection and cannot be passed from person to person.

Yes. Psoriasis affects around 2 to 3 people in every 100 worldwide, so it is a fairly common skin condition.

Psoriasis can start at any age, but it most often appears in adults between the ages of 20 and 30, or between 50 and 60. It affects men and women equally and can be seen in all skin types.

Symptoms

Common symptoms

• Red or pink patches of skin, often with silvery-white scales on top
• Dry, cracked skin that may bleed or sting
• Itching, burning, or soreness around the affected areas
• Thickened, pitted, or ridged nails
• Scaly patches on the scalp, elbows, knees, or lower back

Symptoms in children

• Psoriasis in children may look smaller, thinner, and less scaly than in adults
• It often appears first on the scalp, around the navel, or in the nappy area for babies
• Children may experience intense itching, which can interfere with sleep and play

Symptoms in older adults

• Psoriasis in older adults may be less red and scaly, and can appear in skin folds like under the arms or in the groin
• Skin may become thinner and more fragile, making it easier to injure
• Some medications taken for other health conditions can trigger psoriasis in older adults

Causes

Main causes

• An overactive immune system that mistakes healthy skin cells for a threat and speeds up their production
• Genetics – certain genes make you more likely to develop psoriasis
• Environmental triggers that set off the immune response, such as infections like strep throat, skin injuries, stress, smoking, or cold weather

Risk factors

• Having a family member with psoriasis
• Experiencing high levels of stress or anxiety
• Having an infection, especially a streptococcal throat infection
• Skin damage such as cuts, scrapes, bug bites, or severe sunburn
• Smoking or being around tobacco smoke
• Drinking too much alcohol
• Taking certain medicines – always ask your doctor about potential side effects

When to see a doctor

See a doctor urgently if:

• If you have sudden, widespread symptoms or signs of infection, seek medical care the same day
• If you develop joint pain, swelling, or stiffness that interferes with daily activities
• If your skin becomes extremely painful, blistered, or red over large areas

Book a routine appointment if:

• If you notice persistent red, scaly patches that do not go away with moisturising or gentle skin care
• If psoriasis affects your scalp, nails, or sensitive areas like the face or genitals
• If symptoms are affecting your sleep, work, or emotional wellbeing
• Before starting any new treatment, including complementary remedies, talk to a healthcare professional

Diagnosis

A doctor usually diagnoses psoriasis by looking at your skin, scalp, and nails, and asking about your symptoms, medical history, and any family history of the condition.

Tests that may be done

• A skin biopsy – a tiny sample of skin is taken and examined under a microscope to confirm psoriasis
• Blood tests – these may be done to rule out other conditions that can look like psoriasis
• A careful examination of your joints if you have pain or swelling, to check for psoriatic arthritis

What to expect at your appointment

Your doctor will examine the affected areas, ask about when the rash started and what makes it better or worse, and may gently scrape off a small sample of scale. The appointment usually lasts 20–30 minutes, and you should be able to discuss your concerns and ask questions.

Treatment

There is no cure for psoriasis, but treatments can help control symptoms, reduce flare-ups, and improve the appearance of your skin. The right treatment depends on how severe your psoriasis is, where it appears, and how it affects your life.

Self-care at home

• Keep your skin well-moisturised with plain emollients or fragrance-free creams every day
• Take short, warm baths with mild, soap-free cleansers to gently remove scales without scrubbing
• Avoid scratching; instead, apply a cool compress or pat the area gently
• Manage stress through relaxation techniques, breathing exercises, or talking to someone you trust
• Protect your skin from cuts, scrapes, and sunburn, which can trigger flares

Medical treatments

Doctors may recommend treatments applied to the skin, such as creams, ointments, or lotions, to reduce thickness and scaling. For more widespread or stubborn psoriasis, light therapy (phototherapy) using controlled ultraviolet light can help. If psoriasis is moderate to severe or does not respond to other treatments, there are oral (taken by mouth) or injectable medications that work by calming the immune system. These are sometimes called systemic or biologic therapies. Your doctor will explain the benefits and risks of each option, and treatment choices are always individualised.

Living with this condition

Building a gentle daily skin routine can make a big difference. Use moisturiser right after washing, avoid harsh soaps, and wear soft, breathable clothing. Keeping a diary of what triggers your flares can help you avoid them.

Lifestyle tips

• If you smoke, seek support to quit – smoking can make psoriasis worse
• Limit alcohol, as heavy drinking is linked to more frequent and severe flares
• Protect your skin from injury and extreme cold or sun exposure
• Find healthy ways to handle stress, such as exercise, hobbies, or talking with friends

Diet and exercise

There is no special psoriasis diet, but eating a balanced, colourful diet rich in fruits, vegetables, whole grains, and healthy fats may help reduce inflammation in your body. Regular physical activity can also help control your weight, lower stress, and improve your overall wellbeing. Talk to your doctor before starting any new exercise regime, especially if you have joint pain.

Mental health and emotional wellbeing

Psoriasis can affect how you feel about yourself and may sometimes lead to anxiety or depression. It is normal to feel frustrated, embarrassed, or worried. Talking to a mental health professional can help, and many people find it useful to connect with others who understand what it is like.

Prevention

Psoriasis itself cannot be fully prevented because it is rooted in genetics and the immune system. However, you can reduce the risk of flare-ups by learning your triggers and avoiding them, managing stress, not smoking, limiting alcohol, and taking good care of your skin.

Vaccines

Keeping your vaccinations up to date is generally recommended, especially for flu and pneumonia, since infections like strep throat and colds can trigger psoriasis flares. Always discuss vaccinations with your doctor, particularly if you are on medicines that affect your immune system.

Screening programmes

There is no routine screening test for psoriasis, but it is a good idea to see a doctor for any new or changing skin spots. If you already have psoriasis, regular check-ups can help monitor for related conditions like psoriatic arthritis or heart disease risk.

Complications

If left untreated

• Psoriatic arthritis – joint pain, stiffness, and swelling that can lead to joint damage if not treated
• Skin infections from scratching or cracking
• Increased risk of high blood pressure, heart disease, type 2 diabetes, and some other health problems
• Emotional distress, low self-esteem, depression, or anxiety

Long-term outlook

There is good reason to be hopeful. With the right support, many people manage psoriasis well and live full, active lives. Treatments continue to improve, and your healthcare team will work with you to find a plan that helps control symptoms and protect your long-term health.

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