Psoriasis: Causes, symptoms, and treatments

What is psoriasis?

Psoriasis is a common, long-term skin condition that causes flaky patches of skin which form scales. These patches typically appear on your elbows, knees, scalp, and lower back but they can appear anywhere on your body. It is a condition that may come and go throughout your lifetime, but it is not infectious and cannot be spread from person to person. It does not cause scarring, although it can cause temporary changes in skin colour.

Psoriasis is a chronic (long-lasting) condition characterised by periods of time when your symptoms may be mild or not visible at all, then flare up and become more noticeable and cause irritation or discomfort.

What causes psoriasis?

People with psoriasis produce more skin cells than usual, resulting in a build-up of excess cells that creates the patches associated with psoriasis. Although the process is not fully understood, it is thought to be linked to problems with the immune system.

The exact cause of psoriasis is unknown, although it could be that both genetic and environmental factors play a role. It is thought that something triggers the immune system, making it more active, which then leads to a chronic inflammation that causes the skin cells to reproduce too quickly. It mainly affects the skin but can affect the nails, and in some cases, the joints.

Psoriasis can run in families, although the exact role that genetics plays is unclear.  Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger. There are a number of potential triggers such as an injury to your skin, throat infections, and using certain medicines.

The onset and severity of psoriasis have also been linked to lifestyle factors, including alcohol consumption, being overweight, smoking, and stress. All these factors are known to cause a type of mild inflammation in the body. However, it is not fully understood why these triggers lead to psoriasis, and it may vary from person to person.

How psoriasis is diagnosed

A GP or pharmacist can often diagnose psoriasis based on the appearance of your skin. You may be referred to a specialist in diagnosing and treating skin conditions (dermatologist) if your GP is uncertain about your diagnosis, or if your condition is severe.

Ways you can treat psoriasis

There is no cure for psoriasis, but you’ll be pleased to know there are treatments that can improve symptoms and the appearance of skin patches.

In most cases, the first recommended solution will be a topical treatment (cream or ointment applied to the skin). This could be a topical corticosteroid such as Betnovate or a vitamin D ointment such as Dovonex, which helps to control the body’s production of skin cells. If these are not effective, or in more severe cases, a treatment called phototherapy may be used. Phototherapy involves exposing your skin to certain types of ultraviolet light.

In very severe cases, where the above treatments have been ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body.

Living with psoriasis

Although psoriasis is just a minor irritation for some people, it can have a significant impact on the quality of life for those who are more severely affected. For example, some people with psoriasis report experiencing low self-esteem because of the effect the condition has on their appearance. It's also quite common to develop tenderness, pain, and swelling in the joints and connective tissue. This is known as psoriatic arthritis.

It is important that you talk to a GP or pharmacist if you have psoriasis and are concerned about your physical and mental wellbeing. They can offer advice and further treatment if necessary. They can also help you manage the impact it may be having on your daily life. They may suggest identifying potential risk factors to help manage flare-ups of your psoriasis symptoms and take action to counter these. Recommendations might include:

• Adopting a healthy lifestyle by eating a balanced diet, trying to lose weight if needed, and exercising regularly

• If you smoke, stopping can be beneficial

• If you regularly consume alcohol, reducing your intake may help

• Finding ways to reduce stress whenever possible

• Keep your skin well moisturised to prevent dryness and cracking

• Taking your prescribed medications as directed by your GP or dermatologist

If you experience joint pain, discuss it with your GP or dermatologist and inform your doctor if you notice any symptoms that start to affect your nails.

Although psoriasis is a long-term condition, help is available to support you to manage your symptoms and reduce the impact psoriasis can have on your daily life.