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Psoriasis: Symptoms, Treatments and Causes

Psoriasis: Symptoms, Treatments and Causes

Published: 14th August, 2020 in: Skin Conditions

What is Psoriasis?

Psoriasis is a skin condition that can cause the skin to become irritated, red, dry, flakey and crusty. Skin also becomes covered in silvery scales when suffering a psoriasis flare-up. Whilst only 2% of the population will suffer from psoriasis, it can develop seemingly out of nowhere. Development does however tend to be more common in adults under 35. 

Psoriasis usually affects certain areas of the body more often, such as the knees, elbows, scalp and lower back, although it can develop anywhere on the body. Severity will depend on the individual; some people suffer only with small breakouts while others suffer much larger flare-ups. 

Psoriasis is known as a chronic disease. This means there is no known cure for the skin condition, and treatment involves ways to help manage it.  Sufferers will likely not experience symptoms all the time; they will come in waves and the severity and duration of each flare-up may differ from time to time. 

Symptoms of Psoriasis

The main symptoms of psoriasis are:

  • Dry skin patches that are red, flakey or covered in silvery scales
  • Itching
  • Soreness
  • Cyclical flare-ups - this means that symptoms are not always present. They will worsen and recover in a cyclical nature

Types of Psoriasis

There are a number of different types of psoriasis, ranging from extremely common to relatively rare. Each type of psoriasis presents itself in a slightly different way and therefore may be better managed with different treatments. It is therefore important to understand which type of psoriasis you are suffering with. 

The Most Common Types of Psoriasis

  • Plaque psoriasis - This is the most common type of psoriasis. Around 80% of sufferers will have this type. Plaque psoriasis presents itself as dry red skin lesions that are covered in silver scales. They can be itchy and sore and can develop anywhere on the body however they are usually found on the elbows, knees, scalp and lower back.
  • Scalp psoriasis - This occurs only on the scalp. It can affect the whole scalp or just a small area of it. Much like Plaque psoriasis, it results in red patches covered by silvery scales. Many people experience severe itching with scalp psoriasis and in extreme cases hair loss however, this is temporary.
  • Nail psoriasis - Nail psoriasis causes the nails to become uneven, with pits and dents forming. They may also discolour, grow abnormally, become loose from the nail bed or even crumble.
  • Guttate psoriasis - Guttate psoriasis differs from plaque psoriasis, as the sores form small teardrop shapes on the skin, less than 1cm large. It is more common in children and teenagers and may disappear completely once healed. Many sufferers do then go on to develop plaque psoriasis however. 
  • Inverse (flexural) psoriasis - This type of psoriasis affects folds within the skin. The most commonly affected areas are the groin, the buttocks, underneath the breasts and the armpits. It does not cause lesions, rather smooth red patches which are made worse by friction and sweating. Severe symptoms are therefore more likely to be endured during hot weather.

Rare Types of Psoriasis

  • Pustular psoriasis - This type of psoriasis causes pustules to develop on the skin (pustules are pus-filled blisters). It is not specific to any particular area and therefore can develop anywhere on the body.
  • Palmoplantar pustulosis - Palmoplantar pustulosis on the other hand directly affects the hands and feet. It causes pustules to develop on your palms and the soles of your feet which eventually turn into brown, scaly spots that peel off.
  • Acropustulosis - Again acropustulosis causes pustules to form on the skin however, this refers to when pustules develop on the fingers and toes specifically. When the blisters burst, the skin may be left bright red, sore and it often becomes scaly.
  • Erythrodermic psoriasis - This is one of the most rare forms of psoriasis, affecting the whole body. The body will be covered in lesions which cause intense itching or a burning sensation. This can lead to a number of complications including infection, dehydration, heart failure, hypothermia and malnutrition due to a loss of proteins and fluids.

What Causes Psoriasis?

It is not known exactly what causes psoriasis. It occurs when the skin cells replace one another too quickly resulting in a build up. In normal circumstances, skin cells are produced in the deeper most layer of the skin. They will then make their way to the top layer of the skin as the skin cells die. This should take around 4 weeks. However, for those with psoriasis, this process only takes around 3-7 days. This means that cells that are not mature yet end up on the surface of the skin resulting in sore patches, redness and silvery scales.

Studies have shown that a problem in the immune system may be the cause of this condition. It is thought that T-cells (the cells used by the immune system to fight bacteria and infection) attack the healthy skin cells by mistake, causing more skin cells to be produced at a faster rate resulting in psoriasis.

Psoriasis has been shown to run in families, therefore if you have a family member who suffers from psoriasis you are more likely to develop it yourself. For those who already have psoriasis, there are a number of triggers that are thought to bring on flare-ups or increase the severity of symptoms. 

Triggers include:

  • Injuries to the skin e.g. cuts, bites, sunburn etc. 
  • Alcohol
  • Smoking
  • Stress
  • Hormonal changes, particularly in women e.g puberty, menopause, changes due to the menstrual cycle
  • Medications such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, and ACE inhibitors (used to treat high blood pressure)
  • Throat infections 
  • Other immune disorders e.g. HIV, type 1 diabetes etc.

Diagnosis of Psoriasis

If you think you may have psoriasis you should visit your GP as they will need to confirm this before advising on possible treatment options. 

Usually, the condition will be diagnosed on sight alone however, in some cases a small biopsy of skin may be sent for further analysis. This helps to rule out other conditions that present themselves in a similar fashion, such as seborrhoeic dermatitis. In most cases your GP will be able to diagnose psoriasis relatively quickly but, you may be sent to a dermatologist (a doctor specialising in skin) if this is not the case. 

Psoriasis can also result in arthritis, therefore if your doctor suspects you have this you may also be sent to a rheumatologist (a doctor specialising in arthritis). Blood tests will also likely be carried out to rule out other conditions such as rheumatoid arthritis.

Psoriasis Treatments

There are a number of different psoriasis treatments available, some you can administer at home and others that must be conducted by specialists. Treatment helps to keep the condition under control however in order to find the best treatment for you, you should visit your GP. On determining the type and severity of psoriasis you have, they will then be able to set out a treatment plan for you.

There are 3 main types of psoriasis treatments available: topical treatments, phototherapy and systemic treatments.

Topical treatments are the most common and will be used by nearly all psoriasis sufferers. In the majority of cases, this will be sufficient to curb the symptoms of your condition. In more severe cases however, your GP may prescribe phototherapy or a combination of treatments.

During phototherapy, the skin is exposed to UV light in order to slow down the production of skin cells. If this does not work, systemic treatments may then be prescribed. These work throughout the whole body and are usually taken in tablet, capsule or injection form. Systemic treatments work in a variety of ways, with some slowing down skin cell production and others suppressing the immune system. Due to this systemic treatments are only used as a last resort as they have potentially serious side effects. Your GP will only prescribe these if no other treatment is working and you should always speak to your GP about other options before taking any medication such as this.

Creams for Psoriasis

Steroid creams may be prescribed in order to treat psoriasis. These creams help to reduce inflammation and slow the production of skin cells. There are also a wide range of over the counter psoriasis creams available such as the AproDerm Colloidal Oat Cream which soothes the itching and irritation associated with dry skin condition and Doublebase Gel. Dermalex have also created a psoriasis treatment which activates the skin's natural repair system, in order to normalise skin cell production, relieve symptoms and help prevent future flare-ups.

Ointments for Psoriasis

Ointments are also a common treatment suggested by GPs in the treatment of psoriasis. In the same way as creams, they seek to soothe irritation, provide moisture and protect the skin. Hydromol Ointment is commonly used by people suffering with dry skin conditions.

Soap for Psoriasis

You may also find that using regular soap or body wash further irritates your skin, making psoriasis symptoms worsen. This could be due to fragrances and other ingredients often found in soap. To ensure that you do not cause further damage to the skin, you may want to use a soap or wash specifically designed for the treatment of psoriasis and other dry skin conditions. Both Doublebase Wash Gel and QV Gentle Wash have been formulated to help relieve dry, chapped, itchy, red and sore skin associated with psoriasis. They also provide moisture and protection to the skin.

Psoriasis on the Scalp (Psoriasis Shampoo)

Psoriasis on the scalp is relatively common however, it can be more difficult to treat with medications such as creams or ointments. There are psoriasis treatments specifically designed for the scalp in the form of shampoos and gels. The Dermalex Scalp Psoriasis Treatment Gel should be applied to the scalp two times a day. It helps to normalise skin cell production, accelerating the skin/scalp barrier recovery through activation of the skin’s own repair mechanism and fortifies the barrier through the creation of a protective shield and prevention of water loss. The Psoriderm Scalp Lotion Shampoo also seeks to slow skin cell production through the use of coal tar. Coal tar has mild antiseptic and anti-inflammatory effects, and relieves itching. It is also absorbed into the skin cells and is thought to inhibit DNA replication in these cells. This slows down cell division and stops the cells from multiplying excessively. In turn, this reduces the thickening and scaling of the skin and clears up psoriasis plaques.

Browse our range of psoriasis treatments.

Living with Psoriasis

Living with psoriasis can be difficult. Symptoms can cause distress and discomfort making a normal day to day life challenging. In addition to this, the mental strain and discomfort due to flare-ups can cause significant distress. Whilst psoriasis treatments have proven effective in helping sufferers to manage symptoms, there are also a number of other things you should consider in order to make living with psoriasis that little bit easier.

  • Consistency - you should ensure that you continue to use treatments as directed by the doctor, even if your psoriasis seems to have subsided. Many treatments are also designed to prevent flare-ups therefore if you stop using them, you may suffer more frequently.
  • Review - you should speak to your doctor regularly about your treatment. This will ensure that your treatment plan is up to date and more likely to help with your symptoms.
  • Healthy Lifestyle - ensuring that you follow a healthy diet and exercise regularly is essential to anyone. For those suffering from psoriasis it can help to relieve stress (a common trigger for psoriasis) and can also help to reduce the risk of diabetes or cardiovascular disease (people with psoriasis are more susceptible to these conditions).
  • Self Care and Support - psoriasis can have an impact on people’s mental wellbeing, damaging confidence and can even lead to depression in some cases. Following a self-care plan will help you to take care of yourself both physically and mentally in order to help reduce the impact of psoriasis on your mental wellbeing. If you feel you are struggling, speak to your GP, friends or family or join a psoriasis support group to meet other individuals like yourself.

For further information and advice on psoriasis, contact your GP, speak to a member of our expert pharmacy team, or visit us in-store.

Sources
https://www.nhs.uk/conditions/psoriasis/
https://www.nhs.uk/conditions/psoriasis/symptoms/
https://www.nhs.uk/conditions/psoriasis/causes/
https://www.nhs.uk/conditions/psoriasis/treatment/
https://www.nhs.uk/conditions/psoriasis/living-with/