Psoriasis: Symptoms, Triggers and Treatment Options

Thick, red patches covered with silvery-white scales on the elbows, knees or scalp, itching and cracking, and a constant worry about what people think. Psoriasis is often mistaken for a fungal infection or dry skin and treated with the wrong creams for years. It is not contagious, it is not caused by dirt or by something you ate, and you cannot catch it by touching someone. It is a long-term condition that comes and goes, and it can be controlled very well.

What is psoriasis?

Psoriasis is an immune-system condition in which skin cells are made in days instead of weeks, and pile up as thick, scaly plaques. It often runs in families and typically starts between the ages of 15 and 35, but it can begin at any age.

Psoriasis symptoms

• Raised, red or purplish patches with silvery scales, typically on the elbows, knees, lower back and scalp
• Itching, burning or soreness, and cracked, bleeding skin
• Pitted, thickened or lifting nails
• Flaky scalp that looks like severe dandruff
• Joint pain, stiffness and swelling, especially in the morning. This can be psoriatic arthritis and needs a doctor, as it can damage the joints if untreated.

Psoriasis or something else?

Psoriasis can be confused with eczema, which is itchier and less scaly, and with ringworm, which has a ring-shaped, clearer centre. The treatments are different, and steroid creams can worsen a fungal infection, so it is worth seeing a dermatologist for diagnosis.

Common triggers

• Stress and lack of sleep
• Skin injuries such as cuts, scratches, sunburn or insect bites
• Infections, especially a sore throat from streptococcus
• Cold, dry weather. Many people flare in winter.
• Smoking and heavy alcohol use
• Some medicines, including beta-blockers, lithium and hydroxychloroquine
• Stopping strong steroid tablets or creams suddenly

Treatment

Treatment depends on how much skin is involved and how much it bothers you. Most people start with creams and go up a step if needed.

• Moisturisers: thick, fragrance-free creams and ointments, used daily, soften scales and reduce itch.
• Topical steroids such as betamethasone and clobetasol calm plaques. They are used for limited periods on the body, and with great care on the face and folds, because long use thins the skin.
• Vitamin D creams such as calcipotriol slow the growth of skin cells and are often used together with a steroid.
• Salicylic acid removes scales. Dithranol is used under supervision for stubborn plaques. Tacrolimus ointment helps on the face and folds.
• Phototherapy: carefully controlled narrowband UVB light treatment in a clinic, for widespread psoriasis.
• Tablets and injections for moderate to severe disease, such as methotrexate and acitretin, or modern biological medicines. They need blood tests and regular monitoring. Acitretin must never be used if pregnancy is possible, and pregnancy must be avoided for years after it, so ask your doctor.

Daily care

• Take short, lukewarm baths and moisturise straight afterwards.
• Avoid scratching, picking scales and tight, rough clothes.
• Get some sensible sun exposure, which often helps, but avoid sunburn.
• Manage stress, and sleep well.
• Keep your weight healthy and quit smoking. Both improve psoriasis and treatment results.
• Do not use unknown pastes, “herbal” creams or strong steroid creams from the chemist or a hakeem without a doctor’s advice. Some contain hidden steroids that cause a severe flare when stopped.

Psoriasis and your general health

People with psoriasis have a higher chance of diabetes, high blood pressure, high cholesterol, heart disease and depression. Have these checked regularly, and talk to someone if the condition is affecting your mood or confidence. Psoriasis is common, and you are not alone.

When to see a dermatologist

• A scaly patch that does not clear with moisturiser, or whose cause you are unsure about
• Psoriasis covering large areas, or affecting the face, hands, feet, nails or genitals
• Joint pain or swelling
• Very red, hot, peeling skin over most of the body, which is an emergency
• The condition is affecting sleep, work or mood

Key takeaways

• Psoriasis is a non-contagious immune condition causing thick, scaly plaques.
• Moisturisers, steroid and vitamin D creams control most mild to moderate cases.
• Joint pain with psoriasis needs a doctor, and severe disease has effective modern treatments.
• Avoid unknown creams and herbal pastes that may hide steroids.

Related medicines on Medimart

These are commonly used for psoriasis, on your dermatologist’s advice:

• Calcipotriol: a vitamin D cream that slows skin cell growth
• Betamethasone: a steroid cream for plaques
• Clobetasol: a very strong steroid for short use on thick plaques
• Salicylic acid: helps remove scales
• Dithranol: used under supervision for stubborn plaques
• Tacrolimus: a steroid-free ointment for sensitive areas
• Methotrexate: a prescription tablet for moderate to severe disease
• Acitretin: a prescription capsule for severe disease, not for use in pregnancy

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse eczema and psoriasis care on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please see a dermatologist if you suspect psoriasis.