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PsoriasisPublished by Bupa's health information team, June 2009. This factsheet is for people who have psoriasis, or who would like information about it. Psoriasis is a common skin condition causing patches of inflamed skin. It isn't contagious. Plaque psoriasis is the most common type.
About psoriasisIn psoriasis, the rate at which your skin is replaced is rapidly increased. Your skin is constantly shedding old cells and being replaced with new ones from underneath, in a cycle that usually takes about 28 days. In psoriasis, this process speeds up, only taking about three to four days. New skin cells move rapidly to the surface before they have properly matured, and accumulate on the surface of your skin, forming thick patches called plaques. There is also a build-up of a type of white blood cell (called T-cells) under your skin, which causes inflammation. Psoriasis affects around two in 100 people. Psoriasis can begin at any age, and affects similar numbers of men and women. Most people with psoriasis have the condition for life. However, it tends to come and go - often for no apparent reason - and the severity of each flare-up can vary. Psoriasis can't be caught from other people and it can't be transferred from one part of your body to another. Types of psoriasis
Symptoms of psoriasisPsoriasis occurs in different forms, but usually involves the thickening and reddening of patches of skin. Your skin may feel itchy, and can sometimes feel painful or sore. If you have very mild symptoms, you may not be aware you have it. Some types of psoriasis can affect your scalp - where it can cause redness and flaking - and your fingernails, which can become pitted and discoloured. If you think you have these symptoms, see your GP. Complications of psoriasisAbout one in 10 people with psoriasis also develops associated arthritis (inflamed joints). This is called psoriatic arthritis. Usually the joints at the end of your fingers and toes are affected, although your back, knees and hips may be affected too. Causes of psoriasisIt's thought that in psoriasis, substances produced by your immune system cause your skin to start producing new cells faster than usual and allow T-cells to build up. What makes your immune system act like this isn't clear. You're more likely to get psoriasis if you have a family history of the condition. If one of your parents has psoriasis, you have a one in four chance of getting it too. However, in many people, there is no obvious cause. If you're susceptible to psoriasis, environmental factors may play a role. Triggers include throat infections, cuts, bruises or burns, some medicines, stress or psychological trauma, smoking and high alcohol intake. Diagnosis of psoriasisYour GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your GP can usually diagnose psoriasis from the symptoms you describe and a physical examination. If your psoriasis is extensive or severe, if it's affecting your education or work, or if your diagnosis is uncertain, your GP may refer you to a dermatologist (a doctor who specialises in skin conditions). If you have generalised pustular psoriasis or erythrodermic psoriasis, you may need to be admitted to hospital for treatment. Treatment of psoriasisSelf-helpYour GP will probably advise you to use emollients - creams or lotions that moisten, soften and soothe your skin. He or she will usually prescribe these, but you can also buy them from a shop without a prescription. Discuss this with your GP so that you can get the best results. Topical treatmentsYour GP may prescribe you a medicated cream or ointment. The type and strength of topical treatment will depend on the type of psoriasis you have and include preparations containing:
Oral medicinesIn certain situations, for example if topical treatments haven't controlled your symptoms, or if your psoriasis is extensive, you may be prescribed oral medicines (medicines that you take by mouth) such as:
These medicines work by suppressing your immune system, or by slowing down the production of skin cells, and are prescribed by a dermatologist. If you're a woman, you will be warned not to become pregnant while taking these medicines or for some time afterwards. With some of the tablets, men will also be advised that they shouldn't get their partner pregnant. This is because these medicines can cause serious damage to an unborn baby. Biological agents are newer treatments for psoriasis that can be very effective, but tend to be restricted to people with severe psoriasis. They are given as an injection into your skin, or through a drip into a vein in your arm. Your dermatologist can discuss these treatments with you. You will need to have various pre-treatment tests before you can try these medicines, and you will be monitored with blood tests while you're receiving the treatment. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine. Light therapyIf your psoriasis is widespread (covers a large part of your body), or if it doesn't respond to the above treatments, your dermatologist may recommend light therapy.
Living with psoriasisPsoriasis is a long-term condition and for many people is usually mild. It can, however, have a profound social and psychological impact on daily living. There is currently no cure, but the range of treatments available is usually effective at relieving symptoms when they occur. It may help to talk to your GP about your treatment options and join a self-help group for support.
Related topicsFurther information
Sources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2009
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