Psoriasis

Psoriasis is an immune-mediated skin condition that can cause recurring inflamed, scaly patches and requires individualised care.

Skin cells build up too quickly, forming defined areas of inflammation and scale. It is not contagious. Plaque psoriasis is a common form, often affecting the scalp, elbows, knees, lower back, or other skin sites. Symptoms may settle and return over time, and the effect on comfort, sleep, confidence, and daily routines can vary.

Psoriasis commonly presents with dry, itchy, cracked, red skin and surface scale. The scale may look silvery on lighter skin, while colour changes on darker skin can be violet, grey, deep brown, or less obvious. Some plaques sting or feel sore. Nails may develop pits, thickening, or separation from the nail bed, and some people notice painful or stiff joints.

Psoriasis involves immune activity that speeds the usual renewal of the outer skin layer. It can run in families, but it is not caused by poor hygiene. A flare can follow skin injury, infection, emotional strain, smoking, alcohol use, or certain medicines. A dermatologist can help identify patterns without assuming that any single trigger explains every episode.

The condition often follows a relapsing pattern: plaques may become quieter, then flare in familiar or new areas. Scratching and friction can damage the skin and make plaques more troublesome. Joint pain, swelling, heel pain, or prolonged morning stiffness deserves prompt medical assessment because psoriasis can occur alongside inflammatory joint disease.

Family history can increase susceptibility. Dry air, repeated rubbing, cuts, sunburn, untreated infections, and changes to prescribed medicines may be relevant for some people. Recording when symptoms change, including scalp and nail symptoms, gives the consultation more useful detail than trying to identify a trigger from one flare alone.

A clinician usually assesses the appearance and distribution of plaques, the scalp and nails, and any joint symptoms. They may ask about relatives, recent illnesses, medicines, and treatments already tried. When the appearance overlaps with eczema, fungal infection, or another rash, a small skin sample or further testing may help clarify the diagnosis.

Treatment is chosen according to the areas involved, plaque thickness, symptoms, impact on daily life, and medical history. Moisturisers support the skin barrier. Prescription topical medicines may reduce inflammation or help manage scale. Wider involvement may be treated with light-based treatment or medicines that act on immune pathways. Use prescription treatments exactly as directed, especially on thin or sensitive skin.

Use a bland moisturiser regularly, pat rather than rub after washing, and choose loose fabrics when plaques are sore. Keep nails short if scratching is difficult to control. Let your clinician know if treatment is irritating, messy enough that you cannot use it, or not fitting your routine; practical adjustments can make a regimen more workable.

Seek clinical advice for rapidly spreading redness, warmth, pus, fever, severe pain, or skin that is extensively peeling, as these features need assessment. Also arrange review for new swollen joints, persistent back pain with stiffness, or substantial distress caused by the condition.

Psoriasis cannot always be prevented, but gentle skin care and early attention to recognised flare patterns can reduce irritation. Avoid picking plaques, protect skin from cuts where possible, and do not stop a prescribed medicine without discussing it with the prescriber.

A dermatologist can confirm the diagnosis, assess nails and joints, and build a treatment plan around your symptoms and preferences. Tell them about pregnancy plans, other long-term conditions, and every prescribed or over-the-counter product you use.