Psoriasis is a chronic autoimmune skin disorder that accelerates the production of skin cells. As a result, excess skin cells accumulate and form thick, discolored patches that are often covered with silvery scales.

These patches can look different depending on skin tone. On darker skin, lesions may appear purple or brown, while on lighter skin they tend to be red or pink. These inflamed areas may show up anywhere on the body but are most often found on the elbows, knees, scalp, and joints. Psoriasis can also appear on the genitals, hands, feet, and in skin folds like the underarms or under the breasts.

In milder cases, psoriasis forms small lesions, while more severe forms can affect large areas such as the entire back. The condition typically follows a cycle, with flare-ups lasting weeks or months followed by remission, during which symptoms ease or disappear temporarily.

More than eight million Americans live with psoriasis, with the most common age of onset between 15 and 35. However, children under 10 can also develop the condition, as it can appear at any age.

Types

There are five main types of psoriasis, and it is possible to have more than one type at the same time.

Plaque psoriasis
The most common form, causing inflamed patches with silvery scales.

Guttate psoriasis
Often seen in children and young adults, it produces small, red, round lesions.

Inverse psoriasis
Occurs in skin folds and creates smooth, shiny, discolored patches.

Pustular psoriasis
Characterized by pus-filled blisters, often on the palms and soles.

Erythrodermic psoriasis
The rarest and most severe form, causing widespread redness, peeling, and inflammation that can become life-threatening.

Symptoms

Each type of psoriasis presents with different symptoms. Understanding these helps in selecting the appropriate treatment.

Plaque psoriasis
Affects up to 80% of people with psoriasis. It causes dry, raised, scaly patches that are red on lighter skin and purple or brown on darker skin. Common locations include the scalp, knees, elbows, and lower back.

Guttate psoriasis
This type forms small, round red papules less than 1 centimeter wide, often affecting the arms, legs, torso, and face. It may go away completely or transition into plaque psoriasis later in life.

Inverse psoriasis
Causes smooth, inflamed patches without scaling. These areas are commonly found in moist body folds, where friction and sweating can make symptoms worse.

Pustular psoriasis
Leads to white pustules surrounded by inflamed skin. When the blisters appear on hands or feet, it can make walking or using your hands painful.

Erythrodermic psoriasis
Causes full-body redness, peeling, intense itching, and burning. It can also lead to fever, chills, and nail changes. This form typically occurs when other types worsen or don’t respond to treatment and requires immediate medical attention.

Causes

The precise cause of psoriasis remains unknown, but it is primarily linked to immune system dysfunction and genetics. In people with psoriasis, immune cells mistakenly attack healthy skin cells, leading to inflammation and overproduction of new cells.

Environmental triggers like stress, illness, or skin infections can provoke flare-ups. For example, children may develop guttate psoriasis after a throat infection.

Genetics also play a significant role. Having one parent with psoriasis increases your risk, while having both parents with the condition significantly raises it.

Diagnosis

Psoriasis is usually diagnosed through a physical exam by a healthcare provider or dermatologist. Since it can resemble other skin conditions like eczema, diagnosis may be more challenging.

In some cases, a skin biopsy may be performed. This involves removing a small sample of affected skin to examine under a microscope, which helps confirm the diagnosis and determine the specific type of psoriasis.

Your provider may also ask about symptoms, family history, recent life stressors, and your use of tobacco or alcohol.

Treatment

The right treatment for psoriasis depends on the type, severity, and areas affected. Treatments fall into three main categories:

Topicals
Topical treatments include creams and ointments that may contain coal tar, corticosteroids, salicylic acid, vitamin A derivatives, or immune-modulating agents like tapinarof.

Phototherapy
Also known as light therapy, this approach uses ultraviolet light to reduce inflammation and slow cell turnover. It must be done under medical supervision to avoid skin damage.

Systemic medications
These are oral or injected drugs that affect the entire body and are typically reserved for moderate to severe cases or when other treatments have failed.

While treatment options are the same across all skin tones, people with darker skin may be more prone to side effects like hyperpigmentation or hypopigmentation. In such cases, healthcare providers may adjust dosages or recommend gentler therapies.

Other treatment recommendations

Daily symptoms like itching, dryness, and irritation can make living with psoriasis challenging. Tips for managing these symptoms include:

  • Using mild, unscented soaps

  • Showering with lukewarm water

  • Moisturizing regularly

  • Wearing loose, soft clothing

  • Avoiding harsh skincare products

Most people find success with a combination of treatments tailored to their needs and lifestyle.

Prevention of psoriatic flare-ups

Although psoriasis cannot be prevented, it is possible to manage flare-ups and reduce their frequency and severity. The key is to avoid known triggers and stay consistent with treatment.

Common triggers include:

  • Prolonged emotional or physical stress

  • Infections like strep throat

  • Skin trauma or injury

  • Certain medications

  • Cold or dry weather

  • Tobacco or alcohol use

Lifestyle tips that may help include using humidifiers in dry weather, avoiding red meat and processed sugar, and moderating alcohol intake.

Stress is a common trigger and a consequence of psoriasis. Practicing yoga, meditation, and maintaining a regular sleep schedule can help reduce stress. If stress becomes overwhelming, consider seeking help from a mental health professional or support group.

Living with psoriasis

Living with psoriasis can affect not only your physical comfort but also your emotional and social well-being. It may lower self-esteem and impact your relationships, work, or daily life.

Support from healthcare providers, family, and friends plays a vital role. It’s important to communicate openly with those around you about how psoriasis affects you.

Psoriasis is also associated with other health conditions, including type 2 diabetes, arthritis, heart disease, and depression. Regular checkups and discussions with your healthcare provider can help manage these risks and maintain your overall health.

You do not have to face psoriasis alone. By seeking support and following a treatment plan, you can manage symptoms and live well with the condition.