What Is Psoriasis? Understanding This Chronic Skin Condition

Psoriasis is a chronic autoimmune condition that causes skin cells to grow 3 to 4 times faster than normal, creating thick, scaly patches on your skin. It affects approximately 7.5 million adults in the United States and about 125 million people worldwide. While there's no cure, understanding this condition and modern treatments can help you manage symptoms effectively.

How Psoriasis Works

In psoriasis, your immune system mistakenly attacks healthy skin cells. T cells, a type of white blood cell, become overactive and trigger inflammation. This causes skin cells to develop rapidly and pile up on the surface before old cells can shed. Instead of the normal 28-30 day cycle, new cells reach the surface in just 3-4 days.

The result is raised, inflamed patches covered with silvery-white scales. These areas can be itchy, painful, and may crack and bleed. Psoriasis typically develops between ages 15-25 or 50-60, and affects men and women equally.

Types of Psoriasis

Plaque Psoriasis

The most common type, affecting 80-90% of people with psoriasis. It creates raised, red patches covered with silvery scales, typically on the elbows, knees, scalp, and lower back.

Guttate Psoriasis

Appears as small, drop-shaped spots on the trunk or limbs. Often triggered by a strep throat infection in children and young adults. These spots are usually less thick than plaque psoriasis.

Inverse Psoriasis

Causes smooth, red patches in skin folds like under the breasts, in the groin, or around the buttocks. It's worsened by friction and sweating, making it particularly uncomfortable.

Other Types

Pustular psoriasis creates pus-filled bumps on red skin. Erythrodermic psoriasis is severe, affecting over 90% of the body with widespread redness and shedding. Nail psoriasis causes pitting, discoloration, and changes to fingernails and toenails.

Psoriasis vs. Eczema: Key Differences

While both cause red, inflamed skin, they have distinct features:

• Appearance: Psoriasis creates thicker, more raised patches with well-defined borders and silvery-white scales. Eczema has less defined edges and causes oozing or weeping.

• Location: Psoriasis favors the outer elbows and knees. Eczema typically appears in the inner elbow creases, behind the knees, and on the face.

• Sensation: Eczema causes intense itching. Psoriasis often causes more burning or stinging, with mild to moderate itching.

• Age of onset: Eczema usually starts in infancy or early childhood. Psoriasis typically begins in early adulthood.

Common Triggers for Flares

Research shows that about 36% of psoriasis flares have identifiable triggers:

• Infections: Respiratory infections and strep throat are common triggers. Studies found that psoriasis flares typically occur within 2 days of respiratory infection symptoms.

• Stress: Emotional stress and major life events trigger flares in about 8% of cases.

• Medications: Beta-blockers, lithium, NSAIDs, and corticosteroid withdrawal can worsen symptoms.

• Lifestyle factors: Smoking, alcohol, obesity, and skin injuries can trigger or worsen psoriasis.

Modern Treatment Approaches

Treatment has advanced significantly in recent years. Options range from topical creams for mild cases to systemic treatments for moderate to severe psoriasis. Biologics that target specific parts of the immune system have shown remarkable results, with many patients achieving clear or nearly clear skin.

Newer treatments include IL-17 and IL-23 inhibitors, which block specific inflammation pathways. Some oral medications offer alternatives to injections. Treatment plans are individualized based on severity, location, and impact on quality of life.

Related Conditions

About 30% of people with psoriasis develop psoriatic arthritis within 5-10 years, causing joint pain, stiffness, and swelling. Psoriasis also increases the risk of other conditions including heart disease, diabetes, depression, and inflammatory bowel disease.

When to See a Dermatologist

Consult a dermatologist if you notice thick, scaly patches that don't improve with over-the-counter treatments, if symptoms interfere with daily activities or sleep, or if you develop joint pain alongside skin symptoms. Early diagnosis and treatment can prevent complications and significantly improve your quality of life. A dermatologist can create a personalized treatment plan and monitor for related conditions like psoriatic arthritis.