Psoriasis: Main Causes, Types and Treatment Strategies

Psoriasis is an inflammatory skin disease that causes itchy, flaky, and painful red patches on the skin. Psoriasis typically is genetic and flares can be triggered by the environment.

This blog will talk about psoriasis, its main causes, the types of psoriasis and your treatment options.

What is Psoriasis?


Psoriasis is a non-contagious, chronic inflammatory skin disorder associated with significant morbidity and mortality. The inflammatory skin disease is caused in part by an overactive immune system which stimulates an above average growth and turnover in skin cells.

The affected areas present with red plaques, silvery scales and painful, flaky patches on the skin.

The symptoms you experience from psoriasis can vary in terms of severity. You may have mild, itchy spots causing discomfort while other types of psoriasis result in thick, distributed plaques that prove difficult to treat.

Psoriasis is a source of embarrassment for many as the skin disease can last for long periods of time and appear in very present areas of the skin.

Approximately 7.4 million American adults had psoriasis in 2013 according to research published by the National Institutes of Health (NIH). Meaning, many Americans suffer from the autoimmune disease and seek treatment from dermatologists and skin specialists.

What are the Types of Psoriasis?


Knowing which type of psoriasis you have can inform your dermatologist of the best skin care treatment options available to you.

Most people only have one type of psoriasis at a time. However, psoriasis can also manifest in different ways at the same time.

There are seven types of psoriasis:

  1. chronic plaque psoriasis
  2. guttate psoriasis
  3. inverse psoriasis 
  4. erythrodermic psoriasis
  5. nail psoriasis
  6. psoriatic arthritis
  7. pustular psoriasis

While each type comes with its own unique symptoms, they can result from several triggers:

  • Stress
  • Skin injury
  • Medications
  • Infection
  • Allergies
  • Diet
  • Weather

What Does Psoriasis Look Like When it Starts?


Depending on the type of psoriasis you experience, psoriasis can present in numerous different forms.

Some appear as red plaques on the skin with silvery scales, best characterized as salmon-pink, round and well-bordered bumps.

Psoriasis plaques can itch and possibly feel sore. By scratching these areas, your scales can loosen and potentially result in bleeding.

Psoriasis can be localized to one area or appear in multiple areas simultaneously. Commons areas where psoriasis outbreaks can appear are the elbows, knees, shins, palms, nails, arches of feet, lower back, genitals and anal folds.

Psoriasis can also be distinguished by the pain felt in your joints, known as psoriatic arthritis. 

In fact, it is important to acknowledge that psoriasis does not always appear as red, raised bumps on your skin. There are other types of psoriasis such as plaque or guttate which will have different symptoms.

After assessing the type of psoriasis you have, your board-certified dermatologist can work with you to choose the best treatment for your specific needs.

If psoriasis is not treated, it can lead to skin irritation, dryness and inflammation, which may cause pain or discomfort in some areas of your body. Not treating psoriatic arthritis can lead to joint damage. 

Is Psoriasis Curable?


Sadly, there is no cure for psoriasis. Many treatments exist to ease the symptoms and psoriasis and manage them.

How do you Treat Psoriasis?


Psoriasis is a chronic immune-mediated disease. It has a complex pathogenic process, due to elevated inflammatory markers called cytokines. The specific cytokines involved are TNF-alpha, IL-12, IL-23, and IL-17.

By inhibiting these psoriasis specific inflammatory markers, the disease’s symptoms can be reduced.

Psoriasis can’t be fully eliminated but it can usually be managed with treatment such as topicals,  oral medications, and injectables (biologics) for severe cases.

Oral medications can include:

  • Cyclosporine
  • Retinoid drugs
  • Methotrexate
  • Otezla

Biologics treatments, injected either subcutaneously or intravenously include:

  • Adalimumab (Humira)
  • Etanercept (Enbrel)
  • Infliximab (Remicade)
  • Ustekinumab (Stelara)
  • Guselkumab (Tremfya)
  • Risankizumab (Skyrizi)
  • Tildrakizumab (Ilumya)
  • Secukinumab (Cosentyx)
  • Ixekizumab (Taltz)
  • Brodalumab (Siliq)

Topical treatments include:

  • High potency corticosteroid creams
  • Calcipotriene
  • Salicylic acid
  • Tar-based products
  • Retinoids

Treating psoriasis can also come from using specialized laser treatments like Narrow-band UVB and Excimer lasers.

These methods have shown high levels of efficacy when treating psoriasis in specific use cases.

Management of psoriasis can be difficult, but can be treated with a well-planned and executed treatment regimen.

Oftentimes, treating your psoriasis will also help you feel better emotionally because less stress means fewer symptoms appearing on your body.

Some people may not notice any change when they start taking their medication while others might have an improvement within days after starting treatment. So, don’t hesitate to talk with your dermatologist in Pleasanton about how best to manage this condition.

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