Psoriasis
Last reviewed
Psoriasis is a chronic auto-immune skin condition where the immune system speeds up skin-cell turnover, producing thick, scaly, well-defined plaques — most often on elbows, knees, scalp and lower back. It can affect nails and joints. Treatment ranges from topical steroids and vitamin D analogues to phototherapy, oral systemic therapy and biologics for severe disease.
Psoriasis is an immune-mediated, chronic skin condition. Skin cells that normally take a month to cycle through turnover do it in days, building up into thick, silvery-scaled plaques that don't fall off on their own.
It's not contagious. It's not caused by hygiene. And for most patients it follows a flare-remit pattern that can be controlled — though not cured — with the right combination of treatments. Severity ranges from a single small plaque on the scalp to widespread plaques that affect daily function; treatment scales accordingly.
How psoriasis shows up
- Well-defined, raised plaques with silvery-white scale (plaque psoriasis — most common)
- Scalp involvement — flaking and itching, sometimes mistaken for dandruff
- Nail changes — pitting, thickening, lifting of the nail plate
- Stinging, itching or burning in active plaques
- Joint pain or stiffness (psoriatic arthritis — affects ~30% of patients)
- Common sites: elbows, knees, scalp, lower back, behind the ears
- Flares triggered by infection, stress, certain medications or skin injury
What contributes to psoriasis
- Genetic predisposition — strong family history in many patients
- Auto-immune dysregulation — T-cell driven over-activity
- Triggers: streptococcal infections (guttate flares), stress, smoking, alcohol
- Medications — lithium, beta-blockers, antimalarials can flare it
- Skin trauma (Koebner phenomenon — psoriasis appears at scratch or surgery sites)
- Obesity and metabolic syndrome correlate with more severe disease
When to see a dermatologist
See a dermatologist as soon as you suspect psoriasis — early treatment controls disease activity, reduces scarring of nails and joints, and prevents the cycle of misdiagnosis and OTC creams that don't work. If you have joint pain or stiffness alongside skin plaques, mention it specifically; psoriatic arthritis needs early coordinated care.
How psoriasis is treated at SkinWise
Most patients start with topical therapy: corticosteroids and vitamin D analogues, used in cycles to avoid steroid side effects. Scalp psoriasis often needs medicated shampoos and overnight scalp oils. Moderate-to-severe disease may need phototherapy (narrowband UVB), oral systemic therapy (methotrexate, apremilast) or biologics targeting specific immune pathways — we discuss the trade-offs at consult and coordinate with rheumatology when joints are involved.
Services that treat psoriasis
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Frequently asked questions
Is psoriasis contagious?
No. Psoriasis is an immune-mediated condition — you cannot catch it from another person or pass it on through contact. Public misunderstanding on this point is one of the harder parts of living with visible plaques.
Will I need biologics?
Most patients don't. Topical therapy with periodic phototherapy controls the majority of cases well. Biologics are reserved for moderate-to-severe psoriasis or cases with significant psoriatic arthritis — they're effective but expensive and need careful monitoring.
Does diet help psoriasis?
There's no single 'psoriasis diet,' but reducing weight (in overweight patients), limiting alcohol and maintaining good metabolic health all improve disease control. Anti-inflammatory eating patterns may help some patients; we don't prescribe strict elimination diets without evidence.
Can stress really cause a flare?
Yes — psoriasis flares are commonly preceded by major stress events. Stress management isn't a substitute for medical treatment, but it's a real lever for patients who track their flares carefully.
Ready to start with a consult?
A focused 15-minute first consultation is where we slow down, map your concern and build the smallest plan that will actually move the needle. No oversell, no fixed menu.