A principal source of advice, support and information on psoriasis and psoriatic arthritis
A registered charity no: 1118192
A registered charity no: 1118192
Psoriasis (sor-i’ah-sis) is a long-term (chronic) scaling disease of the skin, which affects 2% to 3% of the UK population – up to 1.8 million people. IT IS NOT CONTAGIOUS and you cannot catch psoriasis from someone else. It appears as red, raised scaly patches known as plaques. Any part of the skin surface may be involved, but the plaques most commonly appear on the elbows, knees and scalp. It can be itchy, but is not usually painful. Nail changes, including pitting and ridging, are present in 40% to 50% of people with psoriasis and around 30% of people (particularly those with moderate to severe psoriasis) will develop psoriatic arthritis. This can cause swelling and stiffness in the joints or stiffness in the lower back.
Although the commonest form features red, raised, scaly plaques, there are a number of types of psoriasis. These look different and may require specific treatment.
Remember, although psoriasis is a chronic condition, it can be controlled and go into remission (go away, often temporarily and sometimes permanently). Not all people will be affected in the same way and doctors will class the condition as mild, moderate or severe.
Mild psoriasis (80% of people affected) involves a few patches which may need treatment but are not likely to cause problems and can be easily controlled.
Moderate psoriasis (15% of people) causes more of the skin to be affected and is widespread but, again, can usually be controlled with self-management under the supervision of a GP or nurse.
Severe psoriasis (5% of people) results in large areas being covered with psoriasis; the condition becomes difficult to self-manage or no longer responds to treatment. At this stage referral to secondary care at a local hospital outpatient department, or in extreme cases, an inpatient stay may be felt necessary in order to provide the most suitable (optimum) care and monitoring.
Normally a skin cell matures in 21 to 28 days. During this time it travels to the surface of the skin, where it is lost in a constant, invisible shedding of dead cells. In patches of psoriasis the turnover of skin cells is much faster, around four to seven days, and this means that even live cells can reach the surface and accumulate with dead cells. It is thought that cells in the immune system (T cells) become overactive, leading to rapid growth of skin cells and the formation of psoriatic plaques. The extent of psoriasis and how it affects an individual varies from person to person. Some may only be mildly affected with a tiny patch hidden away which does not bother them, while others may have large, visible areas of skin involved that significantly affect daily life and relationships. The process is the same wherever it occurs on the body. There are some factors that trigger flares of psoriasis including infection, stress, alcohol and smoking. Obesity is also linked to psoriasis and maintaining a healthy weight can reduce the severity of the disease.
Who does it affect?
It affects men, women and children alike. It can appear at any age in varying degrees but usually between the ages of 10 and 30. The severity of the disease varies enormously, from a minute patch to large patches covering most body areas. Psoriasis can also run in families and it is known that the disease is multi-genetic (a condition where several genes may each have different roles, contributing to specific characteristics of disease) and therefore children may not necessarily inherit psoriasis. It is estimated that if one parent has psoriasis then there is a 15% chance that a child will develop the condition. If both parents have psoriasis this increases to about 75%. Interestingly, if a child develops psoriasis and neither parent is affected there is a 20% chance that a brother or sister will also get psoriasis. This is because the condition is known to skip generations, so somewhere there will be a familial link to a relative via one or both parents.
Is there a cure for psoriasis?
There is no cure at the moment. However, as a consequence of current research, our understanding about what happens in psoriasis is growing and new drugs are being developed. In the meantime, there are a number of treatments that are effective in keeping psoriasis under control.
The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.
Does this mean I will have psoriasis for life?
In the absence of a cure you will always have psoriasis, but this does not mean that the signs will always be visible. Normally, the rash tends to wax and wane (increase and decrease). There will be periods when your skin is good, with little or no sign of psoriasis. Equally, there will be times when it flares up. The length of time between clear skin and flare-ups differs for each individual and is unpredictable. It may be weeks, months or even years.
What are the types of psoriasis?
What can I do to help treat my psoriasis?
There may not be a cure yet but there is much you can do to help maintain and control your psoriasis. Psoriasis, regardless of location or type, is often irritated by contact, particularly tight clothing such as elasticated waistbands, socks, tights, and underwear. It may be useful to wear looser clothing where psoriasis is likely to be irritated either when flaring or during periods of treatment. Identifying factors (e.g. stress, alcohol) that may cause your psoriasis to flare, using a diary, can be helpful.
Yes, there are many forms of treatment for psoriasis, which range from those you apply to the skin (topical) to tablets, and more recently injectable therapies, See Treatments for Psoriasis.
Many people who have psoriasis find that the sun and artificial ultraviolet light (UV) helps to improve their skin’s appearance. For some the change is dramatic. Be aware that exposure to the sun and artificial UV therapy can cause damage to the skin. For further information see Psoriasis and the Sun and Psoriasis and Phototherapy.
For some people, talking therapies such as cognitive behaviour therapy (CBT) can also help them understand the psychological impact of psoriasis and provide a safe therapy which may help them cope with psoriasis. See our free online CBT programme at www.etips.org.uk
Your general practitioner or dermatologist will be best placed to advise you and keep you informed of all current and new treatments available and to recommend the best treatment programme for you personally.
Remember: Your treatment can only be as good as you allow it to be - that means if the treatment takes six weeks, you have to follow it as instructed for six weeks and no ducking out! Adherence to treatment instructions is an essential part of managing your psoriasis.
A healthy diet is important for wellbeing and can reduce your risk of many long-term illnesses. However, there is no clear link between what you eat and the severity of psoriasis symptoms.
I may have psoriasis – what do I do now?
If you think you have psoriasis, go and see your GP. He or she may decide themselves to start treatment or refer you to a dermatologist for advice.
Don’t forget, if you are also experiencing aches and pains in any of your joints, have any other symptoms or if you have a family history of psoriasis, inform the doctor. This will assist with diagnosis and treatment.
Can I get more information?
Yes. The Psoriasis and Psoriatic Arthritis Alliance (PAPAA) is a national charity dedicated to raising awareness and helping people with psoriasis and psoriatic arthritis.
PAPAA produces a range of information covering various topics relating to psoriasis and psoriatic arthritis. For further details contact us directly or visit our website. You’ll find all the details on the back cover of this leaflet.
Remember: All treatments may have unwanted side effects or require special precautions (for example, during pregnancy). Always make sure you have all the relevant information available before embarking on any course of therapy. This includes reading the patient information leaflets (PIL) provided with your medicines.
Can I get financial support?
Lots of people worry about what happens if they cannot work or need financial help because of the effects of their condition. Fortunately for many, with good therapy and management their condition can be controlled and allow for a full and active working life. But if you do find that even for a short period of time you are likely to need help, visit the national government websites online. If it is easier, contact your local government or council office, where you should be directed to the appropriate resource and information. If you require regular prescriptions, you may save money with a prescription prepayment certificate so it is worth speaking to your pharmacist about this.
This article is adapted from the What is Psoriasis? leaflet.
Download full leaflet as a pdf
Always consult your doctor or healthcare provider.
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