Author: Arome David, BSc, MPH, Fellow – Media EIS

Reviewed by: Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights 

• Psoriasis is an autoimmune disease where the body mistakenly attacks itself, causing painful, disfiguring, and disabling skin. 
• The exact cause of psoriasis is still not fully known, but research has shown a combination of genetic and immune system factors as the primary contributory cause. 
•  The most visible symptoms of psoriasis are the appearance of red, itchy, scaly patches on the body.
•  Diagnosis is based on presenting clinical symptoms of typical skin lesions.
• While psoriasis has no cure, treatment helps control symptoms and improve quality of life.
•  Remember to consult your doctor for the most suitable treatment options. 

Introduction 

Imagine walking down the street and being stared at not because you look good, but because of the glaring sight of scaly, red patches on your skin. You are asked what happened to your skin and even offered unsolicited advice from self-proclaimed skincare experts. That is the everyday experience of someone living with psoriasis.Over 60 million people are living with psoriasis globally, yet it is widely misunderstood as a cosmetic issue. Psoriasis is an itchy, disfiguring, and sometimes painful condition that triggers stigma, heightens stress, and isolates individuals from the social spaces they once called home.   

 What is Psoriasis?

Psoriasis is an autoimmune disease where the body attacks itself mistakenly. It is characterised by itchy, disfiguring, and sometimes painful skin lesions [1]. This non-contagious disease makes the skin cells grow faster than normal, leading to thick and scaly patches on the skin.Studies have shown that psoriasis does not just affect the skin but also increases the risk of cardiovascular diseases such as heart attacks and strokes [2].

What causes Psoriasis?  

Although the exact cause of psoriasis is still not fully known, research has shown a combination of genetics and the immune system as the primary contributory cause [3]. 

Genetic

Research evidence has implicated genetics in the development of psoriasis [3]. The role of genetics in psoriasis is a bit complex, but people with a genetic predisposition are at high risk of developing it. People with an inherited risk are more likely to experience the disease, though not everyone with that risk develops symptoms.  

Immune system

In autoimmune conditions like psoriasis, the body turns on itself, with immune cells called white blood cells attacking healthy skin by mistake.  This mistaken attack triggers an event that causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop in rapid succession within a short time. The new skin cells are pushed to the skin surface, where they pile up as psoriasis.  

Common Symptoms of Psoriasis?

The most visible symptoms of psoriasis are the appearance of red, itchy, scaly patches on the skin. The five(5) major types of psoriasis  include:

• Plaque psoriasis
• Guttate psoriasis
• Inverse psoriasis
• Pustular psoriasis
• Erythrodermic psoriasis

Nail psoriasis and psoriatic arthritis are also considered types of psoriasis.

According to the National Psoriasis Foundation, an individual can have more than one type of psoriasis at the same time or in a lifetime.

These symptoms tend to vary with: 

• The type of psoriasis 
•  The location
•  The severity   

Types of Psoriasis  

There are many types of psoriasis. Each of them comes with symptoms that show on the skin or somewhere else.

Plaque Psoriasis

This is the most common type of psoriasis. It accounts for about 90% of psoriasis among people, with glaring features of elevated red areas covered with white and silver scales [4]. It’s mostly found in areas like: 

• Elbows
• Knees
• Scalps
• Trunks
• Limbs

 Guttate Psoriasis  

Guttate psoriasis occurs mostly in children and less in adults. It’s occasioned by infections, especially upper respiratory tract infections like streptococcal pharyngitis. The presenting symptoms are red bumps that cover: 

• Legs
• Arms
• Trunk
• Face 
• Ears
• Scalp

In some cases, it may appear and go away, while in others, it may stay permanently.  

Inverse Psoriasis

This type of psoriasis occurs in areas where the skin rubs against itself. Examples: 

• Armpit 
• Groin
• Under the breast 

The noticeable symptoms are red, shiny patches without skin scales. 

Pustular Psoriasis

It begins with pus-filled bumps that usually appear on the feet and hands. Often triggered by infection, stress, medication, and chemicals. The bumps are surrounded by red skin. When it appears in all parts of the body, it is known as generalised pustular psoriasis.  

Erythrodermic Psoriasis

This is a rare type of psoriasis that causes intense discolouration and shedding of large sheets of the skin. It can affect nearly the whole body and can be life-threatening. It is usually associated with severe itching and pain

Nail Psoriasis

The symptoms of psoriasis do not just appear on the skin. About half of the people with plaque psoriasis will also have nail psoriasis. The signs that come with nail psoriasis are:   

• Yellow, brown, or white colouring on the nail
• Small nail dents
• Nails that crumble
• Nails that lift off the skin

Psoriatic Arthritis

Psoriatic arthritis is associated with swelling, pain, and stiffness in the joints. It affects one in three people living with psoriasis and can occur regardless of the severity of the symptoms.

What Triggers Psoriasis Flare-Ups?

Psoriasis flare-ups can be triggered by varying factors, including:

Stress

Stress is one of the leading triggers of psoriasis. When the body is stressed, overwhelmed, or when anxiety sets in, the body releases stress hormones that trigger inflammation, thereby worsening psoriasis. 

Infections

Infections, especially streptococcal infections, have been known to spark psoriasis symptoms in some individuals.  

Medications

Certain medications, like lithium, widely used for psychiatric conditions; antimalarial drugs; and some other medications used for blood and cardiovascular conditions, have also been associated with triggering or worsening psoriasis [5].   

Smoking and Alcohol     

Smoking and alcohol trigger flares and make treatment less effective. High alcohol intake is linked to more severe psoriasis. Smoking brings harmful toxins into the body that increase inflammation, which can make psoriasis worse. Alcohol also raises certain chemicals like TNF-α and IL-6 that cause more inflammation and trigger psoriasis flare-ups. [6]. 

Weather  

Weather is also an important trigger, especially cold, dry weather characterised by dry air and little sunlight. This can dry up the skin and aggravate psoriasis symptoms. Warm or sunny weather, on the other hand, improves psoriasis. 

Diagnosis of Psoriasis

The diagnosis of psoriasis is based on presenting clinical symptoms of typical skin lesions and medical history. Though there is no special blood diagnosis, a skin biopsy or scraping may be carried out in unclear cases to unveil other disorders.

Psoriasis Treatment Options

Topical treatment

The most widely used psoriasis treatments are medications that are directly applied to the skin. Topical treatments are often the first option, especially for mild to moderate psoriasis. They normally come in creams, ointments, and solutions. Common examples include steroid creams like: 

•  Clobetasol Ointment  
•  Triamcinolone Acetonide 

Other skin ointments that can be used include:

• Vitamin D-based ointments
• Calcineurin inhibitors
• Emollients
• Salicylic acid 
• Coal tar etc

Their use should be guided by a doctor's prescription.  

Phototherapy

Phototherapy, or light therapy, has been in use for decades in the treatment of skin diseases, including psoriasis. Light therapy slows down rapidly growing cells in people with psoriasis. There are also home kits for it that can be used in the house. Common types of phototherapy include:

• Narrowband UVB therapy

This is a targeted form of ultraviolet B (UVB) light. It’s safe for children, people who are pregnant or breastfeeding, and those with a weakened immune system or ongoing illness. 

•  Broadband UVB therapy

 This sends out a wider range of UVB light. It’s not used as much as narrowband UVB therapy because it's not as effective.

•  Excimer laser therapy (XTRAC laser)

 Excimer laser therapy removes red patches from the skin by exposing them to UVB rays.

Systemic treatment – whole-body treatment

This treatment option is used for moderate to severe psoriasis, mostly in cases where other treatments fail. They are immunosuppressant drugs such as methotrexate, cyclosporine, and oral retinoids.  

Home Remedies    

These are some home remedies that may help improve psoriasis. They include:

Exposure to Sunlight

Considerable exposure to sunlight can help improve psoriasis. However, regular sunbathing should be done with caution to avoid sunburn.

Practise Yoga

Emotional stress is one of many triggers that can lead to a psoriasis flare-up. Practising yoga may help manage your stress, which can help reduce psoriasis symptoms. 

Weight Reduction

Weight loss can help reduce psoriasis symptoms and flare-ups by targeting some of the key underlying triggers that make the condition worse. Weight reduction may enhance the efficacy of psoriasis treatment in people who are overweight.  

Healthy Diet  

A healthy diet, appropriate levels of physical activity, and management of other risk factors, including obesity, are important elements of care for psoriasis.

Can Psoriasis Be Cured? 

Though there is no cure for psoriasis, treatment remains the mainstay option to get rid of the symptoms. Management of psoriasis should be geared toward minimising the physical and psychological harm by early initiation of treatment. Many patients achieve clear skin with appropriate therapy and lifestyle adjustments. 

Conclusion 

Psoriasis is a manageable autoimmune disease with many available treatment options. New medical breakthroughs in biologics, small-molecule drugs, and smart AI tools are changing healthcare. They promise more precise treatments, safer options, and a better quality of life for patients. Remember to consult your doctor for the most suitable treatment options.      

References    

1.    Chakith M. R. S, Pradeep S, Gangadhar M, Maheshwari N. C, Pasha S, Kollur SP, et al.. Advancements in understanding and treating psoriasis: a comprehensive review of pathophysiology, diagnosis, and therapeutic approaches. Vol. 13, PeerJ. PeerJ; 2025. p. e19325. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12047224/  

2. Liu L, Cui S, Liu M, Huo X, Zhang G, Wang N. Psoriasis Increased the Risk of Adverse Cardiovascular Outcomes: A New Systematic Review and Meta-Analysis of Cohort Study. Front Cardiovasc Med. 2022;9:829709. Available from: https://pubmed.ncbi.nlm.nih.gov/35402553/

3.    Yan D, Gudjonsson JE, Le S, Maverakis E, Plazyo O, Ritchlin C, et al.. New Frontiers in Psoriatic Disease Research, Part I: Genetics, Environmental Triggers, Immunology, Pathophysiology, and Precision Medicine. Vol. 141, Journal of Investigative Dermatology. Elsevier BV; 2021. p. 2112–22.e3. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8384663/

4.    Brandon A, Mufti A, Gary Sibbald R. Diagnosis and Management of Cutaneous Psoriasis: A Review. Vol. 32, Advances in Skin & Wound Care. Ovid Technologies (Wolters Kluwer Health); 2019. p. 58–69. Available from: https://journals.lww.com/aswcjournal/fulltext/2019/02000/diagnosis_and_management_of_cutaneous_psoriasis__a.3.aspx

5.    Salihbegovic E, Kurtalic N, Omerk E. Smoking Cigarettes and Consuming Alcohol in Patients with Psoriasis. Vol. 33, Materia Socio Medica. ScopeMed; 2021. p. 30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8116091/  

6.    Pradeep S, Sai Chakith MR, Sindhushree SR, Reddy P, Sushmitha E, Purohit MN, Suresh D, Swamy Shivananju N, Silina E, Manturova N, Stupin V, Kollur SP, Shivamallu C, Achar RR. Exploring shared therapeutic targets for Alzheimer's disease and glioblastoma using network pharmacology and protein-protein interaction approach. Front Chem. 2025 Mar 12;13:1549186. Available from:  https://pmc.ncbi.nlm.nih.gov/articles/PMC11938128/  

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published August 11, 2025