Inflammatory

Medically reviewed by Dr. A.M. van Coevorden, dermatologist

± 5 min read

Psoriasisred patches with white scales

Learn what psoriasis is, how to recognise it and which treatments are available. In plain language, based on the patient information leaflet from the NVDV.

What is psoriasis?

Psoriasis is a chronic skin disease that produces red patches with white scales. In psoriasis, skin cells renew far faster than normal, so they build up into thick, scaly patches. You can get these patches anywhere on your body.

Psoriasis often runs in families and comes in flares: sometimes you have hardly any symptoms, then more. The condition cannot be cured, but it can be treated well: with the right treatment the patches settle down in many people, or clear up for a while.

How do you get psoriasis?

A hereditary predisposition plays an important role: if you have psoriasis, someone else in your family often carries the same predisposition. Psoriasis can start at any age. Sometimes it is triggered by:

Damage to the skin
Infections
The use of certain medicines
Stress

What does psoriasis look like?

Psoriasis comes in different forms. The form you have determines what the patches look like and where they appear.

Plaque psoriasis

The most common form: red patches with scales, not all the same size. They usually appear on the elbows, knees, scalp, lower back, palms and soles, and sometimes on the genitals.

Guttate psoriasis

Over a short period, a rash of many small psoriasis spots appears, usually after a throat infection.

Inverse psoriasis

Psoriasis in the folds of your body, such as the groin, navel, armpits, between the buttocks and under the breasts. In these areas you usually see no scaling.

Nail psoriasis

Your nails can also be affected. You may then see pitting, yellow-brown spots, and part of the nail can come loose.

What symptoms does psoriasis cause?

Psoriasis patches can itch or hurt. Inflammation can also develop in your joints, especially in the hands and feet (psoriatic arthritis). Some people with psoriasis feel embarrassed about their skin. If that affects you, talk to your doctor about it. You do not have to keep struggling with it on your own.

Is psoriasis contagious?

No. No form of psoriasis is contagious.

How does the doctor make the diagnosis?

A dermatologist can usually tell from the patches on your skin whether you have psoriasis. Sometimes extra certainty is needed to rule out another skin disease. The doctor then removes a small piece of skin under local anaesthetic (a biopsy).

What treatments are available?

There are three treatment options. Which one suits you depends on how many patches you have and how you responded to earlier treatments.

Cream, ointment or lotion
You apply a prescribed cream, ointment or lotion to the psoriasis patches, usually once or twice a day. Examples are vitamin D cream, corticosteroids (steroid ointment), coal tar ointment and dithranol cream.
Light therapy
A treatment with UV light, usually UVB. Sometimes combined with medicines you take, or with a special bath beforehand (PUVA treatment). A tanning bed does not help.
Tablets or injections
If you have many patches on your body, or the treatments above do not help enough, the dermatologist will discuss tablets or injections with you. Examples are methotrexate, ciclosporin, acitretin, fumarates and biologics.

What can you do yourself?

Keep your skin supple by applying a moisturising cream. This eases the discomfort from the psoriasis patches.

Does psoriasis go away?

No treatment can stop psoriasis from ever returning. With treatment, psoriasis does get a lot better. If you stop treatment, the patches almost always come back within a few weeks to months. Psoriasis can also sometimes stay away for years.

Psoriasis and other conditions

Psoriasis occurs more often alongside other conditions (comorbidities). Your treating doctor takes this into account, especially with tablets or injections.

Psoriatic arthritis

Joint inflammation in areas such as the pelvis, back and knees. Fingers and toes can also become inflamed (dactylitis), as can tendon attachments such as the Achilles tendon (enthesitis). About one in three people with psoriasis develops this.

Depression

People with psoriasis more often have depression, because of the impact of a chronic condition and possibly also because of inflammatory substances found in both the skin and the brain.

Cardiovascular disease

More often high blood pressure, excess weight, type 2 diabetes and high cholesterol (metabolic syndrome), a risk factor for cardiovascular disease. If your BMI is above 25, ask your GP to screen you.

Inflammation elsewhere in the body

Very occasionally an eye inflammation (uveitis). Bowel inflammations such as Crohn's disease and ulcerative colitis also occur more often.

Frequently asked questions about psoriasis

Is psoriasis hereditary?

Yes, a hereditary predisposition plays a big part. If you have psoriasis, someone else in your family often carries the predisposition too. The condition can first appear at any age.

Can I go in the sun with psoriasis?

Sunlight does many people with psoriasis good: many have fewer symptoms in summer. A tanning bed, however, does not help and is not advised. Always avoid burning.

Will psoriasis ever go away completely?

Psoriasis is chronic and cannot be permanently cured, but with treatment it often gets much better and can sometimes stay away for years. If you stop treating it, the patches usually return within weeks to months.

Can psoriasis affect my joints?

Yes. About one in three people with psoriasis develops psoriatic arthritis, with inflammation in areas such as the fingers, toes, back and knees. Discuss any joint symptoms with your doctor.

Does a diet help against psoriasis?

There is no diet that cures psoriasis. Because psoriasis goes together with cardiovascular risks, a healthy weight, not smoking and enough exercise are sensible. A moisturising cream keeps the skin supple.

Sources and more information

NVDV patient leaflet on psoriasis (nvdv.nl)
Psoriasispatiënten Nederland (psoriasispatientennederland.nl)
Huidpatiënten Nederland (huidnederland.nl)

Source: Dutch Society of Dermatology and Venereology (NVDV).

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