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 of the feet, sometimes also on the genitals.
Inflammatory
Medically reviewed by Dr. A.M. van Coevorden, dermatologist, on
± 15 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?
- How do you get psoriasis?
- What triggers psoriasis?
- What does psoriasis look like?
- What symptoms does psoriasis cause?
- Psoriasis on the scalp
- Is psoriasis contagious?
- How does the doctor make the diagnosis?
- What treatments are available?
- Applying treatment yourself, and how to do it well
- What does not help, or has not been proven
- Does psoriasis go away?
- Psoriasis and other conditions
- Lifestyle and psoriasis
- When should you have your psoriasis assessed by a dermatologist?
- Frequently asked questions about psoriasis
What is psoriasis?
Psoriasis is a chronic skin condition that causes red patches with white scales. In psoriasis, skin cells renew themselves much faster than normal, so they build up into thick, scaly patches. These patches can appear anywhere on your body.
Psoriasis often runs in families and comes and goes in phases: sometimes you have hardly any symptoms, at other times more. The condition cannot be cured, but it can be treated well: with the right treatment, the patches calm down in many people or disappear completely 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 has the same predisposition. Psoriasis can appear for the first time at any age. The predisposition alone usually does not set psoriasis off: something else is often added.
What triggers psoriasis?
Psoriasis comes and goes in phases. A flare-up is often set off by something. The best-known triggers are:
- Damage to the skin, such as a graze, a surgical wound or scratching
- Infections, especially a throat infection
- Certain medicines
- Stress
- Smoking
- Drinking a lot of alcohol
Which trigger plays a part for you differs from person to person. Many people keep track for a while of when their skin flares up and what was different in the days before. You can read more about smoking, alcohol, stress and sleep under lifestyle and psoriasis.
What does psoriasis look like?
Psoriasis has several forms. The form you have determines what the patches look like and where they appear.
Guttate psoriasis
Within a short time, a rash of many small psoriasis patches 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. There are usually no scales in these areas.
Nail psoriasis
Your nails can also be damaged. You then see small pits, yellowish-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 ashamed of their skin. If that affects you, talk to your doctor about it. You do not have to carry it around on your own.
Psoriasis on the scalp
Scalp psoriasis is common in people with psoriasis. The patches are often at the hairline, behind the ears and on the neck, and sometimes extend under the hair. You see a layer of scales between the hairs and the skin underneath is red. It often itches.
Dandruff and scalp psoriasis look alike, but they are different conditions with a different treatment. An anti-dandruff shampoo from the shop sometimes reduces the scales for a while. It does not treat the psoriasis itself. That is why many people try shampoos for months without it getting better.
The approach depends on how thick the layer of scales is. You need a prescription for both steps.
First loosen the scales
A thick layer of scales blocks the rest of the treatment. A greasy ointment or a product with salicylic acid softens the top layer. You apply it to the scalp between the hairs in the evening. A shower cap over it makes it work better overnight. The next morning you gently comb your hair to remove the loose scales and then wash it. The scales usually come loose after two or three days. Work carefully so that the skin does not get damaged.
Then a prescription shampoo
With a thin layer of scales, a coal tar shampoo is often the first step. Coal tar reduces the inflammation, reduces scaling and relieves the itching. You apply it to the skin of your scalp, not just to your hair. How often and for how long you use it is agreed with the doctor who prescribes it.
And if that is not enough
If the patches keep coming back, the dermatologist prescribes a lotion or a scalp application that can be spread between the hairs. On hairy skin, a thin liquid works better than a thick ointment. It is usually a corticosteroid, a product similar to vitamin D, or a combination of the two.
Please note
Do not scratch the patches and do not pull the scales off. Damaged skin is itself a trigger: a new psoriasis patch can develop in that spot.
Is psoriasis contagious?
N
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 condition. The doctor then takes 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 have 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), tar ointment and dithranol cream.
Light therapy
A treatment with UV light, usually UVB. Sometimes combined with medicines you take by mouth, or with a special bath beforehand (PUVA treatment). A sunbed 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.
Applying treatment yourself, and how to do it well
Keep your skin supple by applying a moisturising cream. That way you are less bothered by the psoriasis patches.
Moisturising is the basis of every treatment, even if you also use medicines. An emollient is an ointment, cream or lotion without medicine and without perfume, for example based on lanette or cetomacrogol. On hairy skin you use a lotion, on very dry skin an ointment.
Four things that make the difference:
- Apply it twice a day, and keep applying it even when you have no symptoms.
- Do not apply an emollient and a medicated ointment at the same time. Leave about an hour between them.
- Use the fingertip unit to know how much you need: the amount that fits on the tip of your index finger, up to the first joint.
- In the skin folds, between the buttocks and on the face, the skin is thinner. A different product often applies there. Use nothing there other than what has been prescribed.
Some ointments start to work less well if you use them for a long time. If you notice that, go back to your doctor instead of applying more often or more thickly.
Please note
Never stop a prescribed steroid ointment all at once. The symptoms then often come back, sometimes more severely than before. Your doctor will tell you how to reduce it step by step.
What does not help, or has not been proven
Many products that promise relief or a cure circulate around psoriasis. This is what is known about them.
A diet or supplements
There is no diet that cures psoriasis. There is no scientific evidence for a special diet or for dietary supplements, and supplements are not recommended. A healthy weight is sensible, though, because psoriasis is more often linked to cardiovascular risks.
Herbs and acupuncture
Not enough research has been done to know whether these treatments help, or whether they are safe. If you want to try something, discuss it with your doctor first, especially if you take medicines.
The sunbed
Sunlight does many people with psoriasis good, and many have fewer symptoms in summer. A sunbed does not help and is not recommended. Light therapy in hospital is something different: that is UV light in a controlled dose, under supervision.
Stopping as soon as it improves
This is the most common mistake. If you stop treatment, the patches almost always come back after a few weeks to months. With a steroid ointment you never stop all at once, but reduce it as your doctor advises.
Does psoriasis go away?
No treatment ensures that psoriasis never comes back. With treatment, psoriasis does get a lot better. If you stop treatment, the patches almost always come back after a few weeks to months. Psoriasis can sometimes also stay away for years.
Psoriasis and other conditions
Psoriasis occurs more often together with other conditions (comorbidities). Your treating doctor takes this into account, especially with tablets or injections.
Psoriatic arthritis
Joint inflammation in, for example, the pelvis, back and knees. Fingers and toes can also become inflamed (dactylitis), as can tendon attachments such as the Achilles tendon (enthesitis). About a third of people with psoriasis develop this.
Depression
People with psoriasis have depression more often, 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
High blood pressure, overweight, type 2 diabetes and high cholesterol (metabolic syndrome) occur more often, 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.
Lifestyle and psoriasis
Since 2026, the Dutch dermatology guideline (NVDV) includes lifestyle recommendations for psoriasis. There are indications that smoking and heavy alcohol use can worsen psoriasis. For smoking, this applies most strongly to palmoplantar pustular psoriasis, the form with pustules on the palms and soles. Quitting smoking and drinking less is therefore sensible, also for your general health. There is no scientific evidence for special diets or supplements; supplements are not recommended. Many people notice that stress affects their skin. Stress reduction, for example with mindfulness, can help. Exercise has no proven direct effect on psoriasis itself, but it benefits your general health and lowers the risk of conditions that are more common in people with psoriasis. Getting enough sleep may also play a role: there are indications that sleep affects the immune system. Lifestyle is a complement to your treatment, not a replacement for it.
Which diets have been studied? For a low-calorie diet, a ketogenic diet, a nightshade-free diet and intermittent fasting, there is not enough evidence that they improve psoriasis. If you would like to work on your diet, guidance from a specialist dietitian on an anti-inflammatory eating pattern, such as the Mediterranean diet, can be an addition to your treatment. Food does not remove the cause of psoriasis.
Vitamin D tablets and fish oil (omega-3) are not recommended as a treatment for psoriasis. That is different from a vitamin D cream on prescription, which is used to treat psoriasis patches.
Do you take tablets or injections for psoriasis? Alcohol can reduce how well they work. One more reason to drink as little as possible.
Exercise can feel difficult if sweat makes you itch or if you feel self-conscious about your skin. Loose, breathable sportswear prevents chafing. Have a shower after exercise and moisturise your skin afterwards.
When should you have your psoriasis assessed by a dermatologist?
A dermatologist is the medical specialist for skin and psoriasis. Have your skin assessed if:
- you are not sure whether it is psoriasis, or for example eczema or dandruff
- the patches do not calm down with what you are using now
- your ointment seems to work less well than before
- the psoriasis keeps coming back or spreads
- you have patches on your scalp, face, in skin folds or around your genitals
- you also have painful or stiff joints
At 247dermatologist, a BIG-registered dermatologist reviews your photos within 12 to 48 hours. You do not need a referral and a consultation costs from €39. The dermatologist makes a diagnosis where possible and gives you a treatment plan that suits your type of psoriasis. No waiting list: in the Netherlands, the average wait for a dermatologist appointment is five weeks.
Frequently asked questions about psoriasis
Is psoriasis hereditary?
Yes, a hereditary predisposition plays a major role. If you have psoriasis, someone else in your family often has the predisposition too. The condition can appear for the first time 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 sunbed does not help, however, and is not recommended. Always avoid sunburn.
Does psoriasis ever go away completely?
Psoriasis is chronic and cannot be cured for good, but with treatment it often gets a lot better and can sometimes stay away for years. If you stop treatment, the patches usually come back after weeks to months.
Can psoriasis affect my joints?
Yes. About a third of people with psoriasis develop psoriatic arthritis, with inflammation in, for example, the fingers, toes, back and knees. Discuss joint symptoms with your doctor.
Does a diet help with psoriasis?
There is no diet that cures psoriasis. Because psoriasis is linked to cardiovascular risks, a healthy weight, not smoking and enough exercise are sensible. A moisturising cream keeps the skin supple.
What causes psoriasis?
A hereditary predisposition plays the biggest role. In psoriasis, skin cells renew themselves much faster than normal, so they build up into thick, scaly patches. If you have psoriasis, someone else in your family often has the same predisposition. The condition can appear for the first time at any age.
What are triggers for psoriasis?
The best-known triggers are damage to the skin, infections such as a throat infection, certain medicines and stress. Smoking and drinking a lot of alcohol can make psoriasis worse. Which trigger plays a part for you differs from person to person.
What is the best treatment for psoriasis?
There is no treatment that works best for everyone. Which treatment suits you depends on how many patches you have, where they are and how you responded to earlier treatments. The usual order is: first an emollient and, if needed, a medicated ointment, then light therapy, and only after that tablets or injections.
How do you get rid of psoriasis quickly?
It does not go away quickly. Psoriasis is chronic and there is no treatment that makes it disappear for good. What can be quicker is starting the right treatment instead of trying different products from the shop for months. With the right treatment, the patches calm down in many people, and sometimes they stay away for years.
What should you avoid eating if you have psoriasis?
There is no food you have to avoid with psoriasis. There is no scientific evidence for a special diet, and dietary supplements are not recommended. Drinking a lot of alcohol can make psoriasis worse, though. A healthy weight is sensible, because psoriasis is more often linked to high blood pressure, type 2 diabetes and high cholesterol.
What really helps against scalp psoriasis?
First loosen the layer of scales, then use a product on the scalp that reduces the inflammation. You need a prescription for both. A coal tar shampoo is often the first step. If it keeps coming back, a lotion or scalp application that can be spread between the hairs is added. An anti-dandruff shampoo from the shop reduces the scales for a while at most.
What causes scalp psoriasis?
The same as elsewhere on the body: skin cells renew themselves too quickly and build up. On the scalp this is especially noticeable, because the scales stay caught between the hairs. Scalp psoriasis is not caused by the wrong shampoo or by not washing enough.
Does smoking affect psoriasis?
There are indications that smoking can make psoriasis worse. This applies most strongly to palmoplantar pustular psoriasis, the form with pustules on the palms and soles. Stopping smoking is therefore sensible, also apart from your skin. This has been part of the lifestyle recommendations in the NVDV guideline since 2026.
Can scalp psoriasis cause hair loss?
Permanent baldness is not part of psoriasis. Some hair can come out temporarily when you scratch or remove thick scales. So work carefully and do not pull the scales off. If you are worried about hair loss, have it assessed.
Is psoriasis contagious?
No. No form of psoriasis is contagious. You cannot get it through touch, by using the same towel or by swimming together.
Do vitamin D tablets or fish oil help with psoriasis?
No. The NVDV guideline advises against vitamin D tablets and fish oil (omega-3) as a treatment for psoriasis. A vitamin D cream on prescription is different: it is used to treat the patches.
Does a nightshade-free or ketogenic diet help with psoriasis?
There is not enough evidence for that, just as for a low-calorie diet and intermittent fasting. If you want to work on your diet, a specialist dietitian can guide you towards an anti-inflammatory eating pattern, as an addition to your treatment.
Can I see a dermatologist directly for psoriasis?
Yes. At 247dermatologist, a BIG-registered dermatologist assesses your skin within 12 to 48 hours, without a referral and from €39.
Want to know what a dermatologist does, when you can see one and how quickly that can happen? Read more about the dermatologist.
Sources and more information
- NVDV patient leaflet on psoriasis (nvdv.nl)
- Psoriasispatiënten Nederland (psoriasispatientennederland.nl)
- Huidpatiënten Nederland (huidnederland.nl)
- NVDV-richtlijn Psoriasis, leefstijlmodules (2026)
- Dutch dermatology guideline (NVDV) Psoriasis, module Lifestyle (2026, in Dutch)
- Dutch Association of Dietitians, skin condition guidelines (nvdietist.nl, in Dutch)
Source: Dutch Society of Dermatology and Venereology (NVDV).
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