Psoriasis is a skin condition that creates thick, pink/red plaque of skin with overlying white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects up to 2% of the U.S. population.
In normal skin, skin cells live for about 28 days and then are shed from the outermost layer of the skin. With psoriasis, the body's immune system attacks itself, which speeds up the growth cycle of skin cells. Skin cells mature in a matter of 3 to 6 days. The pace is so rapid that the body is unable to shed the dead cells, and patches of raised red skin covered by scaly, white flakes form on the skin.
Psoriasis is a genetic disease (it runs in families), but is not contagious. There is no known cure or method of prevention. Treatment aims to minimize the symptoms and speed healing.
Psoriasis is much more than just a skin disease--it is truly a systemic inflammatory illness, and many skin patients are also affect by a destruction joint disease called psoriatic arthritis. People who have psoriasis are at greater risk for contracting other health problems, such as heart disease, inflammatory bowel disease and diabetes. It has also been linked to a higher incidence of cardiovascular disease, hypertension, cancer, depression, obesity and other immune-related conditions.
Types of Psoriasis
There are five types of psoriasis:
Treatment
Psoriasis is classified as mild to moderate when it covers <1% to 10% of the body and moderate to severe when it covers more than 10% of the body. Location of disease also changes severity, because a patient with palm and sole disease may be disabled as opposed to a patient with lesions on the elbows, knees and buttocks. The severity of the disease impacts the choice of treatments.
Mild to Moderate Psoriasis
Mild to moderate psoriasis can generally be treated using a combination of three key strategies: over-the-counter moisturizers, prescription topical treatments and possibly light therapy/phototherapy.
Over-the-Counter Medications
Prescription Topical Treatments
Prescription topical agents focus on slowing down the growth of skin cells and reducing inflammation.
Light Therapy/Phototherapy
Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:
Moderate to Severe Psoriasis
Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.
Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition. These agents can be very effective, but are serious medications that require monitoring because of potential side effects.
Biologics. A relatively new, exciting class of injectable drugs, biologics are designed to suppress the immune system in a very targeted fashion. These tend to be very expensive and have side effects, so they are generally reserved for the most severe cases or patients who have failed other options.
Light Therapy/Phototherapy. Can be used alone or in combination with some of the above medications such as methotrexate or acitretin.
For more information, please visit the National Psoriasis Foundation's website at