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Learn the three levels of psoriasis, as well as the five different types, which each include their own symptoms, causes, and triggers.
Psoriasis is a condition in which the skin cells build up and form scales and itchy, red, dry patches commonly on the scalp, elbows, knees, face, palms, and trunk. It is an autoimmune condition, in which your immune system—which normally attacks infectious germs—begins to attack healthy cells and, thus, causes skin lesions seen in psoriasis.
The skin cells in psoriasis multiply up to 10 times faster than normal. This makes the skin build up into bumpy red patches covered with white or silvery scales. Additionally, psoriasis can be passed down through families and can occur about equally in men and women.
Depending on the extent of skin involvement, psoriasis may be classified into the following:
- Mild psoriasis: When less than three percent of the body surface area is affected by lesions
- Moderate psoriasis: When 3 to 10 percent of your body surface area is affected
- Severe psoriasis: When more than 10 percent of your body surface area is affected
5 types of psoriasis
A few types of psoriasis exist, and knowing which type one has can assist the doctor with diagnosis and coming up with a treatment plan. Generally, people often have just one type of psoriasis at a time, and each type has its own set of signs and symptoms.
The five types of psoriasis include:
- Plaque psoriasis: Also known as “psoriasis vulgaris,” it is the most common type of psoriasis. Symptoms include raised, inflamed, discolored lesions that are covered with shiny white scales. Itchy and painful plaques can break and bleed at times and commonly affect the scalp, knees, elbows, back, hands, and feet.
- Guttate psoriasis: Often beginning in childhood or young adulthood, guttate psoriasis is the second most common type of psoriasis and records for about 30 percent of all instances of psoriasis. This type causes small, pink-red individual spots on the skin that appear on the trunk, upper arms, thighs, or scalp. Triggers for guttate psoriasis include upper respiratory infections, streptococcal infections, tonsillitis, stress, and injury to the skin.
- Inverse psoriasis: Otherwise called “intertriginous psoriasis,” it causes red or discolored lesions in skin folds of the body that might appear smooth and shiny. Symptoms include patches of skin that are red, smooth, and shiny but don't have scales. This type of psoriasis worsens with sweating and rubbing and is normally seen in the armpits, crotch region, under breasts, or other skin folds such as those around the genitals and buttocks. Common triggers for inverse psoriasis include friction, sweating, and fungal infections.
- Pustular psoriasis: This type of psoriasis is uncommon and predominantly appears in adults. Pustular psoriasis will, in general, have a cycle where the formation of pustules and scaling follows the discoloration of the skin. It causes pus-filled bumps (pustules) or blisters surrounded by inflamed red skin. It can affect specific parts of the body such as the hands and feet or can be present more generally over the body. Thus, although this type of psoriasis looks frightening, it is not contagious and isn't infectious. Getting an excess of ultraviolet light without the use of sunscreen, pregnancy, infection, stress, and exposure to certain chemicals are some of the common triggers of pustular psoriasis.
- Erythrodermic psoriasis: This is a severe and rare type of psoriasis that disrupts the skin barrier. This disruption might cause protein and fluid loss and increased risk of infections that can lead to severe complications such as pneumonia and congestive heart failure. Edema, or swelling due to fluid retention, may likewise occur, particularly around the lower legs. The body may experience issues regulating its temperature, which can cause shivering. Erythrodermic psoriasis causes severe, fiery skin that looks as if it is burned. Severe itching, burning, or peeling of the skin; a faster heart rate, and changes in internal body temperature are some other notable symptoms. Triggers include sudden stop in systematic psoriasis treatment; an allergic drug reaction; severe sunburn; infections; medications such as lithium, antimalarial medications, and cortisone or coal tar products.
2 complications of psoriasis
Two complications of psoriasis include:
- Psoriatic arthritis: Around 20 to 30 percent of individuals with psoriasis have joint inflammation with symptoms of arthritis. Altogether, this is known as psoriatic arthritis. Symptoms include painful, stiff joints that worsen in the mornings and after rest, swelling of the fingers and toes, and warm joints.
- Nail psoriasis: About 50 percent of people with psoriasis have nail changes. Nail psoriasis is common in individuals with psoriatic arthritis that affects the joints. Symptoms include pitting of nails, tender and painful nails, separation of the nail from the bed, and discoloration (yellow-brown).
Causes and triggers of psoriasis
Although the cause of psoriasis is unknown, researchers believe it's a combination of things.
- Psoriasis is an autoimmune disorder, in which specific triggers can prompt the individual's genes, instructing the immune system to target wrong cells as if they are fighting an infection or healing an injury that results in the rapid production of skin cells.
- Psoriasis will in general run in families, yet it could skip generations.
How to diagnose psoriasis
There aren't any specific tests that help doctors diagnose psoriasis. Commonly, a dermatologist will inspect your skin and talk about your family history.
Because the appearance of symptoms might vary depending on the severity of the condition and type of psoriasis the individual has, the specialist will diagnose the condition by performing a physical examination and assessing rashes and lesions.
The doctor could likewise perform a skin biopsy to exclude other conditions such as eczema (dermatitis).
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Duration of psoriasis
Psoriasis is a chronic, long-lasting condition. As of now, there isn't a cure, and over time, this skin disease can worsen or improve. In some cases, psoriasis can clear up for months or even years at a time and is known as “remission.”
Other people may experience psoriasis flare-ups in recurrent patterns. For example, the disease might improve in summers and worsen in winters.
3 ways to treat psoriasis
Treatment relies on the type and severity of the condition, but may include:
- Medications:
- Moisturizers for dry skin
- Coal tar (a common treatment of scalp psoriasis available in lotions, creams, foams, shampoos, and bath solutions)
- Vitamin D–based cream or ointment
- Retinoid creams
- Hydrocortisone creams (reduce inflammation and soothe itching)
- Salicylic acid (helps reduce swelling and remove scales, often in people with scalp psoriasis)
- Anti-itch agents (include products that contain calamine, hydrocortisone, camphor, or menthol)
- Phototherapy: Phototherapy includes routinely exposing the skin to specific lights under clinical supervision. The light can help slow cell growth, suppress immune activity, and reduce irritation.
- Biologics: These are protein-based drugs derived from living cells. Biologics target the immune cells that cause psoriasis and psoriatic arthritis.
Some of the biologics approved by the U.S. Food and Drug Administration include etanercept, infliximab, and adalimumab.
Home prevention remedies
It is not possible to cure psoriasis; however, an individual might have the option to reduce their risk by avoiding and managing certain factors.
A few techniques include:
- Reducing stress with yoga, exercise, and meditation
- Eating a balanced diet
- Recognizing and avoiding food triggers
- Not smoking or drinking alcohol in excess
- Prioritizing lean protein sources such as chicken breast
- Eating fish rich in omega-3 fatty acids
- Reducing gluten intake if a person has a gluten allergy
A person may likewise have the option to use effective home remedies to reduce symptoms such as itching by keeping the skin moisturized and staying away from hot, prolonged showers.