Face and Body

Sweet relief: How to deal with psoriasis

4 May, 2019 . 0

Managing itchy, red, scaly skin can be a real challenge. Here are five types of psoriasis and some treatments to try.

More than 1.6 million Australians suffer from psoriasis.

While there is no known cure for the irritating and debilitating skin condition, there are various ways to treat it that can bring relief.

What is psoriasis?

Psoriasis is a long-term, autoimmune condition that appears on the surface of the skin as raised, red, scaly patches.

It is not contagious.

Psoriasis Australia chief executive Murray Turner says the condition is often associated with an overactive immune system and other illnesses such as heart disease, Crohn’s disease, diabetes, high blood pressure, obesity and mental health problems.

Flare-ups – when psoriasis becomes particularly prominent and itchy – can be triggered by various factors depending on what type of psoriasis you have.

“We don’t really know how psoriasis is contracted,” Murray says.

“All we know is that the immune system and genetics are involved.

“We also know that something triggers the psoriasis, such as stress, trauma to the skin, infection, medication and possibly diet, allergies and weather.”

Plaque psoriasis

Affecting up to 80 per cent of psoriasis sufferers, plaque psoriasis is by far the most common variation of the condition.

Skincare and cosmetic care specialist Dr Tanya Unni says signs include itchiness, redness, discomfort and raised, inflamed patches of skin covered with silvery-white scales.

“In severe cases, the skin may even crack or bleed,” Dr Unni notes.

Guttate psoriasis

Guttate psoriasis is the second most common form of psoriasis and appears as small, dot-like lesions.

“It often first starts at a young age,” Murray notes.

Dr Unni says it is often triggered by a bacterial infection, such as an upper respiratory tract infection like strep throat.

She adds the lesions are usually found on the arms, legs, trunk and scalp.

“Unlike plaque psoriasis, they are typically not as thick or raised.”

Inverse psoriasis

Also known as intertriginous psoriasis, these smooth and shiny lesions appear on skin folds and creases, such as the armpits, groin and beneath the breasts, due to friction and sweat, Dr Unni says.

“On darker skin tones, inverse psoriasis presents as purplish, brown or darker lesions within body folds,” she explains.

“On Caucasian skin, it displays as bright-red lesions in the same areas.

“Many people with inverse psoriasis are commonly found to have another type of psoriasis elsewhere on the body at the same time.”

Pustular psoriasis

Pustular psoriasis is a rare condition that is believed to be hereditary, can break out within hours, and may affect areas including the palms, fingers, toes and soles.

Dr Unni says it often marked by raised pustules filled with non-infectious pus, which can be surrounded by red and inflamed skin.

“This may cause tenderness, itching and sometimes pain.

“Systemic symptoms such as fever and chills may accompany severe cases, necessitating urgent medical attention for proper diagnosis and treatment.”

Erythrodermic psoriasis

Erythrodermic psoriasis is one of the rarest and most serious forms of psoriasis.

It can cover most of the body in a red, itchy, burning, scaly rash and be fatal.

“The skin becomes intensely painful (and) itchy and sheds in large, scaly sheets, making it prone to infection,” Dr Unni says.

“(It) can be accompanied by fever and an increased heart rate, requiring immediate medical attention.

“Early intervention is crucial for better outcomes and improved quality of life.”

How is psoriasis treated?

Treatment depends on the type of psoriasis you have.

“Everything from topical ointments to steroid creams, anti-inflammatories and antibiotics can be used as treatment options,” Murray says.

“Everybody reacts to treatment differently.”

Here are some treatments for psoriasis:

Topical treatments

Most patients will be prescribed a topical treatment (a medication that is applied to the skin) to see if their psoriasis can be controlled.

“For mild cases, topical treatments like steroids, vitamin D preparations, coal tar preparations, salicylic acid and tazarotene are often used to alleviate symptoms and manage the condition,” Dr Unni says.

Light therapy

Light therapy, or phototherapy, is generally used for more severe cases of psoriasis.

Patients are exposed to controlled doses of ultraviolet light to slow down rapid skin cell turnover, Dr Unni explains.

This may help reduce inflammation but can also cause some side effects, such as dry skin and cold sores.

Systemic and biologic treatments

Systemic treatments can include prescription drugs, while biologic treatments are typically injected.

“In some cases, systemic treatments and biologic agents are prescribed to target the underlying immune system dysfunction and modify the disease process,” Dr Unni says.

“These therapies are particularly effective for managing psoriasis that affects larger areas of the body or fails to respond to other treatments.”

Other ways to treat psoriasis

As well as prescribed treatments, you could try:

Using moisturiser to help hydrate your skin.
Improving your lifestyle by quitting smoking, eating healthily and cutting back alcohol.
Exercising regularly.

Joining a patient support group can also be beneficial for those with psoriasis to improve their wellbeing, Dr Unni says.

If you think you might have psoriasis, see your doctor, who may refer you to a dermatologist or rheumatologist.

For more on skin conditions:

Written by Charlotte Brundrett. Updated by Melissa Hong, August 2023.