How to deal with psoriasis

Psoriasis is one of the most common skin autoimmune ailments in the world. It’s incurable, but it need not be a life sentence.

There is no known cure for the irritating and debilitating condition, but there are various ways to alleviate its symptoms.

What is psoriasis?

Up to 1.6 million Australians suffer from psoriasis.

Psoriasis is a long-term, non-communicable immune disease that appears on the surface of the skin as raised, red, scaly patches.

“A person with psoriasis has an overactive immune system and the condition is associated with a number of other commodities such as heart disease, Crohn’s disease, diabetes, high blood pressure, obesity and mental health problems,” says Psoriasis Australia chief executive Murray Turner.

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

“We don’t really know how psoriasis is contracted; all we know is that the immune system and genetics are involved,” says Murray.

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

The 5 types of psoriasis

Plaque psoriasis

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

“It can be very painful and itchy with patches often cracking and bleeding,” says Murray.

Guttate psoriasis

“It appears as small dot-like lesions and is the second most common form of psoriasis. It often first starts at a young age,” says Murray.

The condition is often triggered by a bacterial infection such as strep throat.

Inverse psoriasis

Otherwise known as intertriginous psoriasis, it’s one of the most painful forms of psoriasis.

“This type of psoriasis shows up as very shiny red lesions on the body. Many people with inverse psoriasis will also have another form of psoriasis somewhere else on the body,” Murray says. 

Pustular psoriasis

Caused by plaque build-up, pustular psoriasis is believed to be hereditary since it often runs in families.

Commonly appearing on the hands and feet, and accompanied by red, inflamed skin, the bumps often become pustules.

“White pustules usually appear, surrounded by red skin. The pus is white skin cells that aren’t contagious,” says Murray.

Erythrodermic psoriasis

Erythrodermic psoriasis is deemed one of the rarest and most serious forms of the condition due to the complexity and severity of its symptoms.

“It occurs in approximately 3 per cent of people with psoriasis, however can be very painful and itchy and may cause large portions of skin to come off in sheets,” says Murray.

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,” he says. “Everybody reacts to treatment differently.”

Treatments available in Australia are categorised into three forms:

Topical treatments

Usually lotions and emollients that are applied to the skin. Depending on the severity of the psoriasis, most patients will be prescribed one of these to see if their psoriasis can be controlled.

Ultra-violet photo-therapy/photo-chemotherapy

Patients are exposed to controlled ultraviolet B (UVB) light for a specific period of time. The light penetrates the skin and slows the growth of affected skin cells.

Systemic and biologic treatments

Taken orally or by injections, systemic treatments work throughout the body. They are usually given to patients with moderate to severe psoriasis.

Biologic treatments are developed from a living cell cultured in a laboratory. This type of treatment is used for patients who have not reacted to the other forms of treatment. Biologics target specific parts of the immune system, and are only prescribed according to strict Health Department rules.

Other ways to treat psoriasis

As well as prescribed treatments, patients can try:

  • Using a daily moisturiser to help skin hydration.
  • Lifestyle improvements, such as quitting smoking, improving their diet and reducing alcohol intake.
  • Regular exercise.

Joining a patient support group can also be beneficial to deal with psoriasis.

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

Wondering about other skin conditions? Read our guides on how to treat rosacea, how to care for eczema-prone skin and what to do about adult acne.

Written by Charlotte Brundrett.