What to do if you have psoriasis? | Dr Anastasia Therianou MD, PhD

What to do if you have psoriasis?

8 Sep 2020

Psoriasis, or tickle, is a common chronic skin disease affecting around 2% of people in the UK. It is rarely serious, but the itchiness and rawness that often accompany psoriasis flare-ups can be hard to live with, as well as its red and flaky appearance. So if you suffer from it, here are the things you need to know.

What is psoriasis?

A skin disease that occurs equally in men and women, psoriasis is an autoimmune condition that causes the overproduction of skin, resulting in red and scaly skin and irritation. It can start at any age, but most often develops in adults under 35 years old, affecting men and women equally. Tickle occurs cyclically, with flare-ups followed by periods of ‘remission’. It can look alarming, but it’s not contagious.

Psoriasis types

There are five different types of this disease. The most common type is plaque psoriasis, which causes red, inflamed patches on the skin which are often covered with skin plaques. Guttate psoriasis is common in childhood and causes small pink spots. Pustular psoriasis, more common in adults, causes white, pus-filled blisters and red inflamed skin. Inverse psoriasis causes bright areas of red, shiny, inflamed skin.

Severe tickle

The fifth type is erythrodermic psoriasis and it is both severe and very rare. Often covering large sections of the body, your skin appears sunburned and scales can slough off in large sections. Sufferers may experience fever or become very ill. As this type is life-threatening it’s important to see your GP.

Common symptoms

While it is rarely serious, psoriasis skin can be itchy and uncomfortable and feel like it’s crawling and prickling. In some cases, it is even painful. Where tickle affects hands and feet, you may have rawness with painful cracks that can bleed, affecting walking and use of your hands. Nail psoriasis can be painful if it causes your nail to lift away from the nail bed, and psoriatic arthritis causes pain and swelling in joints.

Causes and triggers

If a family member is or has been affected by tickle you are more likely to suffer from it. Flare-ups can be triggered by a variety of factors including stress, alcohol, skin damage, infections, and even intense sunlight. Some medications, including lithium, beta-blockers, high blood pressure medication, and some malaria treatments can also trigger flare-ups.

Where does psoriasis appear?

Chronic plaque psoriasis, the most common type, tends to appear on knees, between buttocks, on elbows, on the trunk, on the scalp, and behind the ears but may appear in other places on your body like palms and soles of the feet. Guttate psoriasis and pustular psoriasis both appear on the trunk and arms and legs.

Nail psoriasis

Around half of the people who have psoriasis also get a nail psoriasis. This can include salmon pink discoloration under the nail, pitting and ridging of your nail’s surface, and thickening and yellowing of the nails. It can also involve separation of the nail plate from your nail bed and even complete destruction of the nail.

Conditions related to psoriasis

There are a number of serious conditions related to tickle which make tackling the triggering factors important. Moderate to severe tickle increases the risk of heart disease and stroke and the disease can also be associated with diabetes, obesity, venous thromboembolism, high cholesterol, and high blood pressure, as well as inflammatory bowel disease.

What you can do

Once diagnosed by your GP, making certain lifestyle changes will help you to manage your symptoms. Staying a healthy weight, following a balanced diet, and exercising regularly are recommended. If you smoke, now is the time to stop and to avoid excessive alcohol. Find ways to reduce stress and anxiety and discuss any medication that may be having an impact on the condition with your dermatologist.


There is no cure for tickle but it can usually be treated and managed very well. In most cases, topical treatments (applied to the surface of the skin) are enough to manage the condition. In more severe cases, phototherapy using ultraviolet light, tablets, or injections are required. There is also evidence that acupuncture can help in some cases.

If psoriasis is becoming a problem for you and you would like to discuss treatment options, arrange to see a dermatologist.

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