Psoriasis – one condition, many treatments

Getting the right treatment

Once you develop psoriasis, it may well come and go for the rest of your life. However, if you use a medication specifically prescribed for your psoriasis, in the correct way, it is possible to control your condition and focus on feeling confident and getting the most out of your life.

Another big question is to what extent the condition will affect you, and this is more or less impossible to answer. Your psoriasis experience could be only the mildest symptoms with the occasional patches and itching, or more severe physical symptoms. Wherever you are on this spectrum, the important thing is to take control and stay positive.

What exactly is psoriasis?

Psoriasis is a chronic disease that appears on the skin. It occurs when the immune system sends out faulty signals that make new skin cells grow too quickly. With psoriasis, the normal cycle of skin cells, which usually takes about a month, is sped up to a cycle that is completed in just a matter of a few days. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and ‘plaques’ form. The two characteristic features of psoriasis are: excessive skin cell growth and inflammation.

There are seven types of psoriasis. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white build-up of dead skin cells. Psoriasis can occur on any part of the body and may, in some cases, be associated with other serious health conditions, such as diabetes, heart disease and depression.

Each person’s experience of psoriasis will be different. Some people will experience only the mildest physical symptoms, with occasional patches and itching, while for others the physical symptoms can be much more severe. Similarly the emotional impact affects people differently.

How many people are affected?

Anyone can develop psoriasis. It is equally common in men and women, and affects about 2-3% of the global population, which is around 100 million people.

Psoriasis can start at any age, but most people develop psoriasis in their twenties. There is a peak during late teens or early twenties and a second peak when people reach their fifties.

What causes psoriasis?

The exact cause of psoriasis is still unknown. It is a complex condition with multiple potential causes, which may be genetic, immunological, environmental and psychological. These factors alter how skin cells function, speeding up the rate at which skin cells are produced and shed.

Psoriasis is not contagious. Nobody gave it to you and you cannot pass it on by touch, swimming or even intimate contact.

Common forms of treatment include:

  • Non-prescription (over-the-counter) topical treatments that are applied directly to the skin. These include: moisturisers (or emollients), keratolytics (such as salicylic acid) and coal tar shampoos and topical solutions.
  • Prescription topical treatments which are applied directly to the skin and require a prescription from a doctor. These include: topical steroids, vitamin D3 analogues, combination products and topical retinoids.
  • Systemic treatments which are not applied directly on the skin, but administered in other ways, such as tablets or injections. These include different types of biologics, traditional non-biologic systemic therapies and oral retinoids.
  • Prescription phototherapy which includes a number of treatments that involve controlled exposure to ultraviolet (UV) light.
To find the best treatment to suit your particular psoriasis, it’s important to have regular discussions with your doctor. Once they have a clear picture of your preferences and lifestyle, they will be able to create a treatment plan that works for you. They will also be able to help you overcome any issues with the treatment, to keep you on track.

Coping with psoriasis

Everyone copes with psoriasis differently and the choice of therapy should be based on conversations between you and your doctor. 

A treatment which works well for one person may not work for another. And in some cases, a treatment that has previously worked well for someone may not be the right choice for them in the future. 

So work with your doctor to find the right treatment for you.

UK/IE 2013b/00072, Date of prep: April 2015

Psoriasis on different body areas

The symptoms of psoriasis can vary depending on which part of the body is affected.

Discuss your psoriasis with your doctor, who will be able to prescribe an appropriate treatment and help you manage the condition.

Learn more by selecting a body area
Face i
Hands & nails i
Legs & feet i
Scalp i
Skin folds i

How to care for psoriasis on the face

Manage psoriasis on the face with some simple techniques

Facial psoriasis most often affects the eyebrows, the skin between the nose and upper lip, the upper forehead and the hairline. It's important to discuss with your doctor which treatments or products are suitable for use on delicate areas such as the face.

What can I do?

In addition to treatments advised by your doctor for psoriasis on the face, there are a number of simple techniques and preventative measures that can help you manage the condition.

Try to use skin care products that have been specifically formulated for sensitive skin. Use an electric razor to shave – it's less harsh on the skin than a manual razor. Also try to get into the habit of patting rather than rubbing when you dry your skin. Once dry, use a moisturising cream to keep the skin rehydrated.

Caring for your skin all year round

The skin on your face is delicate. When you have facial psoriasis it is much more sensitive to the weather than usual and adapts to changes of temperature less easily. Wind and rain in autumn and winter can dry out the skin , so apply a protective cream to your face before going out and wear a hood or scarf.

Always try to use non-irritating and gentle skin care products that have been specifically formulated for sensitive skin.

Heat and sunlight in spring and summer can also increase inflammation, so avoid direct exposure to sunlight in very sunny weather to prevent burning. Use a suitable protective cream, preferably a total sunblock for the face, especially during a flare-up.


Remember that apart from during a flare-up, moderate amounts of exposure to the sun may actually help to clear plaques.

UK/IE 2013b/00072, Date of prep: April 2015

Hand & Nail Psoriasis – What to expect.

https://psoriasis.qualitycarebyleo.co.uk/myqualitycare/articles/understanding-psoriasis/hand-and-nail-psoriasis-what-to-expect

Common symptoms and precautionary measures

Psoriasis on your hands and nails can make daily activities or delicate tasks difficult to carry out.

Hand and nail psoriasis can be difficult to cope with. The plaques are often more visible than those on the body or scalp, and hands are very important in interpersonal relationships like shaking hands in social and professional situations.

Common symptoms of hand and nail psoriasis

A flare-up of psoriasis on the palm of the hand is often accompanied by cracking, blisters and swelling.

In around half of cases, psoriasis on the hands affects the nails.
  • Holes in the nails – also called pitting – is the most common characteristic.
  • Nails may become white and thick. As a result of dryness, lines can also appear running across the nail.
  • When the cuticles are affected they can no longer act as a protective barrier.
  • Inflammation can also spread under the nails.

In around half of cases, psoriasis on the hands affects the nails.

Treatment options and precautions

You should talk to your doctor about hand and nail psoriasis and the current treatment options. You can also ask for help with management strategies and simple precautions that you can take.

Some ways to prevent psoriasis from flaring up and affecting the hands and nails include avoiding movements that cause repeated friction to the hands and keeping nails trimmed and as short as possible. Long and loose nails can continue to be injured as they catch and rub against surfaces. 

It is also important to protect nails from damage because any injury or trauma can often trigger or make nail psoriasis worse. Wearing gloves, if possible, while you are using your hands during activity that is likely to damage your nails is the simplest way to help prevent this.

UK/IE 2013b/00072, Date of prep: April 2015

Psoriasis on the legs and feet. How to get control

https://psoriasis.qualitycarebyleo.co.uk/myqualitycare/articles/understanding-psoriasis/psoriasis-on-the-legs-and-feet-how-to-get-control

Common symptoms and precautionary measures

Psoriasis on the legs

If you have psoriasis on the legs, often the skin on your shins and knees can be very itchy. You may find that your ankles can also swell at the end of the day because of poor circulation. Keeping your legs as moisturised as possible and bending your knees from time to time when standing, or elevating your feet when sitting or lying down, can really help reduce swelling and any itchiness.

High temperatures or prolonged periods of standing can cause the veins in your leg to swell, putting more strain on the skin.

Psoriasis on the feet

Certain types of psoriasis can also affect different parts of the foot. When your skin on the toes and heels is inflamed, it can crack, blister and become swollen and painful.

Keeping your feet as clean and fresh as possible is key when trying to manage psoriasis on your feet. Footwear should be light and comfortable and, where possible, you may want to choose shoes that will keep your feet cool and dry and allow the air to circulate freely. You could also try foam, cork or water-filled insoles or use insoles made from polymers which act as shock-absorbers and may protect healing skin.

In winter, feet should be kept warm, particularly if you have poor circulation in the legs and in warmer weather, using a daily footbath may be helpful.

UK/IE 2013b/00072, Date of prep: April 2015

Hair care for scalp psoriasis

How to cope with scalp psoriasis

Symptoms and how to cope with psoriasis on the scalp

As well as the scalp itself, scalp psoriasis can also affect the ears, the area above and behind the ears, the earlobes, the nape of the neck, the forehead and the hairline.

Hair care and psoriasis

It's important to treat your scalp very gently if psoriasis is present. Wash and dry your hair gently. If you use a hair dryer you should use the cool or very low heat setting and hold it at least 30 cm. from your head.

Remember to thoroughly dry behind your ears and on both sides of the earlobes.
Any brushing or combing of the scalp should be done particularly gently to avoid aggravating the existing psoriasis symptoms. Use a hairbrush with natural bristles rather than a hard plastic brush, and avoid using rollers and curlers which can pull the hair and dry the scalp.

Use a hairbrush with natural bristles rather than a plastic brush, and avoid using rollers and curlers which can pull the hair and dry the scalp.

Consider your hairstyle

You may also want to consider what kind of hairstyle is practical. A short haircut could be more comfortable and practical if you have severe psoriasis on your scalp.

Whatever hair style you choose, it may also be best to avoid styles that place tension on the hair, such as back combing or putting it up too tightly. If you are suffering from a flare-up on the scalp, you may want to put off perming or dying your hair until it has healed. Don't be embarrassed about telling your hairdresser about your psoriasis and ask them to treat your scalp gently.

You can always talk to your doctor or healthcare professional

As always, your healthcare professional is the best person to advise you on how to care for your scalp and the different treatment options for the condition. They can also help you with any general concerns about using hair styling products while you are using a treatment, so do make sure you involve them in any decisions you make regarding your psoriasis.

UK/IE 2013b/00072, Date of prep: April 2015

How to manage psoriasis in your skin folds

Common symptoms and how to manage psoriasis in skin folds

The skin in skin folds such as the armpits and under the breasts is more delicate and thinner than in other areas. Rubbing and sweating can be a cause of frequent psoriasis irritation.

It can get hot and damp where the skin has less contact with the air. This increases the likelihood of yeast and fungal infections, especially in areas where you sweat more, such as the armpits, under the breasts, and in the groin and crotch area.

As often as possible, try to wear loose, comfortable clothing. The best materials are cotton or poly-cotton mixes.

Taking precautionary measures

To help manage the condition, try to keep skin folds as dry as possible even after the psoriasis has cleared. You should also take care to wash the gently and dry it carefully afterwards. If necessary, you can use tissues to make sure smaller folds are completely dry.

Try to wear loose, comfortable clothing. The best materials are cotton or poly-cotton mixes. Women may also want to avoid wearing under-wired bras as these can increase perspiration.

Keep dry and comfortable

For psoriasis in the groin and crotch area – around the genitals and anus and between the buttocks – it can be a good idea to have an additional daily wash in warm summer weather. Afterwards, remember to dry your groin and buttock creases thoroughly.

You should wear comfortable cotton underwear. If possible, avoid tight jeans and trousers. It is best not to wear synthetic materials next to the skin as they cause sweating. For men, boxer shorts are better than briefs as they allow air to circulate.

UK/IE 2013b/00072, Date of prep: April 2015