What Are the Causes of Psoriasis and its Symptoms?

Psoriasis is an autoimmune condition, which manifests as a chronic skin problem and typically presents itself in the form of flaky, red patches of skin, sometimes with white scales on top.

Although these patches can occur anywhere on the body, the most common locations are on the back, scalp, knees and elbows. Psoriasis affects men and women equally and most people who get psoriasis flare-ups develop the condition before the age of 35.

The condition is not yet fully understood, but it is widely believed to have a genetic link, meaning those with a family history of the condition are more at risk of getting psoriasis. The severity and development of psoriasis can vary significantly, but many people will psoriasis will experience long term symptoms. With that said, there may be periods where many of those diagnosed with psoriasis notice that their symptoms subside or disappear, only to reappear another time.

The condition is thought to affect somewhere in the region of two percent of the population in the UK.

Here, we're going to take an in depth look at the causes of psoriasis and why psoriasis develops in some people. But first, let's take a look at the symptoms of this often distressing skin condition.

What Are the Common Symptoms of Psoriasis?

Psoriasis is a skin condition that causes red, flaky skin that can become scaly and very dry. The scales can appear silvery or white on white skin and grey on brown and black skin. Those with brown or black skin may also notice that their affected skin becomes purple or darker brown.

Many people with psoriasis also notice that their affected skin becomes itchy and sore and a psoriasis flare up may cause inflammation in the skin.

Over time, and depending on the form of psoriasis, some people may develop very dry, hard skin called psoriasis plaques.

Other, less common, symptoms may include a burning sensation around the patches, pitted nails and sore, painful joints. This is most commonly associated with severe psoriasis, rather than mild to moderate psoriasis.

Common Types of Psoriasis

There are five main types of psoriasis, as outlined below. Plaque psoriasis is by far the most common of these types, accounting for somewhere in the region of 90 percent of all psoriasis cases.

Since there is more than one type of psoriasis, it can be difficult to know what treatments can improve symptoms. Also adding to the confusion is the fact that a small percent of people with psoriasis may also develop another type at the same time, or one type may become another or become worse over time. Although it's most common to have one type of psoriasis at a time.

Plaque Psoriasis

Plaque psoriasis is the most common type of psoriasis and is characterised by raised areas of dry, red skin, called plaques, which often have a white, silver or grey scaly centre.

If left untreated, these plaques may become inflamed with broken skin that may crack and bleed. It can occur anywhere on the body, but most commonly this type of psoriasis occurs on the elbows, knees, lower back and the scalp.

Guttate Psoriasis

Sometimes referred to as 'eruptive psoriasis', a type of psoriasis called guttate causes small patches of red or pink skin, in multiple clusters, often in a 'droplet' shape, covering large parts of the body.

Common areas affected by this type of psoriasis include chest, arms, legs and scalp and is most common in children and teenagers. It can develop as a result of developing a streptococcal throat infection and may develop into plaque psoriasis. However, in most people, it will clear up completely after a few weeks.

Inverse Psoriasis

Inverse or flexural psoriasis is a type of psoriasis which typically presents itself as inflamed but smooth patches of skin, usually situated in skin folds, such as in the groin or navel areas, under the breasts or behind the ears.

It can become worse by sweating and friction, so if you have it, you may have a higher risk of developing psoriasis flare ups in the heat, when exercising or if wearing tight fitting clothing.

Pustular Psoriasis

As the name suggests, this variety appears as patches of pustules, which are filled with pus. It can be localised, meaning it is restricted to a specific part of the body, or generalised, affecting any part of the body.

Pustular psoriasis is a less common type but this type of psoriasis can cover any part of the body.

Erythrodermic Psoriasis

Sometimes known as psoriatic erythroderma, this is the most rare form of psoriasis. It manifests as patches of inflamed skin, which affect the majority of the body and cause severe itching and burning.

Erythrodermic psoriasis can come on suddenly and may cause you to quickly lose water and protein from your body. For this reason, it may cause severe dehydration and malnutrition and for this reason, may require hospital treatment.

What Are the Main Causes of Psoriasis?

The ultimate cause of psoriasis is unclear, and as a result there is no known way to prevent psoriasis happening in the first place. Research suggest that psoriasis is caused by a problem with the immune system, resulting in an abnormal production of skin cells, which causes skin cells to be replaced too quickly.

It is not known exactly why this occurs, but various studies have demonstrated a strong genetic link, indicating that there is a hereditary element. However, while it is likely a genetic disease, the triggering of the condition is associated with environmental factors.

Among the various lifestyle factors believed to contribute towards a person developing psoriasis, or their symptoms worsening, are: stress, smoking, excessive alcohol consumption, obesity and changes in climate or temperature. Indeed, the condition is often worse in the winter months.

A number of medications have also been associated with the onset of psoriasis, with beta blockers, anti-inflammatory drugs and lithium included in this list.

Are There Common Psoriasis Triggers?

Whilst it isn't known what exactly causes psoriasis to develop, there are some common triggers that can lead to flare ups in someone with the condition. As mentioned above, common triggers include unhealthy diet and lifestyle factors such as smoking, drinking too much alcohol and high levels of stress.

Other psoriasis triggers include hormonal triggers such as puberty, periods, pregnancy and the menopause. A cut or other injury to the skin can also lead to a flare up, as can sunburn. Having another immune condition, such as HIV, can also lead to a worsening of your symptoms.

Can a Lack of Vitamin D Cause Psoriasis?

Currently, there is conflicting evidence over the role of vitamin D and psoriasis. It's thought that those with psoriasis might avoid the sun if it's a trigger for them, and therefore they may have lower levels of vitamin D (as it's produced by the body when sunlight hits the skin).

It's advisable to take a daily vitamin D supplement during the winter, and all year round if you avoid exposing your skin to the sun.

Can Stress Cause Psoriasis of the Scalp?

Scalp psoriasis can develop in patches across the scalp or over the entire scalp. In some people, in develops into plaque psoriasis. Scalp psoriasis causes are just as unknown as psoriasis elsewhere on the body, but stress can be a trigger. Therefore, taking steps to reduce stress and get enough good quality sleep can be helpful for managing your scalp skin.

What Are the Best Psoriasis Treatments?

While there is no established cure for psoriasis, a number of treatments have proved to be effective in managing the symptoms. For those with mild cases, a topical treatment may usually suffice and there are a number of creams and ointments available, with coal tar, dithranol and corticosteroids often recommended.

Light exposure or phototherapy is another established way to help improve symptoms and it is often utilised when topical treatment fails to generate the desired results.

In the most severe cases, it may be necessary to combine topical treatments and/or light exposure with more comprehensive methods, such as oral medication or injections to help manage the symptoms and causes. Often, these more systematic treatments work by suppressing the immune system.

What Are the Early Symptoms of Psoriasis?

Psoriasis is a chronic skin condition that can affect anyone at any age, but many people's psoriasis symptoms start between the ages of 20 and 30 years old.

Also, psoriasis runs in families so if a close family member has the condition, then you're more likely to get psoriasis also. So it can be helpful to learn about the the management and treatment of psoriasis so that you're fully aware of the early signs.

It's important to remember that psoriasis isn't contagious - you can't get it from touching someone with it or by sharing towels or anything else at home. However, if you are having a flare up, particularly one with sore, broken skin, you may want to avoid sharing towels until your skin is back under control, for simple hygiene reasons.

Is There a Cure for Psoriasis?

Unfortunately, as yet, there is no know way to completely treat psoriasis so that it disappears forever. Instead, creams and other skin treatment can help to manage the symptoms and signs of psoriasis.

How to Diagnose Psoriasis

In most instances, psoriasis is diagnosed and treated by a GP, without blood tests or skin biopsies. However, where there is doubt about how to treat the condition, or if the psoriasis does not respond to first-line treatments, patients may be referred to a dermatologist.

Due to the fact that psoriasis is a chronic condition, long term treatment is necessary and patients should establish a continuous care plan with their doctor following a psoriasis diagnosis.

Management and Treatment: Living with Psoriasis Symptoms

Those living with psoriasis can have drastically different experiences, depending on the severity of the disease and the extent of the symptoms, ranging from mild irritation, to extreme discomfort.

Nevertheless, there are certain steps that all sufferers should take. Firstly, it is important that those with the condition consult regularly with a medical professional, follow the treatment plan provided, and review that plan when necessary.

In terms of self-treatment, topical creams and ointments can help to reduce symptoms and alleviate discomfort, while it is important to maintain good levels of personal hygiene.

Scientists have established a link between stress and the onset or worsening of psoriasis, so regular exercise, mindfulness techniques and general stress management can be highly effective. All treatments should be continuous, rather than in response to flare ups.