Understanding Psoriasis: More Than Skin Deep
Did you know that psoriasis affects around 1 in 50 people? It’s more than just a skin condition—it can have a significant impact on confidence, relationships, and overall health.
I’m Dr. Finbar, a GP with a special interest in dermatology, and in this blog, I’ll explain what psoriasis is, what causes it, how it affects the body and mind, and what treatments are available.
What Is Psoriasis?
Psoriasis is a long-term (chronic) skin condition driven by inflammation. It causes patches of thickened, scaly skin known as plaques.
These plaques can appear anywhere but are most common on the elbows, knees, scalp, ears, face, hands, feet, and genitals. It can range from mild and symptom-free to itchy, painful, and widespread.
Psoriasis can affect anyone, but it tends to appear in two age groups: late teens to early 30s, and again between ages 50–60. It affects men and women equally.
It’s important to know that psoriasis is not contagious, but it does carry a stigma. Many people feel self-conscious and may avoid activities like swimming or wearing short sleeves, which can take a real toll on wellbeing.
What Causes Psoriasis?
In healthy skin, cells mature and rise to the surface over 3–6 weeks, shedding invisibly. In psoriasis, this process speeds up drastically—taking only 4–7 days. The result? Immature cells build up on the surface, creating red, scaly plaques.
This accelerated cell turnover starts in the immune system. Certain immune cells (T cells) become overactive and release inflammatory chemicals, mistakenly treating the skin as if it were injured or infected.
Common triggers include:
Infections (like strep throat)
Skin injuries
Hormonal changes
Certain medications (e.g. beta-blockers, lithium)
Stress—this is a major factor in flare-ups in my experience
The Hidden Impact of Psoriasis
Psoriasis isn’t just skin deep. Up to 1 in 4 people with psoriasis may develop psoriatic arthritis—a painful, inflammatory joint condition. It often affects the hands, feet, knees, back, and neck, with morning stiffness being a key symptom.
Psoriasis is also linked to a higher risk of heart disease, stroke, and high blood pressure. We don’t yet know exactly why, but ongoing inflammation likely plays a role. That’s why I advise all my patients with psoriasis to prioritise their cardiovascular health.
Why Did I Get Psoriasis?
The two main contributors are:
Genetics: Psoriasis often runs in families. If one parent is affected, there’s a 15% chance a child will develop it. If both parents have psoriasis, the risk rises to 75%.
Immune System: Psoriasis is an immune-mediated condition, so managing your immune health through lifestyle becomes key—good sleep, nutrition, and stress management are essential tools I discuss with my patients.
Types of Psoriasis
There are several different types of psoriasis, each with unique features. I’ll be sharing shorter videos and articles about each type soon, so you can find the one that best applies to you.
How Is Psoriasis Diagnosed?
Diagnosis is usually clinical—based on how the rash looks and where it appears. Sometimes it can resemble eczema or other conditions. In such cases, dermoscopy or even a skin biopsy may be used to confirm the diagnosis.
Treatment Options for Psoriasis
While there is no permanent cure for psoriasis, there are many effective treatments. Management is tailored to your symptoms and may involve a combination of the following:
1. Lifestyle Modifications
Wear loose clothing to reduce skin friction.
Check heart health: blood pressure, cholesterol, and glucose.
Improve your diet: reduce ultra-processed and sugary foods; increase omega-3 from fish and extra virgin olive oil.
Supplement vitamin D—10mcg daily during autumn/winter.
Exercise regularly, ideally combining aerobic and resistance training.
Avoid smoking and reduce alcohol intake.
Manage stress: consider CBT, mindfulness, or online support resources like PAPAA’s free CBT programme.
2. Topical Treatments
These include:
Emollients: hydrate skin and soften plaques.
Steroids: reduce inflammation (potency depends on area).
Vitamin D analogues (e.g. calcipotriol): slow skin growth.
Calcineurin inhibitors: suitable for face/folds.
Salicylic acid: reduces scaling, often used with steroids.
Coal tar: helps with scaling (messy but effective—Exorex is a gentler option).
Dithranol: used for stubborn plaques; rarely used now.
3. Phototherapy
Controlled exposure to UV light, mostly UVB, can be effective in moderate to severe cases. This is usually delivered in hospital settings. While helpful, it carries a small risk of increasing skin cancer, so it’s carefully supervised.
4. Systemic Treatments
For more severe psoriasis or psoriatic arthritis:
Oral medications like methotrexate or ciclosporin reduce immune activity.
Biologic therapies (e.g. etanercept, adalimumab) target specific immune pathways. These are usually prescribed by dermatologists and may require blood tests and close monitoring.
How Will Psoriasis Affect Me?
Psoriasis affects everyone differently. The severity doesn’t always reflect the emotional burden, so it’s important to speak openly about how it’s impacting your life. Support is available, and treatments can make a real difference.
Sign up for our free psoriasis lifestyle checklist
UK Support & Resources
Here are some helpful organisations:
You can also join their online forums to share your story and learn from others.
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