Psoriasis Symptoms
Psoriasis is a chronic immune system disease that makes your skin cells multiply too fast. The signs and symptoms of psoriasis can vary, depending on the type of psoriasis you have.
Common psoriasis symptoms
The most common type of psoriasis is called plaque psoriasis, and the most common psoriasis symptoms are:
Skin rashes or patches. These may start as small bumps and turn into larger patches that are red, dark pink, or purple and covered in loose, silver, white, or gray-colored scales. These scaly areas are called plaques. In severe cases, the plaques grow and merge into one another, covering large areas. You are most likely to find them on your scalp, elbows, knees, or lower back.
Itchy, painful skin. The inflamed skin may crack or bleed, especially if you scratch it. That can lead to infection and, in severe cases, cause severe pain, swelling, and fever.
Problems with your fingernails and toenails. They might change color and get pits. The nails may also begin to crumble or detach from the nail bed. About half of people with plaque psoriasis have nail trouble.
Psoriasis also can come with psoriatic arthritis, which causes achy, swollen joints. Between 10% and 30% of people with psoriasis also have this painful joint condition.
Less common psoriasis symptoms
Small red dots. You're most likely to see these on the arms, legs, or torso, in children or young adults with a type called guttate psoriasis. It's commonly triggered by strep throat.
Pus-filled bumps. A type called pustular psoriasis can cause these bumps on just your hands and feet or, less commonly, all over your body. It's often caused by medications, infections, stress, or chemical exposure.
Smooth red patches in skin folds. These patches in the groin, armpits, or beneath the breasts could be a type called inverse psoriasis.
Red scaly skin over most of the body. This could be a sign of a rare, severe form called erythrodermic psoriasis, triggered by sunburn or medication.
Psoriasis vs. eczema
Psoriasis and eczema are separate skin conditions. But, because they can both cause skin rashes and itching, they can be easy to mix up. Some ways to tell the difference:
Appearance. Eczema rashes are usually red, dry, areas, with fine scales and no clear borders. Psoriasis plaques have clear edges and built-up scales.
Location. Eczema rashes often appear in skin folds and creases, like the crook of the elbow or knee, especially in children. Adults might have patches on their face or hands. While psoriasis patches can appear anywhere, they are most common on the outer, bony, parts of the elbows and knees, as well as the scalp and lower back.
Itch. Eczema rashes can be intensely itchy. Psoriasis rashes tend to be less itchy and may cause more of a burning or stinging sensation.
Psoriasis Flare-Ups
Psoriasis is a chronic condition that may get better for a while then flare up again for weeks or months at a time.
While it's not always clear why flare-ups happen, they can be linked with certain triggers. Those vary from person to person. If you can figure out your triggers, you might be better able to control your psoriasis symptoms.
Psoriasis triggers
Because psoriasis is an immune system problem, flare-ups are commonly linked to changes in your health or environment that affect your overall immune system or cause skin inflammation. These triggers can include:
Infections. Any infection, including colds and flus, might trigger a psoriasis flare-up. Strep throat can trigger guttate psoriasis, especially in children.
Skin injuries. If you have psoriasis, you have extra reason to protect your skin. Any bruise, scrape, bite, rash, or sunburn can trigger a flare-up by causing skin inflammation. So can a tattoo. Psoriasis symptoms often flare a week to 10 days after an injury. Picking at and scratching injured skin can make things worse.
Stress. Emotional stress can make autoimmune disorders like psoriasis worse. Since psoriasis can also cause stress, you risk getting into a cycle of flare-ups. Learning relaxation techniques might help.
Some medicines. These include some beta-blocker drugs used to treat high blood pressure and heart disease; lithium, a treatment for bipolar disorder; and pills taken to treat malaria. Tell your doctor if you have psoriasis and are being treated for any of these conditions.
Changes in weather. Cold, dry, weather is a common trigger, probably because dry skin is more vulnerable. But some people have flare-ups when they spend a lot of time in the sun or in air conditioning during hot spells. Keeping skin moisturized and using sunscreen can help in any weather.
Alcohol. Drinking, especially heavy drinking, may trigger or worsen symptoms and interfere with treatments. Combining certain psoriasis medications with alcohol can have dangerous side effects.
Smoking. Using tobacco or being around secondhand smoke raises your risk of getting psoriasis and makes psoriasis symptoms worse. If you want to quit smoking, ask your doctor for help.
Whatever your triggers, it's important to work with your doctor to come up with a treatment plan to get your psoriasis symptoms under the best control possible.
Psoriasis on Darker Skin
You can get psoriasis no matter what your skin color is. But it's sometimes misdiagnosed in Black people and other people of color, because psoriasis symptoms can look a little different on different skin tones.
One reason for misdiagnosis is that medical textbooks and online images of psoriasis symptoms have mostly featured White skin.
So a doctor unfamiliar with darker skin might misdiagnose you with other skin conditions, such as eczema, seborrheic dermatitis, or rosacea.
But psoriasis is the same disease no matter your skin type. The biggest difference is that while psoriasis plaques usually look pink or red on White skin, on darker skin, they can be light to dark brown, purple, or gray. The scales and skin flakes may look silvery white on light skin and gray on dark skin.
In addition, after psoriasis clears on darker skin, patches that are lighter or darker than the surrounding skin may remain for some time. That's called dyspigmentation.
These discolored patches are not scars, and they will clear up eventually, though it can take from a few months to a year or longer. Your skin doctor (dermatologist) may be able to treat them so they clear more quickly. Ask about this if the appearance of the patches bothers you.
Takeaways
The most common signs of psoriasis are patches of scaly, itchy skin that can crack and bleed. The patches can look pink, red, brown, purple, or gray, depending on your skin tone. Some less common forms of psoriasis have different symptoms, such as small red dots or smooth red patches. Psoriasis is sometimes mixed up with other skin disorders, such as eczema, but your doctor should be able to tell the differences.
