Mild Psoriasis: What You Should Know

What Is Psoriasis?

Psoriasis is an autoimmune disease that is due to the buildup of skin cells, as they grow at an abnormally fast rate. Though we are not aware of the exact cause of psoriasis, the medical community does believe that genetics plays a big role.  

Psoriasis primarily affects the skin but can also involve the nails and joints. Those with psoriasis may notice their skin has patches of dry, thick, red skin with silvery scales.

Psoriasis lesions are usually found on knees, elbows, scalp, back, palms, and feet.

Psoriasis can also on the face and it usually is found between the eyebrows, between the nose and upper lip, the upper forehead and the hairline. As the skin on the face is more sensitive and thin, psoriasis needs to be carefully treated in these locations.

Who Gets Psoriasis:

Both genders are equally likely to develop psoriasis, while 3.6 percent of Caucasians are likely to develop it compared to African-Americans. It usually develops between the ages of 15 and 35, but it can develop at any age. It is very rare for infants to de diagnosed with psoriasis.

What Are the Symptoms of Psoriasis? 

If you think you or a loved one may have psoriasis, look for some symptoms listed below.

o   Red patches of skin with silvery scales

o   Dry, cracked skin that can bleed

o   Itching, burning or soreness

o   Thickened or pitted nails

o   Stiff or swollen joints

How is Psoriasis Diagnosed:

Your doctor will examine your skin and likely ask you questions about how and when it started as well as if there is a family history of psoriasis. A dermatologist may want to perform a skin biopsy to accurately diagnose the rash.

How Severe is My Psoriasis?

Psoriasis is categorized into mild, moderate and severe.

The severity is based on the amount of your body that is affected by psoriasis.

Mild psoriasis affects less than 3% of your body, moderate psoriasis affects 3-10% of your body, and severe psoriasis affects over 10% of your body.

Aside from severity, there are also different types of psoriasis. Plaque psoriasis is the most common type and is characterized by raised, red patches covered with a silvery white buildup of dead skin cells. They are itchy and can be painful. These plaques usually affect the scalp, knees, elbows and lower back.

Guttate psoriasis appears as small, dot-like lesions. It is the second most common type of psoriasis. It usually starts in childhood or young adulthood, and can be triggered by a strep infection.

Inverse psoriasis shows up as very red lesions in body folds, including behind the knee, under the arm or in the groin.

Pustular psoriasis appears as white pustules surrounded by red skin. The pus consists of white blood cells. Pustular psoriasis occurs most often on the hands or feet, but can occur anywhere else on the body. It is not an infection.

Erythrodermic psoriasis is a very severe form of psoriasis that leads to widespread, intense redness over most of the body.

You can have severe itching and pain, and the skin may come off in sheets. It is rare and usually affects those with unstable plaque psoriasis. Please keep in mind that if you have a flare of this type of psoriasis, see a doctor immediately.

Are there Triggers for Psoriasis?

There may be triggers that can cause you have to have a flare of your psoriasis. Some of these include:

Skin Trauma – Even mild cuts, bruises, and burns can cause a worsening of your skin. This is a well known condition and is called Koebners phenomenon. Get medical advice before getting a tattoo if you have psoriasis.

Stress – Distress is bad for a lot of reasons, and that includes psoriasis.

Several patients say that they experience more symptoms during times of stress.

Medications – Beta-blockers which treat high blood pressure and abnormal heart rhythms are a well known culprit. These medications usually end with an –olol like Atenolol, Metoprolol, etc. Lithium, which is used for bipolar disorder and medications used for malaria are also known to trigger psoriasis. NSAIDS (non-steroidal anti-inflammatory drugs) can also cause a psoriasis exacerbation.

Infections – Tonsillitis and strep throat can cause guttate psoriasis. A few weeks after the infection, you may experience other types of psoriasis listed above. Those with HIV may have worsened symptoms.

Alcohol – Drinking alcohol is known to be a trigger of psoriasis flares, especially in men. A study showed that heavy drinking can decrease treatment efficacy in men. 

Smoking – Smoking can definitely have a negative effect on psoriasis. A study found that smoking may play a role in the onset of psoriasis and its clinical appearance. Smoking has been found to nearly doubles a person's risk of getting psoriasis, with the the risk increasing with the number of cigarettes smoked per day. This can affect women more than men.  

What Else Should I Know:

Anyone can get psoriasis, but you are at a higher risk if someone in your family has it. Also, those with psoriasis are at a higher risk of developing some diseases including:

Psoriatic arthritis - This can cause joint damage and a loss of function in some joints,

Eye conditions - Eye disorders like conjunctivitis, blepharitis and uveitis are more common in people with psoriasis.

Type 2 diabetes – The severity of the psoriasis, the more likely that risk of  type 2 diabetes.

Cardiovascular disease - The risk of cardiovascular disease is twice as high as it is for those without the disease. Psoriasis and some of its treatment options are known to increase the risk of an irregular heartbeat, stroke, and atherosclerosis.

Other autoimmune diseases - There may be a greater risk of celiac disease, sclerosis and Crohns disease in those with psoriasis.

Kidney disease - Moderate to severe psoriasis has been linked to a higher risk of kidney disease.

Emotional problems - Psoriasis can also affect your quality of life which can take a toll on your emotional well-being.

Treatment Options for Mild Psoriasis:

Though classified as mild, psoriasis can still be very debilitating if the rash is very noticeable and/or is causing significant stress. Your doctor will ask you questions about how much the rash bothers you, how visible it is and will let you know about several treatment options. Treatment is divided into three categories, topical, light therapy, and systemic medications.

Topical steroids – This type of medication can decrease inflammation. They range from weak to strong, with the stronger steroid being more effective but also carries more adverse effects. Generally, weaker potency steroids are reserved for the face, neck, groin and underarm area as the skin in these areas are much more sensitive and is thinner. Stronger steroids can be used elsewhere as the skin is thicker.

Side effects of topical steroids to keep note of include thinning skin, skin color change, and they can cause acne and stretch marks. They can also make your capillaries (small blood vessels) more noticeable which is called telangiectasias. These negative effects are not as likely with short duration of treatment with topical steroids.

Vitamin D analogues -These forms of vitamin D can slow skin cell growth. Keep in mind these agents may irritate the skin.

Topical retinoids - These are vitamin A formulations that can decrease inflammation with skin irritation as an adverse effect.  These medications increase sensitivity to sunlight, so be sure to apply sunscreen before going outdoors.

Calcineurin inhibitors -These medications also decrease inflammation. This class of medications is especially helpful to use around the eyes where skin is thin.

Salicylic acid - Helps with eliminated dead skin cells which decreases scales.

Coal tar - This also reduces scaling, itching and inflammation.

Moisturizers - Moisturizing can reduce itching, scaling and dryness. Try to get moisturizers in an ointment form as it is more hydrating.

 

Light therapy - This therapy helps in various ways including slowing skin turnover, reducing inflammation and scaling. This treatment uses natural or artificial ultraviolet light.

Sunlight. Small, daily sunlight exposure may be helpful but  intense sun exposure is not good for your skin. Ask your doctor about the best way to do this.

UVB phototherapy. Used for mild-moderate psoriasis. Temporary side effects include redness, itching and dry skin. Using a moisturizer may help decrease these side effects. Narrow band UVB therapy is also available which may be more effective but unfortunately can cause more severe burns.

Psoralen plus ultraviolet A (PUVA).  – This is an aggressive treatment option that penetrates deeper into the skin. Adverse effects include an increased risk of skin cancer.

Other Medications

Oral and injected medications are generally reserved for patients with severe psoriasis. Their side effect profile can be more serious.

 

A Word From VeryWell:

Psoriasis ranges from mild to severe and there are many different forms. See your dermatologist for the best personalized treatment advice. Keep in mind the other medical conditions that can be associated with psoriasis and stay vigilant. Try not to drink alcohol or smoke as these habits can exacerbate psoriasis. As with several medical conditions, stress can also worsen psoriasis, so try to stay positive. 

 

 

 

 

 

View Article Sources
  • National Psoriasis Foundation. "Psoriasis." https://www.psoriasis.org/about-psoriasis/treatments
  • De Oliveira M de FSP, Rocha B de O, Duarte GV. Psoriasis: classical and emerging comorbidities.Anais Brasileiros de Dermatologia. 2015;90(1):9-20. doi:10.1590/abd1806-4841.20153038.