Plaque psoriasis is the most common type of psoriasis. It is characterized by patches of skin covered in silvery scales. These plaques can be itchy and sometimes painful.
Psoriasis is a long-term inflammatory condition that results from a problem with the body’s immune system. Skin changes and other symptoms can occur, but treatment can help manage it.
There are several types of psoriasis, but plaque psoriasis is the most common. Plaque psoriasis involves an overgrowth of skin cells, leading to skin patches covered with silvery scales. The patches, or plaques, can be itchy and painful.
The plaques have a well-defined edge and can appear almost anywhere on the body, but they typically affect the scalp, knees, elbows, and lower back.
The symptoms tend to come and go, worsening during a flare and improving or disappearing during remission.
Here are some pictures of plaque psoriasis symptoms:
- plaques of skin with well-defined edges
- itching, cracking, and bleeding of skin
- thick, ridged, and pitted nails
On lighter skin, the lesions may be pink. On darker skin, the plaques may be darker than the surrounding skin. Heavy white or silvery scales often cover the surface of the plaques.
Psoriasis plaques can occur anywhere on the body but are most likely to appear on the elbows, knees, lower back, and scalp.
A flare-up is when symptoms of psoriasis appear or worsen. A flare-up can last for several weeks or months. Between flares, the symptoms may improve or disappear. This is called remission. This cycle tends to repeat itself.
Scientists do not know what exactly causes psoriasis, but genetic and immune factors appear to play a role.
People with psoriasis may have specific genetic features that predispose them to the disease.
Psoriasis can run in families, but not everyone with these genetic features develops psoriasis.
The relevant genetic features may increase a person’s risk of developing symptoms in certain circumstances, however. An infection, for example, may trigger psoriasis in a person who has a genetic predisposition.
A person can have genetic features that make them susceptible to psoriasis but not develop the condition. Nevertheless, exposure to certain triggers can cause symptoms to appear.
Possible triggers include:
- injury to the skin
- certain medications
- infections and other illness
- weather changes
Some people also report that alcohol use, allergies, and dietary factors affect their psoriasis.
Some of these circumstances or factors can trigger the start of psoriasis but also a flare-up.
Psoriasis is a multisystem disease that can affect many aspects of a person’s life and health.
People with plaque and other types of psoriasis are also more likely to experience:
- other autoimmune disorders, including ulcerative colitis and Crohn’s disease
- features of metabolic disorder, such as heart disease, high blood pressure, obesity, and diabetes
Current guidelines recommend people with psoriasis have regular screening for diabetes, lipid levels, and other health measures that may indicate cardiovascular or other health problems.
Doctors sometimes misdiagnose plaque psoriasis because the symptoms may resemble those of other conditions, including:
- seborrheic dermatitis
- pityriasis rosea
- Mycosis fungoides (cutaneous T cell lymphoma)
- lichen planus
- ringworm, also known as tinea
In the case of seborrheic dermatitis and psoriasis, there is a disorder known as sebopsoriasis that overlaps with both.
A doctor can usually diagnose plaque psoriasis by looking at the skin and nails and examining someone’s medical history.
Sometimes, a doctor will use a skin biopsy to confirm a diagnosis. They will take a small sample of skin to examine under a microscope. This procedure can help rule out other conditions.
Anyone who notices unusual changes in their skin should see a doctor.
Individuals with a diagnosis of psoriasis should follow their treatment plan and see their doctor if symptoms persist or worsen or if treatment results in adverse effects.
There is currently no cure for plaque psoriasis, but many treatment options are available, depending on the individual and the severity of symptoms.
- topical treatments, including ointments, creams, and shampoos to relieve skin symptoms
- light therapy to relieve skin symptoms and possibly prevent flares
- laser therapy that targets specific skin patches
- corticosteroid injections to reduce severe inflammation
- systemic therapy
- biologic drugs
- lifestyle choices
Most people with mild symptoms can treat psoriasis at home with topical treatments.
Topical treatments are often the first choice for managing plaque psoriasis.
Ingredients in topical treatments include:
Applying creams and ointments that contain one or more of these ingredients can:
- reduce inflammation
- slow skin cell growth
- soothe the skin
- reduce dryness and cracking
- improve itching
It is best to check first with a doctor or pharmacist before choosing a topical treatment, as some may suit an individual better than others. In certain cases, there may not be enough scientific evidence to confirm that they are safe to use or that they work.
Some oral or injected medications that affect the whole body may help treat moderate to severe plaque psoriasis.
Examples of these systemic medications include:
The impact of a systemic therapy will depend on the therapy, but the effects are likely to include reducing inflammation and changing how the immune system works. A doctor will monitor for any adverse effects that may occur.
These drugs affect the immune system and target the underlying cause of psoriasis. A range of biologics is available on prescription.
A doctor may prescribe one of these drugs if a person has moderate to severe symptoms of plaque psoriasis.
Phototherapy uses natural or artificial light to reduce symptoms.
- controlled exposure to sunlight, under medical supervision
- exposure to UVB light
- PUVA, which combines medication with UVA exposure
- Excimer laser therapy
- home phototherapy, if a doctor advises this
Various home remedies may help manage psoriasis.
Skin-care tips include:
- Taking a short bath or shower every day in warm but not hot water.
- Using coal tar or hypoallergenic products as a doctor or pharmacist recommends.
- Washing gently with the hands rather than scrubbing with a sponge to avoid irritation.
- Moisturizing with a thick hypoallergenic emollient within 5 minutes of bathing.
- Applying wet wraps with medication or moisturizers in them.
Other lifestyle tips include:
- indigo naturalis
- curcumin, present in turmeric
- dietary options
- fish oil, which contains omega-3
People should speak with their doctor first before trying any of these.
The experience of plaque psoriasis varies widely between individuals. There is no way to predict how long a flare-up or a remission will last, or how severe symptoms will be.
Plaque psoriasis is
In some cases, pustular psoriasis can develop, which can be life-threatening.
However, there are many ways to manage plaque psoriasis, and some medications can now help reduce the frequency and severity of symptoms.
Here are some questions people often ask about plaque psoriasis.
How do you reduce scaling on plaque psoriasis?
Emollient creams may help reduce roughness, itching, and dryness in plaque psoriasis.
The author of a
Avoid the temptation to scrape off the scale, as this may open the skin to infection and more discomfort.
What causes plaque psoriasis?
Genetic and environmental factors probably contribute. For people with a genetic susceptibility, smoking, stress, infections, and other factors can trigger it.
What are the signs and symptoms of plaque psoriasis?
Skin changes include the appearance of raised, silvery patches on the skin that may be pink on some skin tones. The patches may be painful and itchy, and they may crack and bleed.
Plaque psoriasis is a common condition that people can often manage with topical treatments. If symptoms persist or become severe, other treatments are available that can help manage psoriasis.
Anyone who notices new or worsening skin changes or who starts to have joint pain or other symptoms should see a doctor.
Learn more about the different types of psoriasis
Find out about these different types of psoriasis: