Psoriasis

Patients who have psoriasis experience chronic symptoms that include red, itchy and scaly skin. These symptoms can be uncomfortable, interfering with your quality of life and self-esteem. In addition, psoriasis can be associated with other medical conditions, including psoriatic arthritis and cardiometabolic disease. At Frontier Dermatology, our providers have the experience and knowledge necessary to help psoriasis patients understand all of their treatment options and find the one that best fits their individual needs.

What is Psoriasis?

Psoriasis is a common chronic immune-mediated inflammatory skin disorder. Patients with psoriasis experience patches of red, itchy or scaly skin, most commonly on the knees, elbows, scalp or torso. These patches may come and go in cycles, with flare-ups lasting for weeks, months, or even years.

There are several types of psoriasis, which include:

Plaque psoriasis
Scalp psoriasis
Palmoplantar psoriasis
Nail psoriasis
Guttate psoriasis
Inverse and/or genital psoriasis
Generalized pustular psoriasis
Erythrodermic psoriasis
Psoriatic arthritis

What Causes Psoriasis?

Psoriasis is believed to be a condition caused by immune system dysfunction leading to skin cells that regenerate at a faster than normal rate, resulting in thickened scaly red patches in patients with lighter skin tones, and reddish-brown to purplish-gray patches in those with more pigmented skin. Certain risk factors can increase your likelihood of developing psoriasis, which includes a family history of psoriasis, smoking, alcohol consumption, obesity, and stress.

Psoriasis flare-ups are often triggered by a range of environmental or other factors. Some common psoriasis triggers include:

Infections
Injury
Heavy alcohol consumption
Cold or dry weather
Medications including lithium, blood pressure medication or antimalarial drugs
Smoking and secondhand smoke
Stress
Withdrawal of oral or systemic corticosteroids

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What You Should Know

We're committed to assisting you with any inquiries you may have. Should your questions extend beyond the information provided in our FAQ section, please don't hesitate to reach out to our office.

Are their symptoms with Psoriasis?

Not all patients will experience the same psoriasis symptoms. The most common symptoms are red scaly patches that can be itchy, burning, and/or painful. Psoriasis patients may also experience swelling or stiffness in the joints as well as thickened, pitted or ridged nails.

Psoriasis may increase your risk of other complications including psoriatic arthritis, eye conditions, obesity, type 2 diabetes, cardiovascular disease, high blood pressure or other autoimmune conditions including celiac disease and multiple sclerosis.

What are Psoriasis Treatment Options?

The diagnosis of psoriasis can usually be made by a careful skin examination, although in some cases a biopsy may be required to make an accurate diagnosis. This involves removing a small skin sample which can then be examined in a lab.

After making a psoriasis diagnosis, your provider may recommend a variety of treatment options which can include topical therapies, light therapy (phototherapy) or oral and injectable medications. Because every person is different, your provider will work with you to find the best treatment option that fits your individual goals and needs.

Topical therapy options include:

Corticosteroids that are used for short periods to relieve acute flares
Non-steroidal creams such as aryl hydrocarbon receptor modulators, phosphodiesterase 4 inhibitors, vitamin D analogues, retinoids, and calcineurin inhibitors are often used alongside topical corticosteroids as maintenance therapy
Salicylic acid shampoos to reduce scaling on the scalp
Coal tar, or other tar products, to reduce scaling, itching and inflammation Phototherapy (narrowband UVB)
In-office treatment 2-3x/week

Full-body unit
Excimer (a hand-held device used to treat localized stubborn areas like the scalp)
Excimer (a hand-held device used to treat localized stubborn areas like the scalp)
Hand/foot unit

At-home therapy (some insurances will cover an at-home device)

Oral or injected medication options include:

Orals

Methotrexate
Retinoids (acitretin)
Cyclosporine
Otezla
Sotytku

Biologics

TNF-alpha inhibitors: Humira, Enbrel, Remicade, Cimzia
IL-12/23 inhibitors: Stelara
IL-17 inhibitors: Cosentyx, Taltz, Siliq, Bimzelx
IL-23 inhibitors: Tremfya, Skyrizi, Ilumya

In addition to these treatment options, your provider is likely to suggest at-home routine options that can help you best prevent future psoriasis flares. This can include habits such as bathing daily, moisturizing effectively and frequently, covering plaques and otherwise affected areas. Your provider may also recommend avoiding alcohol and maintaining an overall healthy lifestyle, prioritizing a balanced diet and routine exercise. Finally, identifying your psoriasis triggers

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