Plaque psoriasis – what to know about the most common type of psoriasis

Plaque psoriasis

What is plaque psoriasis and what are the symptoms

Plaque psoriasis is the most common form of psoriasis.1,2 It affects about 9 in every 10 people with psoriasis.1 It is an immune-mediated condition,3 which means your immune system attacks healthy cells.4 It is a long-term condition (chronic)2 although symptoms can come and go over time.1

What are the symptoms of plaque psoriasis?

Plaque psoriasis causes red, raised patches with silvery scales on the surface of the skin.1,2 The silver build-up is made up of dead skin cells,3 due to unusually fast skin cell production.2,4 Psoriasis plaque can be painful and itchy.2 It may crack and bleed.2 It often appears on the elbows and knees but can appear anywhere on the body.2

If you are worried you may have psoriasis you should talk to a pharmacist, nurse or doctor.3

scalp psoriasis elbow psoriasis knee psoriasis

How severe is my psoriasis?

Plaque psoriasis is classed as mild, moderate or severe. Psoriasis severity depends on how much skin is affected and how it impacts your quality of life.3

What is mild plaque psoriasis?

Mild psoriasis is when you have red and scaly skin bumps on less than 3% of your body. Although it is called mild, it can still be very uncomfortable. Topical treatments applied to your skin, such as creams and shampoos can help provide relief.3 If you have been diagnosed with mild psoriasis your doctor will discuss with you what treatment is right for you. They may recommend topical treatments you can buy from your pharmacist, or they may prescribe stronger formulations.3,4

What is moderate and severe plaque psoriasis?

Moderate plaque psoriasis appears on 3-10% of your body. Severe plaque psoriasis (chronic plaque psoriasis) covers at least 10%. If you have moderate or severe plaque psoriasis you should talk to your doctor about a treatment plan that works for you. You may need a combination of treatments. This can include topical treatments, light therapy or systemic treatments.3

What is plaque psoriasis caused by?

The causes of plaque psoriasis are not fully understood.2,6 It is thought to be caused by genetic factors (ones you can’t change) and environmental factors (ones you can change).6,7 Scientists believe that mutations in genes are an important reason for psoriasis. While around 10 in every 100 people carry these mutated genes, only 2 or 3 in every 100 develop psoriasis.3,7 It is thought that environmental triggers, in combination with genes, are responsible for psoriasis.7 These triggers may include: stress, certain medications, skin injuries, allergies, diet, weather, smoking or alcohol.2,8

As your immune cells attack your skin cells, your skin constantly renews itself. Healthy skin cells are usually shed and replaced every month. In psoriasis, this process speeds up to several days. As a result, red plaques consisting of dead skin layers build up.4

How to treat plaque psoriasis

At the moment there is no cure for plaque psoriasis, but there are options to help you manage your condition.2

Keeping your skin moisturised is important.9 Applying moisturising creams (emollients) every day reduces redness9 and itching10 and helps your skin to heal.9 Try using moisturising soaps and applying moisturising creams after showering and washing your hands.9

  • Topical treatments are usually the first treatment your doctor will prescribe. They are applied on your skin’s surface and include creams, gels and ointments.1 Your doctor should talk to you about which formulation will be right for you1 and the correct way to apply them.10 After the first four weeks of starting a new topical treatment you should have a review so you doctor can see how you are getting on.1
    - Corticosteroids (steroids) help reduce swelling, itching and irritation.5 Potent steroids should only be used for a limited time1 and only applied to affected areas of the skin.11 Over use can cause side effects, such as skin thinning.1,11
    - Vitamin D formulations can be used alongside steroids or on their own.1 They stop the skin cells being replaced so quickly (reducing the thickness of plaques).10
    - Coal tar preparations may also be prescribed.1 Coal tar might stain clothes and bed sheets, irritate the skin, make it more sensitive to sunlight or even promote skin cancer. Its carcinogenic properties are only thought to be true for concentrations much higher than those in psoriasis treatments, however, regular skin cancer check-ups are advised when using regularly.9
    - Salicylic acid containing products can be prescribed to help remove scales in scalp psoriasis.1,10
  • Light therapy (phototherapy) may be recommended if you have plaque psoriasis or guttate-pattern psoriasis that cannot be controlled with topical treatments.1 It involves your skin being exposed to ultraviolet light 2 to 3 times a week.1,10 This will be carried out by a healthcare professional. Phototherapy is not the same as indoor tanning. The use of sunbeds is not recommended to treat psoriasis.10
  • Systemic drugs may be recommended if:1
    - Your psoriasis can’t be controlled with topical treatments and
    - It is having a significant impact on your physical, psychological or social wellbeing and
    - It covers more than 10% of your body or
    - It is localised and is causing you significant impairment or distress or
    - Phototherapy has been ineffective or can’t be used

Systemic drugs can only be prescribed by a specialist.1 They take effect inside the body after being given by an injection or tablet.10

  • Biologic drugs can only be prescribed by doctors who specialise in the treatment of psoriasis.1 They target your immune system and are given by an injection or an infusion.2
  • Natural remedies can complement conventional treatments. They are not backed up by scientific evidence, but many people are convinced that they have benefits. They include: applying aloe vera gel on your skin12 or apple cider vinegar on your scalp,2 using shampoos with tea tree oil,13 taking a warm bath in Dead Sea salts,9 or consuming turmeric.14 Please always speak to a healthcare professional before trying any natural remedies, as they may have dangerous interactions with other medications.

Common questions on plaque psoriasis

Is plaque psoriasis contagious?

Plaque psoriasis is not contagious.2

How are plaque and scalp psoriasis connected?

Scalp psoriasis is the formation of psoriatic plaques on your scalp. They can extend beyond your hairline onto your forehead to the back of your neck and around your ears.3

How can I tell the difference between plaque psoriasis and eczema?

Plaque psoriasis can look similar to eczema. However, plaque psoriasis tends to be thicker and can be recognised by silvery scales. Eczema appears less swollen and is often behind the knees, ankles, wrists and inner elbows.15

What is the difference between plaque psoriasis and psoriatic arthritis?

People with psoriatic arthritis have joint pain and swelling as well as the silvery skin patches of psoriasis. Both conditions may come and go. People with plaque psoriasis may develop joint symptoms at a later date.2

Outlook on living with plaque psoriasis

Even though plaque psoriasis is a long-term condition,2 the right treatment can help relieve your symptoms and improve the appearance of your skin.4

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

UK/IE MAT-25910 Date of prep: June 2019

  1. NICE guidance. Psoriasis assessment and management. 2012.
  2. www.healthline.com/health/psoriasis#psoriasis-treatments (accessed June 2019).
  3. www.psoriasis.org/about-psoriasis (accessed June 2019).
  4. www.nhs.uk/conditions/psoriasis/ (accessed June 2019).
  5. www.nhs.uk/medicines/hydrocortisone-skin-cream/ (accessed June 2019).
  6. S Segaert and M Ropke. J Drugs Dermatol 2013; 12(8): e129-37.
  7. www.psoriasis.org/research/genes-and-psoriatic-disease (accessed June 2019).
  8. MP Schon and WH Boehncke. N Engl J Med 2005; 352(18): 1899-912.
  9. www.psoriasis.org/about-psoriasis/treatments/topicals/over-the-counter (accessed June 2019).
  10. SIGN. Treating psoriasis and psoriatic arthritis. 2012.
  11. www.psoriasis.org/about-psoriasis/treatments/topicals/steroids (accessed June 2019).
  12. www.healthline.com/health/aloe-vera-for-psoriasis (accessed June 2019).
  13. www.healthline.com/health/psoriasis/can-tea-tree-oil-help (accessed June 2019).
  14. www.healthline.com/health/psoriasis/psorriasis-and-tumeric (accessed June 2019).
  15. www.webmd.com/skin-problems-and-treatments/psoriasis/psoriasis-or-eczema#1 (accessed June 2019).

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