Psoriasis – one condition, many treatments

young man with beard

Getting the right treatments

Psoriasis is a condition where your symptoms may come and go. You may have severe symptoms for a few days or weeks, known as a 'flare-up'. Then periods where your symptoms are mild or have gone completely. There is no cure for psoriasis.1 However, from mild to severe, there are many different treatment options to help relieve your psoriasis symptoms.1,2 You can talk to your healthcare professional and together find the right treatment for you.2 Using your treatments as discussed with your healthcare professional is the best way to manage your psoriasis.3 This will allow you to focus on feeling confident and getting the most out of your life.

What you need to know about psoriasis treatments

If you have psoriasis, keeping your skin moisturised every day is an important part of caring for your skin. You should use moisturising soaps and apply emollient cream straight after washing to help lock the moisture into your skin. This can reduce the redness and itching and help your skin to heal.4

Psoriasis treatments range from topical treatments to tablets, injectable medication, and light therapy.2,5 Your treatment will depend on many factors, such as the severity of your disease and what will best fit with your lifestyle and personal needs.2how

All medicines have side effects and precautions that must be followed. Always read the patient information leaflet for any medicine you are buy from you pharmacist or are prescribed by your doctor. Always follow your pharmacist's or doctor's advice when taking a medicine.

Over-the-counter topical treatments

There are topical treatment options available for you to buy from your pharmacist.4 If you think you have psoriasis, or have been diagnosed, you should make an appointment to talk to your healthcare professional about what treatments they can prescribe that are appropriate for you. If you have not been diagnosed with psoriasis and are worried that you may have the condition, seek the advice of a healthcare professional.

Prescription topical treatments

Topical treatments are usually the first treatment your healthcare professional will prescribe. They are applied to your skin’s surface and include creams, gels and ointments.2 Discuss with your healthcare professional about which formulation will be right for you,2 the correct way to apply it2,6 and what to expect. After the first 4 weeks of starting a new topical treatment you should have a review so your doctor can see how you are getting on.2

Corticosteroids (steroids) help reduce swelling, itching and irritation.7 You should only apply steroids to the affected areas of your skin.8

Vitamin D formulations can be used alongside steroids,2 combined in the same formulation as a steroid,9 or on their own.2 They may be used during rest periods from steroids.2 They stop the skin cells being replaced so quickly6 (reducing the thickness of plaques). Vitamin D formulations can be used if you have scalp psoriasis and are intolerant to steroids.2

Coal tar preparations may also be prescribed.2 They may be used during rest periods from steroids.2 Coal tar might stain your clothes and bed sheets.4

Dithranol stops your skin cells being replaced so quickly.6 It is usually applied in short contact therapy.2 So it is applied and then washed off after an hour, which can be done in the bath or shower.10 Dithranol cream comes in different strengths. Your doctor should try the lowest strength first and gradually build up until the best dose for you has been found.10

Salicylic acid-containing products can be prescribed to help remove scales in scalp psoriasis.2,4,6

Tazarotene ointment contains vitamin A. It stops skin cells being replaced so quickly.6

Light therapy

Light therapy (phototherapy) may be recommended if you have plaque psoriasis or guttate-pattern psoriasis that cannot be controlled with topical treatments.2 It involves your skin being exposed to ultraviolet light 2 to 3 times a week.2,6 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.6

Systemic drugs

If you have severe psoriasis and other types of treatment don’t deliver the desired results, systemic drugs can be an option.1,2 Systemic treatments are usually given as a pill or an injection.6

Systemic drugs may be recommended if:2

  • 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.2

Systemic drugs include:

Immunosuppressants for example methotrexate and cyclosporine.2 They work by suppressing your body's immune response.1

Oral retinoids for example acitretin, a form of vitamin A,11 reduce the rate that skin cells grow.11 Acitretin works slowly. Your symptoms may get worse before they get better. It may take 2 to 4 months for symptoms to improve.11

Apremilast may be used for severe psoriasis.2,12

Biologics are a type of medication that targets specific parts of the immune system. They are given by an injection or infusion.1 There a number of different biologics. If one is unsuccessful another can be tried.2

For more information on treating psoriasis please visit the NHS website. 

Natural remedies

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 skin,13 apple cider vinegar on your scalp,1 using shampoos with tea tree oil,14 taking a warm bath in Dead Sea salts,4 or consuming turmeric.15 Please always speak to a healthcare professional before trying any natural remedies, as they may have dangerous interactions with other medications.

Coping with psoriasis

Everyone copes with psoriasis differently. A treatment which works well for one person may not work for you.5 Work with your doctor. Once they have a clear picture of your preferences and lifestyle, they will be able to create a treatment plan that works for you.2,5 They will review your treatments,2 to help you overcome any issues and keep you on track.

Psoriasis on different body areas

The symptoms of psoriasis can vary depending on which part of the body is affected.

Discuss your psoriasis with your doctor, who will be able to prescribe an appropriate treatment and help you manage the condition.

Learn more by selecting a body area
Face i
Hands & nails i
Legs & feet i
Scalp i
Skin folds i

How to care for psoriasis on your face

man checking his face for psoriasis in the mirror

Manage psoriasis on your face with some simple techniques

Psoriasis can affect the skin on your face. It usually appears on your eyebrows, upper forehead, hairline and the skin between your nose and upper lip. Psoriasis on your face should be treated carefully because the skin on your face is sensitive.1,2

What can I do?

There are a number of simple things that can help you manage psoriasis on your face.

  1. Use a moisturising cream to keep your skin hydrated2
  2. Try skin care products that have been specifically made for sensitive skin2,3
  3. Use an electric razor to shave – they are less harsh on the skin than a manual razor3
  4. Try to get into the habit of patting rather than rubbing when you dry your skin4

A healthcare professional may recommend suitable treatments for your face.

Caring for your skin all year round

When you have facial psoriasis your skin may be more sensitive to the weather.5

Cold weather can dry out your skin.6,7 Therefore, in the autumn and winter it is particularly important to apply a protective cream to your face and wear a hood or scarf.7

Over exposure to the sun can trigger psoriasis.2,8 Avoid too much exposure to sunlight in very sunny weather.8 Wear sun block rather than sun screen for better protection.8

Apart from during a flare-up, moderate amounts of exposure to the sun may help to clear psoriasis plaques. However, it is important to increase exposure to the sun gradually without burning.9

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-26485 Date of prep: July 2019

  1. www.psoriasis.org/about-psoriasis (accessed July 2019).
  2. www.healthline.com/health/facial-psoriasis (accessed July 2019).
  3. www.everydayhealth.com/psoriasis/living-with/shaving-safely-with-psoriasis/ (accessed July 2019).
  4. www.webmd.com/skin-problems-and-treatments/psoriasis/caring-for-psoriasis#1 (accessed July 2019).
  5. MP Schon and WH Boehncke. N Engl J Med 2005; 352(18): 1899-912.
  6. www.healthline.com/health/psoriasis-things-you-should-know#1 (accessed July 2019).
  7. www.webmd.com/skin-problems-and-treatments/psoriasis/features/winter (accessed July 2019).
  8. www.healthline.com/health/psoriasis/best-sunscreen (accessed July 2019).
  9. www.papaa.org/further-information/psoriasis-and-sun (accessed July 2019).

Nail psoriasis and psoriasis on hands – what to expect

man scratching his ha

Caring for hands and nails with psoriasis

A flare-up of psoriasis on your hands often causes cracking, blisters and swelling. About half of people with psoriasis find their nails are also affected. This causes pitting (holes in your nails), thickening and they may turn yellow-brown.1

Hand and nail psoriasis can be difficult to cope with. It can make daily activities such as housework, or simple tasks such as putting on socks and shoes, hard to carry out.2

As your hands are more visible than other parts of your body, people may notice this type of psoriasis more. You may feel that this makes you feel more self-counscious and embarrassed and in doing so, this may have an impact on your quality of life.2

Psoriasis on hands

Can you get psoriasis on your hands?

Psoriasis can affect your hands. Like on other parts of your body, it can cause your skin to become swollen, cracked and blistered.1 If you have psoriatic arthritis, the joints in your hands can be affected too. They may be painful and swollen. If you have pustular psoriasis you may have red, pus-filled bumps on your hands.3

Psoriasis on hands
Image source: iStock

Symptoms of psoriasis on hands

Symptoms include raised, red skin that has a scaly, silvery appearance. Psoriasis patches may feel sore, itchy and there may be cracking and bleeding.3

Nail psoriasis

Fingernail psoriasis is more common than toenail psoriasis. Your symptoms can be mild or severe and the severity does not depend on psoriasis elsewhere on the body. Nails may be the only site affected or there may be areas of psoriasis elsewhere on your body.4

Psoriasis nails
Image source: iStock

Symptoms of nail psoriasis

Symptoms include:4,5

  • Pitting (small holes in your nails)
  • Nails turning a yellow-brown colour
  • Thickening
  • The nail becoming separated from the nail bed
  • Sometimes you can get an infection in this gap
You may want to keep your nails as short as possible. Consider wearing gloves whenever possible to protect your hands and nails. Try wearing cotton gloves when doing chores and rubber gloves when washing up.1,4,5

As with all forms of psoriasis, triggers include; stress,3 certain medications,6 skin injuries,3 allergies,7 diet,7 weather,8 smoking6 or alcohol.6 Reducing stress, eating a healthy diet and limiting alcohol intake can help keep your symptoms at bay.3

Treating hands and nails with psoriasis

You should talk to your doctor about the treatment options available and discuss what is right for you.

There are a number of different treatments for psoriasis. In addition, nail psoriasis could be treated with a steroid that is injected into your nail bed. If you have an infection you may need antifungal drugs. Light therapy can also be used. This will be carried out by your doctor.1,5 If you have severe nail psoriasis you may need your nail removed.5

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-26476 Date of prep: July 2019

  1. www.psoriasis.org/about-psoriasis/specific-locations/hands-feet-nails (accessed July 2019).
  2. Aldredge, Lakshi M et al. JDNA 2018; 10(4): 189-97.
  3. www.healthline.com/health/psoriasis (accessed July 2019).
  4. www.papaa.org/further-information/nail-psoriasis (accessed July 2019).
  5. www.healthline.com/health/nail-psoriasis#symptoms (accessed July 2019).
  6. https://www.healthline.com/health/psoriasis/triggers-to-avoid (accessed July 2019).
  7. https://www.psoriasis.org/about-psoriasis/causes (accessed July 2019).
  8. MP Schön. & WH Boehncke. N Eng J Med 2005; 352(18): 1899-912.

How to manage psoriasis on the feet and legs

couple

Psoriasis on the legs

Having psoriasis on your legs can cause them to feel sore and itchy.1 If you have psoriatic arthritis your knee joints can be swollen and painful.1 Severe symptoms can mean you struggle to walk and climb stairs.2 Make sure that you tell your healthcare professional what impact having psoriasis on your feet and legs has so you can discuss the best approach to your care.

Keeping your legs as moisturised as possible, by daily use of moisturising creams or emollients, can relieve the itchy feeling.3 Keeping your legs moving can ease stiffness. Talk to your healthcare professional about what types of exercises are best for you.2

If your knees are swollen raising your feet when sitting or lying down can help reduce the swelling.4

Psoriasis on feet

Certain types of psoriasis can affect your feet.1,5 There are two forms of psoriasis that can be seen on the feet.5 A milder form causes the feet to be dry and scaly, and a more severe form causes pustular psoriasis, red bumps filled with pus, to form.5 Psoriasis on the soles of your feet can be difficult to cope with.5 Psoriatic arthritis can affect your ankles.1 This can cause the joint to be swollen and painful and the skin to be red and inflamed.1 Your toes may also become swollen.6 Dactylitis is a type of psoriatic arthritis which can cause an entire toe to swell.6

Keeping your feet moisturised can help. Once or twice a day soak your feet in warm water, pat them dry and cover them with moisturising cream, petroleum jelly or colloidal oatmeal to lock in the moisture.5

You may want to choose shoes that will keep your feet cool and dry and allow the air to circulate freely.7 Soft, sturdy shoes will help support your feet.8 You could also try foam, leather, cork or rubber insoles which cushion sore feet.9

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-26488 Date of prep: July 2019

  1. www.healthline.com/health/psoriasis# (accessed July 2019).
  2. www.healthline.com/health/psoriatic-arthritis# (accessed July 2019).
  3. www.psoriasis.org/about-psoriasis/treatments/topicals/over-the-counter (accessed July 2019).
  4. www.healthline.com/health/how-to-reduce-swelling-in-knee-quickly# (accessed July 2019).
  5. www.everydayhealth.com/psoriasis/symptoms/when-psoriasis-affects-your-feet/ (accessed July 2019).
  6. www.psoriasis.org/about-psoriatic-arthritis (accessed July 2019).
  7. www.podiatrytoday.com/guide-dry-skin-disorders-lower-extremity (accessed July 2019).
  8. www.webmd.com/arthritis/psoriatic-arthritis/psoriatic-arthritis-and-your-feet-finding-shoes-that-fit#1 (accessed July 2019).
  9. www.everydayhealth.com/psoriatic-arthritis/treatment/psoriatic-arthritis-shoe-tips/ (accessed July 2019).

Hair care for scalp psoriasis

How to cope with scalp psoriasis

How to cope with psoriasis on your scalp

Scalp psoriasis can appear beyond your hairline to your forehead, the back of your neck and around your ears.1

Hair care and psoriasis

Hair loss is a common problem with scalp psoriasis. This is often due to damage to the hair follicles caused by rubbing and scratching your scalp, and from chemicals or ingredients in treatments and products.1 While psoriasis can be itchy, it is important to try to minimise irritants and avoid scratching where possible if you can.1 Here are some ways to help:

  • Be gentle when washing your hair. Avoid shampoos that contain mint as this can irritate your psoriasis.2 Tea tree oil has been shown to be effective in treating scalp psoriasis, so you may want to try a tea tree shampoo.2
  • Using conditioner every time you wash your hair can help to keep your scalp moisturised.2
  • Try to avoid blow drying your hair, but if you do keep your dryer on the lowest setting.2
  • Be gentle when brushing or combing your hair.3 Only brush your hair when it is dry and use a brush with natural bristles.4

Consider your hairstyle

Tight hairstyles can irritate your scalp which may cause your psoriasis to flare-up.3 If you are using curlers or rollers try to avoid pulling your hair or letting them touch your scalp.3 If you are suffering from a flare-up, you may want to put off perming or dying your hair until your symptoms have gone.3

Don't be embarrassed about telling your hairdresser or barber about your psoriasis. They are used to seeing different scalp conditions.5 Knowing about your condition will help them avoid products or techniques that may irritate your psoriasis or cause a flare-up.5

Talk to your healthcare professional, they will be able to give you advice about caring for your hair with scalp psoriasis.3

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-26478 Date of prep: July 2019

  1. http://www.psoriasis.org/about-psoriasis/specific-locations/scalp (accessed July 2019).
  2. www.everydayhealth.com/psoriasis/treatment/smart-ways-to-manage-scalp-psoriasis/ (accessed July 2019).
  3. www.aad.org/public/diseases/hair-and-scalp-problems/scalp-psoriasis/tips-for-managing/hair-styling-tips-that-can-reduce-flares-of-scalp-psoriasis (accessed July 2019).
  4. naturespathways.com/south-central-wisconsin-edition/february-2014-south-central-wisconsin-edition/the-best-tips-for-dealing-with-a-dry-itchy-scalp/ (accessed July 2019).
  5. www.psoriasis.org/advance/safe-styling-for-scalp-psoriasis (accessed July 2019).

    How to manage psoriasis in your skin folds

    man swimming in ice water

    Common symptoms and how to manage psoriasis in skin folds

    Skin folds are areas of your body where skin rubs against skin, for example the groin, inner thigh, armpits and under the breasts.1 A type of psoriasis called inverse, or hidden psoriasis, often affects skin folds.1-3 It affects about a quarter of people with psoriasis and is particularly common in obese people.3 Skin at skin folds is thinner,2 so more delicate. It is more likely to be irritated by sweat and rubbing and is prone to yeast or fungal infections because of its location.1,2 You and your doctor should look out for this.2

    Inverse psoriasis appears as smooth, shiny red patches.1-3 The skin isn’t dry and crusty like plaque psoriasis,1,2 it may even feel moist.1 These areas are likely to be irritated and itchy.1

    Inverse psoriasis occurs because skin folds are moister than more exposed areas where plaque psoriasis is more common.1 People with inverse psoriasis often have plaque psoriasis too.1,2

    Because your skin folds are sensitive, inverse psoriasis can be difficult to treat.1,2 Ask your doctor or pharmacist how to apply your treatment in skin folds.1

    Keep clean, dry and comfortable

    If you have inverse psoriasis you should keep your skin clean by gently bathing it.4 It is important to wear loose clothes that let your skin breathe such as cotton4 and natural fibres.

    As often as possible, try to wear loose, comfortable clothing. The best materials are cotton or poly-cotton mixes.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-27016 Date of prep: July 2019

    1. www.healthline.com/health/inverse-psoriasis# (accessed July 2019).
    2. www.psoriasis.org/about-psoriasis/types/inverse (accessed July 2019).
    3. Khosravi H et al. J Drugs Dermatol 2017; 16(8): 760-6.
    4. www.psoriasis.org/advance/coping-inverse-psoriasis (accessed July 2019).

    This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or another 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-26701 Date of prep: July 2019

    1. www.healthline.com/health/psoriasis (accessed July 2019).
    2. NICE guidance. Psoriasis assessment and management. 2012.
    3. www.psoriasis.org/advance/how-stick-your-treatment-plan (accessed July 2019).
    4. www.psoriasis.org/about-psoriasis/treatments/topicals (accessed July 2019).
    5. www.psoriasis.org/about-psoriasis/treatments (accessed July 2019).
    6. SIGN. Treating psoriasis and psoriatic arthritis. 2012.
    7. www.nhs.uk/medicines/hydrocortisone-skin-cream (accessed July 2019).
    8. www.psoriasis.org/about-psoriasis/treatments/topicals/steroids (accessed July 2019).
    9. British Dermatology Society (BAD). Topical treatments for psoriasis.
    10. Dithrocream summary of product characteristics. www.medicines.org.uk/emc/product/3755 (accessed July 2019).
    11. www.psoriasis.org/about-psoriasis/treatments/systemics/soriatane (accessed July 2019).
    12. NICE guidance. www.nice.org.uk/guidance/ta419/chapter/1-Recommendations (accessed July 2019).
    13. www.healthline.com/health/aloe-vera-for-psoriasis (accessed July 2019).
    14. www.healthline.com/health/psoriasis/can-tea-tree-oil-help (accessed July 2019).
    15. www.healthline.com/health/psoriasis/psoriasis-and-turmeric (accessed July 2019).

    Read more articles

    You are now entering a website created by LEO Pharma in the UK and Ireland.

    Scroll to top