Under normal circumstances skin cells are replaced over 28 days, but in psoriasis this takes just four days. These new skin cells gather and push up at the skin surface forming a raised red rash with silvery scales, called plaques.
This rash can be very uncomfortable and itchy. It usually appears on the knees, elbows or the scalp. It can, however, appear anywhere on the body. The appearance also makes people feel very self-conscious about the way they look. So much so that many people avoiding letting their skin be seen in public and wear inappropriate clothes in warm weather.
Why does it happen?
No one knows precisely what causes psoriasis. It often appears to be triggered by any of the following: a sore throat or chest infection; burns, sunburn or other skin injury; a stressful life event such as an exam, relationship problems or bereavement, for example.
Psoriasis is certainly not infectious and is nothing to do with poor skin hygiene. For about one in three people it runs in their family although it often skips a generation.
Can I stop it?
It's difficult to know what to do to avoid it because so little is understood about why psoriasis starts in the first place Generally speaking keeping stress levels at a minimum and the immune system strong to keep infections away may help.
Although it's not yet possible to cure psoriasis, it is possible to keep it at bay with treatment.
Should I see a doctor?
It's important to get the diagnosis confirmed since many skin rashes look similar but need different treatments. The GP is usually able to do this and recommend the best treatment options.
When more powerful treatments may be needed then an appointment with a skin specialist is recommended.
Treatments
Light cotton clothes tend to be less irritating to the skin than wool or synthetic ones.
The skin needs to be kept well moisturised to prevent itching and irritation. Use an emollient cream or ointment. Some of these can also be used as a soap-substitute which helps to keep the protective oils on the skin.
A variety of skin creams and ointments are available to help remove the plaques and keep the psoriasis under control.
Some people benefit from ultraviolet light treatment that is used and supervised by hospital clinics. Occasionally tablets are used to treat psoriasis when other methods aren't helping. These suppress the immune system and again are monitored by hospital specialists.
This article was last medically reviewed by Dr Rob Hicks in May 2005.
First published in October 1997.
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