When to Seek Medical Care
You may want to see your doctor or health care practitioner if you have a sudden eruption of small red drop-like lesions of guttate psoriasis. This form of psoriasis is usually a mild inconvenience to most people. Most of the time, the lesions last several weeks to a few months. Other times, the guttate eruption can develop into chronic plaque psoriasis. Scarring is not a problem.
The doctor can prescribe treatments that help relieve itching. This type of psoriasis usually "runs its course" and goes away without treatment in a few weeks.
Exams and Tests for Guttate Psoriasis
Guttate psoriasis is typically diagnosed after the doctor or health care practitioner performs a physical exam of the skin. A dermatologist generally can tell if it is psoriasis just by looking at the skin. Skin biopsies are seldom necessary to confirm diagnosis.
Findings from blood tests may confirm that the patient had a streptococcal infection recently. Increased levels of certain antibodies are present in more than one half of patients.
Home Remedies for Guttate Psoriasis
This type of psoriasis may be treated at home in most mild-to-moderate cases. Keeping the skin moist will prevent extra irritation. Thick moisturizers applied after a bath to keep in moisture and soften the skin are helpful.
Over-the-counter topical steroids may help to reduce inflammation and itching.
Medical Treatment for Guttate Psoriasis
Usually, guttate psoriasis goes away in a few weeks without treatment. Simple reassurance and moisturizers to soften the skin may be sufficient care. The choice of treatment depends on the severity of the outbreak and the individual's preferences. For example, applying topical steroids, although effective, could be bothersome because the outbreak occurs over a large portion of the body in most cases.
- Antibiotics: If you have a history of psoriasis, the doctor will most likely take a throat culture when you have a sore throat. If the culture results are positive (meaning that you have a streptococcal infection), then starting immediately on antibiotics for the infection is very helpful.
- Phototherapy: Sunlight can help clear up this type of psoriasis. The ultraviolet (UV) light in sunlight helps to reduce psoriasis symptoms in some people. It slows the production of excess skin cells made in psoriasis, and has been shown to decrease the number of skin mast cells that cause inflammation in psoriasis.
The doctor may prescribe a short course of artificial light therapy (phototherapy). Broadband ultraviolet B or narrowband ultraviolet B light may be used.
More resistant cases may benefit from PUVA therapy, which combines an oral psoralen drug with exposure to ultraviolet A light. Psoralen drugs make the skin and eyes more sensitive to the sun. The drug is taken a few hours before the light therapy. Precautions need to be taken to prevent exposure to the sun for 24 hours after treatment because the skin is extra sensitive to the sun and can blister. For more information on psoralen drugs, see Understanding Psoriasis Medications.
People using PUVA therapy may experience a number of adverse effects, such as nausea and vomiting. These effects are sometimes remedied by taking psoralen pills after a meal. The sensitivity to the sun persists up to 24 hours after someone takes the drug. The person on PUVA therapy should wear special protective sunglasses and should avoid sun exposure during this treatment period.