7 Types of Psoriasis

Medically Reviewed by Poonam Sachdev on April 11, 2024
Written by Annie Stuart, Rachel Reiff Ellis
11 min read

There are a few types of psoriasis. While some are similar, they can have different symptoms and treatments. Each type affects a different area of your body.

Knowing which kind of psoriasis you have helps you and your doctor make a treatment plan. Most people have only one type at a time. Sometimes, after your symptoms go away, a new form of psoriasis may appear.

In general, most types of psoriasis result from the same triggers:

Other things that may trigger psoriasis include:

Here's how you can spot the seven types of psoriasis and what you can do to treat them.

This is the most common type. About 8 in 10 people with psoriasis have this kind. You may hear your doctor call it "psoriasis vulgaris."

The symptoms of plaque psoriasis include raised, inflamed, red skin covered with silvery, white scales. On darker skin, the patches may be purplish with gray scales. These patches may itch and burn. It can appear anywhere on your body, but it often pops up in these areas:

  • Elbows
  • Knees
  • Scalp
  • Lower back

Plaque psoriasis treatments include:

Topical treatments. These go on your skin and are usually the first thing doctors try. Some have steroids; others don’t. Prescription products slow skin cell growth and ease inflammation. Types of topical treatments include:

  • Coal tar. This dark liquid comes from tar and may be part of shampoo, ointments, or foams. You can get some products with coal tar in them without a prescription.
  • Vitamin D creams. Your doctor may prescribe these alone or in combination with a corticosteroid.
  • Topical retinoids. These topical treatments come from vitamin A. You shouldn’t use them if you’re pregnant.
  • Immunosuppressives. Topical medicines called calcineurin inhibitors can reduce inflammation and plaque buildup if corticosteroids aren’t working. They work by turning down your body’s immune response.

Phototherapy . This treatment uses ultraviolet (UV) light. You’ll get it at your doctor's office or at home with a phototherapy unit.

Systemic medications. These prescription drugs work throughout your body. You’ll get them if you have moderate to severe psoriasis that doesn’t respond to other treatments. You could take them by mouth or get them as a shot or IV. This category includes drugs called biologics, which target specific parts of your immune system that play a role in the inflammatory process. Learn more about systemic treatments for psoriasis.

There are many home remedies to help treat your psoriasis, too. You can:

Take daily baths. Keep them short and warm (not hot), and pat yourself dry afterward instead of rubbing.

Moisturize frequently. Applying cream or ointment when your skin is moist, such as right after bathing, is the best time to help lock in moisture. Thick options are best, such as petroleum jelly.

Step into the sun. Exposure to natural light can improve psoriasis. Start with about 5 minutes at the height of the daytime light. Talk to your doctor first, especially if you’re taking any medications that increase your sensitivity to sun.

Manage stress. Stress can make psoriasis flare. Get regular exercise, eat a balanced diet, get enough sleep, and practice relaxation techniques such as meditation and deep breathing to calm your system.

Keep track of triggers. Pay attention to your environment, foods you’re eating, medications, and stress levels so you can figure out what makes your psoriasis flare and avoid them as much as you can.

Once the plaques are cleared, your skin in those areas may be discolored. You may have darker patches (hyperpigmentation) or lighter patches (hypopigmentation). This is often more noticeable on darker skin. Typically, this clears on its own over time.

This type often starts in children or young adults. It makes up about 8% of psoriasis cases.

Guttate psoriasis causes small, pink-red spots on your skin. On darker skin, the spots may be purplish. They often appear on your:

  • Trunk
  • Upper arms
  • Thighs
  • Scalp

This type of psoriasis may go away within a few weeks, even without treatment. Some cases, though, are more stubborn and require treatment. Around one-third of people who have guttate psoriasis go on to have plaque psoriasis. In these cases, guttate psoriasis is an early psoriasis sign.

To treat mild guttate psoriasis, you can use:

Creams. Itching and inflammation can be treated by creams, especially those containing cortisone or other corticosteroids. Creams that have coal tar in them can help, too.

Medications with vitamins. You can apply medication containing vitamin D on your skin, or you can take medications with vitamin A by mouth.

Dandruff shampoo. You can get this over-the-counter shampoo in a prescription-strength version to treat guttate psoriasis on your scalp.

For severe cases, treatments include:

Biologic medications. These target parts of your immune system and stop them, easing your symptoms.

Phototherapy. You can treat your guttate psoriasis with UV light. You can use this on its own, or along with other medications.

Immunosuppressants. These drugs lower your body's immune response, which will help ease the symptoms of guttate psoriasis.

This type is usually found in these locations:

  • Armpits
  • Groin
  • Under the breasts
  • Skin folds around the genitals and buttocks

Symptoms include:

  • Patches of skin that are bright red, smooth, and shiny but lack scales
  • Getting worse with sweating and rubbing

Common triggers are:

Treatments for inverse psoriasis include:

Ointments. There are a few ointments that can help with this form of psoriasis:

  • Anti-inflammatory creams such as roflumilast (Zoryve) or tapinarof (Vtama)
  • Calcipotriene (Calcitrene, Dovonex, Sorilux), a form of vitamin D that helps lessen discoloration
  • Corticosteroid creams or ointments, to ease inflammation

Injectable medications. You may use drugs such as adalimumab (Humira Pen, Humira Pen Crohn's-UC-HS Start, Humira Pen Psoriasis-Uveitis), etanercept (Enbrel), or infliximab (Avsola, Inflectra, Ixifi, Remicade, Renflexis). You can inject these under your skin, or your doctor can inject them into your vein.

Oral medications. You can take medications by mouth to treat severe forms of inverse psoriasis. They come in pill or capsule form. Some options include acitretin (Soriatane) capsules, apremilast (Otezla) oral tablets, deucravacitinib (Sotyktu) oral TYK 2 inhibitor, or methotrexate (Otrexup (PF), Trexall Tablets, Xatmep).

Phototherapy. Just like with guttate psoriasis, UV light treatment can help ease the symptoms of inverse psoriasis.

This kind of psoriasis is uncommon and mostly appears in adults. It causes pus-filled bumps (pustules) surrounded by red or purplish skin. These may look infectious but are not. Although these blisters can clear up within days, the condition is chronic, meaning they usually come back.

This type may show up on one area of your body, such as the hands and feet. Sometimes, it covers most of your body, which is called "generalized" pustular psoriasis. When this happens, it can be very serious, so get medical help right away.

Symptoms include:

Triggers include:

  • Topical medicines (ointments you put on your skin) or systemic medicines (drugs that treat your whole body), especially steroids
  • Suddenly stopping systemic drugs or strong topical steroids that you used over a large area of your body
  • Getting too much UV light
  • Pregnancy
  • Infection
  • Stress
  • Exposure to certain chemicals

Types of pustular psoriasis

Von Zumbusch psoriasis. Doctors also call this generalized pustular psoriasis because it often covers large parts of the body. It comes on quickly and can cause fever, chills, severe itching, change in heart rate, fatigue, and muscle weakness.

Palmoplantar pustulosis. This localized type of pustular psoriasis shows up on the palms of your hands and/or soles of your feet, specifically the base of your thumb and sides of your heels.

Acropustulosis. Also called acrodermatitis continua of Hallopeau (ACH), this very rare type of pustular psoriasis often happens after an injury or infection. It only affects the tips of the fingers or toes, specifically your nails.

Treatments for pustular psoriasis include:

  • Topical medications, creams, or ointments
  • Oral medications
  • Phototherapy (best used after blisters have cleared and skin is less irritated)
  • Biological treatments

The goal of treatment is to get rid of pustules, prevent side effects (such as infections), and stop itchiness or pain. Often, identifying the underlying cause of pustular psoriasis and treating that condition can help reduce the chance that it will come back.

This type is the least common, but it's very serious. It affects most of your body and causes widespread, fiery skin that appears to be burned.

Other symptoms include:

  • Severe itching, burning, or peeling
  • A faster heart rate
  • Changes in body temperature

If you have these symptoms, see your doctor right away. You may need to get treated in a hospital. This type of psoriasis can cause severe illness from protein and fluid loss. You may also get an infection, pneumonia, or congestive heart failure.

Triggers include:

  • Suddenly stopping your systemic psoriasis treatment
  • An allergic drug reaction
  • Severe sunburn
  • Infections
  • Medications such as lithium, antimalarial drugs, cortisone, or strong coal tar products
  • Alcohol use disorder
  • Significant stress or a traumatic event

Erythrodermic psoriasis may also happen if your psoriasis is hard to control.

Psoriasis can't be cured, but treatment can lessen and prevent symptoms. In severe cases, you'll need medical care, sometimes at a hospital.

You might use treatments such as:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Oral retinoids
  • Biologic therapies
  • Hypoallergenic moisturizers and cool compresses
  • Topical ointments such as corticosteroids or retinoids
  • Immunosuppressants such as cyclosporine or methotrexate
  • Disease-modifying antirheumatic drugs (DMARDs)

With erythrodermic psoriasis, stay away from:

  • Phototherapy that uses UV light
  • Oral corticosteroids
  • Coal tar products

Up to half of those with psoriasis have nail changes. Nail psoriasis is even more common in people who have psoriatic arthritis, which affects your joints.

Symptoms include:

  • Pitting of nails, where small notches form in your nails
  • Tender, painful nails
  • Separation of the nail from the bed
  • Color changes (yellow-brown)
  • Chalklike material under your nails
  • Thickened nails
  • Grooves in your nail
  • Crumbling nails
  • Thick skin under your nails
  • Colored spots under your nails

You're more likely to have a fungal infection, too.

Treatment for nail psoriasis can be tricky. You might have to try multiple options before you find one that works. Treatment types include:

Injectable medications. For severe nail psoriasis, your doctor will inject medicine into the skin around your nails. You might receive adalimumab (Humira Pen, Humira Pen Crohn's-UC-HS Start, Humira Pen Psoriasis-Uveitis), etanercept (Enbrel), ixekizumab (Taltz), or ustekinumab (Stelara).

Oral medications. These are also for serious cases. They come in liquid, pill, or tablet form. You might take apremilast (Otezla), cyclosporine (Gengraf, Neoral, Sandimmune), deucravacitinib (Sotyktu), or methotrexate (Otrexup (PF), Trexall, Xatmep).

Corticosteroids. These are prescription drugs and come in the form of cream, ointment, or nail polish.

Phototherapy. This can also help with nail psoriasis as it does with psoriasis that affects your skin.

Laser therapy. Your doctor might use a pulsed dye laser (PDL) that will reach the blood vessels under your nails. This might help make your condition less intense.

Psoriatic arthritis is a condition where you have both psoriasis and arthritis (joint inflammation). In more than 80% of cases, people had psoriasis for an average of 12 years before getting psoriatic arthritis. About 90% of people with psoriatic arthritis also have nail changes.

The symptoms of this type include:

  • Painful, stiff joints that are worse in the morning and after rest
  • Sausage-like swelling of the fingers and toes
  • Warm joints that may be discolored

There's no cure for psoriatic arthritis, but you can use some treatments to help control inflammation, pain, and disability. Some options include:

Medications

  • NSAIDs can lessen pain and inflammation if you have a mild version.
  • Conventional DMARDs are another type of drug that can slow down the condition's progression and save your joints and tissues from damage.
  • Biologic agents are another class of DMARDs that affect different parts of your immune system.
  • Targeted synthetic DMARDs can help if biologic agents and conventional DMARDs aren't helpful.
  • Newer oral drugs, such as apremilast (Otezla) and deucravacitinib (Sotyktu), lower inflammation. They're for people with a mild to moderate version who can't use DMARDs or biologic agents.

Therapy. Occupational, physical, and massage therapy can help ease pain, allowing you to move better. 

Procedures and surgery. You may need joint replacement therapy if your joints have been damaged. Steroid shots can also help with this condition, as they lower inflammation.

Parapsoriasis is the term for a group of rare skin problems that look like psoriasis but behave differently. Your doctor may need to take a sample of your skin (biopsy) to be sure of what you have.

Like psoriasis, parapsoriasis shows up as a patchy rash. Spots are usually pink or red but also can appear brown or yellowish. They can be raised and bumpy with a scaly or wrinkly appearance.

You typically get them on your chest, stomach, and back, but they also may appear on your arms and legs. They're generally round or oval but can be different sizes.

You may have itching, but you probably won't have any other symptoms.

There are two kinds of parapsoriasis:

Small-plaque. Rash spots are less than 5 centimeters (about 2 inches) across. It's usually considered harmless.

Large-plaque. Rashes are bigger and sometimes irregularly shaped. Some people with this form get a kind of lymphoma called mycosis fungoides. It's a cancer of the white blood cells that starts in the skin. Some doctors consider large-plaque parapsoriasis a separate disease. Others think it's just an early stage of mycosis fungoides.

Most people with small-plaque parapsoriasis don't need treatment. But if you have symptoms or want to get rid of that appearance, topical corticosteroids can help. If this doesn't work, phototherapy may be a better option.

Treatment options for large-plaque parapsoriasis include topical corticosteroids (for mild versions) and phototherapy (for more severe cases).

There are many different forms of psoriasis. The most common by far is plaque psoriasis. Each type looks and acts differently, affecting different parts of your body. If you notice signs of psoriasis, see your doctor. Although treatment can’t cure psoriasis, it can ease symptoms and help prevent the symptoms from worsening.

What is a rare type of psoriasis?

Both pustular psoriasis and erythrodermic psoriasis are rare. Only 3% of people with psoriasis have the pustular type, and 2% have erythrodermic type.

What can be mistaken for psoriasis?

Eczema, or a group of conditions that make your skin itchy, inflamed, or rash-like in appearance, is commonly confused with psoriasis. One type of eczema, seborrheic dermatitis, can look very similar to psoriasis on your scalp. Another condition called parapsoriasis also causes plaques and shares a similar name to psoriasis. But it is a different condition with a different cause than psoriasis. Skin cancer, hives, ringworm, and a condition called keratosis pilaris (which causes bumpy skin) can also sometimes look like psoriasis.