Your Psoriasis Questions Answered

If you've just been diagnosed with psoriasis, you may have a few questions about it. Here are answers to some of the more common ones people ask.

What's the difference between psoriasis and eczema?

To an untrained eye, these conditions may seem alike. But while they're both skin diseases, they're not the same. In fact, "They're 100 percent different," says Whitney High, MD, an associate professor of dermatology and the director of the Dermatopathology Laboratory at the University of Colorado Anschutz Medical Campus.

Psoriasis doesn't usually affect children, High says. But eczema, or atopic dermatitis, is a childhood disease. Eczema also tends to be itchier than psoriasis. Only about a third of people who have psoriasis say they have itchiness.

And the conditions are likely to appear in different places. Eczema often shows up on kids' faces and buttocks and the inside of their knees and elbows. Psoriasis isn't typically found in those places.

Plus, "The same person that has childhood eczema doesn't get psoriasis. And the person who has psoriasis as a young adult usually didn't have childhood eczema," High says.

What causes psoriasis?

Doctors aren’t exactly sure. “I get that a lot of times; ‘Why do I have it?’” says Melvin Chiu, a doctor of dermatology at the David Geffen Medical Center at the University of California, Los Angeles. “I don’t really … have a good answer for that. It’s a big mystery, I think, right now.”

Chiu says researchers believe the two main culprits behind psoriasis are your genes and your environment. Scientists are still tracking down which genes are to blame, but they think that about 1 out of every 10 people got at least one of the genes that can lead to psoriasis from their parents.  But only about 3% of people who have those genes get psoriasis. That's where the environment comes into play.

Researchers think things like infection (especially strep throat), an injury to the skin, certain medications, smoking, and other things may trigger the condition.

What's the cure?

"There is no cure at this point," Chiu says. "It's a chronic condition. … You may have times when it'll be worse, and there may be times when it'll get better." He also says there may be some lucky people in whom it's very minimal. Or it gets better and doesn't get worse again. But, he says, most people "can expect it will be persistent." Treating it can make it better. But when treatments stop, it often comes back.

"There are some really excellent treatments," he says. "There are newer treatments in the pipeline, and many treatments [that] are available currently … work very well." Those treatments don't cure the disease, he says. "But they significantly improve the disease and make [people] feel better."

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What are the treatments?

The most common ones are medicines prescribed by your doctor. They include foams, solutions, ointments, or creams, called topicals, that you put on your skin, along with drugs you take that affect your whole body. Your doctor also may recommend light therapy.

"Consult with a board-certified dermatologist, and they'll be happy to discuss any and all of these options, including over-the-counter options when they're appropriate," High says.

What works for one person may not work for another. That's why you and your doctor need to talk about what your treatment plan should be.

Chiu says that with the treatments available now, "we can get skin a lot better." He says that 20 to 30 years ago, psoriasis patients had much worse options and many fewer ones than people do now. "I tell people, it's kind of an exciting time in psoriasis."

Can the sun help?

Some research says a little every day can help with your symptoms. But, as always, you have to be careful not to overdo it. A sunburn may lead to a flare-up.

Is psoriasis contagious?

You can't "give" it to anyone, and no one can "catch" it from you.

"You can touch psoriasis all day long," High says. "As a dermatologist … I see at least one person if not a few people with psoriasis [every work day], and I don't have it." High adds, "My wife doesn't have it. I didn't bring it home. I don't do special laundry. I don't undress in the garage or anything like that."

What is psoriatic arthritis?

Up to 30% of people who have psoriasis get this condition as well. It causes inflammation and swelling in your joints that can lead to pain and stiffness.

If you have psoriasis and feel any discomfort in your joints, tell your doctor. It's important to treat it quickly so your joints don't get damaged.  

Are any other conditions linked to psoriasis?

Research is still under way, but scientists think people with psoriasis and psoriatic arthritis may be more likely to have other serious diseases.

"There's an increasing appreciation that psoriasis can manifest in other ways: increased risk of cardiovascular disease, increased risk for obesity … a natural risk for diabetes," High says. "It might impact your life in ways that you can't even really fully predict now."

Besides cardiovascular diseases and obesity, psoriasis also has been linked to cancer, Crohn's disease, depression, and liver disease, among others.

That's even more reason to stay in touch with your doctor and make sure you have a plan.

WebMD Feature Reviewed by Stephanie S. Gardner, MD on July 21, 2019

Sources

SOURCES:

American Academy of Dermatology: “Psoriasis,” “Who Gets and Causes.”

National Psoriasis Foundation: “About Psoriasis,” “The Immune System and Psoriatic Disease.”

CDC: “Prevalence of Psoriasis Among Adults in the U.S.”

Whitney High, MD, associate professor of dermatology, University of Colorado; Dermatopathology Laboratory director, University of Colorado.

Melvin Chiu, MD, director, Psoriasis and Phototherapy Center, David Geffen School of Medicine, University of California, Los Angeles; assistant professor of medicine, David Geffen School of Medicine, UCLA; health sciences assistant clinical professor, dermatology, David Geffen School of Medicine, UCLA.

American Academy of Dermatology: “What’s the difference between eczema and psoriasis?”

National Psoriasis Foundation: “About Psoriatic Arthritis,” “Causes and Triggers,” “Comorbidities Associated with Psoriatic Disease,” “Genes and Psoriasis,” “Moderate to Severe Psoriasis and Psoriatic Arthritis: Biologic Drugs,” “Psoriasis Treatments,” “Why early diagnosis is critical for psoriatic arthritis.”

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