SSM Cardinal Glennon Children's Medical Center
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Skin Problem: Psoriasis

Psoriasis = Red, Flaky Skin

If you have psoriasis, you probably know how to say this tricky word. The "p" is silent.

Psoriasis (say: sor-EYE-uh-sus) is a skin problem that causes areas of red, flaky skin. These areas, called plaques (say: plax), form when skin cells build up on the surface of the skin. Psoriasis can show up anywhere on the body, but is most common on the scalp, knees, elbows, and upper body.

Psoriasis is a chronic condition. (A chronic condition is one that a person has for a long time or one that goes away and keeps coming back.) Psoriasis can be simply annoying, but it also can be painful. And having psoriasis can be upsetting. Why? Because a person might feel embarrassed or worried about how he or she looks.

Treatment can help the symptoms and make people who have psoriasis feel better. Support groups also can help.

Right now, there's no cure for psoriasis, but lots of good options are available to treat the symptoms. Smart choices, such as keeping a healthy diet and weight, also can help. Even just getting a little bit of natural sunlight can make the symptoms better. Your doctor will tell you if this might work for you.

What Causes Psoriasis?

Doctors aren't certain why some people get psoriasis, but they do know how the disease works. In your blood, you have a kind of white blood cell called a T lymphocyte, or T cell. T cells travels around your body fighting off stuff that could make you sick, like bacteria and viruses.

When someone has psoriasis, T cells attack healthy skin. The body's immune system responds by sending more blood to the area. The body then makes more skin cells and more white blood cells.

It's important to know that your body is always making new skin cells and shedding old ones. With psoriasis, the dead skin and white blood cells can't be shed quickly enough, and they build up on the surface of the skin as thick, red areas. As the skin cells die, they form silvery scales that eventually flake off.

Psoriasis is passed down in your family's genes. So if someone in your family has psoriasis, that can increase your risk of getting it. It's not contagious, so you don't catch it like a cold or chickenpox.

How Do I Know If I Have Psoriasis?

If you have psoriasis, you'll most likely have one or more of these symptoms:

  • raised red areas of skin with silvery scales
  • dry, cracked skin that may bleed at times
  • itching, soreness, or a burning sensation where the rash is
  • thick, pitted fingernails

What can make a person's psoriasis worse? Certain medicines, being sick, cold weather, and stress can be triggers. Being overweight also can be a problem because psoriasis can develop in skin folds. A rash is more likely to break out when your skin is hurt because of a sunburn, scratch, or other irritation.

What Will the Doctor Do?

The doctor will look at your skin, scalp, and nails and ask you some questions. The doctor may ask you and your parent if anyone in your family has psoriasis, if you've recently had an illness, or if you've started a new medicine.

On rare occasions, the doctor may remove a small sample of skin to look at it more closely. This is known as a biopsy. A biopsy can tell doctors whether someone has psoriasis or another condition with similar symptoms.

There are lots of ways to treat psoriasis, and different ones work for different people. Your parent and doctor can help figure out which treatments are best for you.

There are two main kinds of treatments:

  1. Medicines can include creams, lotions, and ointments that are put directly on the skin. They also can include pills and injections (shots).
  2. Light therapy, or phototherapy, means exposing the skin to natural or artificial ultraviolet light. A doctor may recommend you go outside and get a little more sun, but too much sunlight can make psoriasis worse.

It's not always easy to find a therapy that works. Sometimes what worked for a while will stop working. A doctor might try one treatment, then switch to another, or recommend a combination of therapies.

It's important to work closely with your doctor and follow the treatment plan carefully. If a certain cream needs to be applied twice a day, be sure to do it. If you're confused or frustrated, be sure to ask for a parent's help.

Reviewed by: Rupal Christine Gupta, MD
Date reviewed: April 2015