Psoriasis: what it is, symptoms, triggers and everyday skin care

Psoriasis is a chronic inflammatory disease that mainly affects the skin, causing reddish patches and scaling. Although it is common, it is still surrounded by myths, starting with the mistaken idea that it spreads through contact. In this article we explain what it is, how to recognise it and which everyday habits can help keep symptoms under control.

What psoriasis is and why it appears

Psoriasis results from an overactive immune response that speeds up the renewal of skin cells. Instead of taking several weeks to reach the surface, the cells build up in just a few days and form thick, red plaques covered with whitish scales.

There is a genetic predisposition: it is more common in people whose close relatives also have the condition. However, having this predisposition does not mean psoriasis will necessarily appear. Usually something has to trigger or worsen the lesions.

Two facts are worth stressing:

• It is not contagious: it does not pass from person to person through touch, shared towels or swimming pools.
• It is chronic but variable: flare-ups alternate with periods in which the skin improves considerably or becomes almost clear.

Symptoms and the most common types

Signs vary from person to person, but the most usual are:

• Red, well-defined plaques with silvery scales, especially on the elbows, knees, scalp and lower back.
• Itching, burning or a feeling of tight skin.
• Scaling of the scalp, sometimes mistaken for severe dandruff.
• Nail changes: small pits, thickening, yellowish spots or the nail lifting from its bed.
• Pain, swelling or stiffness in the joints when psoriatic arthritis is also present.

Dermatologists describe several clinical forms. Plaque psoriasis is the most frequent. Inverse psoriasis appears in skin folds such as the armpits, groin or under the breasts, with smooth lesions and little scaling. Guttate psoriasis appears suddenly, with many small drop-shaped lesions on the trunk, often after a throat infection. There are also rarer pustular and erythrodermic forms, which can cover large areas of the body and require prompt medical assessment.

Psoriasis is also associated with a higher risk of other health problems, such as high blood pressure, type 2 diabetes, excess weight and cholesterol changes. For this reason, follow-up should not focus on the skin alone.

Factors that can trigger or worsen flare-ups

Identifying your own triggers is one of the most useful tools for anyone living with psoriasis. The best known are:

• Psychological stress: periods of greater tension often coincide with flare-ups.
• Infections: especially throat infections.
• Skin injuries: scratches, cuts, sunburn or tattoos can cause new lesions at the site.
• Smoking and excessive alcohol: both are linked to more severe forms and a poorer response to treatment.
• Excess weight: it promotes inflammation and lesions in skin folds.
• Cold, dry weather: many people get worse in winter.
• Some medicines: certain drugs can aggravate the condition. Never stop a medicine on your own; discuss it with your doctor.

A practical suggestion is to keep a simple log for two or three months, noting the days of flare-ups and what happened beforehand (poor nights of sleep, illness, changes in routine). This log helps to spot patterns and is useful at appointments.

Daily care that helps the skin

Treatment is always defined by a doctor, but some habits complement that plan and make the skin more comfortable:

• Moisturise every day: apply a fragrance-free emollient cream straight after bathing, while the skin is still slightly damp, at least once or twice a day.
• Short, lukewarm showers: 5 to 10 minutes, with gentle cleansers. Very hot water dries the skin and increases itching.
• Pat dry: press the towel against the skin instead of rubbing.
• Do not pick at the scales: forcing them off can irritate the skin and cause new lesions.
• Comfortable clothing: cotton fabrics and loose garments reduce friction.
• Moderate sun exposure: short exposures may benefit some people, but sunburn makes psoriasis worse. Use sunscreen on unaffected areas and talk to your doctor before making sun exposure a habit.
• A balanced lifestyle: quitting smoking, moderating alcohol, exercising regularly and maintaining a healthy weight help reduce inflammation.

The emotional impact matters too. Psoriasis can affect self-esteem and social life, and talking about it with your doctor, your family or support groups is part of the care.

In summary

Psoriasis is a chronic, non-contagious inflammatory disease with periods of flare-up and improvement. Recognising the symptoms, identifying what makes it worse and keeping up a routine of moisturising and healthy habits all help to control the lesions better. There are several effective treatments, from topical products to phototherapy and systemic medicines, but the choice depends on the type and severity of each case and should be made by a dermatologist. This article is for information only and does not replace the assessment of a health professional.