Psoriasis Treatment

Psoriasis is a chronic skin condition that causes skin cells to grow abnormally fast. It presents as thick, scaly patches on the skin. In normal skin, cells grow and fall off after about 4 weeks. When the skin sheds off, new cells then grow in place of the cells that have flaked off. When you have psoriasis, those new skin cells come to the skin’s surface much more quickly – in days instead of weeks.

Psoriasis can be an extremely embarrassing condition, especially during swimsuit season. Although psoriasis is not contagious, it is a chronic condition that requires attention to manage it successfully.

While psoriasis can’t be cured, dermatology providers can help patients minimize symptoms, prevent flare-ups, and achieve clearer, healthier skin with consistent treatment and care.

What Is Psoriasis?

Psoriasis is an inflammatory skin disease that occurs when the immune system sends faulty signals, triggering the body to produce new skin cells too quickly. These cells pile up on the surface, creating raised, red, and scaly patches known as plaques.

Common signs and psoriasis symptoms include:

Red, inflamed skin covered with thick, silvery-white scales
Itching or burning sensations
Cracking or bleeding skin
Stiff or painful joints in some cases (psoriatic arthritis)

Psoriasis can develop anywhere on the body, but it often affects the scalp, knees, elbows, hands, feet, and lower back. Symptoms can vary depending on the type and severity of the condition.

What Causes Psoriasis?

It is not exactly clear why some people get psoriasis; however, there is a strong genetic component, and the immune system plays a large role as well. It is widely thought that psoriasis causes relate to overactive T cells, which mistakenly attack healthy skin cells as if they were a foreign substance.

When these T cells trigger inflammation, the body responds by rapidly producing new skin cells, resulting in a buildup of plaques.

Certain factors can increase your risk of developing psoriasis, including:

Family history of psoriasis
Chronic stress or illness
Smoking and heavy alcohol use
Certain infections (like strep throat)
Cold or dry weather

Triggers for Psoriasis Outbreaks

Triggers for psoriasis outbreaks include:

Strep throat
Cold weather
Smoking
Stress
Bug bites
Sunburn
High blood pressure medications

Other common psoriasis triggers include skin injuries (like cuts, scrapes, or tattoos), rapid hormonal changes, and even certain infections or allergies. Identifying what causes your flare-ups is an important part of successful treatment planning.

Types of Psoriasis

There are several types of psoriasis, and symptoms can vary based on the form you have.

Plaque Psoriasis

Plaque psoriasis is the most common type of psoriasis. This chronic skin condition is often characterized by an almost silvery buildup of skin (oval-circular plaques) that can develop on the back, palms, scalp, feet, face, knees, and elbows.

Symptoms of plaque psoriasis include dry, cracking, and itchy skin that can sometimes appear raw and may bleed.

Scalp Psoriasis

Scalp psoriasis appears as scaly, dry, and even cracked and bleeding patches of skin along the hairline, back of the neck, or even behind the ears.

Scalp psoriasis can sometimes resemble dandruff, but the scales are thicker and accompanied by redness and irritation. In some cases, patients may also notice temporary hair shedding due to scratching or inflammation, but psoriasis does not directly cause permanent hair loss.

Other Types of Psoriasis

Other less common forms of psoriasis include:

Guttate psoriasis, which often appears after a strep infection as small, drop-shaped lesions
Inverse psoriasis, which develops in skin folds and appears shiny rather than scaly
Pustular psoriasis, which features small pus-filled bumps surrounded by redness

Is Psoriasis Contagious or an Autoimmune Disease?

Psoriasis is not contagious – you cannot catch it from another person or spread it by touch. It is classified as an autoimmune disease, meaning your immune system mistakenly attacks your body’s own cells, leading to inflammation and rapid cell turnover.

Because of its autoimmune nature, psoriasis often responds well to biologic therapies and immune-modulating medications that calm the overactive immune response.

What to Expect at a Consultation for Psoriasis

If you have lesions and scaly patches that are not going away, we strongly recommend seeing a dermatology provider for treatment options. Your dermatology provider may biopsy the area to determine that it is psoriasis versus another type of skin condition. We want to make sure that you get the right type of treatment to lessen the effects of this chronic skin condition.

During your visit, your provider will also discuss possible triggers, review your medical history, and assess whether your psoriasis affects only the skin or also the joints. Identifying the correct type and severity helps determine the most effective treatment plan.

Treatments for Psoriasis

While there is no cure for psoriasis, there are treatments that can make a dramatic difference in the intensity and severity of your skin condition. Your dermatologist or dermatology provider will tailor a psoriasis treatment plan based on your condition’s type, severity, and response to past therapies.

Topical Treatments for Mild Psoriasis

For patients with mild or localized psoriasis, topical medications are often the first line of treatment. These may include:

Corticosteroid creams or ointments to relieve inflammation and itching.
Vitamin D analogs (like Calcipotriene) to slow skin cell growth.
Retinoids (Tazarotene) to help remove scales and smooth the skin.
Coal tar and salicylic acid preparations to soften thickened plaques.

Regular use of emollients and moisturizers also plays a crucial role in keeping the skin barrier healthy and preventing flare-ups.

Phototherapy and Laser Treatments

For moderate psoriasis or widespread symptoms, light-based therapy can be highly effective.

Narrowband UVB phototherapy exposes the skin to controlled ultraviolet light to slow excessive cell growth.
Excimer laser therapy (such as XTRAC) delivers a concentrated beam of UVB light directly to affected areas, leaving healthy skin untouched.
Phototherapy sessions are short, painless, and require little to no downtime.

At Schweiger Dermatology Group, we offer XTRAC, an FDA-approved psoriasis treatment that helps clear scaly, inflamed patches and keeps the skin symptom-free for months. Most patients experience long-lasting relief with minimal side effects, and XTRAC is covered by most insurance plans.

Systemic Medications for Moderate to Severe Psoriasis

When psoriasis affects large areas of the body or does not respond to topical or light therapy, systemic (whole-body) medications may be prescribed. These treatments work internally to reduce inflammation and regulate the immune response. There are oral pills as well as injectable medications. Because systemic medications can have side effects, regular monitoring and lab testing are recommended for some medications to ensure safety and effectiveness.

Common oral systemic psoriasis treatments include:

Methotrexate or cyclosporine, which suppress overactive immune activity.
Oral retinoids (acitretin) to slow down skin cell production.
Apremilast (Otezla®), which helps control inflammation by blocking certain enzymes involved in psoriasis.
Deucravacitinib (Sotyktu®) blocks the signals involved with inflammation.

Biologic medications have revolutionized psoriasis care. These injectable or intravenous drugs target specific parts of the immune system responsible for inflammation and plaque buildup. These are injectable medications

Common biologics used to treat psoriasis include:

Adalimumab (Humira®), Secukinumab (Cosentyx®), Ustekinumab (Stelara®), and Risankizumab (Skyrizi®).
These treatments are often recommended for patients with moderate to severe psoriasis or psoriatic arthritis.

Biologics can lead to clearer skin, reduced itching, and improved quality of life with fewer flare-ups, and ongoing research continues to expand available options.

Combination and Maintenance Therapy

Many patients achieve the best results through combination therapy, using topical treatments to manage flare-ups while maintaining long-term control with light or biologic therapy.

Maintaining regular dermatology visits helps track progress, adjust medications as needed, and prevent recurrence. When managed properly, most people with psoriasis can achieve long-term remission and confidently maintain healthy, comfortable skin.

Psoriasis Diet and Lifestyle Tips

If you have psoriasis, there are certain diet modifications you can make to keep your psoriasis in check.

The best foods for psoriasis include omega-3 fatty acids from salmon and mackerel and vegetables with anti-inflammatory properties, such as nuts, avocados, kale, spinach, and broccoli.

The worst foods for psoriasis include alcohol, refined sugar, gluten, fried foods, dairy products and nightshade vegetables, such as tomatoes, peppers and potatoes. Maintaining a healthy weight also helps keep your psoriasis in check.

Regular exercise, stress management, and adequate hydration can also help reduce flare-ups. Avoiding smoking and limiting alcohol intake supports overall skin health and may enhance treatment response.

Controlling Psoriasis Outbreaks

There are certain lifestyle measures you can take to help control psoriasis outbreaks. Take a daily lukewarm bath to remove the scales associated with psoriasis. You can also add colloidal oatmeal and bath oils to help soothe inflamed skin.

Moisturize immediately after bathing to lock in hydration and keep your skin barrier strong.
Avoid scratching, use gentle fragrance-free products, and wear soft fabrics that won’t irritate plaques.

Because stress can trigger flare-ups, relaxation techniques such as yoga, meditation, and deep breathing can also play an important role in long-term psoriasis management.