Psoriasis: skin plaques, treatment and refills by video

Psoriasis is a chronic (long-lasting) disease in which the immune system is overactive and makes skin cells multiply too fast. They build up on the surface and form plaques. It is not contagious: it doesn’t spread to other people.

It can start at any age, but it most often begins between ages 10 and 35, or later in life, and it tends to run in families. Symptoms come and go: flares can last weeks or months, followed by periods when it improves.

Some things can trigger a flare: infections (such as strep throat), dry skin, cuts or bites on the skin, stress, some medicines, and both too little sun and sunburn. In Puerto Rico, protect yourself from strong sun: a sunburn can make psoriasis worse.

If your skin itches and is dry or red but without thick, scaly plaques, it may be eczema (dermatitis). If the itch is what bothers you most, see also itchy skin.

Doctor online 24/7: video doctor visits 24/7 — book online and choose your time right away. Every day, any time (Puerto Rico time). This is how you see a doctor online with us.

A first visit for psoriasis is a doctor visit. A refill of a treatment you already use is a follow-up visit. Prices are the same for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. See all prices.

Symptoms vary, but the most common are:

• Patches of thick, red skin with silvery-white scales that itch or burn
• Dry, cracked skin that itches or bleeds
• Patches on the scalp, elbows and knees
• Thick, ridged or pitted nails
• Trouble sleeping because of the itch

Plaque psoriasis is the most common. The other types are:

• Guttate: small, pinkish-red spots on the skin.
• Inverse: redness and irritation in skin folds, such as the armpits and groin.
• Pustular: yellow, pus-filled blisters surrounded by red, irritated skin.
• Erythrodermic: very intense redness covering a large area of the body. It is serious: see the warning signs.

Psoriasis has no cure, but symptoms can be controlled. Mild to moderate psoriasis is treated with creams, ointments, lotions, foams or solutions, especially those containing corticosteroids, and other skin treatments such as vitamin D–based medicines. For scalp psoriasis, solutions, foams and medicated shampoos (over the counter or by prescription) are often used.

If psoriasis is widespread or doesn’t improve with skin treatment, there is phototherapy and there are medicines that act on the whole body; a specialist manages those, and the doctor refers you.

• Keep your skin moisturized.
• Learn what triggers your flares (stress, infections, dry skin, skin injuries) and avoid it.
• Protect yourself from strong sun and avoid sunburn.
• Keep a healthy weight and a nutritious diet.

Some people with psoriasis get psoriatic arthritis: joints become stiff, swollen and painful, and the neck, back or heel may hurt. Tell the doctor as soon as possible, because it can cause serious joint damage. If the doctor suspects psoriatic arthritis, she refers you to a rheumatologist.

People with psoriasis also have a higher risk of fatty liver disease, heart disease and stroke, and of anxiety and depression. The doctor can review those risks with you and, if needed, give you a lab order.

A rare, severe form of psoriasis turns almost all the skin on the body red. For your safety, go to the emergency room or call 911 if you have any of the warning signs on this page.