Psoriasis Isn't Contagious And Other Myths Busted

We just might have to thank Kim Kardashian for raising awareness of psoriasis - a common disease that affects more than 8 million Americans. The lifelong condition that she and other celebrities like LeAnn Rimes have causes unsightly and itchy skin patches.

One of the most frustrating aspects of psoriasis for patients is encountering others' negative reactions to their skin flare-ups. If you don't understand the disease, you might fear getting close to someone who's afflicted. Or, you might even dismiss psoriasis as just a cosmetic problem.

Here, we explain what causes psoriasis, types of psoriasis and what you can do if you have psoriasis. A Franciscan Health primary care physician breaks down common myths about this common skin condition.

Key Takeaways: Psoriasis

• Despite common misconceptions, psoriasis is not contagious. It cannot be caught from or passed to another person. Psoriasis is a chronic autoimmune condition in which the immune system mistakenly signals skin cells to grow too rapidly, leading to the accumulation of skin cells and the formation of thick, scaly plaques.
• The exact cause of psoriasis is not fully understood, but it appears to result from a combination of genetic predisposition and environmental triggers. Having a family member with psoriasis increases one's risk of developing the condition.
• Psoriasis can affect more than the skin — psoriatic arthritis, which causes joint pain, develops in up to 30% of people with psoriasis, and symptoms can range from mild to severe, with flare-ups followed by periods of improvement or remission.
• There are several distinct types of psoriasis, including pustular psoriasis — which is characterized by pus-filled bumps made of white blood cells and is not an infection — and erythrodermic psoriasis, a particularly severe form that causes widespread redness and can be medically serious

What Is Psoriasis?

Psoriasis is a chronic autoimmune condition that mainly affects the skin.

“When you have psoriasis, your immune system sends signals to your skin cells to grow too fast,” said Daniel Hekman, MD, an Indianapolis family physician with Franciscan Health who has a special interest in skin care. “Normally, skin cells take about a month to form and rise to the surface. In people with psoriasis, this process happens in just a few days. Because the skin can't shed these cells fast enough, they pile up and form thick, scaly patches.”

What Are Symptoms Of Psoriasis?

Psoriasis symptoms can vary widely depending on the type and severity, but some common signs include:

• Red, inflamed patches of skin
• Thick, silvery-white scales
• Dry, cracked skin that may bleed
• Itching, burning or soreness
• Thickened or pitted nails
• Joint pain (in a condition called psoriatic arthritis, which affects up to 30% of people with psoriasis)

Psoriasis symptoms may come and go. You might have flare-ups followed by periods when the condition improves or even goes away for a while.

Where Can Psoriasis Appear?

Plaques, or the scaly patches of skin from psoriasis, can appear anywhere, but they are most common on the elbows, knees, scalp and lower back.

Are There Different Types Of Psoriasis?

There are five types of psoriasis, and it is important to know the different types so that the condition is treated appropriately:

• Plaque psoriasis: Plaque psoriasis, the most common form, appears as raised, red patches covered with a silvery white buildup of dead skin cells. These patches or plaques most often show up on the scalp, knees, elbows and lower back. They are often itchy and painful, and they can crack and bleed.
• Guttate psoriasis: Guttate is a form of psoriasis that appears as small, dot-like lesions. Guttate often starts in childhood or young adulthood and can be triggered by a strep infection.
• Inverse psoriasis: Inverse psoriasis shows up as very red lesions in body folds, such as under the breasts, under the arm or in the groin. It may appear smooth and shiny.
• Pustular psoriasis: Pustular psoriasis is characterized by white pustules (blisters of noninfectious pus) surrounded by red skin. The pus consists of white blood cells. Pustular psoriasis is not an infection, nor is it contagious. Pustular psoriasis can occur on any part of the body, but occurs most often on the hands or feet.
• Erythrodermic psoriasis: Erythrodermic psoriasis a particularly severe form of psoriasis that leads to widespread, fiery redness over most of the body. Erythrodermic psoriasis can cause severe itching and pain, and make the skin come off in sheets. It generally appears on people who have unstable plaque psoriasis.

What Causes Psoriasis?

The exact reason psoriasis develops isn't fully understood. It seems to be a combination of genetics and triggers in the environment, which lead to the immune system becoming overactive.

If someone in your family has psoriasis, your chances of getting it are higher.

What Triggers Psoriasis Symptoms?

Even if you're genetically prone to psoriasis, it may only show up after something sets it off. Triggers vary from person to person.

Common triggers that may set off a new bout of rashes or worsen symptoms of existing psoriasis patches include:

• Stress
• Alcohol
• Smoking
• Infections (like strep throat)
• Cold weather
• Dry weather
• Sunburn
• Certain medications (Consult your healthcare provider about which medications may be right for you).
• Skin injuries (cuts, burns, bug bites)

How Is Psoriasis Treated?

Treatment options for psoriasis include:

Topical Treatments

These are creams and ointments applied directly to the skin. They are often the first step in treating mild-to-moderate psoriasis. Examples include:

• Corticosteroids
• Vitamin D analogs (like calcipotriene)
• Coal tar
• Salicylic acid

Phototherapy (Light Therapy)

Light therapy involves exposing the skin to natural or artificial ultraviolet (UV) light under a doctor's supervision. UVB light, a specific band of UV light used in dermatology to treat various inflammatory conditions, can slow skin cell growth and reduce inflammation.

Systemic Medications

For moderate to severe psoriasis, oral or injected medications may be used. These work throughout the body and include:

• Methotrexate
• Cyclosporine
• Acitretin
• Biologic drugs (such as adalimumab, etanercept or secukinumab)

Biologics are more targeted and often used when other treatments don't help or cause side effects.

Lifestyle and home care

In addition to medical treatment, making lifestyle changes can help reduce flares and keep your skin healthier:

• Moisturize daily to prevent dryness and cracking.
• Manage stress through relaxation techniques, as stress can trigger flare-ups.
• Avoid skin injuries, which can lead to new patches (known as the "Koebner phenomenon").
• Quit smoking and limit alcohol, both of which can worsen psoriasis.
• Eat a balanced diet with anti-inflammatory foods such as fruits, vegetables and omega-3 fatty acids.
• Bathe smart by using gentle soaps and lukewarm water, and apply moisturizer afterward.

How Can I Reduce Skin Irritations?

People living with psoriasis can take some measures to reduce the potential of skin irritations. These include avoiding:

• Getting sunburned: Use sunscreen, stay in the shade, or wear sun protective clothes that cover the body.
• Contact with irritants: Products ranging from beauty treatments to household chemicals can irritate the skin.
• Scratching: Use topical treatments during a psoriasis flare to reduce itching.
• Injuries and bites: Wear clothes that cover the body when gardening, camping, and so on.
• Rubbing the skin: When bathing or showering, use products that a doctor recommends. Use lukewarm water, wash gently with the palms of the hands, and pat the skin dry after bathing. Avoid abrasive substances and sponges and try not to rub the skin.

Can Psoriasis Be Cured?

Psoriasis can’t be cured, but there are many effective treatments to help manage the symptoms and improve your quality of life. What works for one person may not work for another, so treatment often involves some trial and error.