‘I’m a Dermatologist, and These Are the Most Common Questions People Ask Me About Psoriasis’
Considering the condition affects nearly 8 million Americans—and most derms see it every day in their practices—it's time to dispel some of that confusion. To help, we asked Dr. Nazarian and other dermatologists to answer the four most common questions they regularly get about psoriasis. The most important piece of knowledge? "It is nothing to be embarrassed about," says Dr. Nazarian.
- Mona Gohara, MD, board-certified dermatologist at Dermatology Physicians of Connecticut and associate clinical professor in dermatology at Yale School of Medicine
- Rachel Nazarian, MD, FAAD, board-certified dermatologist at Schweiger Dermatology Group in New York
1. What is psoriasis, really?
"Psoriasis is the overgrowth of the top layer of skin cells in the epidermis, and is thought to be brought about by an immune reaction in the skin," says Mona Gohara, MD, a board-certified dermatologist based in New Haven, Connecticut. It can show up in a lot of different ways, which can make it hard to spot if you don't have the trained eye of a board-certified dermatologist to help you.
"The classic version is represented by a well-demarcated red rash with a very characteristic silvery scaling," says Dr. Nazarian. "Textbook psoriasis tends to affect the elbows, the knees, the butt, the scalp, and even the nails." However, there's no definitive way to know how psoriasis will appear for you.
In fact, people who have psoriatic biomarkers (that is, medical indicators that you have or are at risk for the condition) can even experience psoriatic arthritis, which differs from the skin condition in that it is inflammation in the joints that causes stiffness and even swelling in areas such as the fingers and toes. All of this to say, it's important to talk to a board-certified dermatologist to ensure you get a proper diagnosis.
2. Did psoriasis happen because of my lifestyle habits?
When patients first get diagnosed with psoriasis, Dr. Nazarian says that they often try to correlate it with something that they have done 'wrong.' "They think it's because they ate something new, or wore the wrong sweater, or traveled to a different climate," she says. In reality, psoriasis is genetic. "Either you have genes that will expose you to having this at some point in your life, or you don't. You can't play the blame game [if you have psoriasis]," says Dr. Nazarian.
Typically, most people begin to see psoriasis in their teens and 20s. While lifestyle habits don't cause psoriasis, if you're genetically predisposed, then habits like binge drinking, smoking, and weight fluctuations can cause flare-ups. Additionally, certain biomarkers can make psoriasis more prevalent, so Dr. Nazarian recommends keeping your cholesterol and blood pressure down to lower your risk.
3. Is it contagious?
No. "Psoriasis is not at all contagious," says Dr. Nazarian. "There is nothing to worry about if you're around someone who has psoriasis—you can't spread this from person to person."
That said, it is possible to spread psoriasis to different places on your own body. "If you traumatize the skin, you can induce a lesion," says Dr. Nazarian. "So let's say you have psoriasis on your knees and elbows but have never had a flare-up on your shoulder. If you scratch your shoulder and irritate the area, you may have a new patch pop up there due to the trauma you've induced." As such, take caution to prevent impact-induced patches from cropping up if you do get diagnosed by a doctor with psoriasis.
4. How do I make it go away?
The best treatment for your psoriasis is the one decided upon with your doctor—but there are now more options available than ever before. "This is such a fortunate time for people who are suffering from psoriasis, because we have really, really evolved when it comes to treatments," says Dr. Nazarian. "We have biologic treatments, which target some of the inflammatory factors, using antibodies to suppress the immune system in the psoriatic pathway, and that won't affect the rest of your body so there are minimal side effects." Biologics essentially function by keeping the part of the immune system that is responsible for causing a proliferation of skin cells to be halted, while allowing the rest of the immune system to function as it usually would. These biologics are prescribed by doctors, but administered via at-home injections (usually four times a year).
In addition, oral retinoids can be prescribed to slow quickly growing cells and reduce swelling in psoriasis patients, and UV light therapy has also been shown to slow the rate of skin cell growth. "If [your psoriasis is] not that severe, you can treat it with cream as needed," Dr. Nazarian adds. One derm-approved pick for easing psoriasis symptoms on your skin? Eucerin Advanced Repair Lotion ($10), which moisturizes, soothes, and exfoliates in a single application.
To learn more about psoriasis, check out the video below.
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