Plaque Psoriasis

What is plaque psoriasis?

Plaque psoriasis (psoriasis vulgaris) is a long-lasting (chronic) autoimmune disease that causes your cells to reproduce very quickly. It’s a type of psoriasis that causes thick, scaly patches called plaques on your skin. It most commonly affects your:

• Elbows.
• Back.
• Knees.
• Scalp (skin on your head usually covered with hair).

Severe cases of plaque psoriasis may affect your entire body, including your:

• Face.
• Feet.
• Genitals (penis, vagina, vulva).
• Hands.
• Legs.

Who does plaque psoriasis affect?

Plaque psoriasis can affect anyone. But you may be more likely to have plaque psoriasis if you:

• Are white.
• Drink alcohol.
• Experience stress or depression.
• Have a relative with psoriasis.
• Have obesity.
• Smoke or use tobacco products.
• Take your medications infrequently.

How common is plaque psoriasis?

Plaque psoriasis is the most common type of psoriasis. It affects about 6.7 million adults. About 80% to 90% of people with psoriasis have plaque psoriasis.

How does plaque psoriasis affect my body?

Plaque psoriasis causes thick, rough, scaly, discolored plaques to develop on your skin. The plaques can be itchy or painful — they may feel like a burn or a sting.

What are the symptoms of plaque psoriasis?

Symptoms of plaque psoriasis include:

• Raised, discolored (red, brown, gray or purple) plaques with a white or silvery surface.
• Cracks (fissures).
• Bleeding.
• Itchiness.
• Irritation or pain.

What causes plaque psoriasis?

Plaque psoriasis is an immune system problem. Your immune response overreacts, causing inflammation, which leads to new skin cells growing too fast.

Typically, new skin cells grow every 28 to 30 days. But if you have plaque psoriasis, new cells grow and move to your skin's surface every three to four days. The buildup of new cells replacing old cells creates plaques.

Plaque psoriasis runs in families, so there may be a genetic trigger. Parents may pass it down to their children.

Can anything cause plaque psoriasis flare-ups?

Plaque psoriasis flare-ups differ from person to person. No one knows exactly what causes them. Common plaque psoriasis triggers may include:

• Certain foods or drinks.
• Certain prescription medications (like lithium and beta-blockers).
• Dry skin.
• Emotional stress.
• Skin injuries (cuts, scrapes or surgery).
• Sun damage.

Is plaque psoriasis contagious?

Plaque psoriasis isn’t contagious. You can’t spread plaque psoriasis to another person through skin-to-skin contact or unprotected sex.

How is plaque psoriasis diagnosed?

Your healthcare provider will examine your affected areas, and they’ll look for common signs of plaque psoriasis. They’ll also ask about your symptoms, your family history and if you’ve recently started or stopped using a product or medication just before your flare-up.

What tests will be done to diagnose plaque psoriasis?

Your healthcare provider may perform several tests to rule out other conditions that could cause your plaques, like eczema or dermatitis. This series of tests is a differential diagnosis. The tests may include:

• Allergy test.
• Biopsy.
• Blood tests to check for causes of a rash unrelated to plaque psoriasis.

Is there a cure for plaque psoriasis?

There isn’t a cure for plaque psoriasis. You may have flare-ups and times where the plaques go away (remission). Treatment can provide relief for your symptoms.

Should I avoid any foods or drinks if I have plaque psoriasis?

Certain foods and drinks may contribute to plaque psoriasis flare-ups. If you have plaque psoriasis, it’s a good idea to keep track of what you eat and drink in a food journal. Keeping track of what you eat and drink can help you and your healthcare provider determine any causes of your flare-ups.

An anti-inflammatory diet may limit your plaque psoriasis flare-ups. Foods that have anti-inflammatory properties include:

• Oily fish, such as mackerel, salmon or sardines.
• Leafy greens, such as spinach and kale.
• Olive oil.

Foods and drinks that may cause flare-ups may include:

• Alcohol.
• Dairy, including cow’s milk and eggs.
• Citrus fruits, including lemons, limes and oranges.
• Gluten (a protein found in many foods, especially wheat).
• Nightshade vegetables, including peppers, potatoes and tomatoes.

What medications or treatments are used to treat plaque psoriasis?

Your healthcare provider may prescribe the following as a cream, lotion or gel to treat mild cases of plaque psoriasis:

• Anthralin.
• Coal tar.
• Corticosteroids.
• Salicylic acid.

Salicylic acid shampoo treats plaques in your scalp.

In more severe or widespread cases of plaque psoriasis, your healthcare provider may prescribe:

• Medicine injections. Your healthcare provider will use a thin needle to inject medicine into your skin or a vein in your arm. These medicines may include adalimumab, etanercept or ustekinumab.
• Oral medicines. Oral medicines are pills or tablets that you swallow with water. These medicines may include acitretin, cyclosporine or methotrexate.
• Phototherapy. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps. The ultraviolet light waves in sunlight can help certain skin disorders, including plaque psoriasis.

Are there any home remedies for symptoms of plaque psoriasis?

Several home remedies can help you manage the symptoms of plaque psoriasis.

While home remedies are safe for most people, it’s a good idea to check with your healthcare provider before trying some of the following options. You may be at risk of developing an allergic reaction.

• Take over-the-counter (OTC) antihistamines for severe itching.
• Bathe or shower in lukewarm — not hot — water. Limit the amount of time you spend in the water to under 15 minutes.
• Use mild soaps or other products that are free of perfumes, dyes and alcohol. Look for products labeled “fragrance-free” or “for sensitive skin.”
• Moisturize your skin several times a day using a cream or ointment, including after your bath or shower. Coconut oil can also keep your skin hydrated while providing relief.
• Add Dead Sea salt to a bathtub filled with warm water — around 95 degrees Fahrenheit (35 degrees Celsius) — and soak your affected areas for at least 10 minutes. You may have to soak your affected areas several times per week.
• Wear loose clothing that allows affected areas to breathe.
• Some studies suggest that herbal therapies, including aloe vera, may provide some relief.

How can I prevent plaque psoriasis?

There isn’t any way to prevent plaque psoriasis. If you have it, it may come and go throughout your life. Treatments can reduce symptoms, even in people with severe plaque psoriasis.

What can I expect if I have plaque psoriasis?

Plaque psoriasis may flare up and go into remission throughout your life. But it can generally be well-managed with treatment.

Can I have sex if I have a plaque psoriasis flare-up on my genitals?

Yes, you can have sex if you have a plaque psoriasis flare-up on your genitals or in your genital region, including your inner thighs, butt crack (intergluteal cleft) or the skin just above your genitals (pubis).

Plaque psoriasis isn’t a sexually transmitted infection (STI). Still, it can look like an STI. It’s a good idea to be honest with your partner if you have a flare-up. If they have any questions, encourage them to talk to a healthcare provider before having sex.

If you have a plaque psoriasis flare-up on your genitals, you may experience discomfort or pain during sex. Sexual lubricants (lubes) and condoms can help ease discomfort, pain or itching.

After sex, carefully clean and dry your genitals and reapply any plaque psoriasis medications.

How do I take care of myself?

If you have plaque psoriasis, the best way to take care of yourself is to:

• Take medications as instructed.
• Use moisturizer regularly, especially after bathing.
• Avoid harsh soaps.

Other steps to stay as healthy as possible include:

• Talking to your healthcare provider about lowering your risk for related conditions, including heart disease, depression and diabetes.
• Lowering your stress through meditation or exercise or seeing a mental health professional.

When should I see my healthcare provider?

Contact your healthcare provider if:

• You develop new symptoms.
• Your symptoms don’t improve after treatment.
• Your plaques look infected (red, purple, gray or white skin; irritation and swelling).

What questions should I ask my healthcare provider?

• How can you tell that I have plaque psoriasis?
• If I don’t have plaque psoriasis, what other skin condition might I have?
• How can I prevent flare-ups and manage my symptoms?
• What medicines do you recommend?
• Do the medicines have any side effects?
• What at-home treatments do you recommend?
• Do the at-home treatments have any side effects?
• What else should I do to improve my symptoms?
• Is there a cream or ointment that you can prescribe?
• Should I see a dermatologist or another specialist?

What is the difference between guttate psoriasis and plaque psoriasis?

Guttate psoriasis and plaque psoriasis look different. Guttate psoriasis looks like small, discolored, drop-shaped scaly spots and usually appears in children and young adults. It typically appears after a sore throat caused by a streptococcal infection. It often goes away after several weeks, even if you don’t seek treatment.

What is the difference between eczema and plaque psoriasis?

Eczema and plaque psoriasis look and feel different. Eczema is very itchy. Plaque psoriasis may be itchy, but it also may burn or sting.

Eczema irritates your skin and makes it change color, and it may cause tough, swollen, dark patches of skin. Plaque psoriasis patches are often white or silvery, and they rise above your skin. Plaque psoriasis is also thicker than eczema.

A note from Cleveland Clinic

Plaque psoriasis is an autoimmune disease that causes thick patches to develop on your skin or scalp. You may feel self-conscious, and it can be unpleasant if it itches or is painful. But it isn’t contagious, and treatments can help your symptoms improve.

It’s important to pay attention to your skin. Contact your health provider as soon as you notice any plaques develop on your skin.