Psoriasis – symptoms, types and when to see a doctor

Content author: physician. Katarzyna Przekazińska-Boager · Editorial work: Editorial team of Wyspa Medycyny Przyjaznej · Medical review: lek. Katarzyna Przekazińska-Boager · Date of creation: 07.08.2026 · Date of review: 07.08.2026 · Updated: 07.08.2026

The article is of an educational nature and does not replace a dermatological consultation or individual selection of treatment. Rapid involvement of a large skin surface, pustular lesions with fever and malaise, as well as increasing pain and swelling of the joints require urgent medical evaluation.

The most important information at a glance

• Psoriasis is a chronic inflammatory disease with an immunological basis - it is not contagious and cannot be infected.
• A typical symptom is well-defined, red lesions covered with silvery scales, most often on the elbows, knees and scalp.
• The disease has several forms that differ in appearance, course and treatment.
• Droplet form often appears in children and young adults after a throat infection.
• Nail changes may be the first and for a long time the only symptom.
• Psoriasis may coexist with arthritis - joint pain and stiffness should be reported to your doctor.
• Skin trauma, infection, stress, smoking and some medications can trigger a flare-up.
• In children, the picture may be atypical and must be distinguished from atopic dermatitis and fungal infections.
• There is no permanent treatment for the disease, but available methods allow for good symptom control.
• It is worth seeing a dermatologist at the first changes, and not after months of self-treatment.

Find out more about the specialist

Doctor. Katarzyna Przekazińska-Boager works at the Island of Friendly Medicine in Gdańsk. He deals with the diagnosis and treatment of skin diseases in adults and children. Psoriasis is one of the diseases in which the diagnosis is usually made on the basis of a clinical examination, and the greatest challenge is to select the treatment to suit the form of the disease, its severity and the stage of the patient's life.

Meet the doctor. Katarzyna Przekazińska-Boager

What is psoriasis

Psoriasis is a chronic inflammatory disease in which the immune system excessively stimulates epidermal cells. In healthy skin, the epidermis renews itself within a few weeks. In a psoriasis outbreak, this process is many times faster - the cells do not have time to mature and exfoliate in the form of a characteristic, silvery scale.

The tendency to the disease has a genetic basis, but the tendency alone is not enough. Symptoms usually require a trigger - an infection, skin trauma, severe stress, or certain medications. Therefore, in some people the disease appears in childhood, and in others only after the age of forty.

Three things are worth saying directly, because patients ask about them at every visit:

• Psoriasis is not contagious. Not transmitted by touch, sharing a towel, swimming pool or sexual contact.
• Not due to lack of hygiene. This belief is one of the main sources of shame that delays treatment.
• It's not a ringworm. Antifungal treatment will not help, and when used alone only delays the diagnosis.

Symptoms - what to look out for

A classic psoriatic lesion is well demarcated from healthy skin, raised, red or pink, covered with silvery-white, layered scales. The border between the lesion and healthy skin can be so clear that you can trace it with your finger - and this is one of the features that distinguishes psoriasis from eczema.

Typical location: extensor surfaces of elbows and knees, sacral area, scalp - often extending a few millimeters beyond the hairline, which is sometimes the first diagnostic clue.

Other symptoms:

• Itching - contrary to popular belief, it occurs in a significant number of patients and can be bothersome.
• Burning and feeling of tightness of the skin, especially with extensive lesions.
• Cracking of the skin and painful fissures in bending areas - hands, feet, joint areas.
• Nail changes - pinpoint depressions resembling a thimble, yellowish discoloration, thickening of the nail plate, separation of it from the bed.
• Appearance of changes at the site of injury - scratches, abrasions, scars, and even injection sites.
• Pain and stiffness of joints, especially in the morning - a symptom that should not be ignored.

The last two points deserve elaboration. The formation of lesions at the site of injury is a characteristic phenomenon of psoriasis and a practical tip: scratching and mechanical scraping of the scales worsens the situation,instead of improving it. However, joint problems may mean psoriatic arthritis - a disease that affects more than just the skin and requires separate treatment. It is worth telling your doctor about them, even if they seem unrelated to the skin.

Types of psoriasis

It is worth noting that three items in this table - inverted, nail and scalp forms - are regularly confused with other diseases. This is the main reason why patients come to a dermatologist after many months of ineffective treatment of mycosis or dandruff.

When you need urgent help

Most forms of psoriasis are chronic and do not require rushing. However, there are situations that require immediate medical evaluation:

• redness and peeling covering almost the entire surface of the skin,
• sudden appearance of numerous pustules with fever, chills and malaise,
• severe skin pain and a feeling of cold and tremors with extensive lesions,
• rapidly increasing pain, swelling and redness of the joint,
• symptoms of infection of the affected skin - increasing redness, warmth, discharge of purulent content, fever,
• sudden exacerbation after discontinuation of medications, especially glucocorticosteroids taken systemically.

The last point concerns a situation that happens more often than it should. Abrupt discontinuation of oral steroids may result in a severe flare-up of psoriasis. Therefore, no general treatment is modified on its own.

Psoriasis in children

Psoriasis in children looks different than in adults and that is why it is sometimes diagnosed with a delay. The lesions are usually smaller, thinner, less visibly exfoliative, and more likely to itch. They also more often affect the face and folds, which is less common in adults.

The droplet form is particularly characteristic in children. It appears suddenly, most often a few weeks after a throat infection, in the form of numerous small lesions scattered on the trunk and limbs. It looks dramatic, and parents are often afraid of an infectious disease - however, this form usually has a milder course than the plaque form.

In the youngest children, lesions may appear in the diaper area and are often confused with irritation or yeast infection. An indication is the lack of improvement after typical treatment and a clear demarcation of the lesion.

What do we most often confuse psoriasis with in children:

• atopic dermatitis - different location, different nature of lesions, stronger itching,
• mycosis of smooth skin - ring-shaped lesion with a clear edge,
• dandruff in lesions on the head,
• diaper rash in infants,
• pityriasis rosea Gibert in lesions scattered on the trunk.

Treatment in children is carried out more carefully than in adults - the selection of preparations, their strength and duration of use depend on the age and location of lesions. Emollients and systematic care remain the basis, and decisions about stronger treatment are made by the doctor individually.

There is one more dimension that must not be omitted. Visible skin lesions in a child are a psychological burden, not only dermatological - it concerns school, swimming pool, PE, relationships with peers. It is worth asking your child how he or she copes with it and telling him or her directly that the disease is not contagious and is not anyone's fault. This conversation can be as important as the ointment selected.

What can cause an exacerbation

• Infections, especially streptococcal pharyngitis - a classic trigger of the droplet form.
• Skin injuries - scratches, abrasions, sunburn, tattoos, also scale scraping.
• Stress - one of the factors most frequently reported by patients.
• Some medicines - including: beta-blockers, lithium, antimalarials; they are never weaned on their own.
• Sudden discontinuation of systemic glucocorticosteroids .
• Tobacco smoking — associated especially with pustulosis of the hands and feet.
• Alcohol - may intensify changes and interact with treatment.
• Excess body weight — promotes a more severe course and changes in skin folds.
• Dry skin and cold, dry air - typical aggravation during the winter months.

It is worth emphasizing the fourth and fifth points together: if you suspect that the drug is intensifying skin lesions, tell your doctor - but do not stop the treatment on your own. Some of these drugs are taken for cardiac or psychiatric reasons, where self-discontinuation carries a much greater risk than exacerbation of psoriasis.

When to see a dermatologist

The penultimate line may be a surprise for patients. The severity of psoriasis is not determined solely by the area of ​​the affected skin. Minor lesions on the hands that prevent work or changes in intimate areas that affect relationships are considered significant - even if they affect a small percentage of the body surface.

What is the diagnosis and what to do next

Psoriasis is diagnosed primarily on the basis of clinical examination - the appearance and distribution of lesions, as well as medical history, including family history. Dermatoscopy is sometimes helpful, and in doubtful cases, a histopathological examination of a skin sample is performed. In the case of nail changes, it is sometimes necessary to exclude a fungal infection, because both diseases may coexist.

Treatment is selected individually, depending on the form, severity, location, patient's age and comorbidities. The available methods include:

• local treatment - preparations applied to the skin, along with systematic care with emollients,
• phototherapy - controlled exposure to radiation of a specific wavelength, carried out in medical conditions,
• general treatment - for forms with more severe, requiring monitoring,
• biological treatment - available in selected clinical situations, conducted in specialized centers.

To put it honestly: we do not have a treatment that would remove psoriasis permanently. The aim is to gain and maintain symptom control, extend periods of remission and reduce the impact of the disease on everyday life. This is a realistic goal and achievable for most patients - provided that it is systematic, which in the case of a chronic disease can be more difficult than the treatment itself.

It is also worth knowing that psoriasis is associated with other health problems - arthritis, metabolic disorders and low mood. Therefore, in the case of a more severe disease, the doctor may propose a more extensive health assessment, even if the patient came only because of the skin.

What the patient can do himself

• Regularly use emollients - moisturized skin itches less, cracks less and responds better to treatment.
• Do not scrape the scales - skin trauma promotes the formation of new lesions.
• Avoid hot, long baths and strongly degreasing soaps.
• Protect the skin againstinjuries, even minor ones.
• Consider quitting smoking - this is especially important when changing your hands and feet.
• Limit alcohol, especially during general treatment.
• Take care of your body weight - influences the course of the disease and the effectiveness of treatment.
• Treat throat infections as directed by your doctor.
• Do not modify the treatment yourself, even if there is visible improvement.

It is worth talking about the sun separately, because there are many simplifications surrounding it. In some patients, moderate exposure actually brings improvement - but sunburn is an injury to the skin and can cause a flare-up. This is not a treatment method, but an observation that should be used carefully and with sun protection.

The most common myths

• "Psoriasis is contagious." No. It is not transmitted by touch, swimming pool, towel or sexual contact.
• "It's the result of poor hygiene." No. It is an immune-mediated inflammatory disease.
• "It's a ringworm." No. Antifungal treatment will not help and delays diagnosis.
• "Psoriasis doesn't itch." Not true - itching occurs in a significant proportion of patients.
• "It's just a cosmetic problem." No. It can affect joints and significantly affect functioning.
• "Diet will cure psoriasis." No. Healthy eating and a healthy weight help, but do not replace treatment.
• "The sun always helps." Not always - a burn may cause a flare-up.
• "Children do not suffer from psoriasis." They are sick. In children, the picture may be unusual and more often confused with other diseases.
• "When the changes disappear, treatment can be discontinued." Not on your own - the decision is made by the doctor.

Skin lesions that won't go away?

Psoriasis treated properly from the beginning can be controlled much more easily than after months of unsuccessful attempts. This also applies to children.

Treatment of psoriasis at the Island of Friendly Medicine in Gdańsk

Doctor. Katarzyna Przekazińska-Boager consults patients with skin lesions - adults and children - at the Friendly Medicine Island. The visit includes an interview, examination of the skin, nails and scalp, and, if necessary, a dermatoscopic examination and establishment of a treatment and care plan.

Control is particularly important with psoriasis - the disease progresses in waves and treatment requires adjustments over time. If the form of the disease requires general or biological treatment, the patient is referred to a center providing such therapy. The current scope of services, availability of dates and prices must be confirmed during registration.

Meet the doctor. Katarzyna Przekazińska-Boager Dermatological consultation

What to ask during the visit?

• Which form of psoriasis is it and what does it mean?
• How do you assess the severity of the disease in my case?
• How long should I continue with the prescribed treatment?
• What can I expect and when?
• What to do if an exacerbation occurs?
• Can any of my medications make the changes worse?
• What emollients and cosmetics are suitable?
• Can my joint problems be related to the disease?
• Are any additional tests needed?
• What does treatment look like for a child and how does it differ?
• When should I go for a check-up?
• What should I worry about before my next visit?

FAQ - Psoriasis

Is psoriasis contagious?

No. It is an immune-mediated inflammatory disease. It is not transmitted by touch, sharing a towel, swimming pool or sexual contact.

What does psoriasis look like?

Classically as well-defined, red, raised spots covered with silvery-white scales - most often on the elbows, knees, sacral area and on the scalp. Unusual characters look different.

Does psoriasis itch?

Yes, in a significant proportion of patients. The belief that psoriasis does not itch is a persistent simplification.

What types of psoriasis are there?

The most common form is the plaque form. In addition, there are droplet, inverted, scalp, nail, hand and foot forms, pustular and erythrodermic forms. Psoriatic arthritis is a separate issue.

Do children suffer from psoriasis?

Yes. In children, the lesions are smaller, thinner, more itchy, and more often affect the face and folds. The droplet form that appears after a throat infection is typical.

What is psoriasis in a child confused with?

Most often with atopic dermatitis, mycosis of the smooth skin, dandruff, diaper rash in infants and pityriasis rosea.

What causes exacerbations?

Infections - especially throats, skin injuries, stress, certain medications, sudden discontinuation of systemic steroids, smoking, alcohol and dry skin and cold air.

Can psoriasis be cured?

We do not have a treatment that will remove the disease permanently. The goal is to control symptoms, extend periods of remission and reduce the impact of the disease on daily life - and this is an achievable goal for most patients.

Is nail psoriasis a fungal infection?

These are two different diseases that may look similar and even coexist. Persistence of changes despite antifungal treatment is an indication for dermatological consultation.

Does psoriasis affect the joints?

May coexist with psoriatic arthritis. Pain, swelling and morning stiffness in the joints require reporting to your doctor, as this form requires separate treatment.

Does diet help with psoriasis?

Correct body weight and healthy eating may have a beneficial effect on the course of the disease, but do not replace treatment. Restrictive elimination diets, especially in children, require discussion with a doctor.

When to see a doctor urgently?

With redness and peeling covering almost the entire skin, with numerous pimples with fever and malaise, and with rapidly increasing pain and swelling of the joint.

Sources

• Island of Friendly Medicine, MD. Katarzyna Przekazińska-Boager: https://www.wyspamedycynyPrzyjaznej.pl/pl/katarzyna-przekazinska-boager
• NHS, Psoriasis: https://www.nhs.uk/conditions/psoriasis/
• NHS, Psoriatic arthritis: https://www.nhs.uk/conditions/psoriatic-arthritis/
• DermNet, Psoriasis: https://dermnetnz.org/topics/psoriasis
• DermNet, Guttate psoriasis: https://dermnetnz.org/topics/guttate-psoriasis
• DermNet, Flexural psoriasis: https://dermnetnz.org/topics/flexural-psoriasis
• DermNet, Scalp psoriasis: https://dermnetnz.org/topics/scalp-psoriasis
• DermNet, Nail psoriasis: https://dermnetnz.org/topics/nail-psoriasis
• DermNet, Generalized pustular psoriasis: https://dermnetnz.org/topics/generalised-pustular-psoriasis
• DermNet, Erythrodermic psoriasis: https://dermnetnz.org/topics/erythrodermic-psoriasis
• DermNet, Psoriasis in children: https://dermnetnz.org/topics/psoriasis-in-children
• NICE, Psoriasis: assessment and management (CG153): https://www.nice.org.uk/guidance/cg153
• British Association of Dermatologists, patient information: https://www.bad.org.uk/patient-information-leaflets/