Psoriasis
An immune condition that speeds up skin cell growth, causing raised red patches with silvery scale, often on the elbows, knees, scalp and lower back. It comes and goes over a lifetime. About 2 to 3 in 100 people have it. Not contagious. About 1 in 4 also get joint pain (psoriatic arthritis).
Treatment options
Ratings show how strong the research is.
- Strong evidenceSteroid ointments and creamsThe first treatment for most patches. Ointments usually work better on thick scale. Use in courses with breaks, and milder strengths on the face and skin folds.
- Strong evidenceSteroid with vitamin D gel or foamA combination of calcipotriol and betamethasone, once a day for up to 4 weeks. Very effective for plaques and the scalp.
- Strong evidenceLight therapy (narrowband UVB)Sessions 2 to 3 times a week for several weeks, for widespread psoriasis. Through a dermatologist.
- Strong evidenceTablets that calm the immune systemSuch as methotrexate, acitretin, ciclosporin, apremilast or deucravacitinib, for moderate to severe psoriasis. Need regular check-ups and blood tests.
- Strong evidenceBiologic injectionsFor severe psoriasis when other treatments haven’t worked. Highly effective. PBS-subsidised through a dermatologist if you meet the criteria.
- Moderate evidenceWeight lossIf you are above a healthy weight, losing weight improves psoriasis and helps treatments work.
- Limited evidenceTar and salicylic acidHelp soften and lift scale, especially on the scalp. Tar can smell and stain.
- Not recommendedSteroid tabletsCan cause a severe flare when stopped.
What you can do
- Moisturise every day, ideally just after a short, warm shower. Use soap-free washes.
- For the scalp, use a medicated shampoo and leave it on for 5 to 10 minutes before rinsing.
- Quit smoking and cut back on alcohol: both make psoriasis worse.
- Avoid scratching and skin injuries, as new patches can form there.
- Tell your doctor about all your medicines, as some (such as lithium or beta blockers) can trigger flares.
See your GP if
- Psoriasis isn’t improving after 4 weeks of treatment
- Patches cover large areas, or affect the face, genitals, hands or feet
- Swollen, painful or stiff joints, or sore heels
- It’s affecting your sleep, mood or relationships
Go to the emergency department if most of your skin becomes red, hot and painful, or you get widespread pus spots with fever or feel unwell.
Evidence and more information
- Healthdirect: Psoriasis
- Australasian College of Dermatologists: Psoriasis
- Psoriasis Australia: Treatment options
maladywise.com/psoriasis/