Psoriasis is a chronic skin disease. It’s considered an immune-mediated disease. This means the immune system acts abnormally.

Psoriasis typically affects the skin, causing skin cells to build up faster than usual. It can also affect other organ systems, especially the joints.

According to a 2021 study, about 7.5 million U.S. adults 20 years or older have psoriasis — a 3 percent prevalence rate (occurrence of a condition). By race and ethnicity, the prevalence rates are:

  • 3.6 percent of white people
  • 3.1 percent of non-Hispanic, including multiracial, people
  • 2.5 percent of Asian people
  • 1.9 percent of Hispanic, including Mexican American, people
  • 1.5 percent of Black people

Psoriasis causes your skin to develop scaly patches that can be itchy and painful.

Psoriasis tends to be pink or red on people with light or fair skin tones, with silvery-white scale. On medium skin tones, it can appear salmon-colored with silvery-white scale. On darker skin tones, the psoriasis could look violet, brown, or reddish brown often with light-colored or grayish-colored plaques.

There are different types of psoriasis, and it’s possible to have more than one type.

There’s limited research and information about managing and diagnosing psoriasis in People of Color. A 2014 study found the prevalence of psoriasis among adults ages 20 and older to be 3.2 percent, and found the rates vary by race and ethnicity:

  • White: 3.6 percent
  • Black/African American: 1.9 percent
  • Hispanic: 1.6 percent

These numbers may not tell the entire story, as People of Color may be disproportionately undertreated and misdiagnosed. This is because psoriasis isn’t always recognized on darker skin tones as it is for people with lighter skin tones.

Read on to learn more about these different types and how they’re treated.

The most common symptoms of psoriasis include:

The symptoms of psoriasis also vary based on the type. There are eight types of psoriasis:

  • plaque
  • guttate
  • inverse
  • pustular
  • erythrodermic
  • psoriatic
  • nail
  • scalp

Psoriasis can lead to mental stress, anxiety, and low self-esteem. Depression is also common in people who have psoriasis.

Other diseases, such as Crohn’s disease, celiac disease, metabolic syndrome, and cardiovascular disease, have been linked with psoriasis.

There are also subcategories of psoriasis types. These appear differently depending on the location of the body. Psoriasis isn’t contagious regardless of type.

Psoriasis patches on darker skin tones may also be more widespread, which can make it difficult to diagnose.

Generally, psoriasis patches appear more purple or brown on darker skin tones, often with thick silvery plaques.

Plaque psoriasis, or psoriasis vulgaris, is the most common form of psoriasis. An estimated 80% to 90% of people with psoriasis have plaque psoriasis. It’s characterized by thick red or purplish patches of skin, often with a silvery-white or gray scales.

These patches often appear your elbows, knees, lower back, or scalp.

Patches are usually 1 to 10 centimeters wide, but can also be larger and cover more of your body. If you scratch at the scales, the symptoms will often get worse.

Treatments

As a way to ease discomfort, a doctor may recommend applying moisturizers to keep the skin from becoming too dry or irritated. These moisturizers include an over-the-counter (OTC) cortisone cream or an ointment-based moisturizer.

A doctor may also work to identify your unique psoriasis triggers, including stress or lack of sleep.

Other treatments may include:

  • vitamin D creams, such as calcipotriene (Dovonex) and calcitrol (Rocaltrol), to reduce the rate that skin cells grow, in combination with topical steroids to reduce inflammation and itching
  • topical retinoids, like tazarotene (Tazorac, Avage), to help reduce inflammation
  • immunosuppressives, such as methotrexate or cyclosporine
  • applications of coal tar, either by cream, oil, or shampoo
  • biologics, a category of anti-inflammatory drugs

Medication may differ for guttate or erythrodermic psoriasis.

In some cases, you may need light therapy. This involves exposing the skin to both ultraviolet (UV)A and UVB rays. Sometimes, treatments combine prescription oral medications, light therapies, and prescription ointments to reduce inflammation.

With moderate to severe cases, you may be prescribed systemic medication in the form of oral, injectable, or intravenous (IV) medication.

Guttate psoriasis appears in small red spots on the skin. In darker skin tones, these spots can appear violet or brown. It’s the second most common type, affecting around 8% of people with psoriasis. Most of the time, it starts during childhood or young adulthood.

The spots are small, separate, and drop-shaped. They often appear on the torso and limbs, but they can also appear on your face and scalp. Spots are usually not as thick as plaque psoriasis, but they can develop into plaque psoriasis over time.

Guttate psoriasis happens after certain triggers. These triggers include:

Treatments

To treat guttate psoriasis, a doctor may prescribe steroid creams, light therapy, and oral medications. Determining the underlying cause of the infection can also help clear guttate psoriasis. If a bacterial infection caused the condition, antibiotics may help.

Flexural or inverse psoriasis often appears in skinfolds, such as under the breasts or in the armpits or groin area. This type of psoriasis is red or purple and often shiny and smooth.

The sweat and moisture from skinfolds keeps this form of psoriasis from shedding skin scales. Sometimes, it’s misdiagnosed as a fungal or bacterial infection. The skin-on-skin contact can make inverse psoriasis very uncomfortable.

Most people with inverse psoriasis also have a different form of psoriasis in other places on the body.

Treatments

The treatments for inverse psoriasis are like plaque psoriasis treatments. They can include:

  • topical steroid creams
  • nonsteroidal such as phosphodiesterase (PDE)-4 inhibitor
  • light therapy
  • oral medications
  • biologics, which are available via injection or IV infusion

A doctor may prescribe a lower potency steroid cream to avoid your skin from thinning too much. You may also benefit from taking or applying medications that reduce yeast or bacteria growth.

Pustular psoriasis can be severe at times. This form of psoriasis may develop quickly in the form of many white pustules surrounded by red or darkened skin.

Pustular psoriasis may affect isolated areas of your body, like your hands and feet, or cover most of the skin’s surface. These pustules can also join together and form scaling. However, if it affects all areas of the body — such as the Von Zumbusch subtype — it can be life threatening because it has severe systemic effects.

Some people experience cyclic periods of pustules and remission. While the pus is noninfectious, this condition can cause flu-like symptoms such as:

There are three kinds of pustular psoriasis:

Each of the three forms of pustular psoriasis can have different symptoms and severity.

Treatments

Treatment may include OTC or prescription corticosteroid creams, oral medications, or light therapy. Biologics may also be recommended.

Identifying and treating the underlying cause may also help reduce reoccurrence of pustular psoriasis.

Erythrodermic psoriasis, or exfoliative psoriasis, is a rare type of psoriasis that looks bright red or dark purplish in people with darker skin tones along with shedding of the skin. The condition is serious and is a medical emergency. You may need to be hospitalized, as your body may not be able to manage your body temperature.

This form of psoriasis is widespread, with red or purple skin and silvery scales. It may cover large portions of your body. Exfoliation often occurs in larger pieces than the small scales typical to most psoriasis.

Erythrodermic psoriasis can develop from:

  • pustular psoriasis
  • widespread, poorly controlled plaque psoriasis
  • a bad sunburn
  • infection
  • alcohol use disorder
  • significant stress
  • abrupt discontinuation of a systemic psoriasis medication
  • using oral steroids, cyclosporin, or methotrexate

Treatments

This condition often needs attention at a hospital. There, you’ll receive a combination of therapies.

This can include an application of medicated wet dressings, topical steroid applications, biologics, or prescription oral medications until symptoms have improved.

Make an appointment with a doctor if you think you have erythrodermic psoriasis.

Psoriatic arthritis (PsA) is a painful and physically limiting condition that affects between 30% and 33% of people with psoriasis. There are five types of PsA with varying symptoms. There’s also no cure for this condition.

Psoriasis is an autoimmune disease, so it can trigger your body to attack your joints and skin. It can affect many joints and often becomes quite severe in the hands and affect the nails. Skin symptoms usually appear before joint symptoms.

Treatments

Treatments for psoriatic arthritis can include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen sodium (Aleve). NSAIDs can help reduce the incidences of swelling and pain associated with psoriatic arthritis.

Prescription medications, such as an oral corticosteroid, may also help reduce inflammation that leads to psoriatic arthritis. Prescription topical medications used to treat psoriatic arthritis include salicylic acid, calciopotriene, and tazarotene.

A unique category of medications known as disease-modifying antirheumatic drugs (DMARDs) can help reduce inflammation and joint damage. Biologics, which are a subcategory of DMARDs, may be prescribed to reduce inflammation at a cellular level.

Although not an official type of psoriasis, nail psoriasis is a manifestation of psoriasis. The condition can often be confused with fungal infections and other infections of the nail.

Nail psoriasis can cause:

  • nail pitting
  • grooves
  • discoloration
  • loosening or crumbling of your nail
  • thickened skin under your nail
  • colored patches or spots under your nail

Sometimes, the nail can even crumble and fall off. There’s no cure for psoriatic nails, but some treatments may improve the health and appearance of nails.

Treatments

Treatments for nail psoriasis are like the ones used for plaque psoriasis. It may take time to see the effects of these treatments as nails grow very slowly. Treatment options include:

  • light therapy
  • oral medications, such as methotrexate
  • biologics

Scalp psoriasis is common in people with plaque psoriasis. For some people, it may cause severe dandruff. For others, it can be painful, itchy, and very noticeable at the hairline. Scalp psoriasis can extend to your neck, face, and ears in one large patch or many smaller patches.

In some cases, scalp psoriasis can complicate regular hair hygiene. Excessive scratching can cause hair loss and scalp infections. The condition may also cause feelings of social stress.

Treatments

Topical treatments are most commonly used for scalp psoriasis. They may require an initial 2 months of intensive applications, plus permanent, regular maintenance. Treatment options include:

  • medicated shampoos
  • tar preparations
  • topical application of vitamin D, known as calcipotriene (Dovonex)

Light therapy, oral medications, and biologics also may be recommended depending on the responsiveness to treatment.

There’s no one cure for any form of psoriasis, but remission and significant healing is possible. Your doctor will work with you to create a treatment plan that helps manage your condition. You can also take steps at home to manage psoriasis.

These can include:

  • practicing relaxation techniques to reduce stress
  • moisturizing dry skin
  • quitting smoking
  • avoiding products that irritate your skin
  • wearing comfortable clothing that doesn’t rub the psoriasis
  • eating a healthy diet

Doctors may slowly build up to the most effective treatment plan for your psoriasis symptoms. Most start with a topical or light therapy treatment and only progress to systemic medications if the first line of treatment is unsuccessful.

Stress, anxiety, depression, and other mental health conditions can be commonly found in people with psoriasis. You may benefit from therapy or support groups where you can meet other people experiencing similar issues or concerns.

You can also talk with a healthcare professional about seeing a therapist who has experience with psoriasis. They’ll be able to help identify ways to cope.

Visit the National Psoriasis Foundation for the latest information on research, events, and programs.

There are different types of psoriasis that present different symptoms. While there’s no cure for psoriasis, treatment can help relieve and manage your symptoms. Talk with a doctor if you’re concerned about your skin.

The type of psoriasis you have, and its severity, will determine your treatment. Generally speaking, milder cases with smaller psoriasis patches can often be treated topically. More serious cases, with larger patches, may require systemic treatment.

Many people believe that psoriasis is contagious, but it won’t spread from person to person. Researchers believe that a combination of genetics and environmental and immune system factors cause psoriasis.

Thanks to the advocacy work of dozens of psoriasis activists and organizations, psoriasis is also gaining more support and awareness. Talk with a doctor if you believe you have psoriasis. They’ll be able to provide treatment options and coping methods.