Plaque Psoriasis: Signs and Treatment

Medically Reviewed by Zilpah Sheikh, MD on April 26, 2024
Written by Stephanie Langmaid
6 min read

Plaque psoriasis is the most common type of psoriasis — a group of skin conditions that affect the skin and cause itchy rashes and pain. Plaque psoriasis causes raised red or purple patches covered with a whitish buildup of dead skin cells. These patches are called plaques. They usually show up on your elbows, knees, scalp, and back, but you can have them anywhere.

Plaque psoriasis is a long-term condition that can cause a lot of discomfort. There's no cure for it, but treatments can help ease your symptoms.

 

Plaques are the main symptom. The patches may be red, brown, purple, or gray depending on your skin tone. They're covered with a white or silvery layer. Plaques tend to show up on both sides of your body. For example, if they show up on one elbow, they will appear on the other one as well.

Symptoms include:

  • Itching
  • Pain
  • Cracking skin
  • Bleeding
  • Burning and stinging

Plaques and symptoms may keep coming back throughout your life.

Doctors aren't sure why people get plaque psoriasis. It's considered an autoimmune disease. That means your immune system attacks healthy cells as if it's fighting an infection. This causes new skin cells to grow much faster than normal, and they build up in thick patches.

Whether you get plaque psoriasis depends on your genes and your health history:

Heredity. Psoriasis seems to run in families. More than 20% of people with psoriasis report having a relative with psoriasis. According to research, if both your parents have psoriasis, you have about a 50% chance of getting it.

Triggers. Something has to happen to start your immune system's reaction. Common triggers are:

  • Skin injury
  • Dry skin
  • Certain goods and drinks
  • Bad sunburn
  • Medicines, such as lithium or malaria drugs
  • An infection, such as strep 
  • Stress
  • Smoking
  • Drinking alcohol

Is plaque psoriasis contagious?

No. It can't be spread by touch or any other form of close contact.

A skin doctor (dermatologist) can usually tell if you have plaque psoriasis just by talking with you about your medical history and looking at your skin. But since psoriasis can look like eczema and other skin diseases, diagnosing it can be difficult. In some cases, your doctor may need to do a biopsy. They’ll take a tiny sample of your skin and look at the cells under a microscope. They might also do some allergy or blood tests to rule out other causes.

Psoriasis can't be cured. You'll probably go through cycles where the rash looks better and then flares up again. The goal of treatment is to minimize the frequency and severity of flare-ups.

You may get medicines to put on your skin or pills, or your doctor may recommend a combination of those. Treatment options include:

Topical medications. If you have only a few plaques, your doctor will probably try a prescription cream first. You put these directly on your skin. They help with inflammation or slow the growth of skin cells. Examples include anthralin and corticosteroids. You can also try over-the-counter topical medicines. Salicylic acid and coal tar are often used to treat mild psoriasis.

Light therapy. If the rash is more widespread, your doctor may treat it with ultraviolet light. This is done at their office or with a special box you can keep at home.

Plaque psoriasis medication

If lotions and light therapy don't work, your doctor may recommend a systemic medication. That means it circulates through your body, rather than just targeting the plaques themselves. These medications calm your immune system or make your skin cells grow more slowly. You may take systemic drugs such as acitretin, cyclosporine, and methotrexate by pill, or your doctor may give you a shot.

Another kind of systemic drug, called biologic drugs, also targets your immune system. These include:

They're given through a shot, pill, or directly into a vein in your arm. They affect a specific type of immune cell or keep certain proteins from causing inflammation. But these drugs can make it harder for you to fight an infection.

Systemic drugs can cause serious side effects, such as depression, aggressive thoughts, liver problems, or a higher risk of skin cancer. It's important to carefully consider your options with your doctor.

Most people who get plaque psoriasis have it for the rest of their lives. You can do a few things to deal with it better:

Avoid triggers. Things such as stress and smoking don't cause psoriasis. But they can make it worse. Try to figure out what triggers your flare-ups. You may be affected by:

  • Alcohol
  • Allergies
  • Cold, dry weather
  • Hormones

Watch your diet. You may notice that certain foods make your psoriasis flare up. If so, avoid those foods. Common diet triggers include:

  • Dairy
  • Citrus fruits
  • Gluten, a protein found in wheat
  • Nightshade vegetables such as tomatoes, peppers, and potatoes

An anti-inflammatory diet may help with psoriasis. Eat plenty of:

  • Fatty fish, such as mackerel and salmon
  • Leafy greens, such as spinach and kale
  • Olive oil

Take care of your skin. A good moisturizer can keep plaques soft and make you less itchy. Avoid harsh soaps. A bath with colloidal oatmeal or Epsom salts can soothe your skin. Try using medicated shampoo for scales on your scalp.

Get support. Plaque psoriasis can take an emotional toll. You may feel self-conscious about the way it looks or overwhelmed by what it takes to manage it. Many people with psoriasis become depressed. If you think you need some help, talk with your doctor about therapy or medication. It also helps to talk with people who understand what you're going through and can offer ways to deal with it.

Work with your doctor. Talk with them about your progress and any changes to your condition. You may need to change your treatment over time. Don't suddenly stop using a psoriasis drug, as it may lead to a more serious illness. Be aware of symptoms that could signal psoriatic arthritis, such as joint pain.

Plaque psoriasis is a long-lasting condition that causes itchy and painful patches on your skin. Many things including a family history and triggers such as stress, smoking, and sunburn can cause it. There's no cure for it. But some treatments such as topical creams and systemic medicines can help you manage your symptoms. It's important to talk with your doctor so they can help find the best treatment for you.

Is plaque psoriasis fungal?

No. It is an autoimmune condition -- it happens when your immune system overreacts.

Should you peel plaque psoriasis?

You should not peel psoriasis, as it can make your condition worse.

Does plaque psoriasis get worse with age?

Age doesn't worsen plaque psoriasis on its own. But some changes that happen as you get older might cause or worsen flare-ups. This can include stress, weakened immune system, certain medications, and thinning skin. Your treatment might need to change as you get older, so it's important to continue seeing your doctor regularly. 

Does drinking water help with plaque psoriasis?

Staying hydrated is good for your skin. Dry skin can be a trigger for flare-ups, and drinking plenty of water helps keep your skin moist.

Is Vaseline good for plaque psoriasis?

Yes. Petroleum jelly is an effective, inexpensive way to keep your plaques and the rest of your body moisturized.

What happens if plaque psoriasis goes untreated?

It's important to receive medical treatment to control your symptoms so you have a better quality of life. Also, all types of psoriasis are linked to an increased risk of other health problems, including heart disease and digestive disorders, so it's crucial to have a health care provider who can examine you for any signs of potential illness.