The typical skin turnover process takes about a month. It starts with cells dividing at the bottom of the outermost layer of skin and pushing older skin cells upward until they reach the surface and then flake away.

Psoriasis is a disease that shortens this cycle of upward skin cell migration to just a few days. The medical community is not entirely sure what causes the skin cell turnover acceleration, but it is linked to an immune system dysfunction that causes inflammation.

Because the process moves so fast, the oldest skin cells don’t have time to flake away. Instead, they build up on the surface and form thick patches known as plaques.. Many people find these plaques on their scalp and/or their knees and elbows, but they can form virtually anywhere. There are several types of psoriasis, generally categorized by body site distribution.

An estimated 80 percent of patients with this disease form plaque that range in color from red or purple to silver and white. Scalp psoriasis is one variation, with plaques ranging from noticeable patches, to thick plaques, to fine scaling in about half of patients, but it also very commonly impacts the extremities, the buttocks, and the genital area.

Smooth patches that develop under the arms and in other skin folds impact about a quarter of patients. Inflammation causes these patches to be deep red. Sweat and friction can irritate the affected skin and make uncomfortable symptoms worse.

About eight percent of patients have guttate symptoms, which appear as small red spots, most often developing on the limbs and torso. This subtype is more common in children and may be induced by a prior strep throat infection.

As the name indicates, this type impacting three percent of patients is distinguished by small pustules erupting on the hands and feet, though the bumps can also cover a large percentage of the body.

In a rare form, only about two percent of patients develop these painful and severe symptoms: fiery redness and large-scale shedding of skin, as well as possible heart rate fluctuations. This type can be fatal, so prompt care is crucial during a flare-up.

Patients may find that multiple fingernails or—less often—toenails are pitted, thick, deformed and discolored. About 15 to 30 percent of patients may also develop psoriatic arthritis, which causes inflammation in the joints.

The ideal treatment for a patient depends on the type, extent, and location of symptoms—though moisturizing is generally an overall good idea. Hudson Dermatology commonly uses excimer laser treatments, with the light energy focusing on small areas to reduce plaques. Narrow band UVB light may also be used for larger regions.

There are many medications available for treating psoriasis. The dermatologists at Hudson Dermatology may prescribe one or more medications, which may be applied directly to the skin or taken orally, or biologic drugs taken via self-injection to work systemically. The choice typically depends on the severity and extent of signs and symptoms, as well as other factors such as any underlying medical conditions. As always—and very importantly—patient preference is of utmost consideration. The medical providers at Hudson Dermatology wield the most up-to-date armamentarium of therapeutic options to tackle psoriasis.

For very mild cases of psoriasis, over-the-counter topical products that contain coal tar may be helpful, though the ingredient can be irritating, so care should be exercised in testing it on a small area of skin before broader application. Other over-the-counter options include hydrocortisone creams, moisturizers, and salicylic or lactic acids for softening scales.

Clearing plaques and other signs of inflammation can bring immense relief. The Hudson Dermatology team also works with patients to explore possible triggers in order to better manage the long-term effects of psoriasis and hopefully tame future flare-ups. Common triggers to avoid include skin injuries, stress, alcohol use, and cold or dry weather conditions.

In addition to psoriasis, Hudson Dermatology provides diagnosis and symptom management for multiple other chronic skin conditions, including rosacea and eczema.

Note that though psoriasis causes pimple-like breakouts, it is different from acne. Since there are so many skin and nail conditions that cause irritation, redness, and bumps, it is important to see a dermatologist to get a proper diagnosis and start the appropriate treatment.

For more information about psoriasis, visit the American Academy of Dermatology’s page on the condition.