Psoriasis FAQs

It is not brought on by poor hygiene, and the presence of psoriasis does not mean that a person’s hygiene is poor.

Psoriasis is not contagious, it cannot be caught by person-to-person contact, or by sharing of bodily fluids (such as by kissing or sharing food or drinks). It also cannot be caught by others in close contact public areas, such as in swimming pools or in saunas.

The visible part of psoriasis is the red, scaly plaques that appear on the surface of the skin. However, the effects of psoriasis can run much deeper.

People with psoriasis often suffer with low confidence and self esteem, which in turn impacts on their relationships and social lives. The treatments can be time-consuming with unpleasant side effects, and people with psoriasis often spend the day feeling uncomfortable, embarrassed, itchy and in pain.

Psoriasis on the hands or feet can make everyday activities difficult, and psoriasis on areas such as the groin or buttocks can make even sitting down or going to the toilet quite painful.

Psoriasis is also linked to the development of psoriatic arthritis, although not everyone with psoriasis will develop this condition. There is ongoing research into the role that inflammation plays in psoriasis, and the potential links to other conditions such as cardiovascular disease, and if there is a link, whether the risk is related to the severity of psoriasis.

Psoriasis is a long term condition, and is known to wax and wane (meaning it comes and goes - sometimes in flares). Like other long term conditions (for example arthritis, diabetes or asthma), there is no 'cure', although there is a wide variety of treatments which can be used to manage psoriasis. Everybody is different, and so it can be a process of trial and error to find a treatment or combination of treatments which work well for you, but many people do find treatments which work for them,

Due to the nature of the condition, some people find areas of psoriasis clear up on their own in time. Some people may experience just a handful of psoriasis 'flares' in a lifetime, whereas others might have some stubborn patches which are almost always there. It can be hard during a flare, but try to remember that psoriasis often does follow this waxing and waning pattern, and that there are treatments to help you get a flare under control.

Certain dyes can be quite harsh to the scalp, and can irritate open lesions, but if milder dyes are used, patch tests carried out, and reputable hairdressers consulted, there is no reason why someone with psoriasis should not dye their hair. This also applies to the use of other hair products.

The face is a delicate area, care should be taken that makeup does not irritate it, and it is always unwise to apply cosmetics to open sores. However, like with hair products, if a patch test is carried out and no irritation occurs, there is no harm in applying makeup. This is the same for fake tan on the body.

Remember, however, that tanning beds have health risks, which can be increased if the individual is undergoing UV light therapy. Fake tanning products such as bronzers, gels and lotions are the safest way to tan. You might also be interested in finding out about camouflage, specifically designed to cover scars and skin conditions such as psoriasis.

People with psoriasis anywhere on their body may feel self conscious when it comes to sex, and this is likely to be increased if psoriasis is actually in the groin or genital area. Also, people with psoriasis in these areas may find that sex can irritate the psoriasis. However, neither of these potential problems means that someone with genital psoriasis should not have sex.

There are practical tips for making sex more comfortable, such as using lubrication or condoms to lessen friction, and body confidence issues can hopefully be dealt with through honest communication with a loving partner. Remember, psoriasis is not contagious and is not sexually transmitted.

People taking certain medications for psoriasis or psoriatic arthritis - such as methotrexate or acitretin - should avoid alcohol, or limit alcohol consumption. This is because it can influence the way in which the medications are broken down in the body, or raise the risk of potential side effects. You should always check with a doctor or pharmacist, and check the patient information leaflet of any medication you are taking, before you drink alcohol.

There are plausible arguments for why drinking might affect psoriasis (alcohol is dehydrating, and therefore could dry skin out even more), but research has been undecided about whether alcohol significantly affects psoriasis or not. Some people might find that alcohol does worsen their condition, but if an individual does not find this, and it is safe to combine alcohol with whatever treatment they are undergoing, then moderate alcohol consumption can be one of life’s pleasures.

Drinking is not an effective way of coping with your skin, or other emotional problems. If you think you may be drinking because you feel upset, worried or depressed, you should talk to your GP.

Many people with psoriasis have little or no problem with their ability to work, and most can and do have jobs and successful careers. In certain areas of work, environmental conditions, the use of chemicals, gloves, and frequent hand washing might make psoriasis worse - you should discuss this and your condition with your employer, and work together to find ways around these issues. This advice is also useful in terms of taking time off work to go to appointments and have treatment.

Some industries, such as food handling and even the NHS, sometimes have concerns over psoriasis and if it is likely to harbour infection or contaminate food and clean areas. Most of the time, this can be addressed by covering the psoriasis with dressings when at work. Do get in touch with the Psoriasis Association for more information on this or any other employment issues.

The National Institute for Health and Care Excellence (NICE) guideline on the assessment and management of psoriasis (CG 153) recommends that doctors should discuss cardiovascular risk factors with all people who have psoriasis, and support any lifestyle changes (such as weight loss, quitting smoking ,etc) that might be needed. It also recommends that people with severe psoriasis should be offered a cardiovascular risk assessment every five years. This is because recent scientific research has suggested that people with psoriasis could be more likely to develop certain other conditions, including heart disease.

However, we still don't completely understand what the link between psoriasis and heart disease is, and certainly not everyone with psoriasis will get heart disease (and vice versa). Research on this topic is ongoing, most notably the IMPACT project based at Manchester University, which is looking into the potential co-morbidities (related conditions) of psoriasis. This is a multi-million pound study, that the Psoriasis Association is involved in directing.

Remember, you can't change the fact that you have psoriasis, but there are other risk factors for heart disease that you can change: make efforts to eat a balanced diet; keep active and maintain a healthy weight; try to give up smoking and to moderate alcohol intake. Visit the British Heart Foundation website for more information on how to keep your heart healthy.

If you look online, you’ll find lots of diets that ‘cure’ psoriasis, and you might see features in magazines or hear people saying that psoriasis can be controlled through eating - or not eating - certain foods. The truth is that scientific research has not yet found a definite link, or found a diet that works for everybody. Some people do say that they’ve noticed an improvement when they cut something out of their daily diet, and if you think you might be eating something that makes your psoriasis worse, then keeping a food diary is an easy way to spot any patterns.

There has been some research in other inflammatory conditions, such as rheumatoid arthritis, that suggests that eating foods that reduce inflammation in the body (such as those high in Omega 3 fatty acids – oily fish, nuts and seeds) may be helpful. There is no definite evidence to say that this works in psoriasis, but, again, it may be an approach that some people find helps. Additionally, some very recent research has suggested that gluten-free diets may help some people with psoriasis. Much more work needs to be done in this area to establish if this is definitely the case.

You will need to have a referral from your GP in order to see a Dermatologist, whether this is via the NHS or if you chose to be seen privately.

Treating psoriasis and/or psoriatic arthritis is often a case of trial-and-error, and many people try a number of different things before they find a treatment, or combination of treatments, that works for them. Because of this, it is not uncommon to find yourself using a treatment that is not working as well as you’d hoped, or that has gradually become less effective.

If your treatment doesn’t work, or stops working, you should make an appointment to see your doctor (Dermatologist or GP) to discuss your other options. There are many different treatments available for psoriasis, and they should be able to advise you. You can read about the different available treatments on our website, or can get in touch with us for more information. Bear in mind that many treatments take weeks to work rather than days, so it’s important to give them a good chance to work even if they don’t seem to be doing much at first.