Overview
In psoriasis the immune system speeds up skin cell production, so cells build up into thick, scaly plaques instead of shedding normally. It is not contagious and is not caused by poor hygiene.
Plaques typically appear on the elbows, knees, lower back and scalp, but psoriasis can also affect nails, skin folds and the genital area. Flares are often triggered by stress, infection (particularly throat infections), skin injury, alcohol or certain medicines.
When to seek urgent medical help
- • Widespread redness covering most of the body with shivering or fever
- • Painful, swollen joints or morning stiffness lasting over 30 minutes
- • Pustules developing rapidly across large areas of skin
Symptoms and signs
- Well-defined raised plaques with silvery-white scale
- Itching, tightness or soreness of affected skin
- Scalp scaling that extends beyond the hairline
- Nail pitting, ridging or separation from the nail bed
- Small drop-like spots after a sore throat (guttate psoriasis)
- Joint pain or stiffness suggesting psoriatic arthritis
Management and treatment
Most psoriasis is controlled with topical treatment. Combining a vitamin D analogue with a topical steroid clears plaques faster than either alone, and scalp psoriasis needs a formulation designed for hair-bearing skin.
Your ChatDoc doctor confirms the pattern of psoriasis, checks for joint involvement and issues the right prescription, with onward referral advice if you need phototherapy or systemic treatment.
Prescription treatment options
Vitamin D analogue + steroid combination
First-line gel or ointment (for example calcipotriol with betamethasone) that flattens plaques within weeks.
Scalp formulations
Shampoos, gels and coconut-oil based preparations that lift scale and treat inflammation on the scalp.
Coal tar and salicylic acid preparations
Useful for thick, scaly plaques and as steroid-sparing maintenance.
Referral for phototherapy or systemic therapy
For extensive or resistant disease, including biologic options through specialist dermatology.
Any prescription is issued only after a doctor has reviewed your case and considers the treatment safe and appropriate for you.
Your online Psoriasis assessment
- 1
Tell us about your concern
Share symptoms, past treatments, medicines and relevant health information.
- 2
Upload clear photos
Upload photos of your concern where applicable.
- 3
Doctor reviews your case
Technology helps organise your answers, but every assessment and prescription decision is made by a doctor, who may message you if they need more information.
- 4
Get your personalised plan
A personalised prescription is issued if treatment is clinically appropriate.
Prognosis and outlook
Plaques usually improve within 4-8 weeks of consistent topical treatment, and many people achieve near-clear skin. Psoriasis tends to relapse, so a maintenance plan reduces how often flares return.
Because psoriasis is linked with joint, cardiovascular and metabolic health, your doctor will also advise on the checks worth having with your GP.
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This page is general medical information and does not replace a personal consultation. Always seek urgent care for severe or rapidly worsening symptoms. ChatDoc is not an emergency service. Call 999 (UK) or 112 (EU) for life-threatening emergencies or 111 for urgent non-emergency help. Do not wait for an online reply.