Naturally, one of the first questions you ask after getting diagnosed with psoriasis may be: Is psoriasis contagious? After all, plenty of skin rashes spread through touch, like the kind impetigo can cause. While psoriasis can look like a contagious rash, it’s actually different from one in many ways. Knowing the truth about psoriasis helps push back against the stigma related to having a visible condition.
And learning a little more about psoriasis and what drives it can go a long way toward giving you the answers you need about how to manage your condition. Here’s what you need to know about psoriasis and how it spreads.
What is psoriasis?
Psoriasis is an autoimmune condition that causes your skin cells to grow faster than usual, according to the Centers for Disease Control and Prevention2 (CDC). Typically, it takes weeks to make new skin cells. But with psoriasis, you can make skin cells in days, causing them to accumulate and cause thick, scaly patches, according to the American Academy of Dermatology3 (AAD). People with psoriasis are also at an increased risk of developing other conditions such as diabetes and high blood pressure, so it’s important to have regular appointments with your physician to monitor your overall health.
There is no cure for psoriasis, so you may have flares that can last up to months followed by a period of remission, the Mayo Clinic1 says.
There are different types of psoriasis, and symptoms can vary slightly with each. But, in general, these some common psoriasis symptoms1:
- Thick, scaly patches of skin
- Dry skin that can itch or crack open and bleed
- Sore skin
- Nail changes, such as pitting
One major thing to know is that psoriasis can look very different depending on your skin tone4. “Psoriasis on fair skin looks like pink, scaly plaques,” Oma N. Agbai5, M.D., assistant clinical professor in the Department of Dermatology at the University of California, Davis, School of Medicine, tells SELF. “Psoriasis on dark skin is also scaly but tends to be dark brown, purple, or gray in color, and sometimes the scale is thicker.”
And psoriasis can cause more than just skin symptoms. “Because psoriasis can be very noticeably [discolored] and scaly, many patients feel self-conscious about being around others,” Vicky Ren6, M.D., assistant professor of dermatology at the Baylor College of Medicine, tells SELF. Some people get lesions on their genitals and groin, which understandably can make them feel self-conscious during sex, she says.
Psoriasis flares are also just really uncomfortable to live through. “Psoriasis can be very itchy and often people scratch till they bleed,” Cindy Wassef7, M.D., assistant professor at the Rutgers Center for Dermatology, tells SELF. “Not only is the intense itch distracting from work and sleep, but bleeding on your skin, clothing, and surroundings can make tasks difficult to accomplish.”
What are the types of psoriasis?
According to the Mayo Clinic1, there are several types of psoriasis:
Plaque psoriasis is common and appears as dry, raised patches of skin covered with scales. Generally, these plaques happen on your elbows, knees, lower back, and scalp.
Nail psoriasis affects your fingernails and toenails. You may have many different symptoms including pitting, abnormal nail growth, discoloration, or separation of your nail from the nail bed.
Guttate psoriasis is more common in young adults and children. It can happen after you get an infection like strep throat and produces lesions that look like small drops on your abdomen, arms, or legs.
Inverse psoriasis primarily affects the groin, butt, and breast areas. The patches are smooth and tend to get worse when you sweat a lot or experience a lot of friction.
Pustular psoriasis is rare and causes sores that are filled with pus. You may get them on your palms or the soles of your feet.
Erythrodermic psoriasis is uncommon and causes a peeling, burning rash that can appear on your entire body.
You may read articles or hear other people discuss psoriatic arthritis in conjunction with psoriasis. Psoriatic arthritis is another autoimmune condition that causes painful, swollen joints. Having psoriasis increases your risk of developing psoriatic arthritis, so it’s important to let your doctor know of any joint symptoms you develop, according to the Cleveland Clinic.
What causes psoriasis?
Experts aren’t clear why some people develop psoriasis, according to the Mayo Clinic1.
Researchers have some theories, though, and it involves a combination of genetics and environmental factors9. “Certain inherited genes have been found to increase the likelihood that an individual will develop psoriasis,” Dr. Agbai says, adding, “People with this genetic predisposition to develop psoriasis can develop psoriasis plaques after exposure to environmental triggers such as infection or certain medications.” Sometimes, there’s no clear event, like having an infection, that triggers psoriasis. “In those individuals, genetic predisposition is thought to be the primary cause,” Dr. Agbai says.
What are psoriasis triggers?
It’s important to understand your specific psoriasis triggers, Dr. Wassef says. “Despite a great treatment plan, if you are still getting exposed to your psoriasis triggers, you will still flare,” she notes. “Finding and eliminating your triggers can help decrease the amount of medicine you use and limit the number of flares you have.”
You may need to do some detective work to figure out your triggers, but keeping a journal that documents your symptoms, the timing of your flare, the weather conditions, your diet, and stress levels may help you pinpoint specific triggers if you have any. “Not everybody with psoriasis can link their flares to certain triggers,” Dr. Agbai says. “In those individuals, genetic predisposition is thought to be the primary cause.”
Psoriasis triggers include1:
- Living in cold, dry climates
- Having skin injuries, like a cut, scrape, or sunburn
- Experiencing stress
- Smoking or chronically being exposed to secondhand smoke
- Suddenly discontinuing an oral or systemic corticosteroids
Can psoriasis spread?
Even though it may look similar to skin infections that spread through skin-to-skin contact, psoriasis is not contagious. “Psoriasis is a chronic inflammatory autoimmune disease and is in no way contagious because it is not related to any infection,” Susan Massick9, M.D., associate clinical professor of dermatology at the Ohio State University College of Medicine, tells SELF.
“No one will get psoriasis by touching it or a person with psoriasis,” Dr. Wassef says. “It is one of the biggest misconceptions, and a lot of stigma related to psoriasis has to do with this false belief.”
Of course, there are other causes of bumps and rashes that you could develop on your skin that can be contagious. While doctors stress the importance of getting a proper diagnosis when you’re dealing with unusual bumps or rashes, there can be some signs that you have psoriasis over something else.
“Psoriasis is often confused for fungal skin infections,” Dr. Wassef says. Psoriasis patches tend to be either pink, dark brown, purple, or gray in color and have raised rashes with scales, she explains. Fungal rashes can also appear in the same colors and be raised but the edges of the rash spread out, Dr. Wassef says. The center of fungal rash such as ringworm10 usually appears normal and isn’t discolored. “This clearing in the center is not seen in psoriasis,” Dr. Wassef says.
Dr. Massick explains that skin infections feel differently than psoriasis. “Typical skin infections will feel warm to the touch and painful with swelling and occasional drainage, whereas psoriasis patches are dry, scaly, and itchy, more than painful,” she says.
How do you get a psoriasis diagnosis?
Your physician will do a physical exam if they think you have psoriasis. They will probably also ask if you have any symptoms like itchy skin in addition to getting your medical history so they can learn if you have blood relatives with the condition or if you’ve experienced possible psoriasis triggers.
Your doctor may also remove a very small piece of your skin that can be analyzed to confirm that you have psoriasis, according to the AAD3. A biopsy can also help your doctor rule out other skin disorders and diagnose your specific form of psoriasis, according to the Mayo Clinic1.
For people of color, getting diagnosed with psoriasis can be really frustrating. Often, people with dark skin are misdiagnosed with other skin conditions because there’s not enough medical awareness about how psoriasis looks on skin of color. (You can look for dermatologists in your area who specialize in treating people with dark skin by using the Skin of Color database.)
The length of time you’ve have psoriasis, any treatments you are using to help your symptoms, and scratching your flare can change the way psoriasis looks, according to Dr. Wassef. So, your physician might do a biopsy just to confirm that you do have psoriasis if they can’t tell visually.
What are my psoriasis treatment options?
There are plenty of psoriasis treatments to help with your specific situation. “Treatment recommendations for psoriasis depend on the severity, location of skin lesions, and amount of body surface area involved,” Dr. Agbai says. Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.
Topical treatments include:
- Corticosteroids commonly treat mild to moderate psoriasis. You can find them as ointments, creams, lotions, gels, foams, sprays, and shampoos.
- Vitamin D analogues can help your skin cells grow more slowly.
- Retinoids may also be used to help your skin cells grow more slowly and to treat nail psoriasis.
- Calcineurin inhibitors help reduce inflammation and are recommended for more sensitive areas where steroids or retinoids can be irritating.
- Salicylic acid shampoos and scalp treatments can target help with scalp psoriasis.
- Coal tar can help relieve your symptoms but can be messy to use.
- Goeckerman therapy uses both coal tar and light therapies to help with symptoms.
- Anthralin can help your skin cells grow more slowly and reduce your symptoms.
Physicians may recommend light therapies, ranging from natural sunlight to different types of artificial light, to treat moderate or severe psoriasis. These include:
- UVB broadband
- UVB narrowband
- Psoralen plus ultraviolet A (PUVA)
- Excimer laser
Oral or injectable medications are used to treat moderate to severe psoriasis:
- Steroids can be injected into your psoriasis flares.
- Retinoids can be taken orally to help with your skin cell production.
- Methotrexate reduces inflammation and skin cell production.
- Cyclosporine suppresses your immune system to prevent psoriasis flares.
- Biologics suppress the specific part of your immune system involved with triggering psoriasis flares. These newer treatments are very effective, and many physicians may recommend these immediately.
Living with psoriasis can be a challenge, but educating yourself about the condition can be helpful in learning to manage your symptoms. And, of course, knowing that psoriasis isn’t contagious will hopefully allow you to feel more comfortable living your life as normally as possible during a flare.
- Mayo Clinic, Psoriasis
- Centers for Disease Control and Prevention, What Is Psoriasis?
- American Academy of Dermatology, Psoriasis: Overview
- American Academy of Dermatology, Can You Get Psoriasis If You Have Skin of Color?
- UC Davis Health Medical Center, Oma N. Agbai, M.D.
- Baylor College of Medicine, Vicky Zhen Ren, M.D.
- Rutgers Robert Wood Johnson Medical School, Cindy Wassef, M.D.
- International Journal of Molecular Science, The Genetic Basis of Psoriasis
- The Ohio State University Wexner Medical Center, Susan Massick, M.D.
- American Academy of Dermatology, Ringworm: Signs and Symptoms
- The Vicious Cycle Between Psoriasis and Mental Health
- 8 Reasons Your Skin Is Peeling—And How to Deal
- How to Find the Right Psoriasis Treatment for Your Symptoms