Quantcast Redness and silver-looking scaling often affect the scalp and hairline with psoriasis. This image displays the fine, scaly, slightly elevated lesions in the armpit (axilla) in psoriasis. In psoriasis, this is a typical elevated lesion with white scale on the knee. This image displays dry, scaly areas of the scalp typical of psoriasis. This image displays widespread red, scaling slightly elevated lesions involving buttocks and lower extremities from psoriasis. Psoriasis of the ear typically involves the ear canal and appears as redness with white scale. Psoriasis often has white, thick scale that comes off in "plates" when picked, causing bleeding. Psoriasis typically has multiple areas of skin involvement with lesions clustered on or near the knees. This image displays a close-up of the scaly, slightly elevated lesions of psoriasis, which often appear to come off in plates. This image displays typical slightly elevation lesions of psoriasis with thick, white scale and redness. This image displays an extensive case of psoriasis that has been triggered by a strep infection. This image displays an uneven, pitted nail separated from the nail bed due to psoriasis. This image displays the contrast between a nail affected by psoriasis (on the right) and one that is normal (on the left). This image displays knees affected by psoriasis. This image displays a separation of the nail from the bed (onycholysis) caused by psoriasis. This image displays cracks in the skin of hands typical of psoriasis. Psoriasis on the bottoms of feet may affect the instep of the sole as well as areas of friction. Psoriasis may be evident in the nails with multiple tiny, pit-like depressions of the nail plate surface. Psoriasis frequently occurs in the genital area of men and women. Psoriasis is not contagious and is not spread sexually. In addition to pitting of the nail surface, this patient with psoriasis has a yellowish discoloration and separation of the nail plate from the nail bed (onycholysis) of the free edges of the nails.
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Picture of Psoriasis: Redness and silver-looking scaling often affect the scalp and hairline with psoriasis. Divider line
Redness and silver-looking scaling often affect the scalp and hairline with psoriasis.
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Treatments Your Physician May Prescribe
Unfortunately, there is no cure for psoriasis, but multiple treatments are very helpful at controlling it.

For disease that affects only the skin (localized disease), topical treatments may be prescribed:
  • Mid-to-high-potency topical steroids for the body or scalp and low-strength topical steroids for the face and skin fold areas as needed. Stretch marks and thinning of the skin can result from overuse of topical steroids, particularly in skin fold areas.
  • Vitamin D creams may be prescribed and are sometimes combined with topical steroids.
  • Vitamin A-based creams may be prescribed, sometimes in combination with topical steroids.
  • Calcineurin inhibitors (tacrolimus, pimecrolimus) may be prescribed.
  • Tar-based therapies are sometimes used. These therapies may have a foul odor and cause irritation in some people.
  • Anthralin creams may be prescribed, but these may stain skin and cause irritation.
  • For the scalp, oils, gels, foams, or solutions, some of which include topical steroids, are used in combination with tar or salicylic acid shampoos.
For more extensive disease:
  • If plaques are extensive, ultraviolet light therapy (phototherapy) may be considered.
  • Oral medications may be used for extensive psoriasis, including acitretin (made from Vitamin A), methotrexate, mycophenolate mofetil, cyclosporin A, and tacrolimus. These medications require close monitoring and may have potentially serious side effects.
  • Newer medications that affect the immune system may be injected at home, and other injected (intravenous) medications given in a medical facility are also available. These medications include etanercept, infliximab, adalimumab, alefacept, and felvizumab. These are very costly and may have serious side effects.
Last Modified: 29 Jan 2008

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