The cause of psoriasis is not fully known, but it is thought to relate to an overactive immune system.

If you have psoriasis you may find that certain substances or activities – triggers – can make it worse. Common triggers include stress, infections, smoking, alcohol, cold weather and some medicines.

Some of the more common symptoms of psoriasis include:

• Raised, red, inflamed lesions covered in silvery scaly plaques
• Small, red, individual spots
• Dry skin that may crack and bleed
• Itching, burning, or soreness of the skin
• Thickened, pitted nails or separation from the nail bed
• Swollen, stiff joints

Only a healthcare professional can diagnose psoriasis. Usually a GP will make the diagnosis, although specialist referral may be required in some cases. Psoriasis is described as ‘mild’ or ‘moderate-to-severe’ according to the intensity and extent of symptoms and its effect on health-related quality of life. Doctors use specific scales – Psoriasis Area and Severity Index (PASI); Dermatology Life Quality Index (DLQI) – to assess the extent and severity of psoriasis and its impact.

Psoriasis is a chronic condition, if you have psoriasis, it is for life. While there is currently no cure, there are a variety of treatments that can help to lessen or clear symptoms for periods. Not all treatments will work for everyone, and you may need to try several before you find one that works for you.

Psoriasis is a complex disease that can have effects, sometimes serious, on more than just the skin. The inflammation seen on the skin can also occur in other parts of the body, leading to diseases such as:¹

• Psoriatic arthritis: affecting up to 35% of people with psoriasis.
• Cardiovascular disease: strongly increased risk of angina, heart attack and blood clots.
• Metabolic syndrome: increased risk of diabetes.
• Obesity: 50% increased risk.
• Inflammatory bowel disease: nearly 3 times increased risk of developing Crohn’s disease.

Up to 60% of people with psoriasis also have depression; about the same proportion as those with cancer.

Reference: 1. Vekic DA, et al. Med J Aust 2015; 16(6): 43–8.

Psoriatic arthritis is associated with psoriasis, and around 3 in 10 people with psoriasis may develop psoriatic arthritis.¹

Reference: 1. Vekic DA, et al. Med J Aust 2015; 16(6): 43–8.

While there is no cure for psoriasis, symptoms can be decreased, and in some cases, disappear, if they are well managed with treatment. A variety of treatments are available for psoriasis and which is best for you will depend on a number of factors. In making a treatment decision, your GP or dermatologist will consider with you: the severity of your psoriasis, its location, how it is affecting your quality of life, and whether you have other health concerns.

• Topical treatments are used when the psoriasis is mild to moderate. ‘Topical’ means these treatments are applied directly to the skin, to help slow down excessive skin cell production and/or reduce the inflammation that psoriasis causes. They address psoriasis from the outside. Topicals include a variety of creams, ointments, gels and lotions, some available over-the-counter, and some only available with a prescription.
• Phototherapy (or light therapy) uses ultraviolet light – the same UVA and UVB rays that the sun gives off naturally. This UV light is delivered via specially designed fluorescent tubes. Used to treat psoriasis that is moderate to severe, phototherapy is effective, but there are factors that need to be considered by you and your healthcare professional, including potential long-term skin damage, and the need for frequent treatments (eg. three times a week).
• Systemic treatments work to address psoriasis from the inside, via the blood, and are generally only prescribed for people whose condition is moderate to severe. They can be divided into two categories: standard systemic treatments, which are usually taken orally; and ‘biologic’ treatments, which are given as an injection under the skin (subcutaneous) or infusion (into the vein).
  • Standard systemic treatments are prescription medicines which work slightly differently depending on the active ingredient. For example, most of them work to reduce the immune system’s activity, while some may also affect how the skin cells behave.
  • Biologic treatments work by blocking the action of specific immune cells or chemical messengers that are known to play a role in psoriasis.

Many psoriasis treatments, including topical creams, oral medications and biologic medicines, are listed on the Pharmaceutical Benefits Scheme (PBS). If you are prescribed one of these therapies, you will be eligible for treatment funded by the Australian Government – providing you are a Medicare cardholder and the severity of your condition meets the funding eligibility criteria. Medicare also provides a rebate for dermatologist consultations and phototherapy treatments.

Many GPs effectively manage psoriasis, but there are occasions when referral to a dermatologist may be necessary. As a general rule, the more severe your psoriasis, the more likely you are to see a dermatologist, either regularly or to manage specific issues. Some treatments can only be prescribed by a dermatologist with experience in treating severe psoriasis.

You will need to have a referral from your GP in order to see a dermatologist.