Plaque psoriasis is the most common type of psoriasis and it gets its name from the plaques that build up on the skin. There tend to be well-defined patches of red raised skin that can appear on any area of the skin, but the knees, elbows, scalp, trunk, and nails are the most common locations. There is also a flaky, white buildup on top of the plaques called scales. Possible plaque psoriasis symptoms include skin pain, itching, and cracking.
There are plenty of over-the-counter products that are effective in the treatment of plaque psoriasis. 1% hydrocortisone cream is a topical steroid that can suppress mild disease and preparations containing tar are effective in treating plaque psoriasis.
Scalp psoriasis is a common skin disorder that makes raised, reddish, often scaly patches. Scalp psoriasis can affect your whole scalp, or just pop up as one patch. This type of psoriasis can even spread to the forehead, the back of the neck, or behind the ears. Scalp psoriasis symptoms may include only slight, fine scaling. Moderate to severe scalp psoriasis symptoms may include dandruff-like flaking, dry scalp, and hair loss. Scalp psoriasis does not directly cause hair loss, but stress and excess scratching or picking of the scalp may result in hair loss.
Scalp psoriasis can be treated with medicated shampoos, creams, gels, oils, ointments, and soaps. Salicylic acid and coal tar are two medications in over-the-counter products that help treat scalp psoriasis. Steroid injections and phototherapy may help treat mild scalp psoriasis. Biologics are the latest class of medications that can also help treat severe scalp psoriasis.
Guttate psoriasis looks like small, pink dots or drops on the skin. The word guttate is from the Latin word “gutta,” meaning drop. There tend to be fine scales with guttate psoriasis that are finer than the scales in plaque psoriasis. Guttate psoriasis is typically triggered by streptococcal infection (strep throat) and the outbreak will usually occur two to three weeks after having strep throat.
Guttate psoriasis tends to go away after a few weeks without treatment. Moisturizers can be used to soften the skin. If there is a history of psoriasis, a doctor may take a throat culture to determine if strep throat is present. If the throat culture shows that Streptococcus is present, a doctor may prescribe antibiotics.
Many patients with psoriasis have abnormal nails. Psoriatic nails often have a horizontal white or yellow margin at the tip of the nail called distal onycholysis because the nail is lifted away from the skin. There can often be small pits in the nail plate, and the nail is often yellow and crumbly.
The same treatment for skin psoriasis is beneficial for nail psoriasis. However, since nails grow slowly, it may take a while for improvements to be seen. Nail psoriasis can be treated with phototherapy, systemic therapy (medications that spread throughout the body), and steroids (cream or injection). If medications do not improve the condition of nail psoriasis, a doctor may surgically remove the nail.