Psoriasis

Psoriasis is a long-term autoimmune skin disease that causes red, scaly, often itchy plaques. It is not contagious, not caused by poor hygiene, and not curable by oils or diet changes. Modern treatment can control it very well. In India, the biggest harms are the social stigma and reliance on unregulated "cures".

What it looks like

• Plaque psoriasis — thick, scaly, well-defined red patches (or brown-grey in darker skin) on elbows, knees, scalp, lower back.
• Scalp psoriasis — thick dandruff-like scaling, often confused with dandruff.
• Nail psoriasis — pitting, thickening, lifting from the nail bed.
• Guttate — shower of small drop-like lesions after a streptococcal throat infection.
• Inverse — in skin folds, smooth and red (not scaly).
• Pustular and erythrodermic — severe forms needing urgent care.

Triggers

• Infections (especially streptococcal throat).
• Stress.
• Alcohol, smoking.
• Some medicines (lithium, beta-blockers, antimalarials, abrupt steroid withdrawal).
• Skin injury (Koebner phenomenon — cuts, tattoos, surgery scars can develop psoriasis).

Important things to know

• Not infectious — you cannot catch it by shaking hands or sharing food. This is the single most damaging Indian myth.
• Linked with depression, heart disease, diabetes, and psoriatic arthritis — so it's more than a skin problem.
• Up to 1 in 3 people with psoriasis develop psoriatic arthritis — joint pain and stiffness, especially in fingers, toes, back. See Psoriatic Arthritis.
• Flares come and go. Periods of clear skin are normal; so are setbacks.

Treatment

• Mild: moisturisers, topical corticosteroids, vitamin D analogues, coal tar, salicylic acid.
• Moderate: phototherapy (narrowband UVB) — widely available at dermatology departments and proven to work.
• Severe: oral immunosuppressant class and biologics — several approved in India (under a dermatologist or rheumatologist).
• Don't self-buy clobetasol or unregulated "psoriasis oils" — they worsen the condition long-term.
• A consistent moisturising routine, stopping smoking, limiting alcohol, and weight management improve control.
• Mental-health support matters — depression is common.

See a doctor

• New suspected psoriasis — confirm the diagnosis.
• Psoriasis spreading, painful, or affecting palms/soles/genitals/face.
• Joint pain, swelling, morning stiffness — screen for psoriatic arthritis.
• Whole-body redness with fever (erythrodermic psoriasis) — emergency.