top of page

Psoriasis Treatment St. Louis

Red, scaly psoriasis plaques on the arm.

Psoriasis is a common skin condition that affects a significant number of people worldwide. It is characterized by red and itchy patches on the skin, and it is estimated to impact around 2-3% of the global population. While there is currently no cure for psoriasis, there are various ways to manage and alleviate its symptoms. There are different forms of psoriasis, including plaque psoriasis, pustular psoriasis, and flexural psoriasis, each presenting its own set of challenges. From inflamed skin plaques to chronic plaque and even pus-filled blisters, dealing with psoriasis can be frustrating. However, there are strategies and treatments available to help manage this condition. Our St. Louis dermatologists at Mid-County Dermatology located at Missouri Baptist Medical Center discuss what psoriasis is below and ways to manage psoriasis.

Different Types of Psoriasis and their Symptoms

Psoriasis is a chronic skin condition that affects millions of people worldwide. It manifests in various forms, each with its own set of symptoms and characteristics. Understanding the different types of psoriasis and their symptoms is crucial for proper diagnosis and treatment.

Plaque Psoriasis: Raised, Scaly Patches on Elbows, Knees, and Scalp

Plaque psoriasis is the most common type, accounting for about 80% of all cases. It presents as raised red patches covered with silvery-white scales. These patches typically appear on the elbows, knees, scalp, lower back, and other areas such as the palms and soles of the feet. The affected skin may feel itchy or painful.

In severe cases of plaque psoriasis, these patches can merge together to form larger areas called plaques. The severity can vary from person to person, with some experiencing mild discomfort while others endure significant pain.

Guttate Psoriasis: Small, Drop-like Lesions Mainly on Trunk and Limbs

Guttate psoriasis often develops suddenly after a bacterial or viral infection like strep throat. This type is characterized by small red spots resembling drops that appear mainly on the trunk and limbs. These lesions are usually not as thick as those seen in plaque psoriasis but can still be itchy or sore.

While guttate psoriasis tends to resolve within a few weeks or months without treatment, it may recur or develop into another form of psoriasis over time.

Inverse Psoriasis: Smooth Red Patches in Skin Folds

Inverse psoriasis primarily affects areas where skin touches skin, such as armpits, groin area, under the breasts in women, or around the genitals. Unlike other types that present with scaly patches, inverse psoriasis appears as smooth red patches that are shiny and inflamed.

Due to its location in skin folds, this type of psoriasis can be particularly uncomfortable and prone to irritation. The constant rubbing and sweating exacerbate the symptoms, leading to further discomfort.

Other Types of Psoriasis

Apart from the three main types mentioned above, there are other less common forms of psoriasis with distinct characteristics:

  • Pustular Psoriasis: Characterized by pus-filled blisters on red skin. It can be localized or spread across larger areas.

Causes and Triggers of Psoriasis Outbreaks

Psoriasis, a chronic skin condition that affects millions of people worldwide, is characterized by the rapid growth of skin cells. While the exact cause of psoriasis is still unknown, several factors have been identified as triggers for psoriasis outbreaks.

Genetic Predisposition

One significant factor in the development of psoriasis is genetic predisposition. Research has shown that individuals with a family history of psoriasis are more likely to develop the condition themselves. Certain genes associated with immune system regulation and inflammation play a role in determining susceptibility to psoriasis. Although having these genes does not guarantee the development of psoriasis, they increase the risk significantly.

Immune System Malfunction

Psoriasis is an autoimmune disorder where the immune system mistakenly attacks healthy skin cells. In individuals with psoriasis, inflammatory signals are sent to the skin cells, causing them to multiply rapidly. This abnormal immune response leads to the formation of red, scaly patches on the surface of the skin. The exact trigger for this immune system malfunction is still unclear but is believed to be a combination of genetic and environmental factors.

Environmental Factors

While genetics and immune system dysfunction contribute to psoriasis development, certain environmental factors can trigger or worsen symptoms in susceptible individuals. These triggers vary from person to person but commonly include:

  • Stress: Psychological stress has long been recognized as a potential trigger for psoriasis flare-ups. High-stress levels can disrupt immune system function and exacerbate existing symptoms.

  • Infections: Bacterial or viral infections such as strep throat or respiratory infections have been linked to triggering or worsening psoriasis outbreaks.

  • Medications: Certain medications like beta-blockers (used for hypertension) or lithium (used for bipolar disorder) can induce or aggravate psoriatic symptoms in some individuals.

  • Injury or trauma: Skin injuries such as cuts, burns, or even tattoos may lead to new psoriasis lesions forming in the affected area, a phenomenon known as the Koebner response.

It is important to note that triggers can vary greatly among individuals, and what may cause a flare-up for one person may not affect another. Understanding personal triggers through self-monitoring and keeping track of symptoms can help manage psoriasis effectively.

Complications of Psoriasis and its Impact on Overall Health

Psoriasis is a chronic autoimmune disease that affects millions of people worldwide. While the condition primarily manifests as a skin disorder, its effects extend far beyond the surface. The impact of psoriasis on overall health can be significant, leading to various complications and long-term problems.

Increased risk of developing other conditions like diabetes and heart disease

Research has shown that individuals with psoriasis have an increased risk of developing certain comorbidities. One such condition is diabetes, a metabolic disorder characterized by high blood sugar levels. Studies have found that people with psoriasis are more likely to develop type 2 diabetes compared to those without the condition. The exact link between psoriasis and diabetes is still being studied, but it is believed that chronic inflammation plays a role in both diseases.

Another concerning complication associated with psoriasis is an elevated risk of cardiovascular problems, including heart disease. Psoriasis has been linked to an increased likelihood of developing conditions such as hypertension, high cholesterol levels, and obesity - all contributing factors for cardiovascular diseases. It is crucial for individuals with psoriasis to monitor their heart health closely through regular check-ups and lifestyle modifications.

Emotional impact: Depression and anxiety are common

Living with a chronic condition like psoriasis can take a toll on one's mental well-being. Many people with psoriasis experience depression and anxiety due to the physical discomfort, social stigma, and emotional distress caused by the disease. The visible nature of psoriatic lesions may lead to feelings of self-consciousness and low self-esteem, affecting interpersonal relationships and overall quality of life.

It is important for individuals with psoriasis to seek support from healthcare professionals or support groups specializing in managing the emotional impact of chronic illnesses. Therapies such as cognitive-behavioral therapy (CBT) can help patients develop coping mechanisms and improve their mental resilience.

Joint pain and inflammation (psoriatic arthritis) affect some patients

Psoriatic arthritis is a specific type of arthritis that affects individuals with psoriasis. It causes joint pain, stiffness, and swelling, often leading to reduced mobility and impaired quality of life. Psoriatic arthritis can affect any joint in the body, including the fingers, toes, knees, and spine.

Managing psoriatic arthritis requires a multidisciplinary approach involving rheumatologists and dermatologists.

Diagnosis and Tests for Psoriasis

Psoriasis is a chronic skin condition that affects millions of people worldwide. While its symptoms are often visible, an accurate diagnosis is crucial to ensure appropriate treatment. Let's explore the different methods healthcare providers use to diagnose psoriasis.

Visual Examination by Dermatologist or Healthcare Provider

The first step in diagnosing psoriasis involves a thorough visual examination by a dermatologist or healthcare provider. They will carefully inspect the affected areas of your skin, looking for key characteristics such as redness, scaling, and raised patches known as plaques. They may ask about your medical history and any family history of psoriasis to gain further insights.

During this examination, it is essential to provide detailed information about your symptoms, including when they first appeared and any triggers that exacerbate them. This information can help the healthcare provider make an accurate diagnosis and develop an effective treatment plan tailored to your needs.

Skin Biopsy to Confirm Diagnosis if Necessary

In some cases, a dermatologist may recommend a skin biopsy to confirm the diagnosis of psoriasis. A skin biopsy involves taking a small sample of affected skin tissue for laboratory analysis. This procedure helps rule out other conditions with similar symptoms and provides definitive evidence of psoriasis.

During the biopsy, local anesthesia is administered to minimize discomfort. The dermatologist will then remove a small section of the skin using a scalpel or punch tool. The sample is sent to a laboratory where experts examine it under a microscope to identify specific characteristics associated with psoriasis.

It's important to note that not everyone with suspected psoriasis requires a skin biopsy. In most cases, visual examination combined with medical history is sufficient for an accurate diagnosis.

No Specific Blood Test for Psoriasis Exists

Unlike some other medical conditions, there is no specific blood test available for diagnosing psoriasis. However, blood tests may be conducted as part of the diagnostic process to rule out other potential causes of skin symptoms or to assess the overall health of individuals with psoriasis.

These blood tests typically check for indicators of inflammation, such as C-reactive protein (CRP) levels. They may evaluate liver function and cholesterol levels as psoriasis has been associated with an increased risk of certain comorbidities.

Clues to Health: Fingernail Changes in Psoriasis

Psoriasis is a chronic autoimmune condition that primarily affects the skin, causing red, scaly patches. However, it's important to note that psoriasis can also have an impact on the nails. In fact, nail changes often accompany the skin symptoms and can provide valuable clues about psoriatic involvement. Let's take a closer look at some of the common nail changes associated with psoriasis.

Pitting (small dents) or ridges on nails may indicate psoriatic involvement

One of the telltale signs of nail psoriasis is the presence of small dents or pits on the surface of the nails. These pitting marks are typically shallow and resemble tiny depressions. Ridges may appear on the nails, running either vertically or horizontally. These abnormalities occur due to an overactive immune response in individuals with psoriasis.

Discoloration or separation from nail bed can occur

Another significant indicator of nail psoriasis is discoloration. Affected nails may exhibit unusual hues such as yellowish-brown or white spots. In some cases, there might be a complete discoloration of the entire nail plate. Furthermore, as psoriasis progresses, separation between the nail and its underlying bed can happen. This condition is known as onycholysis and can cause considerable discomfort.

Nail changes often accompany skin symptoms

It's worth noting that these nail changes frequently coincide with skin symptoms of psoriasis. Individuals who experience pitting or ridges on their nails are more likely to have plaques or lesions on their skin as well. This correlation reinforces the connection between nail health and overall disease severity in psoriatic patients.

Understanding these clues to health is crucial for early detection and effective management of psoriasis-related complications involving the nails. If you notice any concerning changes in your nails along with other symptoms like redness, scaling, or itching of the skin, it's essential to consult a healthcare professional for an accurate diagnosis.

Available Treatments and Management Options for Psoriasis

Psoriasis is a chronic skin condition that affects millions of people worldwide. While there is currently no cure for psoriasis, several treatment options are available to manage its symptoms and improve the overall quality of life for those with the condition.

Topical creams/ointments reduce inflammation & itching

One of the first lines of defense against psoriasis symptoms is the use of topical creams and ointments. These products are applied directly to the affected areas of the skin and work by reducing inflammation, relieving itching, and promoting healing. They often contain active ingredients such as corticosteroids, vitamin D analogs, retinoids, or salicylic acid.

Some popular examples include:

  • Corticosteroid creams: These help to reduce inflammation and relieve itching.

  • Vitamin D analog creams: These regulate skin cell growth and can help alleviate symptoms.

  • Retinoid creams: Derived from vitamin A, these can slow down cell turnover and reduce scaling.

  • Salicylic acid ointments: These promote shedding of dead skin cells and aid in symptom relief.

Phototherapy uses UV light to slow down cell turnover

Phototherapy involves exposing the affected skin to controlled amounts of ultraviolet (UV) light. This treatment option helps slow down rapid cell turnover, which is a key factor in psoriasis flare-ups. There are different types of phototherapy available:

  1. Narrowband UVB therapy: This involves using a specific wavelength of UVB light that has been shown to effectively treat psoriasis without increasing the risk of skin cancer.

  2. PUVA therapy: This combines exposure to UVA light with a medication called psoralen, which makes the skin more sensitive to light. It can be an effective option for severe cases of psoriasis.

While phototherapy can be highly effective, it is important to follow a treatment plan prescribed by a healthcare professional. Overexposure to UV light can increase the risk of skin damage and other complications.

Systemic medications target immune system response

For moderate to severe psoriasis, systemic medications may be recommended. These medications work by targeting the body's immune system response, which plays a significant role in psoriasis development. They can help reduce inflammation and slow down skin cell growth.

Systemic and Topical Agents for Psoriasis Treatment

Psoriasis is a chronic autoimmune condition that affects the skin, causing red, scaly patches to appear. While there is no cure for psoriasis, various treatments can help manage its symptoms and improve the quality of life for those affected. Two primary categories of treatment options include systemic agents and topical agents.

Methotrexate & Cyclosporine Suppress Immune System Activity

Systemic treatments such as methotrexate and cyclosporine work by suppressing immune system activity, which plays a significant role in the development of psoriasis. Methotrexate is an oral medication commonly prescribed for moderate to severe psoriasis. It slows down cell turnover, reducing inflammation and scaling on the skin. On the other hand, cyclosporine is an immunosuppressive drug that targets specific immune cells involved in psoriasis flare-ups.

These systemic agents require close monitoring by healthcare professionals due to potential side effects and interactions with other medications. Regular blood tests are necessary to ensure safety during their use. However, they have shown effectiveness in managing psoriasis symptoms when used appropriately.

Biologic Drugs Block Specific Immune Responses

Biologic drugs represent a newer class of medications for treating psoriasis. They target specific components of the immune system responsible for triggering inflammation and plaque formation on the skin. These drugs are typically administered via injection or intravenous infusion.

By blocking specific immune responses associated with psoriasis, biologics provide targeted relief without suppressing the entire immune system like methotrexate or cyclosporine do. Some common biologic drugs used in psoriasis treatment include adalimumab, etanercept, infliximab, ustekinumab, secukinumab, ixekizumab, and brodalumab.

Corticosteroids Provide Quick Relief but Not Long-Term Solution

Topical corticosteroids are commonly used as a first-line treatment for mild to moderate psoriasis. These creams or ointments contain corticosteroid medications that help reduce inflammation, itching, and redness associated with psoriatic plaques. They provide quick relief and can be effective in managing flare-ups.

However, it's important to note that while corticosteroids offer immediate relief, they are not a long-term solution for psoriasis.

Diet Recommendations for People with Psoriasis

Psoriasis is a chronic autoimmune condition that affects the skin, causing redness, itching, and flaking. While there is no cure for psoriasis, certain dietary changes can help manage its symptoms and improve overall well-being.

Anti-inflammatory Diet Rich in Fruits, Vegetables, and Fish

An anti-inflammatory approach is often recommended. This involves consuming foods that have anti-inflammatory properties while avoiding those that may trigger inflammation in the body.

A rich diet consisting of fruits, vegetables, and fish can be beneficial for individuals with psoriasis. These foods are packed with essential vitamins, minerals, and antioxidants that promote overall health and help reduce inflammation.

Including a variety of colorful fruits such as berries, oranges, and melons in your daily meals can provide you with a good dose of antioxidants. Similarly, incorporating leafy green vegetables like spinach and kale can offer anti-inflammatory benefits due to their high content of vitamins A and C.

Fish rich in omega-3 fatty acids like salmon, mackerel, and sardines are excellent choices for individuals with psoriasis. Omega-3 fatty acids have been found to reduce inflammation in the body and may help alleviate psoriasis symptoms. If you're not a fan of fish or follow a vegetarian or vegan diet, you can opt for plant-based sources of omega-3s such as flaxseeds or chia seeds.

Avoid Trigger Foods Like Alcohol, and Processed Foods

In addition to incorporating beneficial foods into your diet plan for psoriasis management, it's crucial to avoid trigger foods that could potentially worsen your symptoms.

Alcohol consumption has been linked to increased inflammation in the body and can exacerbate psoriasis flare-ups. It's advisable to limit or completely avoid alcohol if you have psoriasis.

Processed foods, especially those high in sugar and unhealthy fats, can contribute to inflammation and may trigger or worsen psoriasis symptoms. These include fast food, sugary snacks, and processed meats. Opting for whole foods instead of processed options can help reduce inflammation and improve overall health.

Understanding Psoriatic Arthritis: Symptoms and Treatment

Psoriatic arthritis is a chronic autoimmune disease that affects individuals with psoriasis, a skin condition characterized by red, scaly patches. This condition not only impacts the skin but also causes inflammation in the joints, leading to pain, stiffness, and swelling. It is crucial to recognize the symptoms of psoriatic arthritis early on to seek appropriate treatment and manage the disease effectively.

Common Symptoms

Joint pain is one of the most prevalent symptoms experienced by individuals with psoriatic arthritis. The pain can range from mild discomfort to severe agony, hindering daily activities. Alongside pain, stiffness in the affected joints is also common, especially after periods of rest or inactivity. This stiffness tends to improve with movement throughout the day.

Swelling in the joints is another symptom that individuals with psoriatic arthritis often encounter. The affected joints may appear larger than usual due to inflammation. Moreover, some people may notice redness and warmth around these swollen areas.

Relieving Pain

If you experience joint pain associated with psoriatic arthritis in St. Louis, MO, there are several treatment options available that can help alleviate your discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed by doctors to relieve pain and reduce inflammation in the joints. These medications provide temporary relief and can be obtained over-the-counter or through prescription.

Applying topical creams or ointments directly onto the affected joints can offer localized relief from pain and inflammation. These topical treatments often contain corticosteroids or other anti-inflammatory ingredients that soothe discomfort.

Slowing Progression

To slow down the progression of psoriatic arthritis and prevent further damage to your joints, your doctor in St. Louis may recommend disease-modifying antirheumatic drugs (DMARDs) as a psoriasis treatment. These medications work by suppressing your immune system's response to reduce inflammation in both your skin and joints.

In some cases where DMARDs are not effective, biologic response modifiers may be prescribed. These drugs target specific molecules in the immune system to control inflammation and slow the progression of psoriatic arthritis.

Consulting Your Doctor

If you suspect that you may have psoriatic arthritis or are experiencing joint pain, it is crucial to consult your doctor for an accurate diagnosis. They will evaluate your symptoms, conduct a physical examination, and may order additional tests such as blood work or imaging studies to confirm the diagnosis.

Key Takeaways on Psoriasis

In conclusion, psoriasis is a chronic skin condition that affects millions of people worldwide. It can manifest in different types, each with its own set of symptoms and triggers. While the exact cause remains unknown, it is believed to be related to an overactive immune system. Psoriasis can have a significant impact on overall health, leading to complications such as psoriatic arthritis.

If you suspect you may have psoriasis or are already diagnosed, it is crucial to seek medical attention for proper diagnosis and treatment options. There are various systemic and topical agents available for managing psoriasis symptoms, along with diet recommendations that may help alleviate flare-ups. Remember to pay attention to your fingernails as well, as they can provide clues about your health in relation to psoriasis.

Take control of your psoriasis by staying informed about the condition and exploring different treatment approaches. Consult with healthcare professionals who specialize in dermatology or rheumatology for personalized advice tailored to your specific needs. By actively managing your condition and following recommended treatments, you can improve your quality of life and minimize the impact of psoriasis on your overall well-being.


What triggers a psoriasis outbreak?

Psoriasis outbreaks can be triggered by various factors such as stress, infections (like strep throat), cold weather, certain medications (such as beta-blockers or lithium), smoking, alcohol consumption, and injuries to the skin.

Can diet affect my psoriasis?

While there is no definitive evidence linking specific foods to psoriasis flare-ups, some individuals report improvements in their symptoms by adopting an anti-inflammatory diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. It's worth experimenting with dietary changes under the guidance of a healthcare professional.

Is there a cure for psoriasis?

Currently, there is no known cure for psoriasis; however, many treatment options are available that can effectively manage the symptoms and provide relief. These treatments aim to reduce inflammation, slow down skin cell growth, and alleviate discomfort.

Can psoriasis be passed on to others?

Psoriasis is not contagious, so you cannot pass it on to others through physical contact. It is a genetic autoimmune condition that can be inherited but does not spread from person to person.


How can I best take care of my skin if I have psoriasis?

To care for your skin when you have psoriasis, it's essential to keep it moisturized with gentle, fragrance-free products. Avoid harsh soaps or hot water that can further dry out the skin. Protect your skin from excessive sun exposure and use sunscreen regularly as some medications used for treating psoriasis can increase sensitivity to sunlight.

bottom of page