Accessibility Tools

Web Accessibility plugin by DJ-Extensions.com

Number 2 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)

Number 1 Skin Cancer & Pre-Cancer Care
Number 1 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)
Number 3 Pigment & Lesion Disorders
Number 4 Non-Cancer Growth
Number 5 Surgical Dermatology (Non-Cancer Procedures)
Number 6 Cosmetic Dermatology
Psoriasis PDF

• Psoriasis

What is psoriasis?

Psoriasis is a chronic (long-term), immune-mediated skin condition that causes skin cells to build up too quickly, leading to thick, inflamed patches (plaques) with scale. It is not contagious.

Many people have flares that come and go. With the right plan, psoriasis can be well controlled.

Types of psoriasis

You may have one type or a combination over time:

1) Plaque Psoriasis (Psoriasis Vulgaris)

Most common type of psoriasis

Appears as raised, red patches covered with thick silvery-white scale

Commonly affects the elbows, knees, scalp, and lower back

Can itch, crack, or bleed

Often chronic but very treatable with topical therapy, phototherapy, and systemic medications

2) Guttate psoriasis

Characterized by small, drop-shaped red spots

Often appears suddenly, especially in children or young adults

Commonly triggered by strep throat or other infections

Usually affects the trunk, arms, and legs

May resolve on its own or evolve into a) plaque psoriasis

3) Inverse psoriasis (skin folds)

  • Occurs in skin folds such as the armpits, groin, under the breasts, and buttocks

  • Appears smooth, red, and shiny (usually no thick scale)

  • Can be worsened by friction, sweating, and yeast infections

  • Often misdiagnosed as a fungal rash

4) Pustular psoriasis

Features white pus-filled bumps surrounded by red skin

Can be localized (hands and feet) or widespread

May be accompanied by fever or fatigue in severe cases

Less common but can be serious, requiring prompt medical care

 

5) Erythrodermic psoriasis

Rare but severe form of psoriasis

Causes widespread redness, intense scaling, and skin peeling

Can disrupt body temperature and fluid balance

Often triggered by infection, medication withdrawal, or severe sunburn

Considered a medical emergency

Why psoriasis happens

Psoriasis is related to immune system activity and genetics. Triggers can include:

  • Stress

  • Illness/infections

  • Skin injury (scratches, burns)

  • Certain medications

  • Cold/dry weather

How we diagnose psoriasis

Diagnosis is usually made with:

  • A focused history and skin exam

  • Sometimes dermoscopy or a skin biopsy if the diagnosis is unclear

Treatment options

Treatment is personalized based on the type, location, and severity.

1) At-home treatments (often first-line)

  • Prescription topical medications (creams/ointments)

  • Moisturizers and gentle skin-barrier care

2) In-office treatments

  • Narrow band UVB Phototherapy (light therapy) or Excimer Laser for widespread or stubborn psoriasis

3) For moderate-to-severe psoriasis

  • Oral or injectable medications, including biologics (when appropriate)

Why Light Therapy Helps Psoriasis

Phototherapy uses carefully measured ultraviolet light to:

  • Slow down overactive skin cell growth

  • Reduce inflammation and redness

  • Improve scaling and thickness of plaques

  • Help control flares and extend periods of clear skin

Narrowband UVB (NB-UVB) Phototherapy

NB-UVB is one of the most common and effective in-office light treatments for psoriasis.

Best for:

  • Widespread plaque psoriasis (multiple areas)

  • Psoriasis that hasn’t responded enough to topical treatments

Patients who want a non-systemic option

What a typical course looks like:

  • Treatments are usually quick (often minutes)

  • Common schedule: 2–3 times per week for several weeks

  • Your dose is gradually increased to balance results and safety

NB-UVB vs Excimer:

Excimer laser delivers a targeted UVB wavelength to specific plaques, sparing surrounding normal skin.

Best for:

  • Localized psoriasis (small or stubborn areas)

  • Scalp edges, elbows, knees, or “few tough plaques”

  • Patients who want targeted treatment with fewer exposures to uninvolved skin

What a typical course looks like:

  • Usually 1–2 times per week

  • Often fewer sessions for small areas (varies by plaque thickness and response)

NB-UVB vs Excimer: Which One Do I Need?

  • Choose NB-UVB if psoriasis is more widespread

  • Choose Excimer if psoriasis is localized or stubborn

  • Many patients benefit from a combined plan (topicals + phototherapy)

Your dermatologist will recommend the best approach based on your psoriasis pattern, skin type, lifestyle, and prior treatments.

Pre-Op Instructions (Before Phototherapy)

(No fasting is needed. These are “before-treatment” tips.)

1–2 weeks before starting

  • Avoid tanning and sunburn

  • Tell us if you:

    • Take medications that increase sun sensitivity (some antibiotics, diuretics, etc.)

    • Have a history of frequent cold sores (for facial treatment planning)

    • Have a history of skin cancer or photosensitivity disorders

  • Let us know if you are pregnant or trying to conceive (treatment planning may change)

Day of treatment

  • Arrive with clean, dry skin on treatment areas

  • Avoid perfumes, body oils, or heavy lotions on areas being treated (unless we tell you otherwise)

  • Bring or use protective eyewear as directed (we provide guidance)

Wear easy clothing to access the treatment areas

Post-Op Instructions (After NB-UVB or Excimer Treatments)

What’s normal after treatment

  • Mild redness or warmth (similar to a mild sun exposure)

  • Mild itching or dryness

Gradual smoothing and fading of plaques over weeks

Skin care after sessions

  • Moisturize daily with a gentle, fragrance-free moisturizer

  • Use gentle cleanser; avoid harsh scrubs/exfoliants on treated areas

  • Use sun protection (hat, protective clothing, sunscreen as appropriate)

Activity tips

  • You can usually return to normal activities right away

  • Avoid intentional sun exposure or tanning while undergoing treatment

Call our office if you have:

  • A painful burn, blistering, or significant swelling

  • Increasing redness that continues to worsen after 24–48 hours

  • New rash in areas not being treated

Frequently Asked Questions

Is psoriasis contagious?

No. Psoriasis is not contagious.

Psoriasis is chronic, meaning it often requires long-term management, but it can usually be well controlled with the right plan.

Many treatments take weeks to show major improvement. Your plan may be adjusted over time based on response.

Both can itch and cause inflammation, but psoriasis often forms thicker plaques with scale, while eczema commonly causes more diffuse, very itchy inflammation. A dermatologist can confirm the diagnosis.

Yes. Psoriasis can cause nail pitting, discoloration, thickening, or lifting.

Yes. Some people develop psoriatic arthritis, which can cause joint pain, swelling, and stiffness. Tell us if you have these symptoms so we can coordinate care.

  • Moisturize daily

  • Use gentle, fragrance-free skincare

  • Manage stress and get adequate sleep

  • Avoid triggers you notice (illness, skin injury, harsh products)

  • Use sun protection (avoid sunburn)

If you have a persistent scaly rash, symptoms that affect sleep or daily life, nail changes, or any joint symptoms, an evaluation can help you get the right diagnosis and treatment plan.

When supervised and dosed correctly, Narrow Band-UVB and Excimer Laser are widely used and considered safe. Your dermatologist monitors dosing to reduce burn risk.

Treatments are typically painless. Some patients feel warmth during treatment or mild redness afterward.

A mild, short-lived pinkness can be expected. A true burn is uncommon but can happen—especially if you’ve had sun exposure or started a sun-sensitizing medication. Tell us about medication changes and sun exposure.

Yes. Both NB-UVB (with proper scalp access strategies) and excimer can be used for scalp-adjacent or localized plaques. Your dermatologist will recommend what fits best.

Yes—many patients experience reduced itch as inflammation improves.

Often yes. Phototherapy works very well with a supportive topical routine. Your dermatologist will guide a safe combination plan.