Psoriasis Q&A

Ask the Consultant

Three of our dermatologists answer common questions on psoriasis including signs and symptoms, causes and treatment options.

Dr Joey Lai-Cheong

Psoriasis is a common inflammatory skin condition that affects up to 4% of the population. It can be associated with other serious conditions such as heart disease, diabetes and depression. Some people with psoriasis may also experience joint pain and joint stiffness.


Dr Jaideep Bhat

Psoriasis is a common inflammatory skin disease affecting 2% of the population. It occurs equally in men and women and can appear at any age. 


Dr Ian Coulson

A common inflammatory skin condition that causes well defined red scaly patches on the elbows, knees, scalp and then elsewhere on the body.

Dr Joey Lai-Cheong

Typically, patients with psoriasis will have scaly red patches (plaques) on the elbows, knees and lower back, although the whole skin including the scalp can be affected. Sometimes, psoriasis can develop after a sore throat and is characterised by drop-like scaly patches all over the body. This is known as guttate psoriasis. Nails can be involved and can often be very distressing for the patient. In some cases, psoriasis can affect the anogenital skin, which can have a significant impact on the person’s quality of life.


Dr Jaideep Bhat

Psoriasis may not have any associated symptoms but can be itchy in delicate areas like the groins or painful on fissured areas of hands and feet. The main complaint of patients is usually the unsightly appearance of their scaly skin rash. Some patients present with scaling on their scalp or nail changes and rarely joint problems too.


Dr Ian Coulson

Usually self-consciousness regarding the appearance. Many people are concerned by scale that comes from the patches. It may be sore, crack and bleed. It can be particularly disabling on the palms and soles, and in the sensitive areas in the groins and armpits.  Up to 20% of sufferers with bad psoriasis get an associated arthritis.

Dr Joey Lai-Cheong

The causes of psoriasis are not fully understood but it is clear that there is an interplay between genetics and the immune system.  A trigger is often implicated such as stress, sore throat, injury to skin, for example, a cut, excessive alcohol, smoking and certain medications such as beta blockers and lithium. There is, however, no evidence that food is implicated in psoriasis.


Dr Jaideep Bhat

The causes are multifactorial with inherited and environmental factors playing a role in its development. Patients are more likely to develop psoriasis if someone in their family has the condition. Psoriasis is not contagious or infectious.


Dr Ian Coulson

Many people recognise that it runs in their family. Stress, bacterial sore throats and some medications can worsen psoriasis.

Dr Joey Lai-Cheong

The condition is diagnosed clinically after a dermatologist takes a comprehensive history and examines the nature and distribution of the rash to determine whether it is psoriasis. Very seldom, a diagnostic biopsy is taken in cases where there is doubt about the diagnosis. There is no blood test to diagnose psoriasis


Dr Jaideep Bhat

It is usually diagnosed by the appearance and distribution of the skin rash by doctors experienced in the disease. Diagnosing Psoriasis requires a careful and thorough examination of the skin, nails, scalp and joints


Dr Ian Coulson

Usually by examination of the skin scalp and nails. It seldom requires skin biopsy.

Dr Joey Lai-Cheong

The severity of the psoriasis and its impact on the patient’s quality of life are important considerations in the management of psoriasis. It is also important to tailor the treatment according to the patient’s circumstances. For example, phototherapy (ultraviolet light treatment) may not be appropriate for a patient whose job involves a lot of travelling.


Dr Jaideep Bhat

Although there is no cure for psoriasis yet, there are several effective treatments available to manage the problem on a long term basis.


Dr Ian Coulson

Reduce the triggers (stress, provoking drugs). Avoid soaps and shower gels that make scaling worse, use light moisturising creams in their place. Topical steroids, vitamin D based creams or cosmetically elegant tar based products.  Natural and artificial ultraviolet light is helpful.

Dr Joey Lai-Cheong

It is important to realise that there is no cure for psoriasis but there are many effective treatments for this condition. Mild psoriasis can be treated with topical preparations such as topical steroids. More severe disease can be controlled with phototherapy (ultraviolet light treatment) under the supervision of a consultant dermatologist. Sometimes, oral medications such as methotrexate and ciclosporin are used for difficult disease. Injection treatments known as biologics such as adalimumab and ustekinumab are used if oral medications have failed. A consultant dermatologist is able to advise and initiate these medications if indicated.


Dr Jaideep Bhat

Treatment of psoriasis depends upon your individual circumstances. Treatments applied to the surface of the skin (topical treatment) maybe sufficient to treat it in many. Patients with more extensive or difficult to treat psoriasis, light treatment (phototherapy), tablet treatment or even injection treatment could be considered. Patients with the condition can get help and support from the Psoriasis Association.


Dr Ian Coulson

For more severe disease, there are at least 6 different types of oral medication available, and if they are unhelpful, the last 10 years has seen the introduction of highly specific “biological” agents that have transformed managing difficult disease.

Dr Joey Lai-Cheong

A consultant dermatologist is the most qualified medical doctor who deals with skin diseases. I am passionate about dermatology and about helping patients of all ages improve their quality of life which can be adversely affected by a skin problem.


Dr Jaideep Bhat

Dermatology has always been considered to be the Cinderella specialty of medicine but I discovered a flair for this unique branch in the early 1990’s during my training and decided to pursue it further in my career to become a Consultant Dermatologist in 2005. I have always loved the variety and the daily challenges that that this branch of medicine offers me. Lastly, I have an “eye for detail” which in my mind is the most important tool of a good dermatologist.


Dr Ian Coulson

Surprisingly I won a prize in dermatology as a student. I had inspiring trainers in my early career. Dermatologists were a jolly lot who were such good physicians. It has been great to see the advances in therapy that have drastically improved the lives of skin disease sufferers.

Dr Joey Lai-Cheong

I am the co-author of the skin anatomy chapter of the latest edition of the world leading anatomy textbook, Grays Anatomy, which was published in 2015.


Dr Jaideep Bhat

Having practised as a Consultant Dermatologist at the BMI The Priory Hospital for a decade whilst working in the local NHS trusts too, I have been fortunate to have numerous highlights in my career. However, I believe, that my career highlight is not the accolades earned in the years but the simple heartfelt “Thank you’” from my patients over the years for making a difference in their lives. It is this aspect of my job that makes it a privilege and honour to be a Consultant Dermatologist


Dr Ian Coulson

Not editing an award winning textbook, or becoming President of the North of England Dermatological Society – but receiving a bag of soft liquorice last week from a little boy whose eczema I helped along the way. I have such simple pleasures!

To find out more about a dermatology consultation call us on 0808 101 0337 or make an online enquiry.

  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runners Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.
  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runner Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.