Is psoriasis hereditary? (And can you avoid it?)

Key Points

• Psoriasis is an autoimmune condition that causes itchy, red patches of skin. It can also affect your joints and eyes.
• You're more likely to get psoriasis if a family member has it. But environmental triggers also play a role.
• While there’s no cure, lifestyle changes and medications can help manage symptoms.

The problems psoriasis can create are more than skin-deep.

Sure, most people are frustrated by its thick, scaly rashes that can feel itchy or painful. But psoriasis can also increase the risk of arthritis, heart disease, cancer and kidney problems. Many people also struggle with eye problems and mental health issues.

Psoriasis tends to run in families. So while treating it can be challenging, a little know-how can help you avoid flares and keep your skin as calm as possible.

And if you’re looking to get prescription treatment online, Dr. B can help! Read on to learn about how to treat psoriasis for the long term. Then start a $15 online consultation—no video chat required.

What is psoriasis?

Psoriasis is a chronic autoimmune disorder that causes thick, red or scaly rashes on your skin. It affects about 2% of the population, and most people develop their first symptoms before they turn 35.

Psoriasis can happen anywhere on the body—including the tongue, fingernails and eyelids. But it most commonly appears on the hands, feet, scalp, elbows, knees and torso.

The different types of psoriasis include:

• Plaque psoriasis. This is the most common form, it affects about 80% of people with this disease. It causes red, thick patches of skin covered in silvery scales.
• Guttate psoriasis. This form can create small red bumps that typically appear on the chest and back.
• Inverse psoriasis. Smooth, sore patches, usually in skin folds like the groin or armpits
• Pustular psoriasis. Small bumps filled with pus, like pimples
• Erythrodermic psoriasis. Widespread redness with skin that comes off in sheets. This can be life-threatening and requires immediate medical help.

Psoriasis is a relapsing-remitting condition, which means it goes through cycles. During the relapsing period, skin is mostly clear. During a flare, symptoms get worse. Environmental factors—like stress or infection—can trigger symptoms and lead to flares.

At no time are the rashes contagious.

What causes psoriasis?

Psoriasis is an autoimmune disorder. That means it’s caused by a problem with how the immune system reacts to threats.

The immune system is supposed to only respond to problems or threats—like a cut or germ—and then carefully target and fix the problem. When the threat goes away, the immune system should calm down.

People with psoriasis have an overactive immune response. That means their immune system goes into overdrive when facing even minor problems. Sometimes, the immune system activates even if it’s not facing a threat!

This is a problem because an activated immune system causes many changes in the body, including inflammation (swelling). When that happens too much or in the wrong place, inflammation can cause damage.

Many people with the condition also have a problem with how their skin cells grow. Their cells turnover faster than usual. Sometimes, their skin cells don’t produce enough lipids (a type of fat). As a result, their skin might look dry and flaky.

Is psoriasis life-threatening?

While psoriasis can be uncomfortable, it’s usually not life-threatening. But that doesn’t mean it can’t cause serious problems. Your skin is your most significant defense against invaders. When that defense system weakens or breaks down, it’s easier for germs to get inside your body.

Psoriasis is also linked to higher rates of heart disease, kidney problems, cancer and mental health disorders. When it affects the joints, it can cause swelling, pain and stiffness that makes it hard to move. About 30% of people develop arthritis because of it. Some also have eye problems, like conjunctivitis or uveitis (eye inflammation).

Very rarely, some people also develop a side effect called erythroderma—when psoriasis affects a very large part of your body. The skin may look burned or come off in large sheets. When this happens, your body has trouble regulating temperature and fluid levels. This can be very dangerous and requires emergency help.

What is the genetic link to psoriasis?

While the cause of this disease is complex, family history definitely plays a role.

Researchers estimate there’s a 60-90% chance of inheriting the condition. That means if you have a parent or sibling with the disease, you’re much more likely to develop it, too.

Most people with psoriasis have a change in one or more of 80 different genes linked to psoriasis risk. Some may never have symptoms. Others might develop symptoms only after encountering a trigger.

Specific gene changes can also affect how the disease develops. For example, people with a change to gene HLA-Cw6 are more likely to develop symptoms before age 40.

Environmental triggers for psoriasis

Genetic changes related to psoriasis aren’t enough to cause symptoms. Something in the environment usually has to trigger it and cause symptoms. Managing or avoiding those triggers can help prevent flares.

Some common triggers include:

• Injury. If a cut, fall, or burn damages the skin, it can trigger a plaque to form over that skin area.
• Certain medications. Drugs like Chloroquine, Lithium, beta-blockers and steroids can make this condition worse. People with psoriasis should also talk to their provider before using non-steroidal antinflammatories (like Ibuprofen or Naproxen).
• Weather. Symptoms tend to get worse in cold, dry weather. Many people experience some relief during the summertime.
• Infection. Certain infections can trigger a flare, including upper respiratory infections caused by Streptococcus bacteria (strep throat).
• Stress. Stress and mental health problems can make this condition worse.
• Alcohol and smoking. Both smoking and alcohol consumption can trigger a flare.
• Other medical conditions. Some medical conditions can make psoriasis worse. These include obesity and hypocalcemia (having low calcium levels in your blood).

How to treat psoriasis

The first step in managing psoriasis at home is to avoid things that can trigger a flare.

Here are some habits that can help:

• Use a protective moisturizer
• Avoid injury or skin damage
• Avoid alcohol and smoking
• Spend time in the sunshine every day (but use sunscreen!)
• Maintain a healthy body weight
• Eat a heart-healthy diet to reduce the risk of heart problems
• Manage stress and get help for mental health issues

When it comes to protecting skin, using a high-quality moisturizer can help skin stay moisturized.

For mild cases, over-the-counter medicines can help manage symptoms. Medicine like hydrocortisone, coal tar, salicylic acid, camphor, menthol and calamine may help. But check with your provider before trying these to avoid any interactions with other medications.

Treatments that need a prescription include:

• Topical creams or ointments. Prescription steroidal and non-steroidal creams put directly on the skin might be enough for people with mild cases. If symptoms are more severe, your provider may prescribe these topical medicines along with other treatments.
• Oral medications. A range of pills and tablets can help with more severe cases. But they can cause side effects, including digestive issues, skin dryness and more. So you might regularly have to have your blood checked while using them.
• Biologics. These medications target the immune system and can cause significant improvements for people with serious cases. But biologics can make people more vulnerable to infection and illness. They also need to be given as an injection or as an infusion in an IV.

• Phototherapy. Exposing skin to a light therapy UVB lamp can be more effective than exposure to the sun’s UVB rays. Sunlight also increases sunburn risk, so you must be careful about how much sun exposure you get.

How to get psoriasis treatment online

If you’re tired of itchy, painful skin and have tried at-home and OTC remedies to no avail, come to Dr. B!

Take a discreet $15 online consultation, sharing your health history and current symptoms. We’ll connect you with a licensed provider who’ll respond within three working hours. If appropriate, they’ll send a prescription for psoriasis medication to your pharmacy. We’ll even help you find the lowest prescription cost at nearby pharmacies.

Sources

Armstrong, A. W., et al. (2020). Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA.

Elmets, C. A., et al. (2019). Joint AAD–NPF guidelines for the management and treatment of psoriasis with awareness and attention to comorbidities. Journal of the American Academy of Dermatology.

Institute for Quality and Efficiency in Health Care. (2017). Psoriasis: Oral medications and injections.

Kemény, L., et al. (2019). Advances in phototherapy for psoriasis and atopic dermatitis. Expert Review of Clinical Immunology.

Kurd, S. K., et al. (2010). The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Archives of Dermatology.

Nair P.A. et al.. (2023). Psoriasis. StatPearls Publishing.

National Psoriasis Foundation. (2022). Phototherapy.

Parisi, R. et. al (2020). National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modeling study. British Medical Journal.

Raharja, A., et al. (2021). Psoriasis: a brief overview. Clinical Medicine.