And So, It Begins: How to Spot the Early Stages of Psoriasis

Symptoms can start at any age, but the first signs of psoriasis often occur between the ages of 15 and 25, according to the National Psoriasis Foundation.

When psoriasis first appears, you start to notice symptoms of inflammation on your skin. This can include:

• itching, stinging, or burning
• red to silver patches of skin on people with lighter skin types
• purple, grayish, or darker brown patches of skin on people with darker skin types
• silvery-white scales, known as “plaques”
• dry, cracked, or bleeding patches of skin
• thick, rough patches of skin
• joint swelling
• ridged or pitted nails

As the condition progresses, symptoms can start to worsen or become more noticeable.

Symptoms can vary based on the type of psoriasis (we’ll get to the seven main subtypes in a sec), the amount of psoriasis, and the area that’s affected.

While psoriasis can show up anywhere on your body. It most commonly develops on your:

• elbows
• knees
• legs
• scalp
• lower back
• hands or feet
• face

The features, feels, and early symptoms of psoriasis might often depend on what type you have.

Plaque psoriasis

Plaque psoriasis is the most common type, affecting 80 to 90 percent of people with the condition.

This form of psoriasis usually first appears as thick, raised patches of skin — aka plaques. These plaques can be red, purple, or silver and often vary in size. Over time, they may start to feel dry and scaly, which can cause them to itch like crazy.

Guttate psoriasis

Guttate psoriasis appears as tiny bumps that may pop up suddenly on your skin. These bumps, or spots, are usually red or pink and have a scaly texture.

Guttate psoriasis often begins to show up on your arms, legs, or torso, but the condition can develop in other areas.

Guttate spots are known to clear up on their own and sometimes never make a return appearance. No one really knows why this happens, making guttate psoriasis one of the more mysterious psoriasis types.

Inverse psoriasis

While other forms of psoriasis are raised and rough to the touch, inverse psoriasis causes flat, raw-looking rashes in folds of the skin. These reddish or purple rashes are usually smooth to the touch, but that doesn’t make them any less uncomfortable.

Inverse psoriasis usually develops in areas where skin is constantly rubbing on skin (like the armpits, under boob area, and even the genitals). This can cause increasing levels of soreness or discomfort over time — especially when sweat gets trapped in these folds.

Pustular psoriasis

When it comes to pustular psoriasis, you’ll usually see puss-filled bumps often appearing on your hands and feet. These small, inflamed bumps can typically be confused for acne when they first appear.

But you’ll def be able to tell the difference as the condition progresses. The skin underneath the pus-filled bumps will become red and swollen. The area can also become itchy and sore.

As the bumps dry out, they’re usually replaced with scaly, brown dots.

Erythrodermic psoriasis

If you start to experience symptoms of erythrodermic psoriasis, call the doctor — STAT.

This rare, severe form of psoriasis can cause large chunks of skin to shed, leading to debilitating pain. It can also cause an elevated heart rate, dehydration, fever, chills, and muscle weakness. Erythrodermic psoriasis can also lead to hypothermia, making it difficult to stay warm.

Erythrodermic psoriasis spreads fast, causing visible inflammation in nearly 90 percent of your body. This condition can resemble a burn at first, with the skin becoming red, dry, and tender to the touch. You may experience intense itching as the rash spreads.

Most cases of erythrodermic psoriasis occur in people who already have another form of psoriasis. Talk with your dermatologist ASAP if you notice your condition becoming worse or not responding to treatment, as this condition can be life threatening.

Nail psoriasis

Nail psoriasis affects… well, your nails (obvi). Nail psoriasis is pretty common, impacting about 50 percent of people who already have another type of psoriasis.

At first, you may notice discoloration of your nails (usually yellow, white, or brownish hues), as well as pitting in your nails themselves. As the condition develops, larger dents in the nail may form, and the nail may become rough and crumbly.

Skin cells can also build up underneath your nails, causing the nail to lift and detach from the skin of your finger or toe.

Psoriatic arthritis (PsA)

Psoriatic arthritis (PsA) gets under your skin — literally. This subtype affects the joints and most often occurs in people who already have psoriasis. It can develop at any age, most commonly appearing between ages 30 and 50.

Early signs of PsA can include swollen or tender joints, swelling on the knee or back of the leg, and pain on or around your heel. You may also notice stiffness, specifically in the mornings (because getting out of a cozy bed isn’t hard enough sometimes!).

It’s important to seek treatment for PsA. Ignoring the condition might lead to difficulty moving and even physical disability.

There is currently no cure for psoriasis, but there *are* ways to treat and manage its symptoms.

While some cases of psoriasis are minimal, others can be more severe. No matter what level you’re at, seeking treatment can prevent recurring flares or worsening symptoms.

Talk with your doctor or dermatologist if you have questions or think you might have psoriasis. They can provide you with a diagnosis and discuss treatment options.

You should also talk with your doc ASAP if you experience:

• worsening or spreading symptoms
• swelling or discomfort
• joint pain or other probs
• your treatment no longer working

Your doctor may suggest one or more types of treatment, including:

• corticosteroids
• retinoids
• vitamin D analogues
• salicylic acid
• coal tar
• calcineurin inhibitors
• light therapy
• steroids
• biologics
• immunosuppressants (cyclosporine)

Depending on your specific diagnosis, your doc also may recommend lifestyle changes, such as stress management techniques or a nutritious diet.

Psoriasis isn’t the only condition that can cause dry, flaky skin or itchy rashes. These same symptoms can be signs of many other conditions.

This can include:

• Eczema. A skin condition that causes itchy, red, inflamed skin that can become dry and scaly. You also might have purple, dark brown, or gray patches.
• Keratosis pilaris. A skin condition that causes rough patches of red or brown bumps.
• Hives. Tender, itchy bumps, usually triggered by allergens or irritants.
• Acne. A common skin condition that usually occurs when gunk (like dirt, oil, and dead skin) clogs your pores.
• Rosacea. A condition that causes your face to flush or blush easily, making the skin look red and irritated.
• Parapsoriasis. A condition that sounds like psoriasis and often looks like psoriasis, but isn’t. Parapsoriasis plaques are usually smaller and thinner.
• Ringworm. A fungal infection that forms a circular red rash. On darker skin this rash can also look gray or brown.
• Lupus. An autoimmune disorder that can cause a butterfly-shaped rash on your face.
• Skin cancer. A common type of cancer that can cause a rash or sores.

In the beginning stages of psoriasis, red, purple, or silver scaly patches — or plaques — develop on your skin. These can be itchy or even painful. However, there are many types of psoriasis and symptoms can vary based on which one you have.

There isn’t a cure for psoriasis yet, but there are ways to treat and manage symptoms.

Talk with your doctor if you think you have psoriasis or notice a change or worsening of an existing case. They can work with you on a treatment plan tailored to your needs, such as using a prescription topical or making lifestyle changes. These changes might include managing your stress levels or eating a more balanced diet.