6 Myths About Psoriasis It's Time to Stop Believing

Psoriasis is an autoimmune condition marked by skin inflammation that often causes uncomfortable, scaly or flaky patches on the body.

The condition isn't uncommon — in fact, the Centers for Disease Control and Prevention estimates that about 7 million people of all ages and backgrounds in the U.S. have psoriasis. Still, it's often misunderstood.

"The myths around psoriasis are often due to a lack of understanding and awareness about the condition," Noor Hanif Said, MBBS, dermatologist and Medical Director of Renaissance Dermatology, tells LIVESTRONG.com. "Skin conditions can be stigmatized, leading to misconceptions."

Below, dermatologists debunk the most common myths about psoriasis, once and for all.

Many people believe you can "catch" psoriasis through skin-to-skin contact, or through sexual contact. But this simply isn't true.

Some skin conditions ‌are‌ contagious — athlete's foot, for example, which can cause flaking skin and itchy blisters, just like psoriasis. But athlete's foot is caused by a fungus and therefore can be passed between people, like in a gym locker room or pool area.

The difference between contagious skin conditions like athlete's foot and psoriasis is the root cause — psoriasis is an autoimmune condition, meaning it's caused by the body's immune system mistakenly attacking healthy cells, Dr. Hanif says. (Other common autoimmune conditions include rheumatoid arthritis and type 1 diabetes.)

In short: "You cannot catch [psoriasis] from another person," Dr. Hanif says.

It can be difficult to tell the difference between psoriasis and eczema, as both are immune-related conditions that cause irritated, inflamed skin. But they are not the same — key differences include typical age of onset, location and symptoms.

According to the National Eczema Association, eczema most commonly starts earlier and usually affects babies and children, while psoriasis often takes longer to manifest, typically appearing somewhere between the mid-teens to mid-30s.

Second, eczema is known for affecting the folds or "creases" of the body, like the elbows, knees, wrists and neck. Psoriasis can be anywhere on the body, though the National Eczema Association notes it's often found on the outer parts of the elbows, knees and palms, as well as the scalp, feet, mouth and lower back.

Finally, the severity of itchiness can help determine the difference between eczema and psoriasis. Eczema tends to come with intensely itchy skin, while psoriasis typically burns, stings or feels only mildly itchy, per the Cleveland Clinic.

The conditions are also managed differently, which is why it's important to see a dermatologist for a diagnosis and treatment plan.

Again, what's important to understand here is that psoriasis is a chronic, autoimmune condition.

"[Psoriasis] arises from an overactive immune response, which causes skin cells to grow rapidly. It is not caused by bacteria, viruses or any external factors that can be transmitted from person to person," says Allison Leer, MD, dermatologist and co-founder of Unity Skincare. "Psoriasis results from a combination of genetic predisposition and environmental triggers."

There are five main types of psoriasis:

• ‌Plaque:‌ the most common type, marked by raised red patches and a white-ish buildup of dead skin cells
• ‌Guttate:‌ usually starts in childhood or young adult years and is marked by small, raindrop-shaped sores
• ‌Inverse:‌ usually affects the armpits, groin or breasts and is marked by patches of smooth, red skin
• ‌Pustular:‌ marked by red, scaly plaques that have white pustules (pus-filled blisters) within them
• ‌Erythrodermic:‌ the least common, marked by large, fiery red patches of skin covering nearly all of the body (90 percent of the skin or more)

Across all five types, the cause is the same — a misfiring immune system and never fungus, bacteria, virus or parasites.

It's a common and often hurtful myth that psoriasis or other chronic skin conditions are caused by poor hygiene. But psoriasis cannot simply be "fixed" by washing more carefully or showering more often, Dr. Leer says.

In reality, many people with chronic skin conditions are actually ‌more‌ careful and dedicated to their skin's health when compared to people without skin issues.

It is possible — like in the case of inverse psoriasis, which affects sensitive areas of the body like the armpits, genitals and areas under the breasts — that psoriasis can cause an odor. The smell results from a combination of location and the buildup of skin cells, not from dirt, body odor or grime.

So, no, psoriasis is not caused by poor hygiene, Dr. Leer says. It's a chronic autoimmune condition without a cure, which unfortunately means even the most careful hygiene can't make it go away completely.

While rashes are often the most visible part of psoriasis, the condition is more than skin deep. Psoriasis can affect other parts of a person's body, like their nails, joints and even their mental health.

Nails affected by psoriasis may become discolored or separate from the nail bed, Dr. Leer says.

About 1 in 3 people diagnosed with psoriasis will also develop inflammatory arthritis, per the Cleveland Clinic. Like psoriasis, psoriatic arthritis is a chronic, autoimmune condition marked by joint pain, swelling and stiffness, says Dr. Leer. The severity in symptoms ranges from person to person, but it can affect different joints in the body, and more rarely, the spine, hips and shoulders.

Finally, it's important to understand that chronic conditions of any kind can affect someone's mental health.

"People with psoriasis often deal with physical discomfort like itching and pain. However, the psychological aspect can be even more challenging," Dr. Hanif says. "Many people feel self-conscious about the visible symptoms, which can lead to anxiety, depression and social isolation."

Indeed, an August 2020 review in ‌Cureus‌ notes that psoriasis can cause "psychological strain," and that there's a strong link between psoriasis and depression.

Unfortunately, there are no known cures for psoriasis. Even the exact cause is unclear, though Dr. Hanif notes it's believed to be a combination of genetic and environmental factors.

However, Dr. Hanif says there are a number of treatments available to manage symptoms, including topical creams and lotions (like steroid creams, moisturizers, vitamin ointments and retinol creams), phototherapy (aka light therapy) and systemic medications that work throughout the body (biologics like Taltz or immunosuppressive meds like methotrexate).

The right treatment depends on the type and severity of the psoriasis, but there are other lifestyle factors and at-home self-care strategies that can help manage symptoms. "Lifestyle modifications such as weight management, the cessation of smoking and the management of stress are a few examples of ways to prevent the symptoms," says Dr. Leer. (These are doubly important for people with psoriasis because they're at a higher risk for heart disease, diabetes and stroke.)

Flare-up triggers can include stress, trauma, medication, certain infections (like strep throat, for example), obesity and alcohol consumption, adds Dr. Leer.

Exercise, too, can help manage flares. Some people believe working out can trigger symptoms, but studies point to the opposite: A July 2018 study in ‌Medicine‌ found that physical activity may actually decrease the severity of psoriasis.

Likewise, the National Psoriasis Foundation endorses exercise, recommending 30 minutes of moderate exercise and strength-training at least five days a week.

Psoriasis can be challenging to deal with — even without these misconceptions.

The takeaway here is to remember that psoriasis is a common, noncontagious, chronic condition that affects more than just a person's skin.