Can Psoriasis Hurt?
Psoriasis is an autoimmune condition that causes symptoms to develop on the skin. There are several different types of psoriasis, but the most common form is called plaque psoriasis. Plaques are patches of skin that are raised, red, dry, and often covered with a layer of silvery scales.
Itching and burning
Most people with psoriasis experience the symptoms of itching and burning on the skin. The word psoriasis is derived from a Greek word meaning “to itch.” The itching caused by psoriasis is different than that of other inflammatory skin conditions it happens more often, and the feeling of the itch can be more severe, with a burning quality. People living with psoriasis have compared the feeling of the psoriatic itch to the intensity of getting bite by fire ants. Itching can have a large impact on a person's quality of life. The psoriatic itch can be worse at night and make it difficult to get a good night's sleep. Many also find that they scratch in their sleep and injure the affected skin causing it to bleed.
Uncomfortable flaky scales
Plaques are patches of skin that become inflamed and thickened; they are usually red in color and have a surface that is covered in silvery scales. The scales on top of the plaque can tend to flake and fall off in small pieces. Scales that aren't quite dry enough to flake off on their own can sometimes cause trouble. Scales may pull on some fabrics of clothing, which may cause pain, especially if the skin is already sore or raw from scratching. Keeping skin moisturized can be an important aspect of helping manage this sometimes painful aspect of plaque psoriasis.
Painful blisters and sores
Some people with psoriasis may experience pustular psoriasis a rare and more severe form of psoriasis. With pustular psoriasis, “pustules” develop on the individual's skin. Initially, the skin will become red, dry, and sore to the touch, then not long after pustules begin to appear on the reddened areas. The pustules look like small white blisters and will be filled with clear liquid or pus. Typically, the smaller pustules will combine together and form a large area of pus within a couple of days. Eventually, these larger of pus will dry out and then peel off leaving behind a smooth area of skin where pustules may eventually form again. Pustular psoriasis frequently occurs on the palms of the hand or the soles of the feet.
In addition to itching and burning, plaques can crack and bleed, which can be quite painful. The skin areas that are affected by plaques can be extremely dry and this dryness makes the plaques prone to developing tiny cracks called fissures. The cracks can grow and deepen over time as the plaque develops. As the cracks grow larger and go deeper in the skin, they can extend into a layer of the skin where the skin’s tiny blood vessels (called capillaries) are located. Bleeding happens when the cracks and fissures cause these blood vessels to break. Certain areas of the body may be more prone to cracking and may be more uncomfortable to manage. Areas around the joints, such as the knees and elbows, are areas that are more likely to crack and bleed because they are constantly moving and flexing during normal activities. In addition, rubbing, scratching, or scraping the skin can also cause plaques to crack and bleed.
Psoriasis below the belt
Ceratin areas of the body impacted by psoriasis may be more painful due to the skin being more sensitive. For example, genital psoriasis, the type of psoriasis that most commonly affects the genitals or genital area is called inverse psoriasis. Inverse psoriasis usually occurs in or around folds in the skin, and can affect similar areas such as the armpits, for example, as well as the genitals. The symptoms first appear as smooth, pink or red, shiny areas that can be itchy and tender. However, unlike the other parts of the body, genital psoriasis patches are relatively thin plaques with little or no scaling. In this area, the lesions do not usually have scales, but fissures (cracks) may develop deep in the creases and cause pain. There can be a large emotional toll of managing genital psoriasis due to its impact on intimacy and relationships with partners.
The emotional impact
Living with psoriasis can be difficult, not only because of the physical pain and discomfort its symptoms can cause, but also because its symptoms can be very visible to others and can make those coping with psoriasis feel self-conscious, embarrassed, or isolated. It can be challenging dealing with stigma and misunderstandings related to the cause of psoriasis and its symptoms not being contagious. Another challenge that can impact patients emotionally is the frustration with finding a treatment that is effective and provides lasting effects.
While many may not be aware that psoriasis is more than a skin condition and can have some really difficult symptoms to manage that can be painful and distressing to cope with, there are several treatment options available to patients and there is also a supportive patient community to help cope through difficult days with this disease.
How do you cope with the painful aspects of psoriasis?
Does your psoriasis skin feel out of control? How are you managing?