Can Psoriasis Hurt?
Last updated: September 2022
Psoriasis is an autoimmune condition that causes symptoms to develop on the skin. There are several types of psoriasis, but the most common form is plaque psoriasis. Plaques are patches of skin that are raised, red, dry, and often covered with a layer of silvery scales.
Many people think psoriasis is simply a dry skin condition without understanding its painful and impactful symptoms. Let's break it down for them, shall we?
Psoriasis not only intensely itches - it burns too!
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 bitten 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.
Let's talk the discomfort of psoriasis plaques
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, this larger pus will dry out and then peel off, leaving behind a smooth area of skin where pustules may eventually form again.
Psoriasis skin can crack and bleed!
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.
Psoriasis below the belt
Certain 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 invisible symptoms of psoriasis
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.
How do you cope with the painful aspects of psoriasis?
Does your psoriasis management change with the seasons?