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How Can Psoriasis Affect The Lower Back?

Reviewed by: HU Medical Review Board | Last reviewed: July 2016.

People with plaque psoriasis have a chronic inflammatory condition that causes areas of their skin to become thickened, inflamed, and often covered with silvery scales. These patches of skin are affected by a common symptom of psoriasis called plaques. Plaques can occur anywhere on the body, and they can cause itchiness, a burning sensation, and other types of discomfort.

Many people with plaque psoriasis develop these patches on their torso. In one study of patients with plaque psoriasis, about 25% of people reported that they had patches of psoriasis somewhere on their torso.1 As part of the torso, the lower back area is a particularly common place where these skin symptoms present.

What are the symptoms of plaque psoriasis on the lower back?

The symptoms of plaque psoriasis on the lower back are similar to the symptoms on other affected parts of the body: dry, raised, red or pink patches of skin with silvery scales that can develop in many different sizes. For example, people with psoriasis on the lower back may have a large patch, small patches, or a combination across the lower back area. This skin can become more inflamed from clothing, and crack and become painful. In people who have plaque psoriasis that affects the lower back, it is not uncommon for the affected area to spread downward to the buttock area, and especially into the crack between the buttocks1. Skin in this skin fold area can become very itchy and bleed particularly with scratching.

How can plaque psoriasis on the lower back be treated?

There are generally three different types of treatments that are used by people with plaque psoriasis on the lower back3. Topical treatments are applied directly to the areas of skin that are affected by psoriasis. These treatments area available in many different forms such as creams, gels, ointments, oils, or foams.

Topicals are usually the first treatment people with mild psoriasis will try in order to help relieve their symptoms. Some common types of over-the-counter topical treatments include coal tar and salicylic acid formulas. Coal tar helps to reduce the growth of excess skins cells that causes the plaques to form, while salicylic acid works by helping to smooth and thin the affected skin by lifting some of the scales off of the area.

Other types of topical treatments are only available with a prescription from a healthcare provider. This is because they are very strong, so they need to be used with caution and exactly as directed. These include:

For many people with mild or moderate psoriasis, a combination of topical treatments will help them to manage symptoms effectively. However, people with severe plaque psoriasis may need more powerful medicines to help control their symptoms. One option is a type of therapy that uses ultraviolet light on the affected areas called phototherapy4. Another option is to treat those patients with a class of drugs called systemic medicines. These medicines work by affecting the way the entire body functions. They are taken orally (by mouth in a pill or liquid) or through in injection or infusion.

Tips for living with plaque psoriasis on the lower back

There are many strategies (other than medicines) that people living with plaque psoriasis can use to help manage their symptoms and improve their quality of life. Many people find it helpful to take a lukewarm bath with oils, Epsom salts, or colloidal oatmeal2. Avoiding harsh soaps and hot water is important, however. Applying moisturizer or oils regularly to the skin throughout the day can be beneficial.

It is important for people living with psoriasis to try to figure out the “triggers” of their flare-ups, which are periods of time when symptoms get worse. Common triggers include sun exposure, stress, smoking, and skin injuries. Knowing what your personal triggers are will allow you to avoid them and help to prevent flare-ups.

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