Does Psoriasis Go Away?
Medically reviewed by Leah Ansell, MD
Psoriasis is a lifelong skin condition that never goes away. Though it typically cycles between periods of worsening symptoms (flares) and improvement (remission), the underlying disease process is always there and prone to triggering.
Psoriasis is caused by an overactive immune response. Psoriasis treatments can help keep that in check and reduce itchy skin plaques in a few weeks or months, but they cannot cure this chronic disease. If left untreated, psoriasis will worsen, flares will be longer and more frequent, and complications may occur.
This article discusses how long psoriasis flare-ups and periods of remission can last. It also explains psoriasis triggers, treatments that can help reduce signs and symptoms, and what can happen if the condition is not managed.
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Why Psoriasis Is Not Curable
Psoriasis is an autoimmune disease where the immune system attacks healthy skin tissue. Treatments can help regulate your overactive immune system response, but they cannot permanently correct it.
Some people think remission means that psoriasis is cured, but psoriasis remission often means skin will clear almost completely. In some, symptoms may be drastically reduced, but not gone entirely.
Regardless, skin plaques will return with time.
What Triggers Psoriasis?
People with psoriasis often have periods when their skin symptoms worsen. Flare-ups, or flares, are often the result of specific triggers. Common psoriasis triggers include:
Cold and dry weather
Dry skin
Illness
Skin injuries, like a cut or scrape
Stress
Taking certain medicines
How Long Does a Psoriasis Flare Last?
A psoriasis flare can last from a few weeks to a few months. Flares are usually followed by periods in which symptoms subside.
A psoriasis flare-up is marked by red, dry, and thick skin patches. These patches sometimes contain silvery-white scales that itch or burn. The skin might become cracked and bleed.
Psoriasis plaques frequently appear on the scalp, low back, knees, skin folds (armpits, under the breasts, groin, etc.), and genitals.
Additional symptoms of a psoriasis flare include:
Nail changes, including pitting, thickening, ridges, crumbling, discoloration, and nail bed separation
Emotional effects, including depression and anxiety
Joint symptoms, including stiff, swollen joints if you have psoriatic arthritis
Prompt treatment for psoriasis flare-ups can help people achieve remission or reduce symptoms to manageable levels.
What Is Psoriatic Arthritis?
Psoriatic arthritis (PsA) is a chronic, inflammatory disease of the joints and entheses—the areas where tendons and ligaments connect to bone. Up to 30% of people with psoriasis have psoriatic arthritis.
Related: What Does Psoriasis Look Like?
How Long Does Psoriasis Remission Last?
With treatment, psoriasis can go into remission for months or years. On average, remission of psoriasis symptoms lasts from one to 12 months.
For some people, symptoms may not disappear entirely, but subside to the point that they are no longer troublesome. This is called "almost complete skin clearance," and people in this group might be classified as being in remission.
Most people achieve remission when treatment has successfully isolated the part of the immune system that causes psoriasis. With the proper treatment, many enter remission and experience no visible symptoms for some time. But remission is never permanent, and signs are likely to return.
While rare, some people may experience spontaneous remission from psoriasis. This means that psoriasis has cleared without treatment. In these cases, the immune system has likely turned off its attacks on the body.
How Is Psoriasis Treated?
Psoriasis treatment options include topical medicines, phototherapy, systemic medicines, biologic drug therapies, and corticosteroids.
Topical Psoriasis Treatments
Topical medicines are medicines applied to the skin. Topical treatments for mild to moderate psoriasis include:
Calcineurin inhibitors to reduce inflammation and the formation of skin plaques
Corticosteroids to relieve itching and inflammation
Coal tar to manage scaling and swelling
Moisturizers to relieve skin dryness and itch
Salicylic acid to remove dead skin and scales
Retinoids to reduce inflammation
Dovonex (calcipotriene), a synthetic vitamin D3 applied to the skin, is a common treatment and can be used in combination with a corticosteroid medication. Zoryve (roflumilast) cream, containing a drug called a phosphodiesterase 4 inhibitor, also is approved by the Food and Drug Administration for psoriasis treatment.
Phototherapy
A healthcare provider can give phototherapy treatment in their office or prescribe a unit to be used at home. It uses ultraviolet (UV) light to treat skin areas affected by psoriasis skin plaques.
Systemic Drug Therapy
Systemic drug therapies affect the entire body or act on different body systems. Systemic medicines work by suppressing the immune system to reduce skin cell formation. Common systemic treatments for psoriasis include:
Cyclosporine
Methotrexate
Oral retinoids
Oral corticosteroids
A new drug, Sotyktu (ducravacitinib), was approved by the FDA in September 2022 for psoriasis treatment. Some studies report it's more effective than the popular psoriasis drug Otezla (apremilast) for people with moderate to severe disease.
Related: Psoriatic Disease Drugs in the Pipeline
Biologics
Biologic medicines target specific parts of the immune system to treat psoriasis. They are described in terms of what they target, such as anti-tumor necrosis factor (TNF) or inhibitors of interleukin (IL)-12, (IL)-23, or (IL)-17. Examples of biologics prescribed to treat psoriasis include:
Tremfya (guselkumab), an IL-23 inhibitor
Cosentyx (secukinumab) and Taltz (ixekizumab), popular IL-17 Inhibitors
Stelara (ustekinumab), an IL-12 and IL-23 inhibitor
Humira (adalimumab) and Simponi (golimumab), both anti-TNF biologics
Orencia (abatacept) is a biologic drug that's FDA-approved for use in treating psoriatic arthritis.
At-Home Treatments
Lifestyle changes can also help manage symptoms of psoriasis. Changes might include eating a healthy, balanced diet and avoiding triggers like stress, cold weather, and smoking.
Home remedies like aloe vera and oatmeal baths can help reduce redness and itching. Moisturizers can treat dry skin.
What Happens If You Stop Treating Psoriasis?
If a person stops treating psoriasis, it is possible it will progress and worsen with time. Psoriasis inflammation can also progress, which increases your risk for complications that affect the rest of the body.
Untreated moderate-to-severe psoriasis can develop into psoriatic arthritis. PsA can be painful and disabling, and people with both conditions have a more significantly impacted quality of life.
Additional complications of untreated psoriasis include an increased risk for:
Cardiovascular disease: Including heart attack, stroke, heart valve problems, and heart failure
Metabolic syndrome: A combination of different metabolic disorders, including insulin resistance, elevated blood sugar, high cholesterol, high blood pressure, and abdominal obesity
Type 2 diabetes: Condition in which the body does not correctly regulate and use sugar as fuel
Anxiety and depression
Inflammatory bowel disease: Inflammation of the gastrointestinal tract, including ulcerative colitis and Crohn's disease
Kidney disease: A condition in which the kidneys cannot filter blood normally, resulting in fluid and waste staying in the body
Some cancers: Including squamous cell carcinoma, lymphoma, and basal cell carcinoma
Serious and life-threatening infections
Read Next: Psoriasis and Inflammation
How to Prevent Psoriasis From Returning
There is no one-size-fits-all solution to managing psoriasis. If you are lucky enough to experience remission, you can take steps to keep your skin healthy and clear. Try the following strategies:
Expose skin to sunlight: Some sun exposure can help keep mild psoriasis at bay. Researchers recommend multiple but short sunlight exposures for people with psoriasis who can tolerate sunlight.
Manage stress: Since stress is a psoriasis trigger, it is good to relax and manage stress to keep inflammation from developing.
Avoid scrubbing: Scrubbing skin can irritate it and trigger a psoriasis flare. Wash your skin gently, pat dry, and moisturize.
Keep your body healthy: Staying healthy can reduce systemic inflammation. Eating a nutritious, well-balanced diet, not smoking, being active, and restricting alcohol intake are all recommended.
If Psoriasis Strikes Again
If psoriasis returns, the best course of action is to treat it right away. You have many options for treatment, and new medication options are becoming rapidly available. Try different things to figure out what best keeps symptoms at bay and to prevent psoriasis skin plaques from worsening or returning.
Summary
There is no cure for psoriasis, but it can be managed with medication and by avoiding triggers. For most people, psoriasis cycles between periods of symptom flares and remission.
Psoriasis flare-ups can last a few weeks or months. Prompt treatment can help the skin to clear up faster. Remission commonly lasts between one month and one year. This may involve complete or only partial reduction of symptoms.
Frequently Asked Questions
How long does psoriasis last without treatment?
Psoriasis needs treatment. It rarely goes into remission without it. Even if it does, symptoms are very likely to return at some point.
How do I get rid of psoriasis fast?
There is no quick solution for psoriasis, but topical treatments can help manage symptoms. Medication can help reduce the length of a flare-up and slow down the immune system's inflammatory response.
How do you stop psoriasis from spreading?
Psoriasis can't be passed from person to person, but it spreads on one's own skin because of an internal immune system response. Medications like methotrexate and biologic drugs may slow down that process.
Read the original article on Verywell Health.
