All the Ways Psoriasis Isn't Contagious

Psoriasis occurs when the immune system malfunctions, leading to accelerated skin cell growth

Medically reviewed by Leah Ansell, MD

Psoriasis is an autoimmune skin disease, not an infectious disease. It is not caused by bacteria, viruses, or fungi. This means you cannot "catch" psoriasis from someone else, even through skin-to-skin contact, kissing, or swimming in the same water as someone with the condition. A person with psoriasis does not get the condition from someone else and cannot pass it on to others.

Psoriasis is caused by a problem with the immune system. People with the condition have inflamed, scaly patches called plaques that build up on the skin. The condition has no cure, but it can be treated and managed. 

This article covers causes and risk factors for psoriasis, stigmas associated with the condition, how the condition flares up, and more.

Psoriasis: An Autoimmune Disease That's Not Contagious

Psoriasis affects 7.5 million Americans ages 20 and older. The condition can also affect children and teens. While researchers are unsure what causes psoriasis, they know genetics and the immune system are involved.

T-Cells

Researchers believe that T-cells might contribute to the development of psoriasis. These cells fight off bacteria and viruses that invade the body. In people who develop psoriasis, T-cells attack healthy skin cells and initiate other immune processes that lead to inflammation and rapid skin cell growth.

With normal skin cell production and turnover, it would take weeks for skin cells to die and produce new ones. However, with psoriasis, that process occurs over a few days, and the body does not have an opportunity to shed old skin cells. All the excess skin growth piles up on the skin's outer layer, leading to plaques. Plaques can itch, burn, sting, and bleed.

Genetics

Family history can also increase the risk for psoriasis, especially for people with a first- or second-degree relative with the condition. These include:

• Parents

• Children

• Siblings

• Grandparents

• Grandchildren

• Aunts and uncles

• First cousins

While rare, it is possible to develop psoriasis while not having a genetic disposition or a family history of it.

Triggers

Genetics and family history are not enough to trigger the development of psoriasis. These, along with specific triggers, can lead to psoriasis.

Such triggers include:

• Smoking

• Overconsumption of alcohol

• Chronic stress, both mental and physical

• Having another autoimmune disease, like ankylosing spondylitis and rheumatoid arthritis

• Infections, including strep and staph infections

• Skin injuries or breaks in the skin (i.e., a cut, bug bite, or getting a tattoo)

• Some medicines, including beta-blockers and lithium

Related: What Is Koebner’s Phenomenon?

Stigma About Psoriasis Being Contagious

According to a 2015 study published in the Journal of the American Academy of Dermatology, psoriasis is highly stigmatized. In fact, it may cause the same level of stigma that herpes does. Many study participants reported believing psoriasis was infectious and contagious. 

A 2019 study found that knowledge of psoriasis in the United States is limited. That study showed 54% of people surveyed said they would not date someone with psoriasis, and 39.4% said they would not shake hands with someone with the condition.

Another 32.3% said they would not invite someone with the condition into their home. More than 25% of the people surveyed believed psoriasis was contagious or that it was not a serious illness.

Takeaway

People with darker skin tones may face a different type of stigma. For example, many people do not believe psoriasis affects Black, Asian, and Hispanic Americans, but this isn't true. In fact, these groups have higher rates of severe psoriasis. The higher rates occur because of social misconceptions and a lack of knowledge within the medical community about how psoriasis looks in people of color.

Related: Psoriasis on Black Skin

A very harsh misconception about psoriasis is the condition is linked to poor hygiene. Psoriasis is not caused or worsened by poor hygiene. Like other autoimmune diseases, it is linked to genetics, where something triggers the immune system to malfunction, and the condition develops. 

Misunderstandings about psoriasis exist because of a lack of knowledge about the condition. This can lead to feelings of shame and isolation for people with psoriasis. The stigma can sometimes result in people not seeking treatment, especially those of color who already experience healthcare barriers.

Related: Psoriatic Arthritis Differential Diagnosis: Diseases That Mimic PsA

Despite the existence of misconceptions and stereotypes, research shows people who know someone with psoriasis are less likely to believe or report misinformation about it. People who had previously heard about the condition tended to be more compassionate to people with psoriasis and did not give in to misinformation. 

Psoriasis Flares and Symptom Triggers

Psoriasis is characterized by periods of flare-ups and periods of remission. Flare-ups are times when disease symptoms increase, and remission means disease symptoms are mild or completely gone. 

A psoriasis flare can cause a patchy rash or small scaly spots, dry and cracked skin, itching, burning skin, fever, and fatigue. Skin inflammation and rash last a few weeks or months and then subside. Some people may also experience nail psoriasis, which causes pitting and discoloration of fingernails and toenails.

Related: Is Psoriasis Painful?

Flare-ups are often unpredictable and make living with psoriasis frustrating. While eliminating all psoriasis flares may not be possible, knowing what might trigger flares could reduce future outbreaks. Triggers can vary from person to person and include diet, stress, alcohol consumption, and smoking.

Advances in Psoriasis Care and Treatment

While there is no cure for psoriasis, the condition is treatable and manageable. In recent years, researchers have learned more about disease processes, which has led to a better understanding of the disease and more advanced treatments.

In 2020, the National Psoriasis Foundation partnered with the American Academy of Dermatology and leaders in psoriatic disease to create new treatment guidelines. The guidelines, published in the Journal of the American Academy of Dermatology, provide updated information and more precise guidance on medicinal treatments, phototherapy, comorbidities, and pediatric care.

During a Psoriasis Flare: To Scratch or Not to Scratch

Itching is a common symptom of psoriasis resulting from skin inflammation. Research shows up to 90% of people with psoriasis experience itchy skin. Psoriasis itch can affect your sleep, emotional health, and quality of life. 

While it might be tempting to scratch the itch, scratching increases the risk of a secondary infection. This is because scratching inflamed skin leads to skin abrasions, which can aggravate the skin and make it vulnerable to bacteria. 

Research shows scratching of psoriatic skin is more common while people sleep. A prescription ointment or an over-the-counter (OTC) topical medication like hydrocortisone on inflamed skin before bedtime might help reduce itching. 

Related: Psoriasis and Inflammation

Your healthcare provider can prescribe additional therapies to manage ongoing skin inflammation and reduce itching. Such therapies might include:

• Disease-modifying antirheumatic drugs (DMARDs) like methotrexate 

• Biologic injections and infusions, such as Cosentyx (secukinumab)

• Immunosuppressants drugs like cyclosporine

• Oral retinoids, such as Soriatane (acitretin)

• Phosphodiesterase 4 (PDE4) inhibitors like Otezla (apremilast)

• Prescription topicals—corticosteroids, vitamin D-based medicines, retinoids, and anthralin
  

How to Manage Psoriasis Breakouts

Getting psoriasis treatment can limit inflammation that leads to psoriatic lesions, skin pain, and discomfort. It may also prevent scarring and infections. But even with treatment, it is still possible to experience psoriasis flare-ups.

During flares, you will want to:

• Find ways to be gentle to your skin: Wear soft, comfortable clothing to avoid irritating already inflamed skin. Protect your skin outdoors by wearing long sleeves and pants or applying sunscreen on exposed skin. The National Psoriasis Foundation recommends using a fragrance-free sunscreen labeled "broad spectrum" with a 30 or greater sun protection factor (SPF) that is made for sensitive skin.

• Manage itching: If your skin is itchy, try not to scratch. Instead, use a topical or oral anti-itch medicine. Applying cold compresses can also help bring down skin inflammation to relieve itching.

• Hydrate and moisturize: A warm bath can help hydrate your skin, reduce inflammation, and remove scales. Avoid hot water and sitting in the bath for too long. Use gentle cleansers and colloidal oatmeal to help soothe your skin. Gently towel dry skin and immediately add a thick moisturizing cream. Use a moisturizing cream at least twice daily to reduce dryness.

• Nourish your body: Drinking plenty of water and eating a healthy diet with inflammation-reducing foods can reduce psoriasis symptoms and flare recovery time. Anti-inflammatory foods include olive oil, fruits, vegetables, fish, and spices. You will also want to avoid smoking and alcohol.

• Manage stress: Stress can worsen a psoriasis flare and increase the length of a flare. Try deep breathing or meditation to manage stress. You will also want to avoid activities that stress you during this time.

• Get moving: You may not want to leave home when your psoriasis flares, but try to resist the urge not to do anything. If you do not have a lot of energy, take a short walk in your neighborhood or do some stretching in your home or yard.

• Call your healthcare provider: If you have tried to manage a flare at home and things are not improving, call your healthcare provider. They can prescribe a topical or oral medicine to reduce symptoms and shorten recovery time.

• Don't give up: Some psoriasis flares require time to resolve. Ensure you follow your treatment plan and do not stop taking any medicines without talking to your healthcare provider. Try to get plenty of rest and don't overdo things during this time.
  

Discussing Psoriasis With a Partner

Symptoms like itching, skin pain, and visible lesions can cause physical and emotional distress. And if you also experience genital psoriasis, this can further add to your concerns. Genital psoriasis causes red, itchy patches to form on the penis, scrotum, testicles, vulva, labia, and other genital areas.

It is still possible to enjoy a healthy sex life with psoriasis. The key is communication, and while the conversations can be difficult, you will need to be open and honest about how psoriasis makes you feel and the limitations it may cause when it comes to intimacy. 

You may feel embarrassed or afraid of what your partner thinks or feels after you share your concerns. But if the person you share your concerns with cares about you, they know you are more than your disease, and how your skin looks will not bother them.

Related: How to Talk About Psoriasis

Summary

Psoriasis is an autoimmune skin condition. It causes red, scaly patches of skin. Despite misconceptions, the condition is not contagious. An overactive immune system causes skin cells to grow faster than usual, so they pile up on the skin's surface.

Once you are diagnosed with psoriasis, you will have it for the rest of your life. While there is no cure, the condition is treatable and manageable. Even with treatment, psoriasis can significantly affect your life, including intimate relationships. It can also cause challenges with your emotional health due to misconceptions and stigma.

Communication and education are key. You can reduce misunderstandings and misinformation by providing others with facts about the disease and its effects.

Read the original article on Verywell Health.