Symptoms of Psoriasis

Learn about the common signs of psoriasis, how it can affect the skin and nails, and when to seek help.

Psoriasis is a long‑term inflammatory skin condition that affects people in different ways. It often causes patches of sore, itchy or scaly skin, but symptoms can range from mild to more severe.

Psoriasis can start at any age. Some people notice symptoms suddenly, while for others they develop gradually over time.

Understanding the signs of psoriasis can help you recognise symptoms early and know when to seek advice.

Common symptoms

Patches of red, scaly skin

• Raised areas of red or darker skin

• Covered with silvery‑white scales

• Skin may feel sore, itchy or painful

These patches can appear anywhere, but commonly affect:

• Elbows

• Knees

• Scalp

• Lower back

On darker skin tones, patches may appear purple, brown or grey rather than red.

Itching, soreness or cracking

• Skin may feel dry or tight

• Cracks can develop, which may bleed

• Discomfort can interfere with sleep or daily activities

Scalp psoriasis

Psoriasis can affect the scalp and hairline.

Symptoms may include:

• Flaking skin (sometimes mistaken for dandruff)

• Itching or soreness

• Scales extending beyond the hairline

Nail changes

Psoriasis can affect fingernails and toenails.

You may notice:

• Small dents or pits in the nails

• Discolouration

• Thickened or crumbly nails

• Nails lifting away from the nail bed

Nail changes can happen with or without visible skin patches.

Rarer types of psoriasis

Most people are familiar with plaque psoriasis, but there are other, less common forms of psoriasis. These can look and feel different, and are sometimes harder to recognise.

Having a rarer type of psoriasis does not mean symptoms are less important. If something doesn’t feel right, it’s important to seek advice.

Inverse psoriasis

Inverse psoriasis affects skin folds, where skin rubs together.

It commonly appears:

• Under the breasts

• In the groin

• Under the arms

• Around the genitals or buttocks

Symptoms may include:

• Smooth, shiny patches of red or darker skin

• Soreness or irritation

• Less scaling than other types of psoriasis

Because of where it appears, inverse psoriasis is sometimes mistaken for a fungal or bacterial infection.

Palmoplantar pustulosis (PPP)

Palmoplantar pustulosis mainly affects the palms of the hands and soles of the feet.

Symptoms may include:

• Small, painful pus‑filled spots (pustules)

• Redness and inflammation

• Cracked or thickened skin

• Pain that can make walking or using hands difficult

PPP can have a significant impact on daily life, even when the affected areas are small.

Generalised pustular psoriasis (GPP)

Generalised pustular psoriasis is rare but serious.

It can cause:

• Widespread areas of red, inflamed skin

• Clusters of pus‑filled spots

• Fever, chills or feeling unwell

• Extreme fatigue

GPP needs urgent medical attention.
If symptoms appear suddenly and you feel unwell, seek medical help immediately.

A note on diagnosis

Rarer forms of psoriasis are sometimes:

• Misdiagnosed

• Diagnosed later than plaque psoriasis

If treatments aren’t helping, or symptoms don’t match what you’ve been told to expect, it’s appropriate to ask for further review or referral.

Symptoms can vary and flare

Psoriasis often follows a relapsing pattern, meaning:

• Symptoms may flare for a time

• Then improve or settle (remission)

Triggers vary between people and may include:

• Stress

• Illness or infection

• Skin injury

• Cold weather

Psoriasis and the rest of the body

Psoriasis is linked to whole‑body inflammation, not just the skin.

Some people with psoriasis also develop:

• Joint pain or stiffness

• Fatigue

• Psoriatic arthritis

If you have psoriasis and notice ongoing joint symptoms, it’s important to speak to your GP.

When to speak to your GP

You should contact your GP if:

• You think you may have psoriasis

• Symptoms are painful, itchy or affecting daily life

• Over‑the‑counter treatments are not helping

• You notice joint pain or stiffness

Your GP can help confirm a diagnosis and discuss treatment options, or refer you to a specialist if needed.

Supporting someone with psoriasis

If you support someone with psoriasis:

• Symptoms may be visible, but the emotional impact is not always obvious

• Itching, soreness and fatigue can affect mood and confidence

• Flares can be unpredictable

Understanding the condition can help you offer practical and emotional support.

Key points to remember

• Psoriasis is a long‑term inflammatory condition

• Symptoms affect the skin, scalp and nails

• Flares can come and go

• Support and treatment are available through the NHS