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Does Psoriasis Spread?

Posted on July 30, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Anastasia Climan, RDN, CDN

One of the most difficult aspects of psoriasis is its unpredictability. Once you have psoriasis on one part of your body, it can spread to other locations unexpectedly. As a chronic condition, psoriasis flare-ups come and go, often without warning or a clear trigger. Keeping stress levels down, eating anti-inflammatory foods, and maintaining a gentle skin care routine may help, but even taking every precaution cannot guarantee a full remission of psoriasis symptoms.

Although you may not have total control over the spread or severity of psoriasis, you can use some strategies to help keep it contained and under control. This article explains why psoriasis may spread and what you can do to stop it.

Why Psoriasis May Spread

Psoriasis may spread unpredictably, but there are a couple of notable causes in particular.

The Koebner Phenomenon

Avoiding skin trauma is one way to help prevent the spread of psoriasis because skin trauma can lead to the Koebner phenomenon. The Koebner phenomenon describes how some people’s skin responds to damage caused by sunburns, insect bites, irritants, excessive scratching, cuts, or other trauma with new scaly patches of psoriasis.

A MyPsoriasisTeam member said, “I have Koebner’s, and when I get cut, or if one of my joints is hurting … Bam! I get psoriasis in that spot every time.”

Several members of MyPsoriasisTeam have discovered the Koebner phenomenon after getting a tattoo. As one said, “I got a tattoo to celebrate surviving my bone marrow transplant. It was not my first tattoo, but it caused a severe psoriasis flare-up all over my body. The flare-up was initially just where the tattoo was, but it’s spreading like wildfire.” Another shared, “I went back to the tattoo parlor irate, wanting a retouch and my money back because I couldn't figure out why it looked so bad. I thought it was bad ink or an infection. My dermatologist then explained the Koebner phenomenon to me.”

The skin injury response of developing psoriasis on new patches of skin typically occurs within 10 to 20 days. However, it is possible to notice a reaction in three days or as long as two years after the skin trauma. Protecting your skin from environmental factors by wearing sunscreen and bug repellent when spending time outdoors is a simple and effective preventive measure.

Read more about the Koebner phenomenon.

Pustular Psoriasis

Sometimes, psoriasis manifests as pus-filled bumps, a condition called pustular psoriasis. Pustular psoriasis affects 3 percent of people with psoriasis. It may be localized or widespread. Pustules form over 48 hours, combining with other pustules, and eventually bursting open. The surrounding red, raw skin is prone to new pustules. If left untreated, the affected areas can spread and grow into a life-threatening condition.

How To Stop Psoriasis From Spreading

Taking action to reduce the spread of psoriasis isn’t much different from the interventions you may use as part of your routine psoriasis care.

Keeping up with your usual skin care routine and avoiding psoriasis triggers is essential. Although there’s no way to prevent every flare-up, taking care of your skin (by avoiding irritants and keeping it hydrated) and staying in touch with your dermatologist will help you catch any newly affected areas promptly so you can treat them promptly.

Topical Treatments

Along with lotions and creams to keep the skin from getting too dry and itchy, topical corticosteroids can often be used to stem skin inflammation. However, the application of topical steroids has not been shown to prevent psoriasis outbreaks due to the Koebner phenomenon.

Nonsteroid moisturizers containing ingredients may also provide psoriasis relief and general skin protection. These include:

As one member said, “I truly believe taking vitamin D3 has prevented my psoriasis from spreading and getting worse. I also take other vitamins like C, magnesium, and E.”

Read more about how to choose moisturizers for psoriasis.

Systemic Medication

Koebner’s phenomenon and other types of psoriasis spread may be inhibited by systemic psoriasis treatment, which comes as injections or pills and works throughout the entire body. Systemic treatment may include biologic medications, immunosuppressants, and others such as methotrexate. Biologic medications work by calming overactive immune cells to address the root cause of psoriasis. Nonbiologic medications help with psoriasis in other ways, such as by slowing the rate of skin cell growth.

Phototherapy

Phototherapy or light therapy uses the power of ultraviolet light to slow the rate of skin cell growth to treat psoriasis. Unlike sunlight, which contains both UVA and UVB light, phototherapy machines use just UVB light. For phototherapy, it’s important to work with professional equipment rather than other sources like tanning beds. Tanning beds use UVA light, significantly increasing the risk of skin cancer without the benefits of treating psoriasis. You should not use tanning beds to treat psoriasis.

Many people with psoriasis benefit from phototherapy in their doctor’s office or at home. Maintaining a consistent light-treatment schedule can help prevent psoriasis from spreading and keep flare-ups from becoming severe. A prescription is required to purchase a phototherapy machine for home use. In addition, your dermatologist will want to monitor your skin while you're using phototherapy, so it’s crucial to maintain regular visits even when your skin is doing well.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, nearly 100,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Have you experienced psoriasis spreading? Share your experience in the comments below, or start a conversation by posting on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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