Effect of Psoriasis on High-Impact Areas

High-impact areas include the scalp, face, hands, feet, nails, and genital region. These parts of the body may not be large, but they have a major effect on people’s lives. Researchers have found that people who have psoriasis in these areas are more likely to be depressed and unable to fulfill their social roles and participate in social activities.¹

MyPsoriasisTeam members have shared how embarrassment and anxiety about their skin holds them back. “I’m too embarrassed to go to the hairdresser,” one member wrote. Another commented, “I’m too scared to start a new relationship with someone because of my skin condition.”

Scalp

About half of people with psoriasis have symptoms on their scalp. Plaques can also show up on the neck and forehead, near the ears, and along the hairline.²

“The psoriasis on my elbows and on my scalp has gotten very bad. The itching and flakes are so embarrassing. Everyone stares like I have some kind of disease,” a MyPsoriasisTeam member shared.

“With the white flakes, I can never wear dark colors,” wrote another member living with scalp psoriasis.

Face

About half of people with psoriasis will experience patches of scaly skin and other symptoms on their face at some point.³

“I’m getting a rash on my face now. I’m getting very self-conscious,” a member wrote.

Hands and Feet

Psoriasis can cause itchy scales on the palms and soles of the feet. About 40 percent of people with plaque psoriasis have hand and foot symptoms. Psoriasis in this area of the body can be trickier to treat than psoriasis elsewhere.⁴

“The palms of my hands have flared up,” a member wrote. “It’s almost impossible to walk with the bottoms of my feet much worse.”

Nails

Symptoms like nail discoloration and dented, pitted, or crumbly nails affect more than half of people with psoriasis.⁵ Having nail symptoms is a risk factor for psoriatic arthritis. Eight in 10 people with psoriatic arthritis have nail symptoms too.⁶

“First I lost my toenails, and then my fingernails did the same thing, and they haven’t been normal since,” a MyPsoriasisTeam member shared. “At first I was embarrassed about them for a long time, but I’m 65 now, and I just deal with it the best I can.”

Genitals

Genital psoriasis can affect the vulva, penis, scrotum, and skin around the genitals.⁷ You might also notice symptoms on the inner thighs or around the buttocks.⁸ Genital psoriasis happens more often than you might realize. As many as two-thirds of all people with psoriasis will experience genital symptoms.⁸

“I’m so tired of having genital psoriasis,” one member wrote. “I haven’t been able to be intimate with my husband without pain in four years!”

“I’ve had a couple of relationships in my adult life where psoriasis really got in the way of intimacy,” another member said.

Challenges of Misdiagnosis

Sometimes psoriasis in high-impact areas is misdiagnosed as another condition. Scalp psoriasis can be misidentified as seborrheic dermatitis, a type of eczema that affects the scalp, because symptoms of the two conditions can look similar and affect the same area of the body.² Nail psoriasis symptoms can be confused with fungal infections because these conditions can cause similar nail discoloration.⁶

Genital psoriasis can be incorrectly diagnosed as a sexually transmitted infection or another type of infection. This sometimes happens because primary care doctors or gynecologists aren’t used to seeing psoriasis in this area, so they make an incorrect diagnosis.⁹ Psoriasis in the genital areas may also look different than psoriasis in other areas. It does not always present in the typical scaly way.⁷ Additionally, people with genital psoriasis are often embarrassed to tell their dermatologist, which makes it difficult to get a correct diagnosis and treatment.⁹

People of color can experience more challenges getting a correct diagnosis. They may have to wait three times longer for a diagnosis than white people with psoriasis. They are also four times more likely to need a skin biopsy for diagnosis.¹⁰

Importance of Getting the Right Treatment

Talking to your doctor about your symptoms is the first step to getting relief. This is especially important if you have genital psoriasis and have been too embarrassed to talk about it with your dermatologist. If you’re concerned that your symptoms have been misdiagnosed, you can talk to your doctor about the possibility of psoriasis.

If you have a confirmed diagnosis but your symptoms aren’t well controlled, you can talk to your doctor about other treatment options.

According to the International Psoriasis Council, having psoriasis in high-impact areas is one of the criteria that can make you a candidate for systemic treatments.¹¹ Systemic treatments are medications that affect the entire body. Your dermatologist can help you understand the potential benefits and risks of these medications, which are injected or taken orally (by mouth).

ABBV-US-02001-MC V1.0 Approved 5/2025