Have you noticed itchy, flaky skin or unusual discoloration on your legs? This could be a sign of psoriasis, an autoimmune disease where the body’s immune system mistakenly targets its own skin cells. While psoriasis symptoms can appear anywhere on the body, they often show up on the knees, calves, shins, thighs, and even the toenails.

If your legs are itching and your dermatologist has diagnosed you with psoriasis, understanding the condition is an important first step. Learning how it works can help you find treatments that manage flare-ups (periods of worsening symptoms) and keep symptoms under control.

Symptoms of Psoriasis on the Legs

Symptoms of psoriasis on the legs are similar to those elsewhere on the body. The specific symptoms you have will depend on the type of psoriasis your doctor diagnoses you with. In general, psoriasis on the legs involves flaky patches of skin. These can become inflamed and scaly, and they often itch or burn.

Although most studies don’t focus on the location of psoriasis unless it’s out of the ordinary (like psoriasis on the hands or foot psoriasis), about 3 percent of people in the United States are living with some form of the skin condition. Because psoriasis symptoms commonly develop on the knees, it makes sense that many people with the condition will have it on their legs at some point in time.

Here’s what you should know about the different types of psoriasis that can affect your legs.

Plaque Psoriasis

Up to 80 percent of people with psoriasis have plaque psoriasis, making it the most common type. Raised patches stand out from the rest of the skin. They are usually red or purple, depending on skin tone, and often look scaly. On your legs, you’re most likely to see plaque psoriasis on your knees, though it can show up anywhere on your skin.

Inverse Psoriasis

Approximately one-quarter of people with psoriasis live with inverse psoriasis. It occurs where the skin on your body folds and is most likely to touch other skin. Depending on your skin tone, you’ll see red, purple, or darkened patches. These patches will itch and burn but won’t get scaly. On your legs, you’re most likely to see this at the top of the back of the thigh, under the fold of the buttocks, or possibly behind your knees.

Guttate Psoriasis

About 8 percent of people with psoriasis experience guttate psoriasis. It usually looks like round, inflamed spots of skin. Depending on your skin tone, these spots can be red, purple, or just darker than the rest of your skin. These are called papules, and the legs are one area where they commonly appear, though you may see them on other parts of the body, too.

Pustular Psoriasis

Around 3 percent of people diagnosed with psoriasis have pustular psoriasis.

You’ll see small, pus-filled bubbles or blisters, called pustules, under your skin. Pustular psoriasis can appear anywhere on the body, so you may see it on your legs.

Erythrodermic Psoriasis

Only 2 percent of people with psoriasis have a diagnosis of erythrodermic psoriasis. In this type, you’ll see large areas of the skin become red or purple, and all of that skin may shed at once. You may also get dehydrated, have severe pain and/or itching, and experience changes to your body temperature and heart rate. Erythrodermic psoriasis can affect all or most of your body, including your legs.

How Do People Experience Psoriasis on the Legs?

One MyPsoriasisTeam member explained it this way: “The backs of my calves are scratched to death. Then comes the burn, and they feel like they are on fire.”

For many people, leg psoriasis isn’t just uncomfortable — it can interfere with everyday life, including sleep. “This psoriasis is all over me. Both knees hurt and the top of my thighs. I don’t sleep at night,” one team member said.

When your legs itch or burn, it can be hard to find a comfortable position. Some people with psoriasis on their thighs or calves have trouble sitting, standing, or lying down for long. A MyPsoriasisTeam member said, “I have a bad bout of it on the back of my thighs. It hurts to sit, and I can’t stand for long periods.”

Psoriasis symptoms on the legs can affect the way you feel about your appearance. As one MyPsoriasisTeam member put it, “I have it badly on my calves, so I always wear a long dress or pants.”

Choosing clothing that feels good on your skin and helps you feel confident can make a difference. Soft, breathable fabrics — like cotton or bamboo — may help reduce irritation and make flare-ups feel more manageable.

What Causes Psoriasis on the Legs?

The precise cause of psoriasis is not currently known. Researchers believe that the immune system becomes overactive, which causes changes to your skin. For instance, plaque psoriasis causes the skin cells to multiply too quickly. This causes a buildup of skin cells, which appear as the plaques, scales, and flakes that you see. Researchers don’t yet have a way to determine where a person’s psoriasis symptoms will appear, so there’s no way to know what causes it to show up on your legs specifically.

You’re more likely to get psoriasis if other members of your family have the condition. This is called a family history of the condition. Other risk factors include smoking, having obesity, and taking certain medications, such as beta-blockers, lithium, or antimalarials. People living with HIV and those who’ve recently had a streptococcal infection (like strep throat) also face a higher risk of developing psoriasis.

Treatment for Psoriasis on the Legs

How do you treat psoriasis on the lower legs? Many treatment options are available. Your dermatology team should be able to help you find a treatment or combination of treatments adjusted to your type of psoriasis, severity, presence of other diseases, body type, lifestyle, and needs. Treatment should be completely explained, especially about the way it’s administered and possible side effects.

Topical Treatments

For mild leg psoriasis treatment, your doctor will likely recommend starting with topical treatments, including gels, ointments, lotions, moisturizers, creams, and more. Moisturizers for psoriasis help you hydrate your skin and may contain ingredients like:

• Corticosteroids
• Coal tar
• Topical vitamin D
• Salicylic acid
• Retinoids

These may also help treat your psoriasis and moisturize dry skin. You’ll need a prescription for some of these, so talk to your doctor.

Phototherapy

Phototherapy, also called light therapy, involves exposing the areas of your legs affected by psoriasis to certain types of light. You usually have to do this several times a week for one month or more. There are several types of phototherapy, and your medical team will help you choose what’s best for you.

Systemic Treatments

Because psoriasis is an autoimmune condition, treatment of severe cases often involves addressing the immune system directly. Your doctor might recommend medications like methotrexate or cyclosporine. In some cases, biologics may be prescribed. Newer systemic drugs, including Janus kinase (JAK) inhibitors and phosphodiesterase 4 (PDE4) inhibitors, are taken as oral pills.

Systemic treatments are usually prescribed for moderate to severe psoriasis when other treatments haven’t been effective. Your doctor can help you understand potential side effects and balance the potential risks and benefits of this type of treatment.

Avoiding Triggers

If your psoriasis seems to flare up suddenly, a trigger might be to blame. Identifying and avoiding triggers won’t cure psoriasis, but it can help reduce flares and manage symptoms. Common triggers include:

• Weather changes, especially cold, dry air
• Shaving or skin injuries, such as cuts, scrapes, or sunburn
• Stress, both emotional and physical
• Alcohol use

Getting Medical Help for Psoriasis on the Legs

If you have new or worsening psoriasis on your legs, talk to your doctor to get medical advice right away. Similarly, if your psoriasis on your legs is not improving with treatment, talk to a healthcare provider to come up with a new treatment plan. Your efforts will feel worthwhile when your legs are healing and your psoriasis flare-up is over.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 134,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Are you living with psoriasis on your legs? What does it feel like? Share your experience in the comments below, or start a conversation by posting on your Activities page.