When you hear the word “psoriasis,” you may think of inflamed patches of skin, but psoriasis can cause more than a rash. The condition causes different symptoms depending on several factors, including what type of psoriasis you have. It’s also possible to have more than one form or for your psoriasis to change from one type to another.

Symptoms of psoriasis vary from person to person and can change over time. For most people, symptoms may decrease or disappear during periods of remission, only to reappear or worsen with flare-ups. Luckily, treating psoriasis with topical treatments (applied directly to the skin) or systemic therapies (medications that work throughout the entire body) can help manage many symptoms.

Read on to learn about the different types of symptoms you may experience with psoriasis.

1. Skin Symptoms

Skin symptoms vary based on the type of psoriasis. Scalp psoriasis affects many people and looks like severe dandruff, with raised, discolored, and scaly plaques. These plaques are usually very itchy. Psoriasis can also affect the nails, which is commonly called nail psoriasis.

Plaque psoriasis makes up 80 percent of psoriasis cases. Common symptoms include patches of thick, discolored, inflamed skin.

Keep reading to learn about the most common skin symptoms associated with each type of psoriasis.

Plaque Psoriasis

Plaque psoriasis (also called psoriasis vulgaris) is the most common type — it makes up 80 percent of all psoriasis cases. This type typically affects the elbows, knees, back, and scalp but may appear elsewhere. Common symptoms include patches (or plaques) of thick, discolored, inflamed skin that can crack or bleed easily. Plaques are often covered with white or silver scales and can cause intense itching, burning, and soreness.

It’s important to know that plaques and other skin symptoms look different depending on skin color. Plaques can appear brown, purple, or gray on darker skin, and they may look red or pink on lighter skin. When the scales come off, you might see small spots of bleeding, known as the Auspitz sign.

Learn more about plaque psoriasis.

Guttate Psoriasis

Guttate psoriasis causes small, scaly lesions (spots) that may be pink, red, brown, or purple, depending on your skin tone. They’re usually round or oval and can look like a shower of raindrops scattered across the skin.

This type of psoriasis most often appears on the arms, legs, chest, and scalp, but it can show up almost anywhere except the palms of the hands and soles of the feet. Guttate psoriasis is sometimes linked to a recent infection, especially an upper respiratory tract infection such as strep throat.

Inverse Psoriasis

Inverse psoriasis, also called flexural psoriasis, causes smooth, shiny patches that are usually painful. On lighter skin, these patches usually look red. On darker skin, they may appear brown, purple, or gray. Inverse psoriasis usually appears in areas where sweat and friction occur, such as skin folds in the armpits, genitals, and under the breasts. This form of psoriasis is often confused with fungal infections.

Pustular Psoriasis

Pustular psoriasis, an uncommon form that’s hard to treat, causes discolored skin with small, pus-filled bumps called pustules. These lesions aren’t caused by an infection — they’re sterile (germ-free) but still inflamed and often painful.

The subtypes of pustular psoriasis are classified based on where and how the pustules appear. For example, palmoplantar psoriasis affects the palms and soles. A more severe type, von Zumbusch pustular psoriasis — also called generalized pustular psoriasis — causes pustules all over the body and can lead to systemic symptoms such as fever and joint pain.

Erythrodermic Psoriasis

The rarest type, erythrodermic psoriasis, can affect the entire body, causing a rash that peels, itches, and burns. People with this form of psoriasis usually have fever, chills, dehydration, and swelling. This potentially life-threatening condition usually requires emergency medical care and hospitalization. If you or someone you know develops symptoms of erythrodermic psoriasis, it’s important to seek help right away.

2. Nail Symptoms

Psoriasis and psoriatic arthritis (PsA) can affect fingernails and toenails in various ways. Nail psoriasis can cause the nails and nail beds to become thick and ridged, pitted, loose, or crumbly.

Nails may also change color, developing white spots, thin black lines, or a yellow-red tint beneath the surface. These changes happen because of nail dystrophy (abnormal growth), which can affect the nails’ color, texture, thickness, or shape. Some people with nail psoriasis also develop inflammation or fungal infections in the nails, partly due to the damage caused by psoriasis.

3. Fatigue

Fatigue (persistent exhaustion that doesn’t improve with rest), a very common symptom of psoriasis, occurs because of high levels of inflammation in the body. Up to 30 percent of people with psoriasis also have psoriatic arthritis. PsA can be linked to anemia (low red blood cell count), which can add to feelings of tiredness and low energy.

4. Depression and Anxiety

Depression and anxiety are common among people with psoriasis and PsA, just like in many chronic (long-term) health conditions. Research shows that psoriasis can raise the risk of depression, which may also make psoriasis symptoms worse for some people. Symptoms of depression may include:

• Feeling sad or down most of the time
• Losing interest in activities or hobbies you once enjoyed
• Having trouble concentrating
• Experiencing changes in sleep or appetite

Fatigue, a very common symptom of psoriasis, occurs because of high levels of inflammation in the body.

Researchers have also found that people with psoriasis have a higher risk of anxiety compared to those without the condition. Symptoms of anxiety include:

• Restlessness
• Excessive worry
• Irritability
• Fatigue

5. Insomnia

Pain and itching can lead to insomnia — trouble falling or staying asleep — in many people with psoriasis and psoriatic arthritis. Insomnia caused by pain is sometimes called “painsomnia,” and it can lead to feeling tired, groggy, or unfocused during the day. Poor sleep can also worsen symptoms of both psoriasis and PsA, creating a frustrating cycle.

6. Joint Pain

People with psoriasis may experience joint pain, which can be a sign of psoriatic arthritis. PsA typically causes stiffness, pain, and swelling in the joints and where tendons attach to bones.

If left untreated, PsA can lead to permanent joint damage, disability, or even deformities. In some people, PsA leads to ankylosing spondylitis — inflammation in the spine and hips that can cause the bones to fuse.

7. Eye Symptoms

Psoriasis can also affect your eyes, causing dry skin and scaling around the eyes and on eyelids. People with psoriasis may experience dry eye syndrome and blepharitis (inflammation of the eyelids), leading to itching, discoloration, and swelling.

About 7 percent of people with psoriatic arthritis develop uveitis, a type of eye inflammation that causes pain, redness, blurred vision, and light sensitivity. Left untreated, uveitis can progress and lead to vision loss. If you notice any of these symptoms in one or both eyes, talk to your doctor right away.

At What Age Do Psoriasis Symptoms Appear?

Psoriasis can develop at any age, but it most commonly starts between ages 20 and 30 or between 50 and 60. Infants, children and teens can also experience early signs of psoriasis.

Do Psoriasis Symptoms Go Away?

Psoriasis symptoms may worsen during a flare and ease during a remission period. This chronic condition doesn’t have a cure, but with early diagnosis and the right treatment plan, many people are able to reduce flares and feel better over time.

Common treatments include topical and systemic medications, light therapy, and lifestyle changes. Your healthcare provider or dermatologist can help you build a plan that fits your needs and supports long-term skin health.

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.

Have you had any of these symptoms of psoriasis? What strategies help you manage flare-ups? Share your experience in the comments below, or start a conversation by posting on your Activities page.