9 Sneaky Signs You Have Psoriasis

by Emily Shiffer Health Writer

To understand psoriasis, think I Love Lucy — the episode where Lucy desperately tries to grab chocolates off an accelerating conveyor belt. In this case, Lucy is your skin and psoriasis is the conveyor belt.

The condition develops when a person’s immune system cranks up the production of skin cells and shuttles them to the surface faster than your body can shed old ones — in a few days versus the usual month.

“Since the body is unable to shed the excess skin quickly enough,” says Michael Kassardjian, M.D., a dermatologist and surgeon at Coast Dermatology Medical Associates in Los Angeles, “it piles up.”

The unenviable result: thick red, scaly, itchy patches of skin.

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Psoriasis is a chronic condition (read: there’s no cure), though it can usually be controlled with medications, topical treatments, and stress management.

The exact cause is unclear, though researchers believe bum genetics, a maverick immune system, and environmental triggers conspire to cause outbreaks.

“Infections, injuries, weight gain, smoking, excessive alcohol, stress, and certain medications can cause flare ups,” says Dr. Kassardjian.

If you’ve suddenly broken out in a red, scaly rash, you might be wondering if you have one of five types of psoriasis. Watch for these red flags.

Sneaky Psoriasis Sign #1: Weird Patches on Your Elbows or Knees

Chances are, you’ll first notice psoriasis on your elbows or knees in the form of raised red patches of skin. One study found that half of patients have it on their elbows and a third on their knees.

“Skin inflammation is one of the main features,” says Rajani Katta, M.D., a professor of dermatology at Baylor College of Medicine in Houston, and author of Glow: The Dermatologist’s Guide to a Whole Foods Younger Skin Diet. “That inflammation is what causes the raised red patches.”

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Sneaky Psoriasis Sign #2: Scales

With plaque psoriasis, the most common type, you may notice red patches with well-defined edges — and, on the patches, silvery-white flakes that almost look like scales on a fish. “These are symmetrically distributed and may be itchy,” says Dr. Kassardjian.

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Sneaky Psoriasis Sign #3: Cuts That Grow Taller

“This is known as the Koebner phenomenon,” says Dr. Katta. “Patches of psoriasis may develop at areas of trauma to the skin, such as a cut or a scrape.”

Sneaky Psoriasis Sign #4: Bright Red Patches Where the Sun Don’t Shine

Inverse psoriasis is a subtype that affects areas where skin rubs together, such as the armpit or groin. “You may notice shiny, smooth, bright-red patches instead of scaly ones,” says Dr. Kassardjian.

Woman examining her scalp in the mirror.
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Sneaky Psoriasis Sign #5: Dandruff-like Flakes

Dandruff is caused by a dry scalp. The flakes are small and peel away from smooth skin. The flakes from psoriasis, on the other hand, tend to be thick.

“Look closely,” says Dr. Katta, “and you’ll notice that they’re originating from a raised red patch.”

Sneaky Psoriasis Sign #6: Nail Pitting

Psoriasis can cause excess growth in the nails too, says Dr. Katta. Watch for tiny pits or discoloration. Some people may experience a noticeable thickening of their nails as well.

Sneaky Psoriasis Sign #7: A Raindrop Rash

This is called Guttate psoriasis. “People tend to have sudden eruption of small, scaly, salmon-colored bumps on the torso, legs, and arms,” says Dr. Kassardjian. “They’re shaped like raindrops.”

In children and young adults, Guttate psoriasis often appears as a reaction to an infection like strep throat or chickenpox. When the infection clears, so does the psoriasis. However, Guttate psoriasis can become chronic as well.

Knee pain.
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Sneaky Psoriasis Sign #8: Cranky Joints

“Nearly 40 percent of people with psoriasis experience inflamed joints,” says Dr. Katta. “This can cause pain and swelling and even limit your activity.”

Luckily, there are exercises that can help with joint pain and keep you on the move.

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Sneaky Psoriasis Sign #9: Hand or Foot Blisters

Raised red patches on the palms or soles are common with psoriasis, but an unlucky few develop deep blisters or pustules within these patches, says Dr. Katta. This is known as palmoplantar pustular psoriasis.

Smokers are at higher risk for this type, because nicotine can cause inflammation in the sweat glands of the hands and feet.

Emily Shiffer
Meet Our Writer
Emily Shiffer

Emily Shiffer is a former digital web producer for Men’s Health and Prevention, and is currently a freelancer writer specializing in health, wellness, weight loss, and fitness. She is currently based in Pennsylvania and loves all things antiques, cilantro, and American history.