Dermatology

Psoriasis

Psoriasis is an autoimmune disease that occurs when the body's immune system mistakes healthy cells for dangerous substances.

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What is Psoriasis?

Psoriasis is an autoimmune disease that occurs when the body's immune system mistakes healthy cells for dangerous substances.

It is a common skin condition that causes red patches of inflamed skin with silver-white scales, often on the elbows and knees, but also commonly affects the scalp, face and folds of skin (such as the back of your knees and elbows).

Skin cells typically grow deep inside the skin, and about once a month they rise to the surface. This process is accelerated in those suffering from psoriasis, which causes a build-up of dead skin cells on the surface of the skin.

In some severe cases of psoriasis, dermatologists may recommend medication and injections, which alter the immune response of the body, therefore suppressing the outbreak.

Whatever your personal requirements, you can rest assured that we will provide the leading consultants and techniques for your treatment at our state-of-the-art, purpose-built, central London facility in Chelsea.

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Words from our clients:


Why do people have this treatment?

Why do people have it & Who is suittable

There are a number of reasons why people seek psoriasis skin treatment.

  • Keep symptoms under control
  • Reduce the severity of flare ups
  • Relieve pain caused by psoriasis
  • Improve self-confidence and self-esteem
  • Reduce stress, anxiety and unhappiness
  • Lowers the risk of developing other health conditions, such as psoriatic arthritis, heart disease and depression

What are the symptoms of Psoriasis?

The main symptoms of psoriasis are

  • Inflamed, scaly skin
  • Patches of thick, raised skin
  • Silvery – coloured skin
  • Small, scaly spots
  • Hair loss (on the scalp)
  • Pitted, crumbly nails
  • Blisters 

The most common form of psoriasis is plaque psoriasis, and occurs in roughly 80-90% of cases. This manifests in raised, thickened, silvery skin in plaques of various sizes, with smaller plaques joined together to form larger plaques. Itchiness is a common feature of plaque psoriasis. Scratching it will make your symptoms worsen.

The other 10% - 20% of cases can be one of:

  • Guttate psoriasis: characterized by small, scaly pink bumps on the skin, typically on the torso, legs and arms
  • Inverse psoriasis: characterized by smooth red patches of skin that look raw, usually in places where skin touches skin, e.g. armpit, genitals, buttocks 
  • Pustular psoriasis: characterized by sore puss-filled bumps on the feet and the hands
  • Pustular psoriasis (generalized): a very rare life-threatening type of psoriasis where much of the skin’s surface flares up and is affected. Often accompanied by fever, headache, muscle weakness and other symptoms. Immediate medical care is necessary
  • Ethryodermic psoriasis: also life threatening and requiring of immediate medical attention. The skin on most of the body appears burnt, accompanied by fever
  • Nail psoriasis: characterized by pitted, crumbly nails and discolouration. Also nail lifting
  • Psoriatic arthritis: when the psoriasis affects the joints, again requiring immediate medical management

Where does Psoriasis form on the body?

Most commonly psoriasis forms in the following areas of the body:

  • Elbows
  • Knees
  • Scalp
  • Lower back

That said, depending on which type of psoriasis is present, psoriasis can appear almost anywhere in the body and even be generalised across the entire surface of the body's skin.


The cost of Psoriasis Treatment

Consultations From

£ 250

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We successfully treat hundreds of psoriasis cases each year
Our team of ten highly experienced specialist dermatologists have been handpicked to form one of the best independent dermatology units in the country

Our psoriasis specialists have the highest levels of training and qualifications

We work with major bodies and organisations to ensure standards are maintained. These include The British Association of Dermatologists (BAD), Royal College of Surgeons (RCS), Care Quality Commission (CQC) and the General Medical Council (GMC)

Our purpose-built dermatology clinic is conveniently located off Sloane Square, Chelsea


How can you treat Psoriasis?

Unfortunately, there is no cure for psoriasis, but there are a number of ways to manage the symptoms. Psoriasis treatment includes:

Creams, gels and lotions which are applied directly to the affected area of skin are best suited for mild to moderate cases of psoriasis.

There are various different types of topical solutions that can be used to manage psoriasis, depending on the severity of the condition and the parts of the body affected.

  • Emollients (moisturisers) are used to moisturise excessively dry skin, reducing scaling and relieving itching. These can be used with other psoriasis treatments.
  • Topical steroids work by reducing skin inflammation. These are available in various strengths and are often prescribed to help psoriasis on the face or in skin folds. However long-term use of steroid creams in the same place may lead to skin thinning (atrophy).
  • A topical steroid with a Vitamin D analogue such as Dovobet is a good treatment for plaque psoriasis on the body.
    Vitamin D analogues such as calcipotriol can be used on the face and in skin folds and creases to help regulate the immune response to slow down the rate of cell turnover.
  • Tar preparations, such as bath oils, creams, ointment and shampoos, were often used to treat psoriasis by slowing down the rate of cell turnover. Coal tar can be messy and stain clothing, and is now really only used for widespread small plaque psoriasis or guttate psoriasis.
  • Dithranol is another well-established treatment for thick plaques of psoriasis on hardier areas of the body, such as the elbows. It is now mostly used with a short contact regime of gradually increasing concentrations of Dithrocream. It also stains clothes.
  • Calcineurin inhibitors such as Tacrolimus or Pimecrolimus, which were originally developed to treat eczema, are often used on the face and to treat psoriasis in skin folds. Unlike steroid cream, this treatment does not carry a risk of skin thinning. 

Also known as phototherapy, this type of psoriasis treatment delivers a carefully measured dose of ultraviolet light to reduce the body’s immune response. This reduces inflammation of the skin. 

Types of light therapy for psoriasis include:

  • Narrowband ultraviolet B. This uses just a small part of the UVB spectrum.
  • Psoralens plus ultraviolet A or PUVA, which combines a light-sensitising medication with ultraviolet light treatment.
  • Light therapy can be used alongside topical psoriasis treatment. Regular light therapy treatments will be required.

Medications which are taken orally or injected are reserved for patients with the most serious cases of psoriasis which has not responded to other treatments. 

Your doctor may prescribe a psoriasis medication for a short burst and supplement with other treatment types. It is important to discuss a medication plan thoroughly with your doctor.

Types of psoriasis medication includes:

  • Methotrexate (pill)
  • Cyclosporin (pill)
  • Biologics (injections)
  • Medication to treat psoriasis comes with potentially severe side-effects. These will be discussed with you at length at your consultation with our London psoriasis specialist.

What to expect during your Psoriasis consultation at the Cadogan Clinic?

You will meet with one of our highly trained dermatologists at the Cadogan Clinic on Sloane Street, Chelsea for an in-person assessment of your skin.

Your consultant will discuss the following with you at this consultation:

  • The best options for treatment for you given your psoriasis condition, and the results that you would likely achieve with each treatment
  • An explanation of the treatment or treatment plan
  • Go through your past medical historyAnswer any questions you may have

3 Easy Steps

  • Visit the Clinic on Sloane Street, Chelsea for your in-person consultation with one of our dermatologists
  • Start your treatment plan
  • Return to the Clinic to see your dermatologist - if required - to monitor the progress of treatment 

Cadogan Clinic. A strong tradition of innovation

Founded in 2004 by world renown dermatologist Dr Susan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

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Psoriasis Specialists

We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.


What causes Psoriasis?

Psoriasis is a common skin complaint and affects roughly two percent of the population.

Psoriasis occurs when the body’s immune system goes into overdrive, with overactive white blood cells attacking the body’s healthy skin cells. This leads to an overproduction of new skin cells which pile up on the surface of the skin. This pile-up is known as psoriasis. 

It is not known exactly what causes psoriasis, although the condition is not contagious and does not run in families.

However psoriasis is more common in people with white Caucasian skin. Psoriasis can affect people of all ages, but it is most likely to appear first between the ages of 15 and 35 years old.

Although it is not known exactly what causes psoriasis, there are a number of environmental factors which are known to cause the condition to flare up. These are: 

Episodes of stress are known to cause psoriasis flare ups. The presence of psoriasis itself can often cause stress, leaving the patient in a vicious circle. Relaxation techniques, such as meditation, massage and breathing exercises, may be useful alongside your psoriasis treatment if stress is a known trigger for you.

Skin that has been injured or subject to trauma may develop psoriasis. Examples of skin injury include sunburn, cuts or insect bites. This is known as the Koebner response.

Bacterial or viral infections can also increase the likelihood of psoriasis developing. Children who frequently contract strep throat or other recurring infections are at a greater risk of psoriasis. People with HIV or other immune disorders are also at a greater risk.

Certain medications may put you at a greater risk of psoriasis. Medications that have been linked to psoriasis include lithium, beta-blockers, tetracycline, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and malaria drugs. Please do not stop taking any medications without speaking to your doctor first.

Cold dry air dries out the skin, making it more likely to split, crack and bleed. This can lead to infections.

  • Hormonal changes: Hormonal changes, such as puberty or the menopause, can cause women to have psoriasis flare ups.
  • Tobacco use: Smokers are at a higher risk of developing psoriasis. Smoking can also make existing psoriasis worse and much more difficult to treat. Second-hand smoke can exacerbate psoriasis flare-ups.
  • Alcohol use: Although it is not fully understood why, drinking alcohol can cause psoriasis to flare up. It can also make certain psoriasis medications less effective.
  • Obesity: Being overweight or obese is a risk factor for developing psorasis and can make the condition worse if you already have it. However even a small amount of weight loss can help to alleviate patches of sore, itchy, dry skin.

What are the symptoms?

Psoriasis can appear on almost any part of the body, but there are certain areas which are particularly prone to psoriasis. These include the elbows, knees, scalp and lower back.

The symptoms of psoriasis vary depending on whereabouts on the body it develops.

The main symptoms of psoriasis are:

  • Inflamed, scaly skin
  • Patches of thick, raised skin
  • Silvery–coloured skin
  • Small, scaly spots
  • Hair loss (when psoriasis is on the scalp)
  • Pitted, crumbly nails
  • Blisters

There are several different types of psoriasis. Most people have only one of these at a time, although sometimes two different types can occur together. It is not unusual for one form to change into another or worsen. Cases of psoriasis tend to go through cycles, causing problems for weeks or months before easing. The different types of psoriasis are:

This is the most common form of psoriasis, occurring in roughly 80-90 percent of cases. Plaque psoriasis presents as raised, thickened, silvery skin in plaques. The plaques come in various sizes, with smaller plaques joined together to form larger plaques. Itchiness is common in plaque psoriasis, but scratching will make symptoms worse. In the most severe cases, the skin around the joints may crack and bleed.

This can affect all or part of the scalp. Scalp psoriasis presents as red patches of skin, covered in thick, silvery-white coloured scales. Some people may find it itchy, while others don’t. In severe cases, scalp psoriasis may cause temporary hair loss.

Characterised by small, scaly pink bumps on the skin, guttate psoriasis is typically found on the torso, legs and arms. Sometimes this form of psoriasis can disappear completely after a few weeks. It is most commonly found in children and teenagers.

Otherwise known as flexural psoriasis, this type of psoriasis is typically found in folds of skin where the skin touches, such as the armpits, breasts, buttocks and around the genitals. This form of psoriasis is characterised by smooth, red patches of skin that appear raw. Friction and sweating can make inverse psoriasis feel worse, particularly during the summer months.

This type of psoriasis leaves a patient with sore, pus-filled bumps on the feet and the hands.

This is a very rare life-threatening type of psoriasis. This condition affects much of the skin’s surface and a flare up is often accompanied by fever, headache, muscle weakness and other symptoms. Immediate medical care is required.

Although rare, erythrodermic psoriasis is life-threatening and also requires immediate medical attention. This form causes intense itching and burning, causing the body to lose fluid and proteins. This can lead to dehydration, hypothermia, infection, or even heart failure.

Pustules appear on the soles of the feet and palms of the hands before developing into brown scaly spots which can be peeled off.

Pustules appear on the fingers and toes before bursting, leaving bright red areas of skin that may turn scaly or ooze.

In roughly half of the people who suffer from psoriasis, the condition affects the nails. This leads to pitted, dented or discoloured nails. Nails can become loose from the nail bed and, in the most serious cases, the nails may crumble.

This occurs when psoriasis affects the joints, causing them to become stiff, swollen and painful. The condition can get progressively worse if not treated and in severe cases, the joints may become permanently damaged. This condition requires immediate medical management.


Frequently Asked Questions

Psoriasis is a chronic inflammatory condition of the skin which affects 2% of the population and causes an increase in the rate of the cell turnover.

The normal rate of cell turnover is around a month but in psoriasis, it can be as little as 3-4 days. This causes a build-up of skin cells which cannot be shed normally and typically presents as well-demarcated pink or red plaques with a superficial silvery scale.

The plaques tend to be symmetrical and most often occur on the knees, elbows and shins but can occur anywhere on the body. The scalp and flexures of the axillae (armpits) and groin may also be affected. Psoriasis can also affect the nails which classically have tiny depressions or pits and with separation of the distal nail margin from the underlying nail plate and may be associated with arthritis (joint pains).

Psoriasis is due to an immune system dysfunction and is not something you can catch nor is it contagious. It is mediated by T-cells, a class of white blood cells which usually fend off attacks from viruses and bacteria, but with psoriasis the T-cells attack the healthy skin stimulating the increased production of new skin cells and causing inflammation.

The cause of the T-cell malfunction is thought to be a genetic predisposition and environmental factors. There is often a positive family history of psoriasis and the environmental causes include:

  • Infection: especially a streptococcal sore throat which can trigger the onset of psoriasis and precede subsequent flares
  • Stress: this can trigger or aggravate psoriasis
  • Medication: prescribed medication for high blood pressure such as beta blockers can be associated with psoriasis as can
  • Lithium and stopping strong oral or topical steroids
  • Alcohol: excess alcohol intake is associated with bad psoriasis.
  • Obesity
  • Smoking
  • Trauma: psoriasis plaques localize to areas of skin trauma such as a scar. The medical term for this is called
  • Koebnerisation.

Psoriasis is a chronic disease that flares and subsides intermittently over life. While there is no cure for psoriasis (meaning the condition cannot be eradicated completely so a future flare-up never occurs), there are many ways to manage the symptoms.

Topical treatment is best suited for mild to moderate cases of psoriasis and consists of creams, ointments or gels. Sometimes topical treatment will be used as a supplement to a larger medical plan for severe psoriasis.

These can include:

  • Emollients or moisturizers to moisturize dry skin, reduce scaling and relieve itching. These are first-line treatment and can be used with other psoriasis treatments.
  • Topical steroids work by reducing skin inflammation. Mild strength topical steroid creams can be useful for flexural and facial psoriasis but their use needs to be monitored as they can cause skin atrophy (thinning ) if overused.
  • A topical steroid with a Vitamin D analogue such as Dovobet is a good treatment for plaque psoriasis on the body
  • Vitamin D analogues such as calcipotriol can be used on the face and for flexural psoriasis, help regulate the immune response to slow down the rate of cell turnover
  • Coal Tar slows down the rate of cell turnover and has been a treatment for psoriasis for many years but has a distinctive smell, stains clothes and is now mostly used for widespread small plaque psoriasis or guttate psoriasis characterized by widespread small patches of inflamed skin.
  • Dithranol is another well-established treatment for thick plaques of psoriasis on the limbs. It is now mostly used with a short contact regime of gradually increasing concentrations of Dithrocream. It also stains clothes.
  • Calcineurin inhibitors such a Tacrolimus or Pimecrolimus originally developed to treat eczema and used on the face and for flexural psoriasis.

Psoriasis often improves in the summer and on exposure to sunlight.

Light Therapy, also known as phototherapy, harnesses the power of ultraviolet light often in combination with topical treatment if topical treatment alone has not been effective.

Types of light therapy for psoriasis include:

  • Narrowband ultraviolet B
  • Psoralens plus ultraviolet A or PUVA which combines a light-sensitizing medication with ultraviolet light treatment.

Systemic treatment for psoriasis through medication is typically reserved for severe cases or those which have not responded to topical treatments with phototherapy. This is because medication to treat psoriasis are accompanied by potentially severe side effects.

Your doctor may prescribe a psoriasis medication for a short burst and supplement with other treatment types. It is important to discuss a medication plan thoroughly with your doctor.

Psoriasis medications are either taken orally via pill or by injection. Types of these medications include

  • Methotrexate (oral pill)
  • Cyclosporin(oral pill)
  • Biologics (injections)

Research indicates that drinking alcohol is a common trigger for psoriasis, and can increase the likelihood of a flare-up in an individual disposed to psoriasis.

This is not always the case, however, and psoriasis can be triggered by a variety of other emotional, environmental and medical factors.

It is also true that people who do not drink alcohol can suffer from psoriasis.

There is evidence that psoriasis is genetic and it is common that psoriasis sufferers also have family members who suffer from the condition.

This is a very common disorder, however, impacting roughly 2% of the population and variety of other causes are also known to be associated beyond genetics, including an array of environmental and medical causes.

Psoriasis is not contagious. It is caused by an over active immune system, so cannot be given to somebody else.

Typically psoriasis is not dangerous when experienced in mild form.

That said, psoriasis can be a very dangerous condition, particularly when symptoms are generalised (as opposed to localised) and very severe.

If you suffer from psoriasis you should seek a professional medical opinion.

Psoriasis is a chronic condition, which in some cases can severely impact upon a person’s quality of life. If left untreated, it is unlikely that psoriasis will disappear permanently of its own accord.

The goal of psoriasis treatment is to reduce the symptoms and end the flare up. If treatments are successful, psoriasis may go into remission.

However it is worth remembering that psoriasis is highly unpredictable. Remission can be a lengthy process and symptoms may be absent for months or years. But it can also be short-lived and symptoms may return within a few weeks.

Psoriasis is more likely to go into remission if it is treated. One of our psoriasis specialists will be able to advise on which treatment will be best for you.

Psoriasis is a chronic condition. There is no cure for psoriasis. Some treatments can control the condition permanently, or even prompt long remissions.

But since psoriasis is linked to genetic makeup, we do not have a permanent cure for the disease.

Whilst your results may essentially prove permanent, treatments are only able to control the disease and are not able to fully cure it.

It will not be known at the outset whether your treatment is able to deliver permanent results for you

Psoriasis and eczema are common skin conditions, but it is often difficult for the untrained eye to tell the difference between the two conditions.

Eczema makes the skin red and inflamed, it may be scaly, oozing, or crusty and some sufferers may find that they have rough, leathery patches on the skin. Psoriasis can also cause red patches, which may also be silvery, scaly and raised. The skin is thicker and is more inflamed in a person with psoriasis.

You will need to seek a professional medical opinion from a trained dermatologist to understand your skin condition if you are unsure.


A state of the art, award winning clinic.

Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

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Best in class facilities

All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated aesthetics and laser suite, and a full team of specialist nursing staff.

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World class consultants

We have handpicked over 100 of the leading consultants in our field to practice with us, and now help over 20,000 patients each year. We also welcome leading international consultants from the US & Europe regularly to the Clinic.

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Strong tradition of innovation

We were founded in 2004 by world dermatologist Dr Susan Mayou, best known for founding the British Association of Cosmetic Dermatologists and introducing the first Mole Check service to be approved by the British Skin Foundation in the UK. We continue to collaborate with pioneers in our field.

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The Cadogan Clinic is based at 120 Sloane Street in Chelsea, just off Sloane Square and the Kings Road.

We are accessible by all major bus routes that pass through Sloane Square and Sloane Street, as well as Sloane Square tube station.

We are just a 5 minute walk northwards up Sloane Street once you have arrived at Sloane Square.

Local pay parking is available just around the corner from the Clinic on Cadogan Gate, Cadogan Square and Cadogan Gardens. Our local residential parking zone is the Royal Borough of Kensington & Chelsea.

Address: 120 Sloane Street, Chelsea, London, SW1X 9BW


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