Is psoriasis contagious?

No. Psoriasis is an immune-mediated inflammatory condition, not an infection. It cannot be passed from person to person through skin contact, sharing towels, swimming pools or any other route. Patients with visible plaques sometimes face stigma in public settings — the condition is harmless to those around them.

How is psoriasis different from eczema or seborrhoeic dermatitis?

Plaque psoriasis typically has well-demarcated red plaques with thick silvery scale, sharp borders, and a preference for extensor surfaces (elbows, knees), scalp, lower back and nails. Eczema is usually itchier with less well-defined edges, prefers flexures (inner elbows, behind knees) and often has a personal or family history of atopy. Seborrhoeic dermatitis has finer yellow-greasy scale concentrated in oily zones (scalp, sides of nose, eyebrows). When the pattern is mixed, doctor-led assessment — sometimes with biopsy — is how the diagnosis gets settled.

Can stress trigger psoriasis flares?

Yes. Psychological stress is a well-recognised trigger for psoriasis flares, alongside skin injury (the Koebner phenomenon), streptococcal throat infections, certain medications, smoking and weight gain. Stress is rarely the sole driver but commonly tips an underlying tendency into a flare. Stress management strategies are a useful part of the long-term plan alongside medical treatment.

What are the different types of psoriasis?

Plaque psoriasis is the most common form (around 80 to 90% of cases) — the classic thick-scale red plaques on extensor surfaces. Guttate psoriasis shows small drop-shaped lesions, often after a streptococcal sore throat in younger patients. Inverse psoriasis appears as smooth red patches in skin folds without thick scale. Pustular psoriasis features sterile pustules on red skin, sometimes localised to the palms and soles. Erythrodermic psoriasis — widespread redness affecting most of the body surface — is uncommon but a medical emergency. Nail and scalp psoriasis can occur with any of the above.

Should I be screened for psoriatic arthritis?

Yes — joint screening is part of long-term psoriasis care. Approximately 20 to 24% of psoriasis patients develop psoriatic arthritis, which can cause permanent joint damage if untreated. Patterns to watch for include persistent joint pain, morning stiffness lasting more than 30 minutes, sausage-like swelling of fingers or toes (dactylitis), and significant nail changes. Mention any joint symptoms at your review — earlier diagnosis improves outcomes.

Is NB-UVB phototherapy safe long-term?

Narrowband UVB is generally well-tolerated and considered the clinical gold standard for widespread or treatment-resistant psoriasis. Long-term use does involve cumulative UV exposure, so dosing and total session counts are monitored by the treating clinic. Skin cancer risk with NB-UVB appears lower than with older UVA-based regimens, but the cumulative dose remains a clinical consideration — particularly in patients with photodamaged skin, prior skin cancers or immunosuppression. Risk-benefit is discussed at the time of referral.

Will my children inherit psoriasis?

Genetics play a meaningful role — psoriasis often runs in families. The lifetime risk for a child increases when one or both parents are affected, but inheritance is polygenic rather than single-gene, and many patients have no family history at all. Family history does not guarantee a child will develop psoriasis, and most family members of psoriasis patients never develop the condition.

Do I need a referral?

No referral is required. You can book directly. A referral from your GP, rheumatologist or other treating clinician is welcome — it helps with collegial communication, continuity of care, and is sometimes required for biologic and other specialist-initiated therapies. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

Immune-mediated skin disease

Psoriasis

Name: Psoriasis Treatment Melbourne — The Skin Doctor
Published: 2026-06-06

Psoriasis is a chronic, immune-mediated inflammatory disease characterised by rapid acceleration of skin cell turnover. While healthy skin cells take about a month to cycle, psoriatic skin cells reach the surface in just a few days, resulting in thickened, red plaques and silvery scale. At The Skin Doctor we manage psoriasis as a medical condition requiring long-term oversight — providing accurate diagnosis, managing localised flares, and coordinating modern treatments to find the safest path for your skin health.

By Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA

Last reviewed 2026-06-06 · Editorial policy

In brief

Psoriasis is a chronic, immune-mediated inflammatory disease driven by rapid skin cell turnover.
Precision diagnosis matters — psoriasis can mimic eczema, seborrhoeic dermatitis and even Bowen's disease (SCC in situ).
First-line topicals include corticosteroids, vitamin D analogues, calcineurin inhibitors and keratolytics.
NB-UVB phototherapy is the clinical gold standard for widespread or treatment-resistant disease; we coordinate referral.
Advanced therapies (oral immunomodulators, biologics, oral retinoids) are managed through shared care with consultant dermatologists.
Approximately 20–24% of psoriasis patients develop psoriatic arthritis — active joint screening is part of long-term care.
LED is supportive, not a replacement for medical phototherapy in clearing thick plaques.

Precision diagnosis — the first step to control

Expert psoriasis care begins with distinguishing the condition from look-alike rashes. Psoriasis can frequently be mistaken for eczema, seborrhoeic dermatitis, or even certain types of skin cancer such as Bowen’s disease / SCC in situ. ^(1,2)

Dr Chris performs a detailed clinical assessment — and skin biopsies where necessary — to ensure your treatment pathway is built on a definitive medical diagnosis rather than guesswork.

Management pathways

Medical topicals (first line)

For mild to moderate psoriasis, topical treatments are the foundation of care. Beyond simple moisturisers, evidence-based agents are prescribed tailored to body area:

corticosteroids and vitamin D analogues — reduce inflammation and slow cell turnover
calcineurin inhibitors — for sensitive areas such as the face or skin folds
keratolytics — gently remove heavy scaling so other treatments can penetrate

LED light therapy (symptomatic support)

Low-level LED light therapy (red and near-infrared) is used as a supportive adjunct. While LED is not a replacement for medical phototherapy in clearing thick plaques, it can provide valuable symptomatic relief by:

reducing localised redness and inflammation
managing the itch associated with active flares
supporting the skin barrier during recovery

Medical phototherapy

For widespread or treatment-resistant psoriasis, Narrowband UVB (NB-UVB) is considered the clinical gold standard. While not provided on-site at our clinic, it is important for patients to understand this option:

how it works — specific wavelengths (311 to 313 nm) “quiet” overactive T-cells in the skin ^(1,4)
when it is used — when more than 10% of the body is affected, or when topicals fail ⁽⁶⁾
safety — requires clinical monitoring to track cumulative UV exposure

Advanced treatment options

For severe psoriasis that impacts quality of life, there are several advanced systemic therapies. These typically require coordination with a consultant dermatologist for initial prescription, but understanding the options is key to informed care:

oral immunomodulators — medications such as methotrexate or ciclosporin that work systemically to reduce immune activity
biological therapies (biologics) — highly targeted injectable treatments (TNF inhibitors, IL-17 and IL-23 inhibitors) designed to block the specific proteins driving the psoriasis cycle
oral retinoids — used in specific types of psoriasis to help normalise skin cell growth

At The Skin Doctor we provide the necessary medical screening, blood monitoring and shared-care coordination for patients navigating these advanced therapies.

Psoriasis and systemic health (psoriatic arthritis)

Psoriasis is a systemic condition. Approximately 20 to 24% of patients may develop psoriatic arthritis, which can lead to permanent joint damage if left untreated. ⁽⁵⁾ We actively screen psoriasis patients for:

persistent joint pain, stiffness, or “sausage-like” swelling of fingers or toes
morning stiffness lasting longer than 30 minutes
significant nail changes — pitting or lifting

If you notice any of these symptoms alongside psoriasis, please mention them at your next review so the joint pattern can be assessed and referred appropriately.

Symptoms

Well-demarcated red or pink plaques with overlying silvery-white scale — the classic plaque pattern.
Common sites are the extensor surfaces (elbows, knees), scalp, lower back, behind the ears and around the navel.
Itch is variable — present in many patients but less universal than in eczema; some plaques are remarkably non-itchy.
Nail involvement is common — pitting, "oil-drop" discolouration, onycholysis (lifting from the nail bed) and nail thickening.
Auspitz sign — pinpoint bleeding when the scale is gently removed from a plaque.
Koebner phenomenon — new plaques appearing at sites of skin trauma (scratches, surgical scars, sunburn).
Inverse (flexural) pattern — smooth, shiny red patches in skin folds (groin, axillae, under breasts, gluteal cleft) without the thick scale of plaque psoriasis.
Guttate pattern — small drop-shaped pink or red papules and plaques scattered across the trunk and limbs, often after a streptococcal sore throat.
Palmar-plantar involvement — thick scale, fissures and discomfort on the palms and soles, sometimes with sterile pustules (pustular psoriasis).
Joint symptoms — persistent pain, stiffness or "sausage-like" swelling of fingers or toes can indicate psoriatic arthritis (occurs in roughly 20 to 24% of patients).
Pattern fluctuates over months and years — flares are interspersed with quieter periods.

Causes & contributors

Immune dysregulation — overactive T-cell response driving rapid skin cell turnover
Strong genetic component
Psychological stress
Skin injury (the Koebner phenomenon — psoriasis appearing at sites of trauma)
Infections, particularly streptococcal throat infection (often triggers guttate psoriasis)
Certain medications
Smoking, obesity and metabolic factors

Diagnosis

Expert psoriasis care begins with distinguishing the condition from look-alike rashes. Psoriasis can frequently be mistaken for eczema, seborrhoeic dermatitis, or even certain types of skin cancer (such as Bowen's disease / SCC in situ). Dr Chris performs a detailed clinical assessment — and skin biopsies where necessary — to ensure your treatment pathway is built on a definitive medical diagnosis rather than guesswork.

Treatment options

Medical topicals (first line)

For mild-to-moderate psoriasis, topical treatments are the foundation of care. Corticosteroids and vitamin D analogues reduce inflammation and slow cell turnover. Calcineurin inhibitors are used for sensitive areas such as the face and skin folds. Keratolytics gently remove heavy scaling so other treatments can penetrate.

LED light therapy (symptomatic support)

Low-level red and near-infrared LED therapy is used as a supportive adjunct. It is not a replacement for medical phototherapy in clearing thick plaques, but it can reduce localised redness, manage itch during active flares, and support skin barrier recovery.

Medical phototherapy (NB-UVB)

Narrowband UVB phototherapy (311–313 nm) is the clinical gold standard for widespread or treatment-resistant psoriasis. While not provided on-site, we coordinate referral and shared care. It quiets overactive T-cells in the skin and requires clinical monitoring of cumulative UV exposure.

Oral immunomodulators

Methotrexate or ciclosporin work systemically to reduce immune activity. Typically initiated by a consultant dermatologist; we provide medical screening, blood monitoring and shared-care coordination.

Biological therapies

Highly targeted injectable treatments (TNF inhibitors, IL-17 and IL-23 inhibitors) designed to block the specific proteins driving the psoriasis cycle. Specialist-initiated with shared-care follow-up.

Oral retinoids

Used in specific types of psoriasis (including pustular forms) to help normalise skin cell growth.

Psoriatic arthritis screening

Approximately 20–24% of patients may develop psoriatic arthritis. We actively screen for persistent joint pain, stiffness, "sausage-like" swelling of fingers or toes, morning stiffness longer than 30 minutes, and significant nail changes.

When to see a doctor

See a doctor for any persistent thickened red plaques with scale, scalp scale that doesn't respond to dandruff treatments, nail changes (pitting, lifting), or joint symptoms accompanying a skin rash. Because psoriasis can mimic eczema, seborrhoeic dermatitis and some types of skin cancer (including Bowen's disease / SCC in situ), accurate diagnosis is essential before committing to long-term treatment.

Frequently asked questions

Is psoriasis contagious?

No. Psoriasis is an immune-mediated inflammatory condition, not an infection. It cannot be passed from person to person through skin contact, sharing towels, swimming pools or any other route. Patients with visible plaques sometimes face stigma in public settings — the condition is harmless to those around them.
How is psoriasis different from eczema or seborrhoeic dermatitis?

Plaque psoriasis typically has well-demarcated red plaques with thick silvery scale, sharp borders, and a preference for extensor surfaces (elbows, knees), scalp, lower back and nails. Eczema is usually itchier with less well-defined edges, prefers flexures (inner elbows, behind knees) and often has a personal or family history of atopy. Seborrhoeic dermatitis has finer yellow-greasy scale concentrated in oily zones (scalp, sides of nose, eyebrows). When the pattern is mixed, doctor-led assessment — sometimes with biopsy — is how the diagnosis gets settled.
Can stress trigger psoriasis flares?

Yes. Psychological stress is a well-recognised trigger for psoriasis flares, alongside skin injury (the Koebner phenomenon), streptococcal throat infections, certain medications, smoking and weight gain. Stress is rarely the sole driver but commonly tips an underlying tendency into a flare. Stress management strategies are a useful part of the long-term plan alongside medical treatment.
What are the different types of psoriasis?

Plaque psoriasis is the most common form (around 80 to 90% of cases) — the classic thick-scale red plaques on extensor surfaces. Guttate psoriasis shows small drop-shaped lesions, often after a streptococcal sore throat in younger patients. Inverse psoriasis appears as smooth red patches in skin folds without thick scale. Pustular psoriasis features sterile pustules on red skin, sometimes localised to the palms and soles. Erythrodermic psoriasis — widespread redness affecting most of the body surface — is uncommon but a medical emergency. Nail and scalp psoriasis can occur with any of the above.
Should I be screened for psoriatic arthritis?

Yes — joint screening is part of long-term psoriasis care. Approximately 20 to 24% of psoriasis patients develop psoriatic arthritis, which can cause permanent joint damage if untreated. Patterns to watch for include persistent joint pain, morning stiffness lasting more than 30 minutes, sausage-like swelling of fingers or toes (dactylitis), and significant nail changes. Mention any joint symptoms at your review — earlier diagnosis improves outcomes.
Is NB-UVB phototherapy safe long-term?

Narrowband UVB is generally well-tolerated and considered the clinical gold standard for widespread or treatment-resistant psoriasis. Long-term use does involve cumulative UV exposure, so dosing and total session counts are monitored by the treating clinic. Skin cancer risk with NB-UVB appears lower than with older UVA-based regimens, but the cumulative dose remains a clinical consideration — particularly in patients with photodamaged skin, prior skin cancers or immunosuppression. Risk-benefit is discussed at the time of referral.
Will my children inherit psoriasis?

Genetics play a meaningful role — psoriasis often runs in families. The lifetime risk for a child increases when one or both parents are affected, but inheritance is polygenic rather than single-gene, and many patients have no family history at all. Family history does not guarantee a child will develop psoriasis, and most family members of psoriasis patients never develop the condition.
Do I need a referral?

No referral is required. You can book directly. A referral from your GP, rheumatologist or other treating clinician is welcome — it helps with collegial communication, continuity of care, and is sometimes required for biologic and other specialist-initiated therapies. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

References

Related conditions

Medically reviewed by Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA · Last reviewed 2026-06-06 · Editorial policy