Psoriasis – managing flares and looking after your skin
What psoriasis is, why it is not contagious, the treatments that work from creams upward, and the joint and heart risks that come with it.
What psoriasis is
Psoriasis is a long-term condition in which the immune system drives skin cells to build up far faster than normal. The result is thickened, scaly patches, often on the elbows, knees, lower back and scalp, sometimes itchy or sore. It comes and goes in flares.
What sets off a flare
- Stress, which is both a trigger and a consequence.
- Infections, particularly throat infections.
- Skin injury — a cut, a scratch, sunburn or a tattoo can bring up a patch in that exact spot.
- Smoking and heavy alcohol use, both of which also make treatment work less well.
- Some medicines, including certain blood-pressure and mood medicines. Never stop one yourself; ask whether it could be contributing.
- Cold, dry weather for many people; sunlight in moderation often helps, though sunburn does not.
Treatment, step by step
Most psoriasis is managed with creams and ointments. Moisturising heavily is the foundation — it softens scale, reduces itch and makes everything else work better. Beyond that, treatment steps up according to how much skin is involved and how much it affects daily life.
Treatments used for psoriasis in South Africa, from topical to systemic:
Aqueous Cream BP / Emollient — Aqueous Cream Lennon, E45, Epizone
Dry skin; eczema (as emollient/moisturiser and soap substitute)
Coal Tar Preparation — T/Gel, Polytar
Psoriasis; seborrhoeic dermatitis; scalp conditions
Betamethasone Cream — Betnovate, Diprosone, Celestoderm, Diproderm
Moderate to severe eczema; psoriasis; inflammatory skin conditions
Clobetasol Propionate — Dermovate, Clarelux
Severe eczema; psoriasis; lichen planus; discoid lupus
Methotrexate — Abitrexate, Methoblastin
Rheumatoid arthritis; psoriasis; psoriatic arthritis; ectopic pregnancy
Acitretin — Neotigason
Severe psoriasis; severe keratinisation disorders
- Scalp psoriasis needs a preparation designed for the scalp; ordinary creams do not get through hair.
- Phototherapy — controlled ultraviolet light at a hospital — helps many people with widespread psoriasis.
- Tablets and injections that act on the immune system are used for severe disease and need regular blood-test monitoring.
The parts people are not told about
- Joints. Some people with psoriasis develop psoriatic arthritis — stiff, swollen, painful joints, often worse in the morning. Report joint symptoms early; treating it early protects the joints.
- Heart and metabolism. Psoriasis is associated with a higher risk of high blood pressure, diabetes and heart disease, so blood-pressure and glucose checks are part of managing it.
- Mood. Depression is common with visible skin disease and is treatable. It is a reasonable thing to raise at a skin appointment.
Common questions
- Is psoriasis contagious?
- No. It is an immune-driven condition, not an infection. You cannot catch it or pass it on by touch, sharing towels or swimming.
- Can psoriasis be cured?
- There is no cure, but it is very treatable. Most people control it with heavy moisturising plus prescribed topical treatment, stepping up to light therapy or systemic medicines when more skin is involved.
- Why do my joints hurt with psoriasis?
- Some people with psoriasis develop psoriatic arthritis, causing stiff, swollen joints that are often worse in the morning. Tell your clinician early — treating it early helps protect the joints.
Sources
- Adult Hospital Level Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines Online Directory and approved patient information leafletsSouth African Health Products Regulatory Authority
- Adult Primary Care guide: symptom-based integrated approach to the adult in primary careNational Department of Health, South Africa
Last reviewed 11 August 2026.