Carly Kirshen

Carly Kirshen I am a dermatologist specializing in skin diseases, with extensive experience in treating eczema, dermatitis, and psoriasis.

I focus on providing personalized treatment plans to help patients restore healthy, smooth skin and improve their quality of life

Psoriasis is a skin condition that causes flaky patches of skin which form scales.On brown, black and white skin the pat...
04/08/2025

Psoriasis is a skin condition that causes flaky patches of skin which form scales.
On brown, black and white skin the patches can look pink or red, and the scales white or silvery. On brown and black skin the patches can also look purple or dark brown, and the scales may look grey.
These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
Most people are only affected with small patches. In some cases, the patches can be itchy or sore.
Psoriasis affects around 2 in 100 people in the UK. It can start at any age, but most often develops in adults between 20 and 30 years old and between 50 and 60 years old. It affects men and women equally.
The severity of psoriasis varies greatly from person to person. For some it's just a minor irritation, but for others it can have a big impact on their quality of life.
Psoriasis is a long-lasting (chronic) disease that usually involves periods when you have no symptoms or mild symptoms, followed by periods when symptoms are more severe.
Why it happens
People with psoriasis have an increased production of skin cells.
Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days.
The resulting build-up of skin cells is what creates the patches associated with psoriasis.
Although the process is not fully understood, it's thought to be related to a problem with the immune system.
The immune system is your body's defence against disease and infection, but it attacks healthy skin cells by mistake in people with psoriasis.
Psoriasis can run in families, although the exact role genetics plays in causing psoriasis is unclear.
Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger.
Possible triggers of psoriasis include an injury to your skin, throat infections and using certain medicines.
The condition is not contagious, so it cannot be spread from person to person.
How psoriasis is diagnosed
A GP can often diagnose psoriasis based on the appearance of your skin.
You may be referred to a specialist in diagnosing and treating skin conditions (dermatologist) if your doctor is uncertain about your diagnosis, or if your condition is severe.
In rare cases, a small sample of skin called a biopsy will be sent to the laboratory for examination under a microscope.
If your doctor suspects you have psoriatic arthritis, which is sometimes a complication of psoriasis, you may be referred to a doctor who specialises in arthritis (rheumatologist).
You may have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken.

What causes eczema?Several factors cause eczema, including:Your immune system: If you have eczema, your immune system ov...
04/08/2025

What causes eczema?
Several factors cause eczema, including:
Your immune system: If you have eczema, your immune system overreacts to small irritants or allergens (triggers) in your environment. When you contact a trigger, your immune system assumes that these small irritants are foreign invaders, like bacteria or viruses, that can harm your body. As a result, the triggers activate your body’s natural defense system. Your immune system’s defense is to create inflammation. Inflammation causes symptoms of eczema on your skin.
Your genes: You’re more likely to have eczema if there’s a history of eczema or dermatitis in your family. You’re also at a higher risk if there’s a history of asthma, hay fever and/or allergies. Common allergies include pollen, pet hair or foods that trigger an allergic reaction. You could also have a genetic mutation that causes your skin’s barrier function to not work as it should.
Your environment: There’s a lot in your environment that can irritate your skin. Some examples include exposure to smoke, air pollutants, harsh soaps, fabrics such as wool, and some skin care products. Low humidity (dry air) can cause your skin to become dry and itchy. Heat and high humidity can cause sweating and that can make your itchiness even worse.
Emotional triggers: Your mental health could affect the health of your skin, which can cause a flare-up of eczema symptoms. If you have high levels of stress, anxiety or depression, you may have more frequent flare-ups of eczema symptoms.
What triggers eczema to flare up?
Eczema affects each person diagnosed with the condition differently. What causes your symptoms to flare up might not trigger someone else with the condition. Common triggers that cause eczema include:
Dry weather (low humidity).
Fabrics or clothing material.
Makeup or skin care products.
Smoke and pollutants.
Soaps and detergents.
Stress or your emotional well-being.
Touching something you’re allergic to.

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