• Psoriasis
• Psoriatic Arthritis
• Rashes

Is Psoriasis Genetic?

Medically reviewed and edited by Harmony Vance, APRN

Psoriasis can be a mentally and emotionally taxing condition, particularly because it may be visible to others.

Having this chronic disease can significantly reduce your quality of life, especially if your symptoms include itching or pain in the affected areas.

If you have psoriasis, it’s possible that you’re wondering if this condition is genetic.

People with a family history of the condition are more likely to develop it. However, you don’t have to have a genetic history of psoriasis to get it.

In this article, we discuss the relationship between psoriasis and genetics, as well as the treatment options available for those who have it.

What is Psoriasis?

Psoriasis is an inflammatory skin disease that affects over seven million Americans.

It is an autoimmune disease that occurs when the body attacks its cells because it mistakes the growth of new skin cells as foreign invaders.

White blood cells called T helper lymphocytes (T-cells) attack these new skin cells, causing them to overproduce. The new skin cells move to the surface and then force existing ones out.

This excessive cell production results in plaques, which are red and inflamed patches on the skin.

Psoriasis tends to go through cycles where it flares up, and symptoms become more severe. It then may go into remission, where symptoms are reduced or disappear completely.

It’s not completely understood why the immune system attacks skin cells. However, research suggests that both genetics and environmental factors may be involved.

What are the Different Types of Psoriasis?

There are several different forms of psoriasis, each with its own characteristics.

Guttate psoriasis

Small, drop-like lesions on the upper torso that are most frequently found in young adults.

Psoriatic arthritis

A long-term inflammatory arthritis that includes swelling of the fingers and toes.

Generalized pustular psoriasis

A very rare type of psoriasis that usually covers the entire body with pus-filled blisters.

Inverse psoriasis

Red patches in the folds of the skin that often present as red or pink marks in lighter skin tones and purple in darker skin tones.

Psoriatic onychodystrophy

This is psoriasis that affects the nails. It is a very common condition in people who also have psoriatic arthritis.

Seborrheic-like psoriasis

A skin condition that overlaps with seborrheic dermatitis – a health problem that affects the scalp. These conditions share similar symptoms, including itchiness, flaking, and scalp inflammation.

Erythrodermic psoriasis

Erythrodermic psoriasis is the rarest form of psoriasis. It causes the entire body to appear red. Scalp psoriasis

This is usually characterized by patches of psoriasis that form on the scalp. They are typically itchy and painful.

Pustular psoriasis

These are blisters that appear anywhere on the body and are accompanied by scaly skin.

Psoriasis vulgaris

This is the most common form of psoriasis that causes patches of inflamed and scaly skin.

Plaque psoriasis

Dry, itchy, and raised skin patches, usually appearing on the elbows and knees.

What Causes Psoriasis?

Although more research is required, there are two main factors that are believed to cause individuals to develop psoriasis.

Genetic factors

Several genetic studies have found that psoriasis can be passed from one generation to another.

Individuals have a higher disease susceptibility — which means they are predisposed to developing psoriasis — if one of their parents has it.

In fact, according to the National Psoriasis Foundation (NPF), you have a 28% chance of developing psoriasis if one of your parents has the condition.

If both of your parents have psoriasis, you have a 65% chance of experiencing this hereditary disease.

It’s rare to develop psoriasis without a family history of this condition, but it is possible in some cases.

Environmental factors

Researchers have found that genetic causes and environmental triggers must interact for someone to develop psoriasis.

Some examples of environmental risk factors for developing psoriasis include smoking, alcohol consumption, and being overweight. We will unpack more of these later in this article.

Psoriasis Research and Discoveries

Let’s take a look at some of the research that has been done regarding psoriasis, skin cells, and genetics.

What we know about psoriasis cells

Firstly, several studies have found that the skin cells affected by the condition contain a high number of cytokines. These are cell proteins that trigger the inflammatory process.

The second thing we know about psoriasis and genetics is that the skin cells contain gene mutations called alleles.

Alleles are the genes that define our physical traits and characteristics. These genes increase your psoriasis susceptibility locus — a chromosome that is inherited with an illness in families.

What we know about genes

One specific allele is called HLA-Cw6, which is the gene that is now believed to cause psoriasis.

Newer studies have identified two additional genes that may lead to psoriasis:

• CARD14: Changes in this gene can result in high levels of inflammation in the body

• IL23R: This plays a role in the function of the immune system and also increases the inflammatory response in the body

The Complex Connection Between Genetics and the Environment

Let’s take a closer look at the environmental risk factors associated with this skin condition.

Hormonal changes

Research suggests that when women develop psoriasis, it may be a result of hormonal shifts, particularly during puberty, menopause, and pregnancy.

One study found that the introduction of new sex hormones in the body during puberty may trigger or worsen existing psoriasis.

Women going through menopause experience reduced estrogen levels, which has been identified as a trigger for psoriasis symptoms. This is especially true for women who already have the condition.

Lastly, pregnant women have an increased risk of developing psoriasis. Researchers believe this is due to the drop in levels of estrogen and progesterone once their baby is born.

Medications

Some medications may trigger the onset of psoriasis or cause a flare-up of symptoms. In some cases, even after stopping the medication, people will still develop this condition.

According to one study, some medications that may trigger psoriasis include:

• Beta-blockers

• Lithium

• Antibiotics

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

It’s possible for these medications to worsen symptoms of psoriasis because they impact inflammation in the body.

Smoking and alcohol consumption

Both smoking and consuming excessive amounts of alcohol are linked to the development of this skin disease.

Smoking may stimulate the production of the cytokines we discussed earlier, triggering psoriasis.

Studies have shown that when individuals stop smoking, their psoriasis risk lowers.

Stress and anxiety

It is believed that stress and anxiety can worsen psoriasis.

This is because the body responds to stress the same way it does to physical health problems — by creating inflammation. This increased inflammation may cause psoriasis or make it worse.

Since psoriasis is a visible skin condition, flare-ups can be very stressful. This stress, in turn, can make psoriasis worse.

Climate

While weather may not directly cause psoriasis, it’s known that seasonal changes can affect the severity of the condition.

Some research has found that people with psoriasis tend to have clearer skin in warmer months and more symptoms in winter.

Infection or injury

When people have infections, their levels of cytokines increase, which can cause psoriasis.

For example, people with HIV are more likely to develop psoriasis. Strep throat, retroviruses, and papillomaviruses are also linked to psoriasis.

Injury to the skin, also called skin trauma, can trigger psoriasis. Things like sunburn, insect bites, or even a bad scratch can result in psoriasis symptoms due to inflammation.

Obesity

Your weight can increase the risk of developing psoriasis. Being overweight can often result in something called metabolic syndrome — a cluster of health conditions — which is known for causing psoriasis.

One study found that 20 to 50% of people with psoriasis also have metabolic syndrome.

Both metabolic syndrome and psoriasis have the same underlying factors, one of which is inflammation. As discussed earlier, inflammation in the body can trigger psoriasis.

When Should I Seek Medical Attention for Psoriasis?

Severe psoriasis can cause the skin around your joints to crack and bleed, which could lead to infections. This is why it’s vital to seek treatment if you suspect you have psoriasis.

While psoriasis can’t be cured, there are various treatments available to address its symptoms and potentially improve patients’ quality of life.

Treating psoriasis usually involves trying to stop skin cells from growing too fast and reducing inflammation.

The most common treatment options include:

• Topical therapies: These medications are directly applied to the skin and can be bought over-the-counter (OTC) or prescribed by a doctor.

• Phototherapy: This treatment focuses ultraviolet (UV) light on the skin to manage psoriasis symptoms.

• Systemic drugs: These medications work throughout the entire body, and they are usually prescribed to individuals who haven’t found relief with other treatments.

• Biologic drugs: Medicines that work to block the action of the proteins in the immune system associated with psoriasis.

Where Can I Learn More About Psoriasis?

LifeMD can connect you with a licensed medical professional that can help you with any psoriasis concerns you may have. If you are diagnosed with psoriasis, a healthcare provider will guide you through a personalized care plan to manage your condition.

If you think you may be at risk of psoriasis or suspect you have psoriasis, make an appointment with LifeMD to get started with a treatment plan today.

Harmony Vance, APRN

Harmony is a family nurse practitioner and has been caring for patients for over 20 years through various roles in the medical field. She graduated in 2018 with a Master's Degree and a focus on family care.

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