On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Plaque, scalp, flexural and guttate psoriasis are reviewed from photos plus video, with vitamin D analogues, steroid creams, combination gels and scalp preparations prescribed or renewed; widespread, pustular or erythrodermic psoriasis and biologic treatment need in-person specialist care.
- What it is: an immune-driven condition, not an infection, affecting about 2 in 100 people; plaque psoriasis makes up about 8 in 10 cases, and up to 1 in 3 people with psoriasis develop psoriatic arthritis, often years after the skin changes.
- Treatment timelines: topical treatments take 4 to 8 weeks to show their effect; steroid creams are used in courses of up to 4 weeks on the body and 1 to 2 weeks on the face or folds, while vitamin D analogues suit steady long-term use.
- Triggers: streptococcal throat infections (guttate flares), stress, skin injury including sunburn (the Koebner response), smoking, heavy alcohol, obesity, and medicines such as beta-blockers, lithium and antimalarials, or stopping steroid tablets suddenly.
- More than skin: psoriasis raises the risk of psoriatic arthritis, cardiovascular disease, depression and metabolic syndrome, so joints, mood, blood pressure and weight are checked at reviews, not only the plaques.
- Emergency: call 112 or go to emergency care if the skin has turned red, hot and painful over most of the body, if sheets of small pus-filled spots are spreading, or if a sudden flare comes with fever and shivering.
Do not book an online appointment if your skin has turned red, hot and painful over most of your body, if sheets of small pus-filled spots are spreading, or if a sudden flare comes with fever and shivering: erythrodermic and generalised pustular psoriasis are emergencies. New joint pain, prolonged morning stiffness or a swollen finger or toe needs prompt review too; that conversation can start online.
Can an online doctor treat psoriasis?
Often, yes. Clear photographs and a video consultation can often provide enough information to review psoriasis plaques, prescribe or renew topical treatment and screen for psoriatic arthritis. Extensive disease needing phototherapy or systemic medicines is referred for specialist care, and erythrodermic or pustular flares are emergencies.
Psoriasis is a lifelong, relapsing condition, so most of the work is ongoing management rather than a one-time cure, which is a good match for remote care. On Mobi Doctor, a licensed doctor can assess a flare, renew an established topical routine after a review, screen your joints, and make the specialist referral when phototherapy or systemic treatment becomes the right step.
Listen: Psoriasis Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with psoriasis
- Plaque review by photo and video: extent, thickness, scale and the body sites involved decide which treatment, at which strength, in which formulation, and all of that is assessable from good photographs.
- Site-specific prescribing: scalp psoriasis needs gels, foams or medicated shampoos; face and skin-fold psoriasis needs gentler options than elbow plaques tolerate. The doctor matches the product to the site.
- Repeat prescriptions without the waiting room: if your psoriasis is stable on a topical treatment, reviews and renewals are exactly what a video service does well, always via a consultation, with periodic full reassessment.
- The joint and mood check: every consultation screens for psoriatic arthritis symptoms and asks honestly how the condition is affecting your life, because both change the plan.
📷 Photograph each affected area in daylight (elbows, knees, lower back) with one close-up showing scale thickness and one wider shot for overall extent. Part your hair to capture the scalp margin if it is involved, and include your nails: pitting or lifting matters, because nail disease raises the likelihood of joint involvement.
What the doctor checks in an online psoriasis consultation
The review is structured, whether it is a first assessment or a renewal. In a psoriasis consultation, the doctor will typically assess:
- Plaque character and extent: thickness, scale and roughly how much skin is involved, judged from close-ups plus a wider shot, because extent is a referral threshold.
- Body sites: scalp, face, skin folds, nails, elbows and knees each need different potencies and formulations, so the doctor maps every site before prescribing.
- Nail changes: pitting, lifting and ridging, photographed close up, because nail disease raises the likelihood of psoriatic arthritis.
- Joints, at every review: joint pain or swelling, morning stiffness lasting over half an hour, a finger or toe swollen along its whole length, heel or tendon pain, and night-time back stiffness.[2]
- Triggers and medicines: a recent streptococcal sore throat, skin injury or sunburn, stress, alcohol, smoking, and drugs such as lithium and beta-blockers that can worsen psoriasis.
- Current and past treatment: what has been used, at what strength, for how long and with what result, particularly before renewing a repeat.
- Mood and sleep: asked directly, because the burden of visible plaques is a treatment consideration in its own right.
- Photo quality: daylight, a close-up of one representative plaque to show the scale, a wider shot for extent, hair parted at the scalp margin, and nails included; on the video call the doctor can ask you to bend a joint or point to where stiffness sits.
What are the types of psoriasis?
Psoriasis comes in several patterns. Plaque psoriasis is the most common, with thick, scaly, well-defined patches; scalp psoriasis ranges from flaking to crusted plaques; guttate psoriasis scatters small drop-like spots, often after a throat infection; and flexural psoriasis is smooth and shiny in skin folds. Knowing the pattern guides the treatment.[3]
Plaque, scalp, guttate and flexural
Plaque psoriasis shows raised, sharply edged plaques with silvery scale on lighter skin, often violet or dark brown with greyish scale on darker skin. Scalp psoriasis ranges from mild flaking to thick, crusted plaques extending past the hairline. Guttate psoriasis scatters small drop-like plaques across the trunk and limbs, typically in younger people a couple of weeks after a streptococcal sore throat. Flexural (inverse) psoriasis sits smooth, shiny and scale-free in the armpits, groin and under the breasts, where it is often mistaken for a fungal rash.
Common triggers
Flares commonly follow streptococcal throat infections, skin injury (cuts, sunburn and new tattoos, through what is called the Koebner response), stress, heavy alcohol use, smoking and cold, dry weather. Some medicines can worsen psoriasis, including lithium, beta-blockers and antimalarials, as can stopping potent steroid treatment abruptly. Psoriasis is not contagious and is not caused by poor hygiene; it is an immune-mediated condition with strong genetics.
Is it psoriasis, eczema or a fungal rash?
Scaly patches have several causes. Psoriasis makes thick, well-defined plaques with silvery scale and is often only mildly itchy; eczema is poorly defined, very itchy and tends to weep; seborrhoeic dermatitis produces greasy yellowish scale on the scalp, eyebrows and sides of the nose. Flexural psoriasis in skin folds is also easily mistaken for a fungal infection.
Swipe sideways to compare →
| Feature | Psoriasis | Eczema | Seborrhoeic dermatitis |
|---|---|---|---|
| Scale | Thick, silvery, well-defined | Dry or weeping, ill-defined | Greasy, yellowish, fine |
| Itch | Often mild to moderate | Intense | Mild |
| Usual sites | Outer elbows and knees, scalp, lower back | Elbow and knee creases, hands | Scalp, eyebrows, sides of nose |
| Extra clue | Nail pitting, joint symptoms | Personal or family atopy | Worse with stress and cold weather |
Because these overlap, the photo review is how the doctor tells them apart, and it matters: a flexural plaque treated as thrush, or a fungal rash treated as psoriasis, will not settle.
More than skin: joints and mental health
Psoriatic arthritis: the screening question that matters
A significant minority of people with psoriasis develop psoriatic arthritis, sometimes years after the skin changes begin.[2] The warning signs are joint pain and swelling, morning stiffness lasting over half an hour, a finger or toe swollen along its whole length, heel or tendon pain, and back stiffness that wakes you at night, with nail pitting raising the odds. This is why the doctor asks about your joints at every psoriasis review: caught early, psoriatic arthritis can be treated before it damages joints permanently.
The load nobody sees
Itch, scale on clothing, disturbed sleep and the constant awareness of visible plaques take a real toll, and depression and anxiety are more common in people with psoriasis. The World Health Organization recognises psoriasis as a serious non-communicable disease precisely because of this wider burden.[4] Treating the skin usually lifts mood with it, but say so if you are struggling: the doctor can address both in the same consultation.
Psoriasis in pregnancy and while travelling
Treatment is adjusted in pregnancy. Emollients and, in many cases, mild to moderate topical steroids can continue, but vitamin D analogues are used more cautiously and the systemic drug methotrexate is strictly avoided: it must be stopped well before conception by either partner.[1] Tell the doctor if you are pregnant, planning pregnancy or breastfeeding so the plan is made safe.
Climate and travel cut both ways. Moderate natural sunlight helps many people's plaques, which is why some improve on holiday, but sunburn triggers fresh psoriasis on the burned skin, so sensible sun exposure and sunscreen matter. For expats and travellers on an established regimen, online care is a practical way to keep your topical treatment going without a gap: a review by photo and video, then any agreed repeat prescription, usable at a pharmacy near you.
How can I keep psoriasis under control?
You keep psoriasis under control with a steady routine rather than occasional bursts: daily emollients to soften scale, consistent use of your prescribed topical, and attention to the triggers you can change, such as stress, smoking, heavy drinking, sunburn and untreated throat infections. Weight, alcohol and smoking all influence how active psoriasis is.
Because psoriasis links with heart, metabolic and joint health, looking after the rest of your health is part of treating the skin. Regular gentle exercise, not smoking, moderate alcohol and a healthy weight all tend to improve control, and treating a streptococcal sore throat promptly can head off a guttate flare. Keeping a simple record of what set off past flares makes the next one easier to prevent or shorten.
Scalp psoriasis
Scalp psoriasis is common and often the most frustrating site, ranging from fine flaking mistaken for dandruff to thick, crusted plaques along the hairline and behind the ears. Treatment usually combines a descaling product containing salicylic acid to lift the scale, a steroid lotion, gel or foam designed for hair-bearing skin, and coal-tar or antifungal shampoos.[3] Getting the format right (a gel or foam rather than a greasy ointment) makes people far more likely to keep using it, which is what actually clears the scalp.
Which psoriasis treatment might the doctor recommend?
Treatment follows the pattern and the site: steady topical treatment for limited plaques, formulations built for the scalp, gentler options for face and folds, and referral when plaques are extensive or topicals stop holding. This is the framework the doctors use, aligned with the cited guidance:[1]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Limited plaques on trunk or limbs | Vitamin D analogue, a topical steroid course, or a combined calcipotriol and betamethasone gel or foam | Usually yes | Uncertain diagnosis, or plaques not responding after an adequate course |
| Scalp psoriasis | Salicylic-acid descaling, then a steroid lotion, gel or foam made for hair-bearing skin | Usually yes | Thick crusted plaques that do not shift, or hair loss with the plaques |
| Face or skin-fold psoriasis | Milder steroids or calcineurin-inhibitor creams; potent steroids avoided on thin skin | Usually yes | Diagnostic doubt with fungal rashes in folds, or poor response |
| Extensive plaques, significant nail disease, or failed topical treatment | Referral for phototherapy or systemic treatment, initiated and monitored by specialists | Assessment, agreed renewals and the referral itself | Your doctor writes the referral |
| Skin red, hot and painful over most of the body, or sheets of pustules | Emergency care for suspected erythrodermic or pustular psoriasis | No | Always: call 112 or go to emergency care the same day |
Not sure which row is your skin? A doctor can tell you in one consultation.
See available times →Treatment options for psoriasis
What you can do yourself
Daily emollients soften scale, ease itch and help active treatments penetrate: the simple but effective foundation. Reducing alcohol, stopping smoking and managing weight each help, since psoriasis is linked with cardiovascular and metabolic health. Treat streptococcal sore throats promptly, and be sensible with sunshine: modest exposure helps many people, while sunburn triggers new plaques on the burned skin.
Prescription treatment
A prescription is never issued without a consultation. The doctor reviews your skin first, then prescribes or renews what fits. Vitamin D analogues such as calcipotriol are a first-line plaque treatment suitable for steady use. Topical corticosteroids, matched in potency to the body site, are used in courses rather than continuously, because long unbroken use of potent steroids thins the skin and invites rebound flares.[1] The combination of calcipotriol with betamethasone in a once-daily gel or foam is often the most effective topical option, and scalp-specific preparations (salicylic-acid descaling products, steroid lotions and coal-tar shampoos) make scalp psoriasis manageable.[5] Psoriasis on the face and in skin folds is treated with milder steroids or calcineurin-inhibitor creams. When plaques are extensive, nails are involved or topicals are not holding the line, honesty matters: that is the point for referral to phototherapy or systemic treatment (methotrexate, apremilast or biologic injections), which requires specialist assessment and structured monitoring. The online doctor writes that referral and can continue your agreed topical repeats in the meantime.
When psoriasis is treated online, and when you need in-person care
Treated online: flares of previously diagnosed plaque and scalp psoriasis; renewals of an established topical routine after a photo and video review; switches of formulation when a product is not being used (gels and foams for the scalp, milder options for face and folds); guttate flares after a sore throat, with the throat assessed in the same consultation; and joint screening with early referral letters when symptoms suggest psoriatic arthritis.
In-person care: suspected erythrodermic or generalised pustular psoriasis, the same day, as emergencies; extensive plaques, significant nail disease or topical treatment that is no longer holding, where phototherapy or systemic medicines are the right step and specialists initiate and monitor them; suspected psoriatic arthritis, promptly, to protect the joints; and folds or scalp presentations where the diagnosis stays genuinely uncertain despite good photos. In each case you leave with a named next step, not a vague suggestion.
When to get in-person care
Erythrodermic and generalised pustular psoriasis are rare but dangerous. If your skin becomes red, hot and painful across most of your body, if sheets of small pustules appear, or if a flare arrives with fever, shivering or feeling faint, call 112 or go to emergency care immediately: widespread skin failure disrupts temperature control and fluid balance. New joint pain or a swollen digit is not an emergency, but book a review within days, not months.
Treating psoriasis at home: what helps and what does not
Home care earns its place in psoriasis: generous emollients to soften plaques and calm itch, honest management of the triggers that flare it, stress, alcohol, smoking and skin injury, and coal-tar based products from the pharmacy for milder patches.
What home care cannot do: it cannot clear established plaques, which need prescription-strength treatment, from steroid and vitamin-D based creams through to light therapy and modern systemic options for severe disease. And psoriasis with joint pain or stiffness, especially in the morning, may be psoriatic arthritis, where early treatment protects joints permanently. Living with visible plaques because shop products failed is a choice nobody has to make anymore.
The strongest at-home treatment is still a doctor. A video consultation brings one to your sofa: an honest assessment, and a prescription to a local pharmacy when treatment is right. You can see a doctor over video, usually within 15 minutes. Book a video consultation: the exact price is shown before you pay.
Is psoriasis contagious?
No, never. Psoriasis is an immune condition, not an infection: it cannot be caught or passed on by touch, shared towels, swimming pools, intimacy or anything else. The plaques are not infectious material, whatever they look like.
Why this matters: the myth does real damage, from handshakes avoided to swimming pools abandoned, and none of it is justified. Anyone reacting to visible plaques is wrong on the biology.
The same is true of eczema: eczema is not contagious either. What plaques do deserve is proper treatment, which has moved on enormously; living with them untreated is optional now.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Upload your skin photos, then speak to a licensed doctor: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Not sure it’s psoriasis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about psoriasis
What is psoriasis?
Psoriasis is a long-term condition in which the immune system speeds up the turnover of skin cells from about a month to a few days, so cells pile up into thick, red, scaly, well-defined plaques, most often on the elbows, knees, scalp, lower back and nails. Psoriasis affects about 2 in 100 people, runs in families, is not contagious, and flares and settles over years rather than clearing for good.
What causes psoriasis, and what triggers flares?
Psoriasis is caused by an over-active immune response in people with a genetic tendency: about a third have an affected relative. Flares of psoriasis are triggered by streptococcal throat infections, stress, skin injury including sunburn, cuts and tattoos, smoking, heavy alcohol, obesity, cold dry weather, and medicines such as beta-blockers, lithium, antimalarials and suddenly stopped steroid tablets.
What are the types of psoriasis, and what do they look like?
Plaque psoriasis, about 8 in 10 cases, forms thick silvery-scaled plaques on elbows, knees, scalp and back. Guttate psoriasis is a shower of small drop-shaped spots after a sore throat. Flexural psoriasis makes smooth shiny red patches in folds. Scalp psoriasis crusts past the hairline, nail psoriasis pits and lifts nails, and pustular and erythrodermic psoriasis are rare emergencies.
Can an online doctor prescribe psoriasis treatment in Europe?
Yes, after a consultation. A prescription is never issued without one: the doctor reviews your psoriasis by photo and video first, then prescribes topical treatments such as vitamin D analogues, corticosteroids, combination gels and scalp preparations when they fit, with the prescription sent to a pharmacy near you. Systemic tablets and biologics are started and monitored by a dermatologist in person.
Can I renew my usual psoriasis prescription online?
Often, yes: renewing a usual prescription is one of the most useful things online care does for stable psoriasis. If you are settled on a topical treatment such as a vitamin D and steroid combination, the doctor reviews your skin and joints by video, checks the treatment is still right and the steroid courses are not running too long, and renews it, or adjusts it when psoriasis has changed.
Is psoriasis contagious?
No, psoriasis is an immune-driven condition, not an infection: it cannot be passed on by touch, towels, swimming pools, sex or anything else. That is worth saying out loud to partners, colleagues and gym staff, because the mistaken fear of contagion causes much of the isolation people with psoriasis describe, and no precaution of any kind is needed around them.
Can psoriasis be cured, and how long do flares last?
Psoriasis cannot be cured: it is a long-term condition that flares and settles over years, sometimes with remissions lasting months or years. What has changed is control: with the right treatment, most people with psoriasis now reach clear or almost clear skin. A plaque flare improves over 4 to 8 weeks of topical treatment; guttate psoriasis after a throat infection often clears within 3 to 4 months.
How do I know if my joint pain is psoriatic arthritis?
Clues include joint pain with morning stiffness lasting more than half an hour that eases with movement, a finger or toe swollen along its whole length, heel or tendon pain, and back stiffness that wakes you at night. Nail pitting makes psoriatic arthritis more likely. Up to 1 in 3 people with psoriasis develop it, so the doctor asks about joints at every review and refers to rheumatology early.
Does sunshine help psoriasis?
Moderate natural sunlight helps many people's psoriasis plaques, which is why some improve in summer or on holiday, and medical ultraviolet phototherapy uses the same effect under control. The catch is sunburn, which triggers new psoriasis on the burned skin through the Koebner response, so brief regular exposure with sunscreen on unaffected skin is the sensible middle, and sunbeds are never a substitute.
Is it psoriasis, eczema or a fungal rash?
Psoriasis forms thick, well-defined, symmetrical plaques with silvery scale on elbows, knees, scalp and lower back and itches less than it looks. Eczema is poorly defined, intensely itchy, favours creases and comes with a lifelong history of dry skin. A fungal rash is usually one or a few ring-shaped patches with an active scaly edge that spread outward, and it worsens with steroid cream, unlike psoriasis.
What can I do at home for psoriasis?
At home, moisturise thickly every day to soften scale and reduce cracking, use the prescribed treatment on plaques exactly as directed, soak and gently lift scalp scale with an oil or salicylic acid preparation before medicated shampoo, bathe in lukewarm water with a soap substitute, avoid picking plaques, limit alcohol, stop smoking, and keep a note of what preceded each flare. Coal tar preparations remain useful for stubborn psoriasis.
How can I prevent psoriasis flares?
Prevent psoriasis flares by treating sore throats early, protecting skin from injury and sunburn, moisturising daily, managing stress and sleep, keeping weight in a healthy range, not smoking, limiting alcohol, and reviewing any medicine known to worsen psoriasis with a doctor rather than stopping it. Using vitamin D analogue treatment steadily between flares, rather than only during them, keeps many people's plaques quiet.
Is psoriasis treated differently in pregnancy or in older people?
In pregnancy, psoriasis often improves, and when it does not, emollients, mild to moderate steroid creams and some vitamin D analogues in limited amounts are used, while several systemic treatments must be stopped before conception, so planning matters. In older people, thinner skin means shorter steroid courses, and new psoriasis after 50 prompts a check of medicines such as beta-blockers and of the joints.
- Psoriasis: assessment and management (CG153), NICE, National Institute for Health and Care Excellence, 2012 (updated 2017).
- Psoriasis: Clinical Knowledge Summary, NICE Clinical Knowledge Summaries, revised 2024.
- Psoriasis, DermNet New Zealand Trust, reviewed 2024.
- Global report on psoriasis, World Health Organization, 2016.
- Topical treatments for chronic plaque psoriasis (Cochrane Review), Cochrane, Cochrane Collaboration, 2013.
- Psoriasis, NHS, National Health Service (UK), reviewed March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
Related conditions
More about psoriasis from the Mobi Doctor blog
Is Psoriasis Contagious?
Psoriasis is not contagious and cannot be passed from one person to another through touching, kissing, swimmin...
Read article → Health and WellbeingIs Psoriasis Genetic
Is Psoriasis Genetic and What Causes It? Psoriasis has a strong genetic component but is not caused by genes alone. Env...
Read article → Health and WellbeingScalp Psoriasis VS Dandruff
What Is the Difference Between Scalp Psoriasis and Dandruff? Scalp psoriasis causes thick, inflamed, scaly plaques, whi...
Read article →Speak to a doctor about psoriasis over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CET · exact price before payment
See available times →