The Real Connection Between Psoriasis and Psoriatic Arthritis

Psoriasis and psoriatic arthritis do share one common symptom: fatigue, which is likely due to high levels of inflammation, according to NYU Langone Health.

The majority of people with psoriasis won’t develop psoriatic arthritis.

About 7 million Americans have psoriasis, and only a fraction of them will ever develop psoriatic arthritis, according to the Cleveland Clinic. Estimates vary depending on the source, but the Centers for Disease Control and Prevention (CDC) says that roughly 10 to 20 percent of people with psoriasis go on to develop psoriatic arthritis.

In contrast, the Cleveland Clinic estimates that up to 30 percent of people with psoriasis will develop psoriatic arthritis. That said, “having psoriasis is the single most significant risk factor for developing psoriatic arthritis,” Naomi Schlesinger, M.D., chief of the Division of Rheumatology at Rutgers Robert Wood Johnson Medical School, tells SELF.

If you have psoriasis, it’s extremely important to watch for any joint symptoms, such as swelling, pain, or stiffness—the most common signs of psoriatic arthritis—and report them to your physician, says David Giangreco, M.D., a rheumatologist at Northwestern Medicine Delnor Hospital. Psoriatic arthritis is a progressive disease, meaning it can get worse over time. And if you happen to get diagnosed with psoriatic arthritis in its early stages, then your doctor can prescribe treatments that slow the disease’s progression and help preserve your joints.

You can develop psoriatic arthritis any time before or after your psoriasis diagnosis.

Medical experts used to believe that people with psoriasis could only develop psoriatic arthritis within 10 years of their initial psoriasis diagnosis, according to the Cleveland Clinic. However, studies have shown that this isn’t true. In fact, up to 15 percent of people with both diseases actually experienced their psoriatic arthritis symptoms first, according to the Cleveland Clinic. Some people may develop psoriatic arthritis before psoriasis, and others may have had psoriasis for years without realizing it, according to Dr. Giangreco. “Psoriasis can remain hidden from patients on the back of the scalp or buttock area and go unnoticed for long periods of time,” Dr. Giangreco tells SELF. If you have psoriatic arthritis and suddenly notice changes in your skin and nails, then you don’t want to rule out the possibility of psoriasis. Rarely do people have psoriatic arthritis without getting psoriasis, too, according to the U.S. National Library of Medicine.

Experts aren’t sure why psoriasis and psoriatic arthritis are linked.

Psoriasis and psoriatic arthritis are clearly connected, but experts don’t know why some people develop both conditions. However, genetics appears to be involved. Researchers have pinpointed a family of genes called the human leukocyte antigen (HLA) complex as a possible contributor to psoriasis and psoriatic arthritis, according to the U.S. National Library of Medicine. (The HLA complex helps your immune system recognize your body’s proteins compared to proteins from foreign pathogens such as viruses and bacteria, the organization explains.) People with psoriasis or psoriatic arthritis have HLA genes that are different from people who don’t have either condition, according to a May 2021 paper published in The Journal of Rheumatology. And people with psoriasis who have a specific HLA gene mutation are more likely to develop psoriatic arthritis, according to the same paper.

Medical experts also believe that psoriatic arthritis may be inherited. About 40 percent of people with psoriatic arthritis have a family member with either psoriasis or psoriatic arthritis, according to the U.S. National Library of Medicine.

Psoriasis and psoriatic arthritis can severely affect your quality of life.

People with either condition frequently say that their health informs their decision making, from the clothes they buy to their careers. That’s because both conditions can drastically change your life, making it difficult to sleep, work, and do the things you love, like playing with your children or baking. For example, when you have a psoriasis flare, even rolling over in bed or wearing tight clothing can be extremely painful. Some people with psoriasis choose clothing that hides their flares to avoid getting comments about their skin’s appearance. Similarly, joint pain from psoriatic arthritis can make it really hard to sit on the floor with your kids, get out of bed for work, or follow through on plans. This can all become overwhelming, and understandably make some people feel self-conscious about their health conditions.

Psoriasis and psoriatic arthritis treatments can make it easier to live a full life with these conditions.

There are no cures for either disease, but an effective treatment plan can minimize symptoms for both psoriasis and psoriatic arthritis. With psoriasis, doctors generally prescribe treatments that prevent your skin cells from growing too quickly, according to the Mayo Clinic. There are many treatment options for this, including creams, light therapy, or oral or injected medications, the Mayo Clinic explains.

As for psoriatic arthritis, treatments generally focus on controlling inflammation to minimize your joint pain and damage. Your doctor might suggest pharmacological options that target your immune system to lower inflammation, along with exercise or other lifestyle modifications, according to the Mayo Clinic. With each condition, the best treatment depends on your particular situation.

Bottom line: Talk to your doctor if you have psoriasis or psoriatic arthritis symptoms.

Both conditions can cause a lot of physical and emotional pain—but you can find some relief with the right treatment plan. If you think you have psoriasis or psoriatic arthritis (or both) talk to your doctor about how you can live more comfortably.


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