Understanding and Managing Plaque Psoriasis in Older Adults

Plaque psoriasis, a chronic autoimmune condition characterized by the rapid buildup of skin cells, leads to scaling on the skin’s surface. Among older adults, managing this condition poses unique challenges and requires tailored approaches. This article delves into the specifics of understanding and managing plaque psoriasis in the elderly population, supported by facts and recent research findings.

Understanding Plaque Psoriasis

Plaque psoriasis manifests as raised, red patches covered with a silvery white buildup of dead skin cells or scale. These patches are typically found on the scalp, elbows, knees, and lower back but can appear on any part of the body. About 7.5 million Americans suffer from psoriasis, with a significant number being over the age of 50. The condition is not merely cosmetic but is associated with an increased risk of other health issues, including arthritis, cardiovascular disease, and diabetes, which are particularly pertinent to older adults.

Challenges in Older Adults

Managing plaque psoriasis in older adults involves additional complexities. This demographic often deals with multiple health problems that can complicate the management of psoriasis. For instance, the presence of comorbid conditions such as diabetes and cardiovascular disease can limit the use of certain medications due to potential adverse effects. Furthermore, older skin is generally more sensitive and susceptible to side effects from topical treatments.

Effective Treatment Options

Treatment plans for older adults need to be carefully considered. Typically, treatment starts with topical therapies including corticosteroids, vitamin D analogues, or retinoids. For moderate to severe cases, phototherapy or systemic treatments might be recommended. Recently, biologics, which target specific parts of the immune system, have also become a viable option for elderly patients, especially those with moderate to severe psoriasis who do not respond well to traditional therapies.

However, it’s important to balance treatment efficacy against potential side effects. For instance, renal function decline in the elderly can affect medication dosage and selection. Regular monitoring and adjustments based on the individual’s overall health, liver and kidney functions, and response to treatment are crucial.

Integrating Lifestyle Modifications

Beyond medical treatments, lifestyle changes can play a significant role in managing symptoms. Stress is a known trigger for psoriasis flare-ups, and stress management techniques such as meditation, yoga, or simple deep-breathing exercises can be beneficial. Additionally, maintaining a healthy weight is crucial, as obesity is linked to an increased severity of psoriasis. Nutritional considerations, like a diet rich in anti-inflammatory foods—omega-3 fatty acids, turmeric, and antioxidants—can also support overall skin health.

The Role of Skincare

Routine skincare is an essential component of managing plaque psoriasis. Older adults with psoriasis should opt for gentle, moisturizing products to reduce skin dryness and enhance the skin’s barrier function. Bathing in lukewarm water with mild soap followed by immediate moisturizing can help soothe irritated skin and diminish scales. Additionally, it’s crucial to avoid skin injuries or trauma, as these can exacerbate psoriasis symptoms through the Koebner phenomenon, where new psoriasis plaques form at the site of skin injury.

Social and Emotional Impact

The psychological impact of living with plaque psoriasis can be profound, especially in older adults who might already feel isolated due to other health conditions. Peer support groups or counselling can help them cope with the social stigma and emotional stress associated with psoriasis. It is also helpful for caregivers and family members to be involved and supportive, understanding the emotional strain that psoriasis can cause.

Advancements in Psoriasis Research

Scientific research continues to shed light on better managing plaque psoriasis in the elderly. Recent studies are focusing on the genetic markers and pathways that could potentially lead to more targeted and effective treatments. Innovation in drug development, particularly regarding biologics, has opened new avenues for treatment that are less likely to interfere with the overall health conditions common in older adults.


Understanding and managing plaque psoriasis in older adults requires a comprehensive approach that considers the unique physiological changes and medical needs of this age group. By combining effective treatment plans, lifestyle modifications, and supportive measures, the quality of life for older adults living with psoriasis can be significantly improved. Staying informed about new research and treatment options can also provide further hope and assistance to those affected by this challenging skin condition.