What Is Elbow Psoriasis?
Elbow psoriasis is a chronic skin condition that causes areas of thickened, inflamed, red skin on your elbows. It can also develop on other parts of your body, like your scalp or knees.
It’s thought that about 3% of the population has psoriasis. Kids and teens can get psoriasis, but it happens mainly in adults. It may look unpleasant, but it’s not dangerous or contagious.
The most common type of psoriasis on the elbows is plaque psoriasis. You may notice skin plaques that are anywhere from half an inch to 4 inches wide. It may just be on your elbows, or you may see plaques on other spots like your knees, back, and the top of your head.
Dry elbows vs. elbow psoriasis
It can be hard to tell whether you have elbow psoriasis or simply dry elbows. They often look and feel a lot alike. But they are caused by very different things. When you have psoriasis, you have an overactive immune system that speeds up skin cell growth. Normally, your skin cells fall off after about a month. But with psoriasis, it occurs every three or four days. These cells build up on your skin and form the plaques that cause psoriasis.
Dry elbows, on the other hand, are caused by dry skin. It happens when your skin loses too much water, like in the winter. It’s also common among people who live in areas with low humidity – and thus low moisture – such as the Southwestern United States.
Dry elbows also look a little different from elbow psoriasis. If you look closely at elbow psoriasis, you’ll see fine lines from dehydration. There will be some flakiness and an overall rough texture. If you have very dry elbows, there will be deep cracks and possibly even some bleeding. Very dry elbows may itch, and they may look and feel raw.
Elbow Psoriasis Causes
It’s not exactly clear what causes elbow psoriasis. But there are three main theories:
Your immune system. Your skin has three layers: the epidermis, or top; the dermis, or middle layer that contains collagen and blood vessels; and an inner layer of fat. Every day, the cells in the epidermis die and are shed. But when you have psoriasis, your immune system causes your epidermal skin cells to build up faster than your body can shed them. They stay on top of your skin and cause the thickening and scales that come with psoriasis. Also, the blood vessels in your dermis dilate, which can cause the rash to appear red.
Your genes. About 40% of people with psoriasis have a relative with the condition, too. There are several genes that seem to make you more likely to get psoriasis. But there’s no genetic test to know for sure that you’ll develop it.
Your environment. Certain things may make it more likely that you’ll have psoriasis. They include:
- Bacterial and viral infections
- Alcohol
- Medications such as beta-blockers to treat heart disease or lithium to treat a psychiatric disorder.
- Smoking
- Stress
- Injury to skin
- Cold weather
It’s thought that all three of these things work together to create the perfect storm that causes elbow psoriasis.
Elbow Psoriasis Symptoms
From 80% to 90% of people with elbow psoriasis have plaque psoriasis. Symptoms include:
- Patches of thick, raised skin that may be covered by silvery-white scales
- Plaques of different sizes. Sometimes, small ones join together to form big ones.
- Itching where the plaques are. Scratching makes them worse.
- Similar plaques on other parts of your body, like your scalp, knees, or back
- Joint pain, swelling, or stiffness. Some people with elbow psoriasis also have a related condition: psoriatic arthritis.
People of all races and ethnicities can get psoriasis. It seems more common among White people than Asian, Latino or African American people, but this may be because it gets misdiagnosed, or goes undiagnosed, in people with darker skin types. Among these folks, elbow psoriasis may:
- Appear as salmon, dark brown, purple, or violet in color, instead of red. It may also have a grayish – not silver – scale.
- Have thicker plaques and more scaling
- Take up more skin
Elbow Psoriasis Diagnosis
It can be hard to tell on your own whether you have elbow psoriasis or another condition like dry skin. A dermatologist is the best person to make that diagnosis. They will examine the skin on your elbows. They’ll ask you about your family and medical history, including whether:
- Your elbow skin itches or burns
- You’ve had a recent viral or bacterial illness, like the flu or strep throat
- You’re stressed, or had a period or recent stress
- You’re taking any prescription medications
- You have any family members with psoriasis
- You have any joint stiffness, pain, or tenderness
These questions can help your doctor rule out other, similar conditions, like eczema. They may also take a small sample of your skin and examine it under a microscope.
Elbow Psoriasis Treatment
There’s no cure for elbow psoriasis. But there are treatments that can help you manage symptoms, and treat and even prevent flare-ups.
Topical medications
- Corticosteroids. You apply them twice a day when you start treatment. As your symptoms improve, you may go down to once a day. You can buy corticosteroid cream over the counter, as hydrocortisone 1%. Most cases of elbow psoriasis require a prescription-strength cream or ointment. They can cause skin thinning and stretch marks if you use them for long periods of time.
- Calcipotriene (Dovonex, Sorilux) or calcitriol (Vectical). These creams slow down the growth of cells in the top layer of your skin, or epidermis. You also apply them twice a day. Your doctor may prescribe them instead of, or to be used with, corticosteroids. Some medications, like Enstilar and Taclonex, combine calcipotriene and the corticosteroid betamethasone. They can cause skin irritation.
- Tapinarof (Vtama). This cream, which you use once a day, reduces skin inflammation. It can cause folliculitis (inflammation of hair follicles) and irritate your skin.
- Roflumilast (Zoryve). It also reduces skin inflammation and is applied once daily. It can upset your digestive system and cause headaches and trouble sleeping.
- Topical calcineurin inhibitors. These medications, which include pimecrolimus (Elidel) and tacrolimus (Protopic), reduce skin inflammation. They’re generally used for more sensitive areas, like your face, under your armpits, or under your breasts. They can cause burning or stinging.
- Tazarotene (Tazorac). This prescription cream, which is derived from vitamin A, is applied once daily. One brand, Duobrii, combines tazarotene with a topical steroid. It can also irritate your skin.
Phototherapy. UV light exposure can help treat psoriasis. You’ll do it at your dermatologist’s office. Your doctor may also prescribe a home UV unit. It’s very safe, but it can cause sunburn, skin dryness, and itching.
There are also newer lasers used to treat psoriasis. They deliver higher doses of UVB exposure than a machine but are safe because they can be directed only to where you have psoriatic patches. This is a better option if you have a small area of psoriasis, like elbow psoriasis.
Biologics. These are a newer class of prescription medication. They’re injected and block specific proteins, known as cytokines, that cause the inflammation that leads to psoriasis. There are three main types:
- Interleukin-17 (IL-17) inhibitors such as bimekizumab (Bimzelx), brodalumab (Siliq), Ixekizumab (Taltz) and secukinumab (Cosentyx).
- Interleukin-23 (IL-23) inhibitors like guselkumab (Tremfya), risankizumab (Skyrizi), tildrakizumab (Ilumya), and ustekinumab (Stelara).
- Tumor necrosis factor-alpha (TNF-alpha) inhibitors like adalimumab (Humira), certolizumab pegol (Cimzia), etanercept (Enbrel), and infliximab (Remicade).
Your dermatologist will usually try other treatments, like prescription topical creams, before they recommend that you go on a biologic. These drugs are very effective but can make you more likely to get an infection.
Oral medications. There are some pills your doctor may want you to try, especially if for some reason you can’t take a biologic. They include:
- Acitretin (Soriatane). This is a retinoid, which is a substance that comes from vitamin A. Side effects include dry lips and skin, nosebleeds, hair loss, and joint pain. Your doctor will also monitor your cholesterol and liver levels. You’re not able to use it if you are pregnant, or are thinking about becoming pregnant.
- Apremilast (Otezla). This is an oral medication that’s taken twice a day. It can cause side effects such as digestive upset, headache, and sometimes severe depression. You should always let your doctor know right away if you have any mood changes while you’re on this drug.
- Deucravacitinib (Sotyktu). You take it once a day. It can raise your risk of getting a virus like shingles. Your doctor will also want to do bloodwork frequently, to check your liver function and cholesterol levels.
- Methotrexate. You can take this either as a pill or as a shot. It can affect your blood cell counts and liver function. Your doctor may also recommend that you take a folic acid supplement when you’re on it, to reduce side effects like digestive upset.
- Immunosuppressants. If you have a severe case of psoriasis that doesn’t respond to any other medication, your doctor may recommend a short course of drugs such as azathioprine, cyclosporine, or hydroxyurea. Since they suppress your immune system, they can only be used for a short period of time.
Home Remedies for Elbow Psoriasis
If you have elbow psoriasis, there are some home remedies you can try to help relieve symptoms. You can often use these at the same time as prescription medications.
Salicylic acid. You can buy it over the counter as a shampoo, body wash, or cream. It helps shed the top layer of your skin, and thus remove psoriasis scales.
Coal tar. It slows down the rapid growth of skin cells. It’s available over the counter as a shampoo, cream, or oil. You apply them to your skin once or twice a day. The downside is it can smell bad and stain your skin and clothing.
Moisturizers. Over-the-counter emollients that contain petroleum jelly or other thick creams can help to relieve itch. Apply them right when you come out of the bath or shower.
Oatmeal baths. It may help to reduce the itch and rash that come with elbow psoriasis. A 2020 study published in the Journal of the American Academy of Dermatology found that women with psoriasis who applied a 1% colloidal oatmeal lotion to their body once a day for four weeks improved psoriasis in 96% of all patients.
Aloe vera. Research suggests it may help to improve the redness and scaling of psoriasis. The National Psoriasis Foundation recommends you look for a cream that contains at least 0.5% aloe. You can apply it up to three times a day.
Apple cider vinegar. It’s mainly used to treat scalp psoriasis, but you can use it for elbow psoriasis too. The National Psoriasis Foundation recommends that you use organic cider vinegar. Dilute it with water in a one-to-one ratio to prevent skin irritation and burns. Apply it to your elbow psoriasis several times a week, and rinse it off your skin once the solution has dried. Don’t use it if your patches are cracked or bleeding.
Epsom salts bath. A 15-minute warm Epsom salts bath may help to remove scales and improve itch. Apply moisturizer after your bath to prevent dry skin.
Living With Elbow Psoriasis
Lifestyle is important when you live with elbow psoriasis. Here are some things you can do to make your condition more manageable:
Eat a Mediterranean-style diet. This eating pattern, rich in fruits, vegetables, whole grains, nuts, and fatty fish, has been shown to improve psoriasis symptoms.
Wear comfy clothes. Choose lightweight fabrics such as cotton, polyester, rayon, and chiffon. If you do wear wool, try to wear something cotton underneath to provide a barrier for your skin. Shirts with “busy” prints on them also make it harder for people to see psoriasis flakes.
Get small amounts of sunshine. The UV light will help to improve your psoriasis symptoms. But you don’t want to get too much – it can make your psoriasis worse. Talk to your dermatologist to figure out an amount that’s right for you.
Find social support. It’s normal to feel self-conscious and anxious about your elbow psoriasis. If you talk to others who live with the condition, it can help.
Practice mindfulness. Stress is a common trigger for psoriasis. It can also make itching worse. A 2022 review published in the journal Dermatology and Therapy found that eight to 12 weeks of meditation helped to relieve both stress and psoriasis symptoms. Don’t know where to start? An app like Calm can provide exercises.
Takeaways
Elbow psoriasis is a chronic skin condition that causes areas of thickened, inflamed, red skin on your elbows. It can also develop on other parts of your body, like your scalp or knees. It can be hard sometimes to tell whether you have elbow psoriasis or another condition like dry skin. You should see a dermatologist for a diagnosis. There’s no cure for psoriasis, but lifestyle changes and prescription medications (topical, oral, and sometimes even injections) can help.
Elbow Psoriasis FAQs
It’s not clear why some people are more likely to have psoriasis. It happens when your immune system goes into overdrive. Your elbows are a common spot for psoriasis to crop up. Try not to lean on them – it can trigger a flare.
How do you get rid of psoriasis scales on your elbows?
A salicylic wash can help to gently loosen some of the scales. You can then follow up with a medication prescribed by your doctor, like a topical corticosteroid ointment.
What cream is good for psoriasis on elbows?
A thick moisturizer such as CeraVe cream followed by petroleum jelly is best for elbow psoriasis. Put it on as soon as you get out of the bath or shower.
What causes flare-ups of elbow psoriasis?
A recent illness, stress, an injury, or cold weather can all trigger a flare-up of elbow psoriasis.
What happens if elbow psoriasis is left untreated?
It’s important to treat your elbow psoriasis. If it’s not addressed, it could lead to psoriatic arthritis, which causes joint pain and stiffness. It’s also been linked to other conditions, such as diabetes and heart disease.
