Raised, scaly plaques
Thick red or pink patches topped with silvery-white scale, most often on elbows, knees, scalp, and lower back.
Medical Dermatology
Psoriasis
Psoriasis is a chronic, immune-driven condition — not poor hygiene, and not contagious. With today's treatments, most people can get their skin clear or nearly clear.
Overview
Understanding psoriasis
Psoriasis happens when an overactive immune system tells skin cells to grow far too fast. Instead of shedding invisibly, those cells pile up into thick, scaly plaques that can itch, crack, and bleed. It's a lifelong condition that tends to come and go in flares — but it's also one of the most treatable it has ever been.
It's important to know psoriasis is more than skin-deep. It's a systemic inflammatory disease linked to psoriatic arthritis and to heart, metabolic, and mood health, which is why it deserves a dermatologist's eye rather than a drugstore cream. We look at the whole picture, not just the patch in front of us.
We also see how much psoriasis can weigh on you. Plaques on the hands, scalp, or face — or anywhere clothing can't hide — can make people feel self-conscious, avoid short sleeves or swimming, and carry stress that itself makes flares worse. Treating psoriasis well means treating that too. Our goal is skin you feel comfortable in and confident showing.
Types of psoriasis we treat
Psoriasis looks different from person to person. We diagnose the type and tailor the plan to it.
- Plaque psoriasis — the most common form: raised, red patches with silvery scale on elbows, knees, scalp, and lower back.
- Scalp psoriasis — thick, flaky, sometimes itchy plaques along the hairline and scalp, easily mistaken for stubborn dandruff.
- Nail psoriasis — pitting, ridging, thickening, or lifting of the nails, often alongside joint symptoms.
- Inverse psoriasis — smooth, red, tender patches in skin folds (underarms, groin, under the breasts).
- Guttate psoriasis — small, drop-like spots that can appear suddenly, often after a strep infection, especially in younger patients.
- Pustular & other forms — less common patterns that need prompt, experienced dermatologic care.
More than skin — why a dermatologist matters
- Up to 1 in 3 people with psoriasis develop psoriatic arthritis — we watch for joint pain, stiffness, and swelling so it's caught early.
- Psoriasis is linked to higher risk of heart and metabolic disease, so managing the inflammation matters for your overall health.
- Common triggers — stress, infections, skin injury, certain medications, smoking, and alcohol — can be identified and managed.
- The emotional toll is real and treatable; effective skin control consistently improves quality of life.
If flares have left redness or marks behind, the same dermatologists can discuss gentle options through our aesthetic dermatology practice once your psoriasis is well controlled.
Signs & symptoms
What we look for
Itching, burning, soreness
Plaques can itch or feel tender, and may crack or bleed when they're dry or irritated.
Scalp flaking
Persistent thick flakes and plaques on the scalp that don't behave like ordinary dandruff.
Nail changes
Pitting, ridges, thickening, discoloration, or nails lifting away from the nail bed.
Patches in skin folds
Smooth, red, sometimes raw-feeling areas in the armpits, groin, or under the breasts (inverse psoriasis).
Joint pain or stiffness
Achy, swollen, or stiff joints — a signal of psoriatic arthritis that should be evaluated.
How we treat it
Your treatment options
Psoriasis care is not one-size-fits-all. We match the plan to how much skin is involved, where it is, your joints, and your life — and we escalate to advanced options when you need them.
Prescription topicals
Medical-grade steroids, vitamin-D analogs, and newer non-steroidal creams (roflumilast, tapinarof) to calm plaques — including gentler options for the face and skin folds.
Scalp & nail-focused care
Targeted medicated solutions, foams, and shampoos for the scalp, plus treatment strategies for nail involvement.
Phototherapy (light therapy)
Medically supervised narrowband UVB to slow overactive skin cells — a proven option for more widespread psoriasis.
Biologic therapy
Advanced injectable biologics that precisely target the immune signals driving psoriasis (IL-17, IL-23, and TNF pathways) — for moderate-to-severe or stubborn disease, many patients reach clear or nearly clear skin. We manage this care in-house.
Oral systemic medications
Prescription oral options — including newer targeted pills — for appropriate patients who need more than topicals.
Whole-person plan
Trigger management, skin-barrier care, and attention to stress, joints, and overall health so treatment works with the rest of your life.
When to see a dermatologist
If you have thick, scaly, or itchy patches that keep coming back, scalp or nail changes, or any joint pain along with skin symptoms, see a dermatologist. Psoriasis is highly treatable, and starting the right plan early helps protect both your skin and your joints.
Schedule with JuniperCommon questions
Psoriasis FAQ
Is psoriasis curable?
There isn't a cure yet, but psoriasis is very controllable. With today's treatments — especially biologics — many people reach clear or nearly clear skin and stay that way. The goal is long-term control and comfort, not just short-term relief.
Is psoriasis contagious?
No. Psoriasis is an immune-driven condition — you cannot catch it from someone else or pass it to anyone. It's also not caused by poor hygiene.
What are biologics, and do you offer them?
Yes — we prescribe and manage biologics in our practice. Biologics are advanced medications that precisely target the specific immune signals that drive psoriasis (such as IL-17 and IL-23), rather than suppressing the whole immune system. For moderate-to-severe or stubborn psoriasis, they can be remarkably effective, and we handle the evaluation, prior authorizations, and monitoring for you.
Can you treat scalp and nail psoriasis?
Yes. Scalp and nail psoriasis are common and can be frustrating and stubborn. We use targeted topical treatments for the scalp and nails, and when disease is more extensive, systemic and biologic therapies improve the scalp, nails, and skin together.
Does psoriasis affect more than the skin?
It can. Psoriasis is a systemic inflammatory condition associated with psoriatic arthritis and with heart and metabolic health. That's why we look at the whole person — including your joints and overall health — and watch for early signs of arthritis so it can be treated promptly.
I feel self-conscious about my psoriasis. Can that get better?
Absolutely — and you're not alone in feeling that way. Visible plaques can affect confidence, clothing choices, and stress levels, and stress can in turn worsen flares. Getting your skin clear or nearly clear consistently improves quality of life, and we treat the emotional weight of psoriasis as part of caring for the whole person.
Bend & Redmond · Central Oregon
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