Psoriatic arthritis (PsA) is often misunderstood, and those misconceptions can make it harder for people to recognize symptoms, seek care, or understand what living with the condition is really like. It can also be challenging to explain the effects of the condition to friends, family, and co-workers.
“Psoriatic arthritis can also be difficult to diagnose, which can add to the confusion,” says Christopher Richard Morris, MD, a board-certified rheumatologist in Kingsport, Tennessee.
From its demographics to its progression, misconceptions about this autoimmune disease can be surprisingly persistent. Here are five common myths — and the facts to help set the record straight.
Everyday Health
1. Myth: Everyone With Psoriatic Arthritis Has Psoriasis
Not everyone with one condition will automatically have the other. While there is a strong link between psoriasis and psoriatic arthritis, up to 17 percent of people with a PsA diagnosis don’t have any visible skin symptoms at the time of their joint diagnosis.
“Though most adult patients develop psoriasis concurrently or before the symptoms of arthritis, there is a small subset of patients where arthritis develops before the skin manifestations,” says Nayaab Bakshi, DO, a fellow at Stony Brook Medicine’s division of rheumatology in Stony Brook, New York.
That said, Dr. Morris points out that there are PsA patients who may not be aware they also have psoriasis, which manifests in different ways. There can be patches of thick, scaly skin that can appear on the scalp, elbows, knees, or lower back; yellow-brown spots on the nails; or pustules can develop on the hands or feet.
“Psoriasis is not recognized easily, and you may not know what to be looking for,” Morris says. If you do notice a skin eruption, he adds, make an appointment with a dermatologist for a thorough examination.
2. Myth: PsA Is Caused by ‘Wear and Tear,’ Like Osteoarthritis
While both conditions are defined by joint pain, they are driven by different biological processes. Osteoarthritis is a degenerative disease in which the cartilage in the joints breaks down over time due to age, injury, or repetitive use.
PsA is inflammatory, which means joint damage is caused by an overactive immune response.
“Inflammation in psoriatic arthritis triggers a cascade of immune responses that cause joint pain, swelling, and destruction through multiple mechanisms: synovial tissue invasion, cartilage breakdown, and bone erosion,” says Dr. Bakshi. The synovium is the lining in the joints that can become inflamed, causing pain, swelling, and stiffness.
In psoriatic arthritis, your immune system also mistakenly tells your body to strip away bone in some spots while simultaneously building extra bone in others. This uneven process can reshape the joint, whereas osteoarthritis involves the gradual breakdown of protective cartilage.
3. Myth: If Your Skin Is Clear, Your Joints Are Fine
While there is some correlation between the severity of skin symptoms and the severity of the joint pain, the two don’t always move in tandem. The skin and the joints are independent targets of the same overactive immune system.
“We have an immune system that can be directed in many different ways,” says Aly Cohen, MD, a rheumatologist and an integrative health specialist in Princeton, New Jersey, and the medical director of the online education platform the Smart Human. “Because of that variability, you can’t always predict what’s going to become inflamed.”
One study found that some immune cells can migrate from the skin into the joints, where they may continue to trigger inflammation. This could help explain why your joints are affected while your skin looks perfectly healthy.
But it is true that if your skin isn’t clear, your joints may also be affected. Bakshi says the severity of skin symptoms can mirror the severity of joint pain. On the other hand, patients can also have severe psoriasis with mild joint disease, or minimal skin issues with significant joint pain and damage.
4. Myth: Psoriatic Arthritis Primarily Affects Elderly People
Since PsA isn’t an aging-joint issue like osteoarthritis, it doesn’t take decades of living for it to emerge. PsA is triggered by a malfunctioning immune system, and that can activate at any age, including in childhood. Studies suggest that the disease is most common in people 40 to 59 years old.
“There is no great way to understand the demographics,” says Dr. Cohen. “It used to be considered male dominant, but I’ve seen it equalize over the years.” It was also long considered a Caucasian disease, but research now suggests Hispanic and non-white PsA patients may experience more pain and limitations in their daily activities.
More than 1.5 million people in the United States have PsA, and about one-third of people who have the skin condition will develop it. Most people develop psoriasis about 10 to 20 years before being diagnosed with PsA.
5. Myth: The Symptoms Are Limited to Joint Pain and Skin Rash
PsA is often thought of as a condition that is limited to two specific areas, but that view is incomplete. “Psoriatic arthritis (PsA) is a multisystem inflammatory disease that extends beyond joint and skin involvement,” says Bakshi.
In addition to achy joints and skin rashes, other symptoms of PsA include:
Tenderness in the areas where tendons or ligaments attach to bones, such as the back of the heel or sole of the foot
Painful, sausage-like swelling of a whole finger or toe
Nail changes, such as pitting (tiny dents), crumbling, or separation from the nail bed.
Eye inflammation, especially uveitis, which can cause eye pain, redness, and blurry vision, and must be treated promptly to avoid vision loss.
Inflammatory bowel disease
An increased risk of heart disease
The Takeaway
Misconceptions about psoriatic arthritis (PsA) are common, largely because it can be difficult to recognize and diagnose; it can have both a joint and a skin component, and doesn’t always present in obvious or predictable ways.
PsA is an inflammatory disease, not the result of cartilage deterioration. It’s caused by an overactive immune system that damages joints in complex ways, and skin symptoms don’t always reliably reflect what’s happening in the joints.
PsA can affect the whole body, can develop at almost any age, and can impact more than joints and skin. It can also affect your eye, digestive, and cardiovascular health.
Understanding the condition and the effects it may have can help you manage it better.
Learn what foods to include in a psoriasis-friendly diet
KEY POINTS
A Mediterranean-style diet may help reduce psoriasis-related inflammation and improve symptoms.
Foods rich in fibre, antioxidants and omega-3s, like fruits, whole grains and fatty fish, are beneficial.
Limiting processed foods, alcohol and stress can help manage psoriasis flare-ups and inflammation.
Psoriasis is a chronic autoimmune condition that affects around 3% of adults in the United States. It causes red, scaly and inflamed patches on the elbows, knees, scalp and other parts of the skin. These develop because the immune system overreacts to common triggers and produces too many skin cells.
It’s unclear exactly what causes the overactive immune response in psoriasis, but researchers know a combination of genetics and environmental factors are involved. Often, people have a family history of the disease, but factors like infections, medication reactions and stress also play a role.While your eating choices can’t cure psoriasis and there’s no specific diet to follow when you have the condition, some foods like fruits, vegetables, olive oil, nuts, fish, whole grains and beans may help with managing inflammation, research shows.In turn, psoriasis symptoms may be less severe.
Curious which specific foods can help with psoriasis and how? Here’s what nutrition experts recommend.
Fruits & Vegetables
Fruits and vegetables are rich in nutrients including polyphenols, carotenoids and vitamin C that act as antioxidants and may help reduce psoriasis-related inflammation.
“They’re also an excellent source of fibre, which is associated with lower inflammation levels,” says Jennie Miremadi, M.S., CNS, LDN. She recommends pairing berries—which provide antioxidants and fibre—with walnuts for an easy snack.
Across a number of studies, researchers have found that following a Mediterranean-style diet—which includes olive oil and other foods like fruits, vegetables, whole grains, fish and beans—can be helpful for people with psoriasis.
Containing healthy monounsaturated fats and polyphenols, “diet patterns rich in olive oil, like the Mediterranean diet, are associated with lower inflammation overall and may help improve psoriasis symptoms by targeting underlying inflammatory pathways,” says Ilana Schachter, RDN.
Curious how to incorporate more olive oil into your diet? Davis recommends using olive oil as your primary cooking oil and as the base for your salad dressings. She also suggests making a kale salad with purple sweet potatoes, hazelnuts and an olive oil vinaigrette.
In the warmer months, “a watermelon salad with feta, olive oil and fresh herbs can be a refreshing, anti-inflammatory side,” Schachter says.
Whole Grains
Whole grains are a good source of dietary fibre, which has been associated with lower levels of inflammation in the body.Whole grains like oats and barley contain fermentable fibres that gut bacteria break down in the colon to produce short-chain fatty acids. These compounds help reduce inflammation and modulate immune responses, Schachter explains.
While no single food is a standalone treatment for psoriasis, replacing refined grains with whole grains is a dietary pattern that’s consistently associated with lower markers of systemic inflammation.
“Swap white refined grains with whole grains like rolled oats, quinoa, brown rice and whole-grain bread,” Davis says. Other ideas include overnight oats, a bulgur pilaf side dish or quinoa stuffed peppers. For an anti-inflammatory meal that includes whole grains and many other psoriasis-friendly foods, Miremadi recommends combining leafy greens, roasted salmon, farro or quinoa, and then tossing it with lots of extra virgin olive oil and fresh lemon juice.
Fatty Fish
Credit:
Photographer: Robby Lozano. EatingWell design
Fatty fish like salmon, sardines and mackerel are rich in the omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), which research suggests can help reduce systemic inflammation.The body can’t produce omega-3s naturally, so it’s important to get them from the food you eat.
“In a disease like psoriasis, which is characterized by chronic inflammation and immune activation, fatty fish may be supportive for managing inflammation and symptoms,” Miremadi says.
Minimize your intake of processed foods. Consuming ultra-processed foods, like packaged sweet or savoury snacks, processed meats and soft drinks, is linked with a higher risk for psoriasis.A diet high in ultra-processed foods has also been linked with increased inflammation and may worsen or trigger psoriasis flare-ups.
Limit your alcohol intake. Alcohol is known to trigger or worsen psoriasis flare-ups.
Steer clear of smoking. Smoking has been linked with more severe psoriasis and can also increase the risk of developing psoriasis.
Find ways to minimize stress. Stress can trigger psoriasis flare-ups. Habits like journaling, meditation and gentle movement can all help with managing stress.
There’s no standard diet that people with psoriasis need to follow. And no single food can treat or cure the condition. But research suggests that eating specific foods like fruits, vegetables, olive oil, whole grains and fatty fish can help reduce inflammation. This may help support a balanced immune response, which can be beneficial for individuals with psoriasis. Keep in mind that dietary changes work best as a complement to medical treatment, not a replacement for it. And of course, it’s always a good idea to speak with a physician or registered dietitian before making any major changes to your diet.
An important new psoriasis medicine developed under a collaboration between Johnson & Johnson and University of Queensland (UQ) spin-out Protagonist Therapeutics has received approval for use by the United States Food and Drug Administration (FDA). The new drug, icotrokinra, will be marketed as ICOTYDE.
Protagonist was launched from UQ’s Institute for Molecular Bioscience (IMB) in 2001 to pioneer the development of new oral peptide drugs for hard-to-treat conditions. ICOTYDE was jointly discovered by Protagonist and JNJ scientists. The Protagonist team included members of Protagonist’s embedded research team at IMB.
Image: Protagonist Therapeutics founder Professor Mark Smythe.
“I believe this is a life-changing drug for people with this debilitating condition,” said Greg Bourne, the head of Protagonist’s IMB research team. “The science we undertake in Australia, and here at IMB, can transform lives around the world.”
Protagonist founder Professor Mark Smythe added, “These diseases affect millions of people around the world, and currently, most advanced treatments are through injection. But we also know 75 percent of people don’t like needles, especially children, so this oral drug brings targeted treatment and safety expectations with the gentleness and convenience of a once-daily pill.”
Professor Smythe held several executive positions at Protagonist until 2022, when he stepped down to become Chief Executive Officer of Infensa Bioscience Pty Ltd.
Medical milestone
Psoriasis is a chronic autoimmune condition causing inflamed skin patches that affects an estimated 60 - 125 million people worldwide. Millions of people suffer from moderate to severe forms that can have deep physical, social and psychological impacts.
IMB Executive Director Professor Ian Henderson said what it means for those patients is what makes the FDA approval so exciting.
“ICOTYDE offers a convenient, once-daily treatment for those living with psoriasis, and it paves the way for further research into oral therapeutics for other immune-mediated conditions,” Professor Henderson said.
“It highlights the power of collaborative research, reinforces IMB’s reputation as a powerhouse of scientific innovation and positions Australia as a global leader in next-generation therapeutics. Our researchers are accelerating innovation through industry partnerships to tackle diseases with high unmet needs, reaching global markets to improve the lives of millions worldwide.”
ICOTYDE is under additional assessment for the treatment of psoriatic arthritis and inflammatory bowel diseases.
IMB Translation Director, Professor Mark Blaskovich, said “Australia has played an important role in many important medical advancements, including cervical cancer vaccine Gardasil and the discovery that bacteria Helicobacter pylori causes ulcers. We’re very proud of the contribution the IMB made to ICOTYDE as well.”
Protagonist, headquartered in the US with additional research operations at IMB, is one of 20 companies launched by IMB, and one of more than 136 companies originating from UQ intellectual property.
Protagonist, in partnership with Takeda Pharmaceutical Company, is also seeking approval from the U.S. Food and Drug Administration for another drug, rusfertide, another drug developed from Protagonist’s peptide platform to treat polycythemia vera, a form of blood cancer.
It can cause lasting joint damage and even disability if left untreated
Psoriasis, affecting over a million people across Britain, may put those living with the condition and their family members at increased risk of a specific form of arthritis. The condition can affect multiple joints in the body and, when severe cases go untreated, could potentially result in disability.
Psoriasis Association UK reports that approximately one in five people with psoriasis go on to develop psoriatic arthritis. The two key warning signs are psoriasis affecting the skin, nails or scalp, alongside joint pain, stiffness or swelling, although which joints are affected differs significantly from person to person.
Where psoriasis affects the fingernails, it's commonly linked with arthritis in the fingertip joints. Other commonly impacted areas include the knees, ankles, wrists, hips and the smaller joints in the hands and feet.
Arthritis Action notes that psoriatic arthritis can develop in adults of any age. Some people may experience a mild version affecting only one or two finger joints, while others may find the condition spreading to their spine and sacroiliac joints.
Symptoms in affected joints, according to Psoriasis Association UK:
Stiffness, pain, throbbing, swelling and tenderness in one or more joints
Swollen sausage-like finger(s) or toe(s)
Nail changes
Tenderness, pain and swelling over tendons
A reduced range of movement
General tiredness and fatigue
These symptoms often intensify in the morning, with certain people noticing their condition varies over time. There isn't a specific blood test to identify psoriatic arthritis. Healthcare practitioners will assess your joints and examine both your personal and family medical background before carrying out investigations to exclude other common arthritis types like rheumatoid arthritis or gout.
Psoriatic arthritis can affect adults of any age (Image: GETTY)
Managing psoriatic arthritis involves numerous approaches, including physical therapy, occupational therapy and self-care strategies. Certain people may require more clinical interventions such as pain relief medication, steroid injections into joints or potentially surgery, while others could see improvements through a blend of multiple therapies.
Arthritis Action explains: "The treatment of psoriatic arthritis depends on how many joints are affected and how severely. If only one or two small joints are affected, the treatments may be painkillers or anti-inflammatory tablets such as naproxen."
Particular medicines given for severe arthritis presentations can additionally help with skin psoriasis. However, the Psoriasis Association UK notes that some people have developed psoriatic arthritis manifestations prior to any psoriasis becoming evident on their skin.
The hallmark symptom of psoriasis is the appearance of dry, itchy, sore and scaly skin patches covered in what looks like silvery-white scales. According to the NHS, these patches usually range from one to two cm in size, with most people experiencing multiple small patches scattered across their body.
The most common places to get psoriasis are:
Head and behind the ears
Chest, tummy and back
Bottom
Forearms and elbows
Lower legs and knees
Folds of the body such as in the groin
Should psoriasis impact the nails, it may cause pitting or small dents. Similar to psoriatic arthritis, psoriasis symptoms come and go in cycles, with patients experiencing intermittent episodes of the condition.
While psoriasis cannot be cured, it's generally manageable through specialised creams, lotions or ointments. The condition can significantly affect mental health too, which may lead to referral to a mental health specialist for further assistance.
Living with a chronicskin conditiongoes beyond appearance. It affects comfort, confidence, and your overall sense of control. For many men dealing with eczema, Rosacea, or Psoriasis skin rash, daily grooming becomes a balancing act, looking presentable while avoiding irritation. Because inflammation is often persistent, visible, and misunderstood, a more thoughtful approach to skincare is essential.
In recent years, dermatologists have shifted how they approach men’s grooming. A basic bar of soap and any lotion is no longer enough. The focus now is on targeted care, repairing the skin barrier, and maintaining consistency, especially when managing conditions like psoriasis skin rash. The good news is that with the right habits, you can reduce flare-ups, improve skin comfort, and keep your routine simple.
Here are 9 grooming tips every man with a skin condition should know…
If you’re still using a harsh bar soap on your face, it’s time to switch.Gentle, fragrance-free cleansersare far less likely to strip the skin or trigger irritation. Over-washing can also worsen dryness and inflammation, so aim to cleanse twice daily, morning and night, and keep the routine minimal.
#2. Moisturize Like It Matters
Moisturizing is essential when managing chronic skin conditions. A rich, barrier-repairing cream helps strengthen skin that is often compromised in conditions like psoriasis. Apply moisturizer while your skin is still slightly damp to lock in hydration, and reapply as needed throughout the day. With consistency, this step alone can reduce itching and make flare-ups less severe over time.
Sun exposure can trigger or worsen inflammatory conditions, particularly rosacea.Mineral sunscreenscontaining zinc oxide or titanium dioxide are typically better tolerated by sensitive skin than chemical formulas. Wearing sunscreen daily isn’t just about preventing sunburn; it also protects already-reactive skin from further irritation.
#4. Learn to Read Labels
When managing chronic skin issues, ingredients matter just as much as routine. Look for beneficial components like ceramides, hyaluronic acid, and colloidal oatmeal, which support hydration and barrier repair. At the same time, avoid common irritants such as fragrance, alcohol, and aggressive exfoliants. Even products labelled “natural” can aggravate sensitive skin or trigger a psoriasis flare if they contain hidden irritants.
Introducing a new product without testing it first can lead to unnecessary flare-ups. Apply a small amount to a discreet area and wait 24 hours to monitor your skin’s reaction. It’s also best to introduce one product at a time, so you can clearly identify what works and what doesn’t.
#6. Shave Smarter, Not Harder
Shaving can be particularly harsh on sensitive or inflamed skin. Use a single- or double-blade razor, shave in the direction of hair growth, and always use a moisturizing shaving cream. Avoid alcohol-based aftershaves and opt for soothing balms with calming ingredients like aloe or niacinamide to minimize irritation.
Hot showers may feel relaxing, but they can worsen dryness and inflammation. Stick to lukewarm water and keep showers brief. Afterward, gently pat your skin dry instead of rubbing it. Friction alone can aggravate sensitive areas and make conditions like psoriasis skin rash more uncomfortable.
#8. Simplify During Flare-Ups
When your skin is flaring, less is more. Strip your routine back to the essentials: a gentle cleanser, prescribed treatments (if any), a moisturizer, and sunscreen during the day. Avoid introducing new products or using active ingredients like retinoids or exfoliating acids, as these can worsen irritation during sensitive periods.
A solid routine can go a long way, but some skin conditions require professional care. If symptoms persist or worsen, it’s important to consult a dermatologist. Prescription treatments and expert guidance can significantly improve how you manage chronic inflammation.
Time To Get Smarter With Your Skincare
Having a chronic skin condition doesn’t mean giving up on looking good—it means being more intentional about how you care for your skin. Small, consistent changes, from choosing the right cleanser to identifying your triggers, can make a meaningful difference.
With the right approach, even persistent conditions like psoriasis can become far more manageable. In the end, good grooming isn’t about perfection. It’s about feeling comfortable in your own skin.
