Psoriasis Awareness Month: A Professional's Guide to Assessment and Support

Published: August 2025

 

August marks Psoriasis Awareness Month, a time when skincare professionals have a unique opportunity to deepen their understanding of this complex condition and enhance their ability to support affected clients. As a skin expert and educator, I believe that professional assessment and barrier-supporting protocols can significantly improve outcomes for the 125 million people worldwide living with psoriasis.

Understanding Psoriasis: Beyond the Surface

Psoriasis is far more than a cosmetic concern—it's a chronic, immune-mediated inflammatory condition that fundamentally alters skin function. The hallmark of psoriasis is accelerated cell turnover, with skin cells multiplying up to 10 times faster than normal. While healthy skin takes 28-30 days to complete its renewal cycle, psoriatic skin completes this process in just 3-4 days.

 

This rapid turnover creates the characteristic plaques we observe: well-demarcated, raised, red lesions covered with silvery-white scales. However, the visible presentation is only part of the story. The underlying barrier dysfunction creates a vicious cycle that perpetuates and often worsens the condition.

The Barrier Dysfunction Cycle

Understanding the barrier dysfunction cycle is crucial for effective professional support:

 

1. Initial Trigger: Environmental factors, stress, or genetic predisposition activate immune responses
2. Inflammation: Immune activation triggers inflammatory cascades
3. Accelerated Turnover: Inflammation drives rapid cell proliferation
4. Impaired Barrier Formation: Rapid turnover prevents proper barrier development
5. Increased Permeability: Compromised barrier allows more triggers to penetrate
6. Cycle Perpetuation: The process continues and intensifies

 

Professional intervention focuses on breaking this cycle through strategic barrier repair, complementing medical treatments while providing significant relief between dermatologist visits.

Professional Assessment: The P.S.O.R.I. Framework

Accurate assessment is the foundation of effective professional support. I've developed the P.S.O.R.I. Assessment Framework to ensure comprehensive evaluation:

 

P - Pattern Recognition: Observe distribution, symmetry, and characteristic presentations. Plaque psoriasis typically affects extensor surfaces (elbows, knees), while inverse psoriasis appears in skin folds.

 

S - Scale Evaluation: Assess thickness, adherence, and color of scales. Psoriatic scales are typically silvery-white and may demonstrate the Auspitz sign (pinpoint bleeding when removed).

 

O - Observation of Borders: Note the well-defined borders characteristic of psoriatic plaques, distinguishing them from conditions like eczema with more diffuse borders.

 

R - Reactivity Assessment: Evaluate for Koebner phenomenon (psoriasis developing at sites of skin trauma) and identify potential triggers through detailed history-taking.

 

I - Impact Evaluation: Assess both physical symptoms (itching, pain, bleeding) and psychosocial impact on quality of life, relationships, and daily activities.

Types of Psoriasis: Professional Identification

While plaque psoriasis represents 80-90% of cases, recognizing other presentations is essential:

 

Guttate Psoriasis appears as small, drop-shaped lesions, often following streptococcal infections. This form is more common in children and young adults and may resolve spontaneously or progress to plaque psoriasis.

 

Inverse Psoriasis affects skin folds with smooth, red patches lacking typical scales. The absence of scaling can make diagnosis challenging, as it may resemble fungal infections or intertrigo.

 

Pustular Psoriasis presents with sterile pustules on red skin and requires immediate medical referral, especially in generalized forms that may be accompanied by systemic symptoms.

 

Erythrodermic Psoriasis involves widespread redness and scaling affecting more than 75% of the body surface. This represents a medical emergency requiring immediate referral due to potential complications including protein loss, fluid imbalance, and altered thermoregulation.

Professional Barrier Repair Protocols

The cornerstone of professional psoriasis support lies in barrier repair. This approach doesn't replace medical treatment but provides crucial complementary benefits:

 

Gentle Cleansing: Use physiologically compatible cleansers that remove impurities without disrupting the already compromised barrier. Avoid harsh surfactants that can trigger flares.

 

Physiological Lipid Replacement: Apply products containing ceramides, cholesterol, and fatty acids in ratios that mimic healthy skin. This supports barrier reconstruction and reduces transepidermal water loss.

 

Anti-inflammatory Actives: Incorporate ingredients like boswellia, evening primrose oil, or vitamin D liposomes to address inflammation while supporting barrier function.

 

Consistent Protocol: Establish regular treatment schedules that clients can maintain between professional visits. Consistency is crucial for breaking the dysfunction cycle.

Scalp Psoriasis: Special Considerations

Scalp involvement affects 45-56% of people with psoriasis and requires specialized approaches. The thick, adherent scales characteristic of scalp psoriasis can be particularly challenging to manage and may extend beyond the hairline onto the forehead, ears, or neck.

 

Professional scalp protocols should include:

 

-       Pre-treatment scale softening

-       Gentle, non-traumatic removal techniques

-       Barrier-supporting treatments that won't interfere with hair styling

-       Client education about proper home care techniques

When to Refer: Professional Boundaries

Recognizing when to refer clients to dermatologists demonstrates professional expertise and ensures optimal client care. Referral is indicated for:

 

-       Widespread involvement (>5-10% body surface area)

-       Rapidly progressing or unstable presentations

-       Signs of infection or complications

-       Joint symptoms suggesting psoriatic arthritis

-       Significant impact on mental health or quality of life

-       Uncertainty about diagnosis

Supporting Clients Between Medical Treatments

Professional skincare provides valuable support during the often lengthy intervals between dermatologist appointments. This support includes:

 

Barrier Maintenance: Consistent barrier repair protocols that maintain skin comfort and function between medical treatments.

 

Trigger Identification: Helping clients identify and document personal triggers through systematic tracking and professional observation.

 

Product Education: Teaching clients how to select and use appropriate products that support rather than compromise their skin barrier.

 

Emotional Support: Providing a safe space for clients to discuss the psychosocial impact of their condition while maintaining appropriate professional boundaries.

The Future of Professional Psoriasis Support

As our understanding of psoriasis pathophysiology continues to evolve, so too does our ability to provide effective professional support. Emerging research on the skin microbiome, barrier function, and inflammatory pathways offers new opportunities for professional intervention.

 

The integration of technology, including skin analysis devices and telemedicine platforms, allows for more precise assessment and monitoring. However, the fundamental principles of gentle care, barrier support, and professional expertise remain constant.

Conclusion

Psoriasis Awareness Month reminds us of our responsibility as skincare professionals to provide evidence-based, compassionate care for clients with this challenging condition. Through proper assessment, barrier repair protocols, and appropriate referrals, we can significantly improve outcomes and quality of life.

 

The key lies in understanding that psoriasis is not simply a cosmetic concern but a complex condition requiring professional expertise, ongoing support, and collaborative care with medical providers. By elevating our knowledge and skills, we can truly make a difference in the lives of those affected by psoriasis.

 

 

René Serbon is a skin expert and educator specializing in professional skin assessment and barrier function. She provides advanced training for skincare professionals through her Professional Skin Assessment Mastery program and distributes Dermaviduals professional skincare products in Canada.

 

Learn More:

 

-       Professional Skin Assessment Mastery: www.thedermadifference.academy/skincaremastery

-       Dermaviduals Canada: www.dermaviduals.ca

-       René Serbon Skin Expert: www.reneserbon.com

 

© 2025 René Serbon | Skin Expert & Educator