Psoriasis Treated in Owings Mills
What is psoriasis and how does it develop?
Psoriasis is a chronic autoimmune skin condition characterized by red, inflamed, scaly patches with silvery-white scales. Dr. Steven Barry Snyder specializes in diagnosing and managing psoriasis and other complicated skin conditions.
Psoriasis develops when the immune system mistakenly overreacts, causing skin cells to grow and shed rapidly—far faster than normal skin renewal. This rapid cell turnover creates thick, scaly plaques that are often itchy, painful, and cosmetically distressing. Psoriasis is not contagious and cannot spread from person to person.
Psoriasis commonly appears on elbows, knees, the groin area, and the scalp, but can develop anywhere on the body. Severity ranges from mild (small isolated patches) to severe (covering large body surface areas and significantly impacting quality of life).
Types of psoriasis and where they appear on the body
Psoriasis presents in several forms, each with distinct characteristics:
Plaque psoriasis (most common, 80-90% of cases)
Thick, red, scaly patches most commonly on elbows, knees, scalp, and lower back. Plaques can be painful and itchy and may crack or bleed.
Scalp psoriasis
Red, scaly patches on the scalp causing flaking, itching, and sometimes hair loss if severe. May extend beyond the hairline onto forehead and neck.
Guttate psoriasis
Small, drop-shaped red lesions appearing suddenly, often triggered by infection (especially strep throat). Can cover large body surface areas.
Inverse psoriasis
Smooth, non-scaly red patches in skin folds (armpits, groin, under breasts). More common in obese patients and those with poor hygiene in these areas.
Pustular psoriasis
Yellow, pus-filled pustules surrounded by red skin. Can be localized (hands and feet) or generalized (entire body). Severe form requiring urgent treatment.
Erythrodermic psoriasis
Rare, severe form covering most of the body in a fiery red rash. Medical emergency requiring hospitalization.
Accurate diagnosis of your psoriasis type is important because treatment approaches differ based on type and severity.
What triggers psoriasis flare-ups?
While genetics play a major role (about one-third of psoriasis patients have family history), flare-ups are triggered by external and internal factors:
Stress and emotional upset
One of the most common triggers; stress hormones can activate immune flare-ups
Infections
Bacterial infections (especially strep throat) and viral infections frequently trigger or worsen psoriasis
Injuries to skin
Cuts, scrapes, burns, sunburns, or tattoos at the site can trigger psoriasis plaques (Koebner phenomenon)
Medications
Beta-blockers, ACE inhibitors, NSAIDs, and lithium can worsen psoriasis
Cold, dry weather
Winter conditions with low humidity dramatically worsen psoriasis for many patients
Alcohol consumption
Alcohol worsens psoriasis, especially in men
Smoking
Smokers have worse psoriasis; quitting improves outcomes
Rapid weight gain
Weight gain can trigger or worsen psoriasis
Certain foods
While not universally triggering, some patients find that specific foods (alcohol, spicy foods, sugar) worsen flares
Immune system activation
Vaccines or other immune stimuli may trigger flares
Identifying your personal triggers is crucial for minimizing flare-ups and maintaining control.
How does psoriasis affect quality of life?
Psoriasis is more than a cosmetic issue—it significantly impacts physical and emotional well-being:
Pain and itching
Plaques are often intensely itchy and painful, interfering with sleep and daily activities
Emotional distress
Visible plaques cause embarrassment, social anxiety, and depression in many patients
Work impact
Time off for appointments, flare management, and emotional distress affect productivity
Relationship strain
Psoriasis can impact intimate relationships and social interactions
Associated conditions
Psoriatic arthritis (joint inflammation) affects 10-30% of psoriasis patients, causing joint pain and disability
Increased cardiovascular risk
Severe psoriasis is associated with increased heart attack and stroke risk
Metabolic syndrome
Obesity, diabetes, and lipid abnormalities are more common in psoriasis patients
Effective psoriasis treatment improves not just skin appearance but overall quality of life and health outcomes.
Dr. Snyder’s comprehensive approach to psoriasis management
Dr. Snyder customizes treatment regimens based on your psoriasis type, severity, location, impact on quality of life, and response to previous treatments. His multi-pronged approach combines:
Accurate diagnosis
Determining your specific psoriasis type, which guides treatment selection
Trigger identification
Working with you to recognize and minimize personal triggers
Patient education
Explaining your condition and why specific treatments matter for long-term control
Combination therapy
Most effective psoriasis management uses multiple treatment modalities rather than single approaches
Regular monitoring
Assessing treatment response and adjusting the regimen as needed
Dermatologic expertise
Board certification means specialized training in complex skin diseases like psoriasis
Many patients who’ve struggled with psoriasis for years achieve significant improvement or even near-complete clearance with Dr. Snyder’s comprehensive, individualized approach.
Psoriasis treatment options at Dermatology Laser Center & Medispa
Dr. Snyder offers the full spectrum of evidence-based psoriasis treatments:
Topical prescription medications
Corticosteroids, calcineurin inhibitors, vitamin D analogs, coal tar, retinoids, and newer topical immune modulators applied directly to plaques
Systemic (oral) medications
Methotrexate, acitretin, and other oral immunosuppressants for extensive or severe psoriasis not responding to topical treatments
Biologic medications
Injectable or infused medications targeting specific immune system pathways. Options include:
- TNF-alpha inhibitors (Humira, Enbrel, Remicade)
- IL-17 inhibitors (Taltz, Cosentyx, Secukinumab)
- IL-23 inhibitors (Stelera, Tremfya, Skyrizi)
- Other targeted biologics
Ultraviolet light therapy
Narrowband UVB (NB-UVB) phototherapy or PUVA (psoralen + UVA) for body psoriasis; highly effective for extensive disease
XTRAC ULTRA Excimer Laser
Targeted 308nm excimer laser specifically treating psoriatic plaques on elbows, knees, scalp, and other localized areas; spares surrounding healthy skin
Combination in-office treatments
Specialty creams, emollients, and cosmeceutical preparations customized for psoriasis management
Trigger management
Stress reduction counseling, lifestyle modifications, medication review
What is XTRAC laser and why is it effective for psoriasis?
XTRAC ULTRA is a specialized 308-nanometer excimer laser that treats psoriasis by delivering targeted UV radiation directly to psoriatic plaques. Key advantages include:
Targeted treatment
The laser beam treats only the plaques, sparing surrounding healthy skin
Rapid clearance
Many plaques clear after just 5-15 treatments
Ideal for localized psoriasis
Particularly effective for scalp, elbow, knee, and genital psoriasis
Minimal systemic side effects
Because it’s localized, there’s no exposure of your entire body to UV radiation
Can be combined with other treatments
Often used alongside topical medications or systemic therapy for enhanced results
Fast treatments
Sessions take just minutes
Excellent safety profile
FDA-approved with decades of clinical use
XTRAC laser is particularly valuable for patients with limited body involvement or those who prefer avoiding systemic medications.
Biologic medications for psoriasis: how they work and when to use them
Biologics are medications engineered to target specific immune system pathways responsible for psoriasis. They’re typically reserved for moderate-to-severe psoriasis not responding to topical treatments or phototherapy.
TNF-alpha inhibitors (Humira, Enbrel, Remicade)
Block tumor necrosis factor-alpha, a key inflammatory mediator. Often the first biologic choice. Can also treat psoriatic arthritis.
IL-17 inhibitors (Taltz, Cosentyx, Secukinumab)
Target interleukin-17, another critical inflammation pathway. Highly effective for plaque psoriasis; newer option.
IL-23 inhibitors (Stelera, Tremfya, Skyrizi)
Block interleukin-23. Particularly effective for moderate-to-severe plaque psoriasis and pustular psoriasis.
Benefits of biologics: Dramatic improvements or near-complete clearance in many patients; often combined with topical treatments for optimal results.
Considerations: Biologics require monitoring for infections and other side effects; cost can be high but most insurance plans cover them for appropriate candidates; require regular infusions or injections.
Dr. Snyder will determine if biologics are appropriate for your psoriasis and will monitor your response and safety throughout treatment.
Scalp psoriasis: unique treatment challenges and solutions
Scalp psoriasis is particularly frustrating because:
- Thick plaques are difficult to treat with topical medications
- Hair interferes with treatment application and effectiveness
- Flaking and visible scales are socially embarrassing
- Itching can be intense, leading to scratching and hair loss
- Regular shampoos may worsen symptoms
Effective scalp psoriasis treatments include:
- Prescription scalp lotions and foams (easier to apply than creams in hair)
- Medicated shampoos combining tar, salicylic acid, or other actives
- Intralesional steroid injections directly into plaques for rapid improvement
- XTRAC laser therapy targeting scalp plaques
- Systemic medications or biologics for extensive scalp involvement
- Gentle hair care practices (avoid tight hairstyles, harsh chemicals, hot water)
Many patients find significant improvement in scalp psoriasis with Dr. Snyder’s targeted approach.
Psoriatic arthritis: when psoriasis affects your joints
Psoriatic arthritis (PsA) develops in 10-30% of psoriasis patients. Symptoms include:
- Joint pain, stiffness, and swelling (often in hands, feet, knees, ankles)
- Reduced range of motion
- Morning stiffness that improves with activity
- Nail changes (pitting, discoloration)
- Fatigue
Important: Psoriatic arthritis can cause permanent joint damage if untreated. Early treatment with appropriate biologics or systemic medications can prevent disability and joint destruction.
If you have psoriasis and develop joint symptoms, discuss this with Dr. Snyder. He may recommend rheumatology consultation and earlier biologic therapy to protect your joints.
Schedule your psoriasis consultation in Owings Mills
Whether you’re struggling with new-onset psoriasis, have been dealing with chronic psoriasis for years, or simply want expert evaluation and improved management, Dr. Steven Barry Snyder offers comprehensive diagnosis and individualized treatment plans. Dr. Snyder specializes in complex dermatologic conditions and has successfully treated countless psoriasis patients with dramatic improvements.
Call (410) 356-0000 to schedule your psoriasis consultation. We’ll evaluate your condition, discuss your treatment goals, and create a customized management plan designed to clear your skin and improve your quality of life.
Achieve clear skin and better quality of life
Psoriasis doesn’t have to control your life. With modern treatments—from topical medications to biologics to XTRAC laser—most patients achieve significant improvement or near-complete clearance. Dr. Snyder will work with you to find the approach that works best for your psoriasis.
Frequently Asked Questions
Psoriasis cannot be permanently cured, but it can be very effectively controlled and managed. Many patients achieve near-complete clearance and remain clear with appropriate treatment. Others require ongoing maintenance therapy. Treatment goals focus on achieving and maintaining clear skin while minimizing treatment burden and side effects. Dr. Snyder will work with you to achieve the best possible control of your psoriasis.
No. Psoriasis is not contagious and cannot spread from person to person through contact, bodily fluids, or any other means. It’s an autoimmune condition, not an infection. You cannot catch psoriasis from someone with the condition, and your psoriasis cannot infect others.
Stress is one of the most common psoriasis triggers. Psychological stress triggers immune system activation and inflammatory cytokine release that can cause or worsen psoriasis flares. Managing stress through exercise, meditation, adequate sleep, and stress reduction techniques is an important part of psoriasis management. Some patients find that addressing stress alone significantly improves their psoriasis.
Regular moisturizers often aren’t effective enough for psoriasis. Psoriatic skin needs heavier creams or ointments with specific ingredients that reduce inflammation and support skin barrier repair. Look for products containing salicylic acid, urea, lactic acid, or coal tar. Dr. Snyder will recommend specific products most effective for your psoriasis type and severity.
Response time varies. Topical treatments may show improvement in 1-2 weeks. Phototherapy typically shows improvement in 4-6 weeks with regular sessions. Biologics often show improvement within 2-4 weeks, with maximum benefit at 12 weeks. XTRAC laser can show rapid improvement in 5-15 treatments. Dr. Snyder will establish realistic timelines based on your treatment approach and monitor progress.
While diet doesn’t directly cause psoriasis, certain foods may trigger or worsen flares in some patients. Common triggers include alcohol (especially beer and liquor), spicy foods, high-sugar foods, and foods you’re allergic to. Anti-inflammatory foods (omega-3 fatty acids, antioxidants, fruits and vegetables) may help reduce inflammation. Keep a food diary if you suspect dietary triggers. Dr. Snyder can discuss dietary modifications during your consultation.
No. In fact, moderate sun exposure (and UV phototherapy) actually improves psoriasis for most patients. Sunlight triggers vitamin D production, which helps regulate immune function and improve psoriasis. However, you should avoid getting sunburned, which can trigger flares (Koebner phenomenon). Use sunscreen on exposed non-psoriatic skin and enjoy gradual, moderate sun exposure. Artificial UV phototherapy (NB-UVB and PUVA) are proven psoriasis treatments when natural sun exposure isn’t sufficient.
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