Psoriasis
Specialist assessment and treatment for adults and children with psoriasis
At Midland Skin, we offer consultant dermatologist assessment and treatment for adults and children with psoriasis in Birmingham and across the Midlands.
Quick Facts about psoriasis
Best for
Psoriasis or suspected psoriasis
Appointment
Initial dermatology assessment
Treatment
Creams, tablets or injections
Symptoms
Scaly, itchy or sore skin
Provider
Consultant dermatologist
Price
See below
What is psoriasis?
Psoriasis is a long-term inflammatory condition caused by changes in the way the immune system interacts with the skin. It commonly produces well-defined areas of thickened, scaly skin that may itch, crack, bleed or feel sore.
It can affect any part of the body, including the scalp, nails, skin folds, hands, feet and genital area. Its appearance can vary according to the area affected, the type of psoriasis and the person’s skin tone.
Psoriasis is not contagious. It often follows a relapsing course, with periods when it improves and others when it flares. Some people with psoriasis also develop inflammation affecting the joints, known as psoriatic arthritis.
When should I see a dermatologist for psoriasis?
A specialist dermatology assessment can be worthwhile when psoriasis is persistent, difficult to control or affecting your daily life.
You may benefit from an assessment if:
- the diagnosis is uncertain or the rash has changed
- your psoriasis is spreading or becoming more difficult to manage
- treatment from your GP has not provided adequate control
- the scalp, nails, face, skin folds, genital area, hands or feet are affected
- treatments are messy, time-consuming, impractical or causing side effects
- itching, soreness or visible plaques are affecting sleep, work, confidence or relationships
- your child has suspected or established psoriasis
- you have joint pain, swelling or stiffness that could indicate psoriatic arthritis
- you would like to discuss phototherapy, tablet treatment or biologic injections
If your skin becomes rapidly and extensively red or develops widespread pustules, particularly if you have a fever or feel unwell, seek urgent medical attention rather than waiting for a routine appointment.
Derek Spence
Why getting the diagnosis right matters
Psoriasis can resemble eczema, seborrhoeic dermatitis, fungal infection and several other inflammatory skin conditions. It may also look different in children, on different skin tones and when it affects areas such as the scalp, skin folds, palms, soles or nails.
Different conditions require different treatment. The assessment also establishes the type, extent and impact of the psoriasis, checks for possible joint involvement and helps determine whether creams are sufficient or whether another form of treatment should be considered.
Psoriasis is usually diagnosed by examining the skin and taking a careful history. A skin scraping, swab or biopsy is only considered when the appearance is unusual or another diagnosis needs to be excluded.
Treatment pathway
Initial dermatology assessment
A consultant dermatologist assesses your skin, scalp and nails and reviews your symptoms, previous treatments, relevant medical history, medications and any joint symptoms.
Care plan
A treatment plan is discussed with you. This may include prescription creams, tablet or injection treatment, relevant investigations or referral for narrowband UVB phototherapy.
Review consultation
A review consultation is required to assess your response and decide whether treatment should be continued, changed or stopped. Ongoing management and monitoring are discussed where appropriate.
What causes psoriasis to flare?
Psoriasis results from a combination of genetic susceptibility and immune-system activity. Triggers do not cause the underlying condition, but they may bring on or aggravate a flare in some people.
Not everyone can identify a trigger. Possible triggers and aggravating factors include:
- infections, particularly streptococcal throat infections
- injury, friction, scratching or sunburn affecting the skin
- emotional stress
- smoking and excessive alcohol consumption
- some medicines, including lithium and certain beta-blockers
- cold or dry weather
- stopping certain treatments abruptly
How is psoriasis treated at Midland Skin?
Treatment is individualised according to your age, the areas affected, the extent and severity of the psoriasis, its impact on your life, previous treatment and your general health.
No particular prescription or treatment can be guaranteed before assessment.
Prescription creams and scalp treatments
Topical treatment is often appropriate for limited psoriasis. This may include emollients and prescription treatments that reduce inflammation, scaling and excessive skin-cell production.
Different preparations are used for the scalp, face, skin folds, body, hands and feet. Your dermatologist will explain how much to apply, where to use it and how long it should be continued. A manageable treatment routine is important because complicated or impractical regimens are difficult to sustain.
Narrowband UVB phototherapy
Narrowband UVB may be considered when psoriasis is too extensive for creams alone or has not responded adequately to topical treatment.
Midland Skin does not deliver narrowband UVB on site. If it is suitable, your consultant dermatologist can refer you to another private hospital where the course of phototherapy is delivered. Access to this service requires a consultant referral.
Phototherapy involves repeated hospital visits and does not permanently cure psoriasis. Your suitability, the likely treatment schedule and the potential risks and benefits will be discussed before referral.
Tablet and biologic treatment
Tablet or injection treatment may be considered when psoriasis is extensive, has a substantial effect on quality of life, involves particularly difficult areas or has not been adequately controlled with other treatment.
For suitable patients, Midland Skin may offer private access to established and newer tablet treatments and a wide range of modern biologic medicines. Biologics target particular parts of the inflammatory process involved in psoriasis.
The choice depends on the type and severity of psoriasis, previous treatment, other medical conditions, current medication and individual safety considerations. Baseline screening, blood tests and ongoing monitoring may be required.
Children with psoriasis are assessed according to their age, symptoms, areas affected and the effect of the condition on everyday life. Treatment is selected carefully and discussed with the child and their parent or carer.
What can I expect from psoriasis treatment?
There is currently no permanent cure for psoriasis, but treatment can provide substantial control of the skin symptoms and their effect on daily life. Modern systemic and biologic treatments can provide a high level of control for many suitable patients, although no treatment works for everyone.
Some people need intermittent courses of topical treatment. Others benefit from maintenance treatment, phototherapy or longer-term tablet or injection treatment.
The response may change over time, and more than one treatment may need to be considered before finding the most suitable approach. A recurrence after treatment does not necessarily mean that the treatment failed; it reflects the relapsing nature of psoriasis.
Regular review is particularly important for prescription treatments that require adjustment, safety monitoring or decisions about whether treatment should be continued.
Psoriasis consultation and treatment: FAQs
Who will assess me?
You will be assessed by a consultant dermatologist. Midland Skin provides psoriasis assessments for both adults and children.
Will I receive a prescription at my first appointment?
A prescription may be issued at the initial appointment when the diagnosis is sufficiently clear and the proposed treatment is appropriate.
Tablet or biologic treatment may require baseline investigations, screening or further treatment planning before it can be started. A particular medicine cannot be guaranteed before assessment.
Should I stop my creams before the appointment?
Do not stop prescribed treatment unless you have been advised to do so.
Please bring details of everything you currently use and treatments you have previously tried, including how long you used them and whether they helped. Bringing the tubes, packaging or photographs of previous flares can be useful.
Can you arrange narrowband UVB treatment?
Yes, where it is clinically appropriate. Narrowband UVB is not delivered at Midland Skin, but your consultant dermatologist can make the required referral to another private hospital for treatment.
Can I access tablet or biologic treatment privately?
A range of tablet and modern biologic treatments can be accessed privately where clinically appropriate.
Your dermatologist must first assess the severity and impact of your psoriasis, previous treatment and your general health. Blood tests or other screening may be required before treatment and at intervals while it continues.
Why is a review consultation required?
The review consultation is required to assess your response and decide whether treatment should be continued, changed or stopped.
It also allows your dermatologist to address side effects, interpret any monitoring results and reconsider the diagnosis or treatment plan if the response is not as expected.
Why choose Midland Skin for psoriasis treatment?
Psoriasis care should provide a route forward when repeatedly trying different creams has not been enough.
At Midland Skin, consultant-led care can include:
- assessment of adults and children
- confirmation or reconsideration of the diagnosis
- practical optimisation of creams and scalp treatments
- assessment for tablet or biologic treatment
- referral to another private hospital for narrowband UVB
- structured review and ongoing monitoring where required
The aim is to develop a treatment plan that is medically appropriate, practical to follow and proportionate to the effect psoriasis is having on you or your child.
Book in with us
Ready to get started? Book a consultation with our team at Midland Skin. Friendly, expert advice tailored to you.
Fees
Psoriasis Show pricing
Book ConsultationInitial extended dermatology assessment
For eczema, psoriasis, complex or long-standing problems & second opinions. Up to 35 minutes
Review consultation
Standard, up to 20 minutes
Charlotte Grace Dover
References used for this article
- National Institute for Health and Care Excellence. Psoriasis: assessment and management (CG153). Published 2012; last updated 2017. This remains the current NICE guideline covering adults, children and young people.
- Smith CH, Yiu ZZN, Bale T, et al. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2023: a pragmatic update. British Journal of Dermatology. 2024;190(2):270–272.
- Goulden V, Ling TC, Babakinejad P, et al. British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022. British Journal of Dermatology. 2022;187(3):295–308.
- National Institute for Health and Care Excellence. DMARDs: general principles of managing DMARDs. NICE Clinical Knowledge Summaries. Accessed 1 September 2026.
About the Author
This page has been written and/or medically reviewed by Dr Sajjad Rajpar, Consultant Dermatologist and Medical Director of Midland Skin, Birmingham.
Dr Rajpar is on the GMC Specialist Register in Dermatology and has over 20 years’ experience in clinical dermatology. He provides clinical oversight to ensure the information on this page is accurate, balanced and consistent with current dermatology practice.
Dr Sajjad Rajpar
Date last updated: 21st Sep 2026
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