Guttate psoriasis is a rare form of the skin condition that looks different and may have different triggers. Instead of the thick lesions that characterize plaque psoriasis, guttate psoriasis involves tiny spots — “and there can be hundreds,” says Jeffrey Sugarman, MD, PhD, a clinical professor in the departments of dermatology and family medicine at the University of California in San Francisco and the medical director at Redwood Family Dermatology in Santa Rosa.

The spots can be covered with silver, flaky scales, similar to plaque psoriasis.

Guttate psoriasis can break out almost anywhere on the body, though like plaque psoriasis, it appears most often on the trunk and limbs, Dr. Sugarman says.

While around 80 percent of people with psoriasis have plaque psoriasis, only about 8 percent have the guttate type, according to the National Psoriasis Foundation (NPF).

What Causes Guttate Psoriasis?

Very often, guttate psoriasis comes on suddenly. Strep throat is a common trigger, says Sugarman.

Environmental factors seem to play a more important role in guttate psoriasis than in other types of psoriasis, he adds.

According to the University of Florida Health (UFHealth) and the NPF, guttate psoriasis can also be triggered by:

An upper respiratory infection — bacterial or viral
Tonsillitis
Stress
An injury to the skin such as an insect bite, burn, or cut
Medications, such as beta-blockers, which are used to treat heart conditions, and drugs that treat malaria
Excessive alcohol consumption

These triggers can cause guttate psoriasis in people who may have a family history or other risk factors for the disease.

People with weakened immune systems may be susceptible to severe guttate psoriasis, UFHealth says. This includes individuals with:

Human immunodeficiency virus (HIV)
Autoimmune disorders such as rheumatoid arthritis
Cancer for which they are receiving chemotherapy

How Is Guttate Psoriasis Diagnosed?

Dermatologists diagnose guttate psoriasis much as they do plaque psoriasis: mostly from the distinctive appearance of the rash, says Sugarman.

As part of the diagnosis, your doctor will ask whether you’ve had strep throat or another infection, and may do a skin biopsy and a throat culture to confirm the diagnosis, per UFHealth. Your doctor may also ask whether you’ve been taking any new medications or supplements.

Most people get guttate psoriasis as children or young adults, according to the NPF. In older adults, it can often be a precursor to plaque psoriasis, and it often runs in families.

How Is Guttate Psoriasis Treated?

Guttate psoriasis may go away on its own in a few weeks or months. If it doesn’t, it can be treated with topical medications, says UFHealth, though applying creams and ointments to the hundreds of tiny drops on your skin can be tedious. Dandruff shampoos and moisturizers may help, too, UFHealth says.

Phototherapy is often an effective treatment for guttate psoriasis. But phototherapy can make your skin sensitive to light, UFHealth notes.

If you have a severe case, your doctor might prescribe oral or injectable medications to dampen your inflammatory response. This may include a biologic or combination of treatments. An antistreptococcal treatment like penicillin or amoxicillin is sometimes used to treat the acute form of guttate psoriasis, especially in children and young adults. But one review of research found no evidence that it works or is safe, and the authors concluded that more trials are needed to assess this guttate psoriasis treatment.

Can There Be Complications From Guttate Psoriasis?

As with any type of psoriasis, guttate psoriasis may lead to complications.

“Some people can have one episode of guttate psoriasis when they are 12 years old and never have it again,” Sugarman says. “Others wind up with chronic psoriasis and some lipid abnormalities: high blood cholesterol and triglycerides.”

Guttate psoriasis can cause severe itching and, less frequently, serious skin infections, Sugarman says.

Work closely with your doctor to find the best treatment and make this condition easier to manage.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Resources

Guttate Psoriasis. National Psoriasis Foundation. December 21, 2022.
Guttate Psoriasis. University of Florida Health. April 14, 2021.
Dupire G. Antistreptococcal Interventions for Guttate and Chronic Plaque Psoriasis. Cochrane Database of Systematic Reviews. March 5, 2019.

Show Less