If you’re living with psoriasis or psoriatic arthritis (PsA), you’ve probably heard terms like “inflammatory disease” or “immune-mediated disease” — but what do they really mean? And is psoriasis actually an autoimmune condition? The answer matters, because it can help you better understand what’s happening in your body — and what kinds of treatment may work best.

Health experts now recognize psoriasis and PsA as autoimmune diseases, meaning they involve a misfiring immune system that attacks healthy tissues by mistake. This article breaks down what that means, what triggers these attacks, and how knowing your risk factors can empower you to manage flares and feel more in control over your health.

What Is an Autoimmune Disease?

Autoimmune diseases happen when the body’s defense system — the immune system — mistakenly attacks healthy parts of your own body. In people with psoriasis, this immune attack shows up as skin flares.

The immune system is made up of cells and proteins that attack anything foreign to the body, such as invading bacteria, viruses, and other potential causes of infection and sickness. The immune system is designed to attack and neutralize invaders by recognizing molecules on them known as antigens. It’s important that the immune system knows the difference between the body’s own components and a foreign invader.

However, when immune cells begin responding abnormally, they misidentify aspects of our own body as harmful invaders and attack. This abnormal response is described as being autoreactive or autoimmune — “auto” is a Greek prefix meaning “self.” The self-antigens targeted in autoimmune diseases are known as autoantigens.

Autoimmune diseases are classified by the type of tissue that is being attacked. For example:

• In rheumatoid arthritis, the immune system attacks the body’s own tissues, causing damage to joints.
• In type 1 diabetes, it targets insulin-producing cells in the pancreas.
• In celiac disease, the immune system reacts to gluten by damaging the small intestine.
• In certain skin conditions like psoriasis, the immune system creates inflammation in the skin, causing symptoms like skin discoloration, scaling, and discomfort.

What Happens During Psoriasis Autoimmune Attacks?

During a psoriasis flare, the immune system mistakenly attacks the skin. It targets certain proteins, called autoantigens, that are naturally found in skin cells. These autoantigens have been found in psoriatic lesions (patches of inflamed, scaly skin caused by psoriasis).

This attack sets off an intense immune response. Special immune cells called T cells become overactive and trigger inflammation. They release substances known as inflammatory chemicals, including one called interleukin-17A (IL-17A). IL-17A speeds up the growth of skin cells, which leads to the buildup of thick, scaly patches. Because of its role in driving inflammation, IL-17A is the target of several biologic drugs used to treat moderate to severe psoriasis.

Another group of immune cells, called B cells, also plays a role in autoimmunity in psoriasis. B cells make proteins called antibodies, usually used to fight off infections. But in people with psoriasis or psoriatic arthritis, B cells produce autoantibodies, which mistakenly attack the body’s own skin-related proteins. This contributes to the cycle of inflammation and damage.

Over time, these autoimmune attacks can cause more than just skin symptoms. Chronic inflammation from psoriatic disease may also increase the risk for heart disease, a common comorbidity (a condition that occurs alongside another one) in people with psoriasis.

Understanding how the immune system works in psoriasis and PsA can provide you greater insight into symptoms, treatment options, and the importance of long-term care. As research continues, health experts hope to find even more targeted and effective therapies for managing psoriatic disease.

Risk Factors for Autoimmunity

Health experts don’t fully understand why autoimmune diseases like psoriasis develop, but most believe it’s due to a combination of environmental factors and genetic factors.

Psoriasis doesn’t follow a clear pattern of inheritance, but having a family history of psoriasis increases your risk. In fact, researchers have identified certain genes that are more common in people with psoriasis. These genes are involved in how the immune system works, and they may make someone more likely to develop an overactive immune response.

Environmental triggers can also play a role. For example, some cases of psoriasis begin after a strep throat infection. Scientists have found that certain immune cells, called T cells, can attack both strep bacteria and healthy skin. One theory is that these cells may “get confused” and begin attacking the skin even after the infection is gone, leading to autoimmune flares.

If you’re living with psoriasis, it’s also important to know that autoimmune diseases tend to cluster. People with one autoimmune condition, like psoriasis or psoriatic arthritis, may be at greater risk of developing another, such as type 1 diabetes or celiac disease.

Psoriasis Treatment and Autoimmunity

Because psoriasis is driven by the immune system, treatment usually focuses on calming inflammation and dialing down immune system overactivity.

The first step in managing psoriasis often involves making lifestyle changes. Avoiding known triggers — such as stress and smoking — may help reduce flares. Regular physical activity and following an anti-inflammatory diet may also support overall health and ease inflammation.

Healthcare providers may also recommend medications. A dermatologist might start with corticosteroids, which may be applied topically (to the skin), taken orally (by mouth), or injected. These medications mimic a natural hormone in your body called cortisol and work by reducing inflammation. When used as creams or ointments, corticosteroids can slow the rate of skin cell growth, helping to ease symptoms like itching and silvery scales.

If symptoms continue or are more widespread, doctors may prescribe immunosuppressants, such as disease-modifying antirheumatic drugs (DMARDs). One commonly used DMARD is methotrexate, which can be taken by mouth or injected under the skin. These drugs help reduce the immune system’s activity to prevent further inflammation and skin damage.

For moderate to severe psoriasis that doesn’t respond to other treatments, a doctor may recommend biologics. These are injected or infused medications made from living cells (like yeast or bacteria) and designed to target specific parts of the immune system. Biologics block molecules that cause inflammation — including ones like IL-17A — and can help prevent psoriasis flares.

People using biologics should be closely monitored and informed about how the drugs are given and any possible side effects. While biologics are often effective, they may also come with a higher risk of infections and other complications, since they affect the immune system.

Today, doctors recognize psoriasis and PsA as autoimmune diseases. This understanding has led to more targeted treatment approaches that aim to quiet the immune system without shutting it down entirely. As research continues, these therapies are becoming more personalized — and more promising — for long-term symptom relief.

Talk With Others Who Understand

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