Most folks think of psoriasis as a skin problem that shows up on spots that everyone can see, like your elbows, knees, and scalp. But symptoms of this disease may happen in places you don’t expect, like inside your mouth.

Oral Psoriasis

If that’s the case, it’s called oral psoriasis. It’s not a serious medical problem, but it may be uncomfortable. And it can be a struggle to get the right diagnosis. Why? It’s so rare that most doctors have never seen it before, and some aren’t sure it even exists.

Read Pritish article to enhance your knowledge about Oral Psoriasis symptoms and treatments.

What Are the Symptoms?

It can be hard to tell if you have oral psoriasis. The symptoms are often mild and come and go quickly. And doctors don’t even agree on what all the symptoms are.

But in general, experts think that while signs can appear in different spots in your mouth, they’re most common on the inside of your cheeks. You might notice:

oral psoriasis symptoms

  • Patches of red skin with yellow or white edges
  • Sores
  • Peeling skin on the gums
  • Blisters with pus (pustules)
  • Pain or burning, especially when eating spicy foods
  • Changes in how things taste

Oral psoriasis may be linked with other conditions, like:

  • Fissured tongue: grooves or trenches on your tongue
  • Geographic tongue: red patches on your tongue that look like islands on a map
  • Swollen or infected gums

People who have oral psoriasis tend to have symptoms on their skin too, such as thick, scaly patches. The symptoms in your mouth will probably get better or worse along with the symptoms on your skin. So if psoriasis symptoms show up in your mouth, you’re likely to have skin flare-ups, too.

How Do I Know if I Have It?

This can be tricky because oral psoriasis is controversial. Some experts don’t believe it’s really a type of psoriasis. They think the symptoms are caused by another condition.

To figure out what’s causing your symptoms, your doctor may:

  • Ask you questions about your medical history (and your family’s)
  • Take a small sample of skin from inside your mouth to check under a microscope

What does the research say about oral psoriasis?

There is no reliable incidence rate for psoriasis in the mouth. This is because the oral cavities of psoriatic patients are rarely examined and biopsies are generally not taken, so the condition may be underreported.

Also, cells of the mouth turn over quickly, and affected cells may not be present at the time of the investigation. Observations suggest that a common inflammatory process may contribute to the development of both psoriasis and periodontal disease. Standard treatment approaches for psoriasis on the skin surface are typically not appropriate for treatment inside the mouth.

Understanding how the surface of the tongue functions

The tongue’s surface is covered with papillae (small sensory hair-like projections) and taste buds. They go through a normal shedding process. They also help to balance the microenvironment of the mouth and in so doing help keep our mouths moist, healthy, and infection-free. When the mouth gets infected papillae to help to fight off infection.

Sometimes the shedding process happens too early or unevenly. This can create sore areas accompanied by white or red patches (geographic tongue), sometimes with fissures, that is deep cracks or grooves on the surface of the tongue (fissured tongue).

What are fissured and geographic tongue?

In one recent study, investigators sought to identify any correlation between a fissured tongue (FT) and psoriasis severity and age of psoriasis onset. The results: FT is associated with late-onset psoriasis but not with the psoriasis severity.

fissured and geographic tongue

The clinical features of the fissured or geographic tongue (GT) are generally benign, just an inflammatory condition that affects the tongue’s surface.

Discoloration and patchy areas can be found on the surfaces of a geographic tongue. The irregular markings often resemble a map.

Do genetic tests

Your doctor will also want to rule out other conditions that cause similar symptoms, like:

  • Candida infection
  • Leukoplakia
  • Lichen planus
  • Reiter’s syndrome
  • Problems caused by smoking, dentures that don’t fit well, and other issues

What’s the Treatment?

Many people with oral psoriasis don’t need treatment because they’re not bothered by it. But if it hurts, you can start with some simple steps:

  • Rinse your mouth with a mixture of lukewarm water and salt.
  • Don’t eat spicy foods when symptoms are acting up.

    Rinse your mouth

  • If you smoke, stop.

If those home remedies aren’t enough, talk to your doctor. Other options include:

  • Mouth rinses that lower acidity in your mouth and help with pain
  • Medicines you can put on the sore areas in your mouth, such as steroids
  • Pills or capsules (like cyclosporine) for severe symptoms

If you take medications by mouth for skin psoriasis, they should also help with your oral symptoms.

Talk to Your Doctor

For now, there’s a lot we don’t know about who gets oral psoriasis and how to treat it. We don’t even know how many people have it. And experts think that in part, that’s because dermatologists who treat psoriasis don’t usually check inside people’s mouths.

So if you have psoriasis on your skin and notice symptoms in your mouth, tell your doctor. It’s the fastest way you’ll get the treatment you need. And you may actually help your doctor better understand this unusual condition.

mouth examined routinely

Having your mouth examined routinely

For people with psoriasis, routine skin exams by a dermatologist should include the mouth, looking at the oral mucosa in order to identify subtle changes which could represent oral psoriasis.2

Routine dental exams should also consider the changes in the condition of the oral cavity including the tongue and gums, looking for symptoms that are consistent with oral psoriasis. This could improve the capturing of more accurate incidence reporting.