Pustular psoriasis is not the most common type of psoriasis, but it’s one of the most uncomfortable ones. Even though the cause of pustular psoriasis is currently unknown, many treatments exist to alleviate the symptoms and make living with this condition easier.

People diagnosed with pustular psoriasis should know as much as possible about its causes and available treatments. Keeping this condition at bay is easy when you use all the available tools to fight it.

What Is Pustular Psoriasis?

Pustular psoriasis is one of the five psoriasis types. It may occur in conjunction with plaque psoriasis or appear on its own. The most obvious symptom of pustular psoriasis is pus-filled blisters. They are aesthetically unappealing and painful. These blisters sometimes go away on their own. Their reappearance patterns seem random.

Pustular psoriasis starts with an area of the skin becoming red and tender. However, no raised patches occur as in plaque psoriasis. In several hours, the tender skin becomes covered with pus-filled blisters. Eventually, blisters turn thick and brown. With time, they peel off, revealing shiny and smooth skin.

Pustules may occur on any part of the person’s body, including hands, feet, and torso. The most uncomfortable spots this psoriasis may appear on are palms and soles of the feet.

Even though the blisters are filled with pus, contacting them or the pus itself won’t make another person acquire psoriasis. Pustular psoriasis is not contagious. The pus doesn’t contain an infection.

Even though with time, pustules tend to go away on their own, it’s important to keep this condition at bay. Otherwise, a patient may experience such symptoms as headaches, fever, weakness, boosted heart rate, and nausea. Untreated pustular psoriasis may result in a lethal outcome.

Three Types Of Pustular Psoriasis

Five types of pustular psoriasis exist. It’s important to contact a doctor to diagnose one of them and figure out the right pustular psoriasis treatment.

1. Generalized Pustular Psoriasis

Generalized pustular psoriasis, also called Von Zumbusch pustular psoriasis, starts with the appearance of painful redness on the skin. The pus-filled blisters occur within several hours. They dry out and peel off in about 24 to 48 hours.

This type of psoriasis occurs in both adults and children. Children have lighter symptoms. Their pustules tend to go away quicker and without treatment.

The symptoms of generalized pustular psoriasis include severe itching, fever, increased heartbeat, muscle weakness, dehydration, and chills.

In case severe symptoms are present, a patient requires immediate medical care. If not treated timely, the condition can cause anemia, weight loss, and exhaustion. The complications of this condition may include hair loss, bacterial infection, liver damage, and eventual heart failure.

The treatment for this type of pustular psoriasis includes:

  •         Antibiotics
  •         Topical steroid creams
  •         Oral steroids

A generalized pustular psoriasis is an acute form of psoriasis. It’s also rather rare, especially in children.

This condition can also occur during pregnancy. Pustular psoriasis in pregnancy is known as pregnancy-associated impetigo herpetiformis. It usually appears in the third trimester and carries a risk of stillbirth or fetal abnormalities.

2.    Palmoplantar Pustular Psoriasis

Palmoplantar pustular psoriasis gets its name for the areas it usually occurs on. This type of pustular psoriasis attacks palms and soles of feet. The symptoms of palmoplantar pustular psoriasis are the same as for other types. The condition starts with reddening of the skin and the appearance of pus-filled blisters. Within days, the blisters turn brown and peel off.

The patterns of this psoriasis type are random. The triggers can be different for each person. However, one common trigger exists. Smokers have a more frequent occurrence of this psoriasis than non-smokers do.

Treatment of pustular psoriasis on palms and soles of feet includes:

  •        UV light
  •         Topical steroids
  •         Immune system suppressants
  •         Oral medications.

3. Acrodermatitis Continua Or Acropustulosis

This type of pustular psoriasis occurs on fingers and toes. It may only appear on one of the digits. The pustules break out at the end of a finger or toe in an area, where it used to be infected or injured.

These pustules burst quickly. They leave a sore, which leaks fluid. With time, the sore gets covered with crust only to peel off and restart the process once again. The nails can also be affected by the condition, leading to deformation.

This type of pustular psoriasis on the feet and hands is very painful. It can limit their function. The treatment of acropustulosis involves:

  •         Topical steroids
  •         Oral medication
  •         Bandages

Acrodermatitis continua is highly resistant to treatment, thus reducing the patient’s quality of life substantially.

Triggers Of Pustular Psoriasis

While pustular psoriasis causes are currently unknown, many triggers can start the flare-up. Each patient has his or her own set of triggers, which leads to the appearance of the blisters. Some of the common pustular psoriasis triggers include:

  •         Certain drugs – pain and fever reducers containing aspirin, ibuprofen, naproxen, some antidepressants, penicillin, psoriasis drugs (coal tar and calcipotriol), and zinc pyrithione.
  •         Steroids – if a patient stops taking steroids before the treatment is over, an acute withdrawal may trigger psoriasis
  •         UV Light – too much sunshine may trigger pustular psoriasis on hands, feet, and the rest of the body. Pustular psoriasis on the face is also possible, but not as common.
  •         Stress – this is one of the most common triggers for all types of psoriasis, including pustular.
  •         Pregnancy – pregnant women may suffer from generalized pustular psoriasis. Some doctors believe that pregnancy is a trigger.
  •         Cuts and infections – overactive immune system or the physical damage to the skin may trigger psoriasis.

Natural Pustular Psoriasis Treatment

While treating pustular psoriasis naturally isn’t always possible, a patient can reduce the risk of experiencing an outbreak by following simple rules.

1. Lowering The Stress Levels

Trying to avoid stressful situations and learning how to deal with them can help a person avoid pustular psoriasis outbreaks. Among the recommended approaches are meditation, yoga, and tai chi.

2. Watching The Diet

Processed, greasy, and gluten-containing food can become triggers for pustular psoriasis. Even though none of the studies confirms the relation between gluten and this condition, many patients report that reducing the gluten in their diet helps them live without outbreaks longer.  

3. Staying Fit

Overweight people often suffer from severe cases of psoriasis. Some of the treatments don’t work for them as well as they do for patients with a normal BMI. Losing weight can help a person reduce the severity of the pustular psoriasis outbreaks.

4. Quitting Drinking Alcohol And Smoking

Drinking and smoking have been reported as common triggers for pustular psoriasis. Smokers usually have shorter clear skin periods than nonsmokers do. Medications don’t work as well for smokers as they do for non-smokers.

The same is true for people, who don’t limit their alcohol consumption. Ideally, a psoriasis patient shouldn’t drink any alcohol or at least reduce the intake to reasonable levels.

When To Contact A Doctor

In many cases, pustular psoriasis can come and go without causing too much discomfort to a patient. However, it’s important to contact your doctor when you experience psoriasis symptoms for the first time. Diagnosing the condition is vital to finding proper treatment and avoiding severe breakouts.

Sometimes, blisters can cover large areas of a patient’s body. In such a case, hospitalization may be required. Even though pustules can go away on their own in just a few days, leaving them without treatment may be dangerous, especially for children and pregnant women.  

Pustular psoriasis can be life-threatening. Avoiding the treatment can lead to lethal consequences.


Pustular psoriasis is one of the most unpleasant types of this condition. However, the symptoms can be kept at bay easily. With the right approach to treatment, patients suffering from pustular psoriasis can lead a normal life. Avoiding the triggers can help extend the periods between the breakouts.