Psoriasis is not just skin deep: It can affect both the outside of the skin as well as the inside of the body and mind.

It’s a skin disease that sometimes causes pain, because it can cause misery. With more than 2 percent of the U.S. population suffering from psoriasis, let’s look at its cause and effects. August is psoriasis awareness month.

What is the cause, course and treatment of psoriasis?

Psoriasis is a skin disease that leads to red and scaly skin. It can be confused with eczema in appearance, so it’s recommended you see a professional to properly diagnose it.

Nobody wants to have it. In adults, psoriasis often affects the elbows and knees. In children with psoriasis, the scalp, eyes, genitalia and feet are often involved. Even so, any and all of the skin can be the target of this disease in adults and children alike.

The course of psoriasis is unpredictable: Sometimes it goes away and never comes back. Sometimes it comes and goes, and sometimes it never goes. The cause of psoriasis is not completely understood, making it difficult to prevent.

People with psoriasis inherited the tendency to develop it. What triggers the disease is unclear.

Although there is no cure for psoriasis, there is therapy. It can be treated in various ways — with creams, ointments, pills and phototherapy. If you are an adult with psoriasis, your provider can prescribe or refer for treatment. It is good to control psoriasis, partly because it increases comfort and partly because it lowers risk for other problems. In children, the associated risks and response to therapy are currently being studied.

Why is psoriasis so miserable? It’s obvious when something shows on the outside, but what happens on the inside is hidden and can even be worse. It is not unusual for psoriasis to be associated with depression. Is that because people with psoriasis feel society’s intolerance? That’s unclear, too.

Psoriasis is not only connected to depression but also to obesity and many other diseases. These other diseases associated with psoriasis have inflammation as a common component: heart disease, thyroid problems and diabetes are examples. Psoriasis is an independent risk factor when it comes to heart disease. In other words, psoriasis is like having high cholesterol. Whether these correlations exist in children is currently being studied.

The consequence of psoriasis and all these associated diseases is that they not only can harm the affected individuals, they can also affect society in many ways — socially and economically. People who have any of these diseases can have a reduced ability to function, and that can affect work. Health care costs for those with psoriasis are significantly higher, particularly if other diseases coexist.

What can others do? First, be empathetic. Understand this is not a contagious disease. So it’s OK to hug and shake hands with those you know who have psoriasis.

Second, encourage friends and family members to seek care. It can help them, and it can help society.

Third, support research when you can, on anything. In the end, knowledge gained can help to improve life for us all.

Fourth, volunteer to help your community, in any way. More than two out of every 100 people have psoriasis, so chances are that you will be helping someone in the community with this disease. Help reduce the heartbreak of psoriasis by doing what you can: Be understanding.

Janice L. Pelletier of Orono is head of pediatric dermatology at Eastern Maine Medical Center and vice president of the Maine Chapter of the Maine Academy of Pediatrics.