Guttate Psoriasis: Symptoms, Causes and Whether It Goes Away
What guttate psoriasis looks like, why it follows a sore throat, whether it clears and how it's treated.
Part of our psoriasis guide.
Get urgent help first. Call 999 or go to A&E if your skin suddenly becomes red and inflamed over most of your body, or you have widespread pus-filled spots, especially with a fever, chills or feeling very unwell. These can be signs of erythrodermic or generalised pustular psoriasis, which are emergencies. See a GP soon if you have painful, swollen joints. Online treatment isn't suitable in these situations.
Key fact: guttate psoriasis causes many small, drop-shaped spots, often 2 to 3 weeks after a strep throat infection. It frequently clears within a few months, but can come back or turn into plaque psoriasis.
Adults only online, and not in pregnancy or breastfeeding. Access Doctor's online psoriasis service is for adults aged 18 and over, and can't supply treatment if you're pregnant or breastfeeding: your GP or midwife can help. Children with psoriasis should see their GP.
What is guttate psoriasis?
Guttate psoriasis causes many small, drop-shaped, scaly spots (guttate means "drop-like"), usually on the chest, back, arms and legs. Each spot is typically less than 1cm across. It's most common in children, teenagers and young adults.
It often appears suddenly, about 2 to 3 weeks after a streptococcal throat infection (strep throat or tonsillitis). It's not contagious, even though the throat infection that triggered it may have been.
What it looks like
- Lots of small, round or oval spots, appearing over a few days.
- Pink or red on white skin; darker, purple or greyish on brown and black skin.
- Fine scale on top.
- Can be itchy.
Guttate psoriasis or something else?
| Rash | How it differs |
|---|---|
| Pityriasis rosea | Usually starts with one larger "herald patch", then oval patches in a Christmas-tree pattern on the back. Clears by itself in about 6 to 12 weeks. |
| Plaque psoriasis | Fewer, larger, thicker plaques, usually on the elbows, knees and scalp. |
| Fungal infection | Usually fewer patches with a ring-shaped edge. |
| Viral rashes | Often with a fever and clear more quickly. |
A GP can usually diagnose guttate psoriasis by looking at the rash and asking about a recent sore throat. See also our guide to psoriasis vs eczema and other rashes.
Does guttate psoriasis go away?
Often, yes. Guttate psoriasis frequently clears on its own within a few weeks to a few months. In some people it comes back after another throat infection, and some go on to develop long-term plaque psoriasis.
How guttate psoriasis is treated
- Emollients to soothe dryness and itch.
- A steroid or vitamin D treatment for itchy spots, prescribed after a diagnosis. Because there are many small spots, treating each one can be impractical.
- Light therapy (narrowband UVB) works well for widespread guttate psoriasis and is offered by dermatologists. See light therapy.
- Antibiotics are given if there's still an active strep infection; they don't usually clear the psoriasis itself.
See a GP for a first episode. A new widespread rash should be diagnosed in person, especially in children. Access Doctor's online service is for adults with psoriasis already diagnosed, and doesn't treat guttate psoriasis covering large areas of skin.
UK safety and reporting side effects
Prescription psoriasis treatments are only supplied after a GPhC-registered pharmacist independent prescriber reviews your consultation, including where your psoriasis is, how much skin it covers and what you have used before. Always read the patient information leaflet. Since 2024, UK steroid packs show their strength on the front (mild, moderate, strong or very strong). The MHRA advises using topical steroids for the shortest time needed, and to tell a healthcare professional if your skin flares badly after you stop a steroid you have used for a long time, which can be a topical steroid withdrawal reaction.
If you think you've had a side effect, tell your pharmacist or doctor. You can also report it to the MHRA through the Yellow Card scheme.
Getting help
For a new rash, see your GP. If you have established plaque psoriasis on your body, arms or legs, see our psoriasis treatment page and our treatment options guide.
Frequently Asked Questions
What triggers guttate psoriasis?
Most often a streptococcal throat infection, about 2 to 3 weeks before the rash appears. Other infections, stress and some medicines can also trigger it.
Does guttate psoriasis ever go away?
Often, yes. It frequently clears within a few weeks to a few months. It can come back after another throat infection, and some people later develop plaque psoriasis.
Is guttate psoriasis contagious?
No. The rash itself can't be passed on, although the throat infection that triggered it can spread to others.
How is guttate psoriasis different from pityriasis rosea?
Pityriasis rosea usually starts with one larger herald patch, then oval patches in a Christmas-tree pattern, and clears by itself in 6 to 12 weeks. Guttate psoriasis has many small drop-like spots and often follows a sore throat.
What is the best treatment for guttate psoriasis?
Emollients and, for itchy spots, a steroid or vitamin D treatment. Widespread guttate psoriasis responds well to narrowband UVB light therapy from a dermatologist.
References
- NICE Clinical Knowledge Summaries. Psoriasis. cks.nice.org.uk
- NHS. Psoriasis. nhs.uk
- British Association of Dermatologists. Psoriasis: an overview (patient information leaflet), August 2023. skinhealthinfo.org.uk
- NICE. Psoriasis: assessment and management (CG153). nice.org.uk
Medical disclaimer: This article is for information only and isn’t medical advice. Prescription psoriasis treatments need a clinical consultation before they can be supplied. If your skin is red all over, you have widespread pus spots, a fever or you feel unwell, seek medical advice the same day. In a medical emergency, call 999.