What To Do If You Suspect A Medication Is Flaring Your Psoriasis
If you ever have a medical emergency, for this or anything else, you need to call 911 or visit your local hospital right away.
If this is not an emergency its important to speak with your pharmacist or prescribing doctor as soon as possible.
Bring them a copy of references below so you can show them the research on medications that worsen psoriasis because this is a real science-based possibility.
Work with your doctor to decide the best strategy for you to address the concern. As I always remind my clients, never just stop taking prescribed medications because you read something on the internet!
Keep in mind that medications may or may not be what’s flaring your psoriasis. But they could be a trigger within your perfect storm.
LEAVE A COMMENT BELOW Id love to hear your experience with medications and psoriasis flares!
If you are looking for custom and targeted recommendations on how to handle psoriasis flares, let’s discuss your root causes and start working on a more sustainable route forward.
How Is Psoriasis Treated
Treatment usually depends on the severity of the disease, size of the areas involved, and the type of psoriasis.
- Topical medicine: These medicines are ointments, creams, and pastes that are applied on the skin.
- Moisturizers: These soothe your skin by keeping it moist and preventing dryness.
- Steroids: This medicine may be given to decrease inflammation.
- Vitamin D and retinoids: These are vitamin-based creams that are used to clear plaques.
- Anthralin: This medicine decreases swelling and excess skin cells that form scales.
- Salicylic acid: This peeling agent helps decrease scaling of the skin and scalp.
- Tar preparations: These medicines decrease itching, scaling, and inflammation. They may be shampoos, creams, or bath oils.
Things That Can Trigger An Outbreak Of Psoriasis
Does it often feel like your psoriasis flares up for no reason? One or more triggers could be to blame. In fact, everyday things like a cold, a bug bite, or even stress can trigger psoriasis.
Triggers can vary from person to person, but discovering what they are and learning how to deal with them can help you gain control of your psoriasis and endure fewer flare-ups.
At Valerius Medical Group & Research Center, we want you to live happy and healthy, so weve put together seven common triggers to look out for.
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What To Think About
Some medicines used to treat psoriasis can cause serious side effects. You and your doctor will discuss how long to use treatments that could cause harm. You will also need to see your doctor regularly and may have blood tests while using some medicines.
Many oral or injected medicines used to treat psoriasis aren’t safe during pregnancy. If you are pregnant, talk to your doctor before taking any medicines.
How We Treat Your Psoriasis
After we confirm your psoriasis diagnosis, we discuss your treatment options. Depending on the amount of body area involvement, locations, and severity of your condition, we may recommend over the counter treatments, a little sunlight exposure, or a variety of prescription topical or systemic medications.
Minimal or localized psoriasis often responds to topical preparations. Whereas more widespread moderate or severe psoriasis may require oral or injectable medications.
Determining the best treatment plan is a collaboration between our patients and Dr Mittelbronn to find what works best, while keeping individual needs and safety in mind.
To learn more about psoriasis and find which treatment is right for you, at Lakeview Dermatology to schedule a consultation today.
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Triggers Of Psoriatic Arthritis Flares
Every person has their own unique experience with psoriatic arthritis flare-ups. Something may cause a flare-up in one person but not in another. Thats why its important to track and log the triggers that set off your symptoms. Show the log to your doctor. Finding a link or pattern between certain activities and your psoriasis flare-ups can help control your outbreaks.
Common psoriatic arthritis triggers include the following.
Skin trauma or injury: This might include cuts, bumps, bruises, scratches, scrapes, or infections. Prevent injuries by being careful when cooking, gardening, nail trimming, and shaving. Wear gloves and long sleeves when doing an activity that could potentially cause injury.
Dry skin: Dry skin can cause a flare-up. Aim to keep skin hydrated with moisturizing lotions and creams.
Sunburn: While sunshine is good for psoriasis, getting sunburned is not. Always carry a hat and sunscreen.
Stress: Relaxation and stress reduction tactics such as yoga and meditation can alleviate stress and anxiety. Consider joining a psoriasis support group.
Alcohol: In addition to potentially causing flare-ups, alcohol can interfere with the effectiveness of certain medications.
Excess weight: Extra pounds can stress joints. Additionally, psoriasis plaques can develop in skin folds. People with psoriasis are at a higher risk of cardiovascular disease, which can be triggered by an unhealthy weight. Talk with your doctor about a diet and exercise plan.
Symptoms Of Psoriatic Arthritis
The main symptoms of psoriatic arthritis include:
- stiffness
- swelling of toes and fingers
- foot pain, especially in the sole of the foot and the back of the heel
- lower back pain
- joint pain
Joints can become swollen, warm to the touch, and painful. The impact of these symptoms ranges from mild to severe. They can affect joints on both sides of your body or just one side.
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Beta Blockers And Drug
Clinical manifestations of beta-blocker-provoked psoriasis. In the past, beta blockers have been known to cause drug-induced/exacerbation of psoriasis, psoriasiform dermatitis, eczematous eruptions, and lichenoid changes. Psoriasiform eruptions are the most common cutaneous consequence of beta-blocker therapy, seen more frequently in patients with no past or family history of psoriasis., Clinical improvement after withdrawal of the implicated drug is the distinguishing feature in many cases suggesting drug-induced psoriasis. In a case-controlled and case-crossover study of 110 patients who were hospitalized for extensive psoriasis vulgaris, beta blockers were considered a major factor in triggering or aggravating psoriasis.â Practolol is the prototype cardioselective beta blocker, which is no longer available due to the high incidence of cutaneous side effects reported, including psoriasiform eruptions and exacerbations of pre-existing psoriasis. Transformation of plaque-type psoriasis into pustular psoriasis with pindolol has also been observed. In addition, atenolol has been reported to precipitate psoriasiform pustulosis. Topical application of timolol in the treatment of open-angle glaucoma has been reported to induce psoriasis and to transform psoriasis vulgaris into psoriatic erythroderma through the passage into the systemic circulation via the conjunctiva.,
What Are The Symptoms
Symptoms of psoriasis appear in different ways. Psoriasis can be mild, with small areas of rash. When psoriasis is moderate or severe, the skin gets inflamed with raised red areas topped with loose, silvery, scaling skin. If psoriasis is severe, the skin becomes itchy and tender. And sometimes large patches form and may be uncomfortable. The patches can join together and cover large areas of skin, such as the entire back.
Psoriasis can also affect the fingernails and toenails, causing the nails to pit, change colour, and separate from the nail bed.
In some people, psoriasis causes joints to become swollen, tender, and painful. This is called psoriatic arthritis .
Symptoms may disappear , even without treatment, and then return .
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Dr. Carolyn Jacob, medical director of Chicago Cosmetic Surgery and Dermatology and a member of the American Academy of Dermatology , was diagnosed with psoriasis 36 years ago. Its what got me into dermatology, she said.
Untreated, people with psoriasis can leave a trail of unsightly scales that make them want to stay home. Most people dont care for that, said Dr. Amy McMichael, chair of the dermatology department at Wake Forest Baptist Health in North Carolina and a member of the American Academy of Dermatology. Now we can get those patients to where they have a very manageable disease.
Most people with psoriasis develop itchy, scaly plaques that are usually white or silver. They often crop up on the knees, elbows, lower back or scalp. On the scalp, they can spread to psoriasis of the face.
The Triggers Behind Psoriasis Flare
Psoriasis is a skin condition that is associated with the immune system. It causes the natural life cycle of skin cells to occur more rapidly, which can lead to patches of skin that are scaly, red, itchy, and painful. The following are some of the triggers that can lead to flare-ups and steps you can take to avoid them.
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Problems With The Immune System
Your immune system is your body’s defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell.
T-cells normally travel through the body to detect and fight invading germs, such as bacteria. But in people with psoriasis, they start to attack healthy skin cells by mistake.
This causes the deepest layer of skin to produce new skin cells more quickly than usual, triggering the immune system to produce more T-cells.
It’s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role.
Avoid Trauma To Your Skin
One interesting and unique feature of psoriasis is a response called the Koebner phenomenon. This is the skins tendency in psoriasis to cause new areas or worsen existing areas with trauma or damage to the skin.
Common causes of this reaction are cuts and scrapes, but anything that damages the skin can cause it, especially picking and scratching at your lesions. Chronic rubbing or friction such as caused by a tight hat brim, waistband, or chin strap are some other examples, as well as thermal burns or chemical damage to the skin.
Also keep in mind that while a bit of sun exposure can be beneficial, too much sun exposure, especially a sunburn is another trauma and possible trigger for a flare.
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Identifying Triggers Is The First Step In Preventing Symptoms
Psoriasis is a chronic autoimmune disorder characterized by the spontaneous appearance or worsening of symptoms, known as flares, followed by periods of remission. The cause of flares is poorly understood but triggers such as skin trauma, cold weather, stress, and smoking are known to set the stage. It’s believed that the sudden rise in inflammation that these psoriasis triggers prompt reactivates the autoimmune response.
When this happens, the immune system releases compounds called cytokines as if the body has encountered an actual threat. The ensuing inflammation is what causes the outbreak of symptoms, primarily skin lesions known as plaques.
What Are Common Triggers For Plaque Psoriasis
Each person with plaque psoriasis has a different set of triggers.1,2 Some people may have more triggers than other people do. Some triggers affect certain people but not others, and some people react to certain triggers more severely than they do to other triggers. However, there are some triggers that are common among people with plaque psoriasis. These include:
- Infections
- Lifestyle and environmental triggers: stress, smoking, drinking alcohol heavily, diet, allergies and weather
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Tips For Preventing A Psoriasis Flare
Knowing that psoriasis is a common skin condition that affects more than 8 million Americans and about 125 million people around the world isn’t much comfort when youre dealing with constant symptoms or a flare-up.
The classic signs of red patches, flaking and silvery scales, burning, tenderness, thickening, and cracking are not only uncomfortable, they can be embarrassing as well.
While theres no cure for psoriasis, there are ways to help manage your symptoms and try to keep flare-ups to a minimum. Dr. Matthew Mittelbronn at Lakeview Dermatology in Lake Worth, Texas, treats a wide range of skin conditions, including psoriasis, and can help you find the right treatment for yours.
One of the most important aspects of any psoriasis treatment involves your participation. The better you are consistent with using recommended treatments and avoiding those things that can worsen or trigger your psoriasis, the better youll be able to keep your psoriasis under control and help prevent flare-ups.
Here are some tips:
What Leads To Flare
According to several scientific studies, close to 10% of the population has one of the genetic markers that can lead to psoriasis. Fortunately, only 2-3% of the population actually ends up having symptoms.
For those of us that fall into that 2-3%, it helps to know what can cause flare-ups so we can minimize the symptoms that we need to deal with.
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Less-common types of psoriasis can cause tiny pink bumps, skin thats sore and red, pus-filled bumps on the hands and feet or other skin problems. You can have more than one type of psoriasis.
Its also possible to have psoriasis with arthritis, where the psoriasis affects the joints. According to the NPF, 30 percent of people with psoriasis will go on to develop psoriatic arthritis.
Infusion Or Injectable Medications For Psoriasis
Whereas most traditional psoriasis medications affect the whole immune system, modern infusion medications are more targeted, treating only the compromised portion of the immune system. This offers a greater degree of treatment precision as well as fewer secondary complications. Infusion or injectable biologics for psoriasis work by blocking T-cells or other proteins within the immune system that cause psoriasis to develop.
Some of the common infusion therapy medications for psoriasis include:
- Upper respiratory infections
- Fatigue
In rare cases, certain severe side effects may occur. Seek emergency care immediately if you experience any of the following:
- Symptoms of an allergic reaction including hives, itchiness, tingling sensation, dizziness, breathing difficulties, and/or swelling of the mouth, tongue, and lips
- Heart failure symptoms include shortness of breath and swelling of ankles or feet
- Immune reactions symptoms include joint pain, rash on your cheeks or arms which worsen with sun exposure, and/or shortness of breath
- Blood problems symptoms include a fever that does not go away, bruising easily, and paleness
- Nervous system problems symptoms include dizziness, numbing or tingling, vision problems, and/or weakness in the arms or leg
Biologic medications also can weaken your immune systems ability to fight against infection.
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Immunosuppressants Like Methotrexate And Covid
Methotrexate was initially used to treat cancer, but was approved to treat severe psoriasis in the 1970s. It works by inhibiting an enzyme that leads to rapid skin cell growth.
One of the potential side effects of taking methotrexate is a weakened immune system, specifically due to low levels of infection-fighting white blood cells. This increases infection risk.
Because of this, people taking methotrexate are at an increased risk of serious illness from COVID-19. This makes vaccination vital.
People taking methotrexate are not at an increased risk from the COVID-19 vaccine. However, it appears as if those taking methotrexate generate a reduced immune response to COVID-19 vaccination. More on that later.
on people taking biologics for psoriasis found that antibodies to the novel coronavirus spike protein were developed following vaccination. How long this protection lasts is currently unknown, though.
What Are The Clinical Features Of Drug
Drug-induced or drug-aggravated psoriasis may induce:
- Localisedplaque psoriasis, often affecting scalp, knees, elbows, buttocks and/or genitals
- Generalised plaque psoriasis, with scattered plaques on all parts of the body
- Erythroderma when the entire skin surface is red and scaly.
Acute generalised exanthematouspustulosis is a severe drug-induced eruption that closely resembles generalised pustular psoriasis.
Palmoplantar pustulosis can also be drug-induced, often by tumour necrosis factor inhibitors. Although closely related, palmoplantar pustulosis is no longer classified as a type of psoriasis. It nearly always occurs in smokers.
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What To Do If Your Medication Triggers Your Psoriasis
Psoriasis that is caused or worsened by a medication can look similar to regular psoriasis, so it can be hard to know if a medication is to blame for your flare. Its important to keep in mind that other things like stress or an illness can also trigger psoriasis.
If you think a medication is making your psoriasis worse, the first step is to talk to your provider. Its important that you dont stop any medications on your own. Your provider will help you come up with a plan to stop the medication and start a new one if needed.
In some situations, just stopping the medication will improve or reverse the psoriasis flare. In other situations, you will need to treat the psoriasis even after stopping the medication. If this happens, your provider will help you come up with the best treatment plan for you.
When Should I Consider Medication
If your psoriasis symptoms are still a problem despite a good skin care routine, it might be time for medication. There are good over-the-counter and prescription creams that can help, such as coal tar, salicylic acid, steroids, anti-inflammatories, vitamin D, and combination treatments. For people with severe psoriasis, including those with psoriasis affecting the joints, medications by mouth or injection are often necessary.
But keep in mind: Certain medications and lifestyle habits can impact your psoriasis symptoms, too. Smoking, alcohol, and stress are all known psoriasis triggers. Smoking can even make psoriasis more severe and harder to treat.
Diet and exercise can affect the symptoms and severity of psoriasis. Consider following a Mediterranean diet, which is high in extra virgin olive oil, fruits, vegetables, fish, chicken, and whole grains.
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