How To Avoid Psoriasis Flare
- How to Avoid Psoriasis Flare-Ups
3 min Read Time
Did you know nearly 7.4 million people in the United States suffer from psoriasis? While its possible to develop psoriasis at any age, it is predominantly diagnosed in adults, with the average onset being between ages 15 and 35.
Unfortunately, having psoriasis also increases your risk of other medical issues. Around 33% of those with psoriasis will also develop psoriatic arthritis. If you have psoriasis, you are also at a higher risk of type 2 diabetes, heart disease, high blood pressure and kidney disease.
Because of this, its important that you know the signs to look out for with psoriasis. In this article, were discussing everything you need to know about the condition and what to do if youre diagnosed so you can avoid psoriasis flare-ups.
Avoid Any Factors That Aggravate Psoriasis
In most people who have psoriasis, there is no apparent reason why a flare-up happens at any given time. However, in some people, psoriasis is more likely to flare up in certain situations. These include the following:
There is no evidence that any particular foods or diets are any better or worse for psoriasis than any other.
It Can Happen At Any Age
Psoriasis is most likely to begin between the ages of 15 and 35 or between 50 and 69. But while those age ranges are prime for its development, the condition can manifest at any age. No matter how old you are, it might be smart to ask your doctor about psoriasis if you are experiencing any of the possible symptoms.
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Psoriatic Arthritis Symptoms: Spot The Signs
Psoriatic arthritis can cause different symptoms from person to person. But there are several common symptoms:
- Psoriasis and pitting of your nails.
- Painful, swollen joints, most commonly in your hands, feet, wrists, ankles and knees.
- Reduced range of motion and stiffness in your joints, especially in the morning.
- Fatigue.
- Digestive disorders like inflammatory bowel disease.
What Causes Psoriatic Arthritis
The exact cause is not known. Inflammation develops in the synovium of affected joints and sometimes in other parts of the body such as tendons and ligaments. It is not clear what triggers the inflammation. It seems that the immune system is affected in some way which leads to inflammation. Genetic factors seem to be important, as psoriatic arthritis occurs more commonly in relatives of affected people. However, it is not a straightforward hereditary condition. It is thought that a virus or other factor in the environment may trigger the immune system to cause the inflammation in people who are genetically prone to it.
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What Are Possible Complications Of Psoriasis
In some cases, psoriasis also causes arthritis. This is known as psoriatic arthritis. It causes pain, swelling, and stiffness in the joints. Psoriasis can raise your risk for diabetes, heart disease, and lymphoma. People with psoriasis are also more likely to have emotional stress and depression. Severe psoriasis can lead to erythroderma. In that condition, the skin all over the body is red and inflamed.
Who Develops Psoriatic Arthritis
About 1 person in 10 with psoriasis develops psoriatic arthritis. About 2 in 100 people develop psoriasis at some stage in their lives.
In most cases, the arthritis develops after the psoriasis – most commonly within 10 years after the psoriasis first develops. However, in some cases the arthritis develops much later. In a small number of cases the arthritis develops first, sometimes months or even years before the psoriasis develops. Men and women are equally affected.
Psoriasis most commonly first occurs between the ages of 15 and 25 and psoriatic arthritis most commonly develops between the ages of 25 and 50. However, both psoriasis and psoriatic arthritis can occur at any age, including in childhood.
Note: people with psoriasis also have the same chance as everyone else of developing other types of arthritis such as rheumatoid arthritis and osteoarthritis. Psoriatic arthritis is different, and is a particular type of arthritis that occurs only in some people with psoriasis.
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Why Are There Fewer Options To Treat My Late
At present, there is limited data about the safety of biologic and systemic treatments for seniors. Conditions common among older adults kidney, heart and liver diseases, dementia, diabetes, and obesity can increase the risks of potential side effects and drug interactions. And because biologic treatments target the immune system, they may also be less safe for people with weakened immune systems.
Is There A Cure For Psoriasis
There is no cure at the moment. However, as a consequence of current research, our understanding about what happens in psoriasis is growing and new drugs are being developed. In the meantime, there are a number of treatments that are effective in keeping psoriasis under control.
The art of treating psoriasis is finding the best form of treatment for each individual. There is no single solution that is right for everyone.
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Emotional Impact Of Psoriasis
Because of the effect that psoriasis can have on physical appearance, low self-esteem and anxiety are common among people with the condition. This can lead to depression, especially if the psoriasis gets worse.
Your GP or dermatologist will understand the psychological and emotional impact of psoriasis, so talk to them about your concerns or anxieties.
Enhancing Healthcare Team Outcomes
Plaque psoriasis is a complex life long disorder with enormous morbidity. Thus, it is best managed by an interprofessional team.
Insulin resistance and cardiovascular diseases are more common in psoriatic patients as are metabolic comorbidities. Obesity is the most common comorbidity observed in children with psoriasis. Many patients present with reduced quality of life and psychological manifestations and need special attention and counseling. Thus, primary care clinicians should advocate lifestyle modification such as reducing weight, reducing alcohol intake and smoking cessation may help control psoriasis, improve the results of treatment and prevent future complications.
Sudden onset, palmoplantar keratoderma, severe nail dystrophy, the involvement of skin folds should arouse suspicion of associated HIV infection in whom pustular forms are also more common with a higher frequency of arthritis.
Teaching Points
Outcomes
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How Psoriasis Is Diagnosed
A GP can often diagnose psoriasis based on the appearance of your skin.
In rare cases, a small sample of skin called a biopsy will be sent to the laboratory for examination under a microscope.
This determines the exact type of psoriasis and rules out other skin disorders, such as seborrhoeic dermatitis, lichen planus, lichen simplex and pityriasis rosea.
You may be referred to a specialist in diagnosing and treating skin conditions if your doctor is uncertain about your diagnosis, or if your condition is severe.
If your doctor suspects you have psoriatic arthritis, which is sometimes a complication of psoriasis, you may be referred to a doctor who specialises in arthritis .
You may have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken.
How Is Psoriasis Diagnosed
Doctors usually diagnose psoriasis by examining the skin, scalp, and nails. They’ll also ask whether someone else in your family has psoriasis and if you recently had an illness or started taking a new medicine.
Rarely, doctors might take a skin sample to check more closely. A can tell the doctor whether it’s psoriasis or another condition with similar symptoms.
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How Will Menopause Affect My Ability To Manage My Psoriasis How Should I Prepare
During menopause, hormone levels shift, resulting in lower levels of estrogen. We know that low estrogen levels in postmenopausal women is associated with dry skin, decreased collagen production with thinning of the skin, and loss of elasticity.
Theres no definitive data that menopause has a direct effect on psoriasis. But limited data suggests low estrogen levels may be associated with worsening of psoriasis.
Psoriasis may be harder to treat in people with weakened skin, so its important to do what you can to keep your skin healthy before menopause begins. Wearing sunscreen and practicing sun-protective behavior are the absolute most important things you can do to protect your skin when you are young.
What Is The Outlook For Psoriasis
Psoriasis affects different people in different ways. In general, plaque psoriasis is a persistent condition with flare-ups that come and go. However, some studies have shown that, over time, plaque psoriasis may go away completely at some point in around 1 in 3 people. Some people have a number of years where they are free from psoriasis and then it may flare up again.
The less common guttate psoriasis usually goes away completely after a few months. But, if you have an episode of guttate psoriasis, you have a higher than usual chance of developing chronic plaque psoriasis at a later time.
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What Does Psoriasis Look Like
Psoriasis usually appears as red or pink plaques of raised, thick, scaly skin. However, it can also appear as small, flat bumps or large, thick plaques. It most commonly affects the skin on the elbows, knees, and scalp, though it can appear anywhere on the body. The following slides will review some of the different types of psoriasis.
What If Those Psoriasis Treatments Dont Work
If psoriasis doesnt improve, your healthcare provider may recommend these treatments:
- Light therapy: UV light at specific wavelengths can decrease skin inflammation and help slow skin cell production.
- PUVA: This treatment combines a medication called psoralen with exposure to a special form of UV light.
- Methotrexate: Providers sometimes recommend this medication for severe cases. It may cause liver disease. If you take it, your provider will monitor you with blood tests. You may need periodic liver biopsies to check your liver health.
- Retinoids: These vitamin A-related drugs can cause side effects, including birth defects.
- Cyclosporine: This medicine can help severe psoriasis. But it may cause high blood pressure and kidney damage.
- Immune therapies: Newer immune therapy medications work by blocking the bodys immune system so it cant jumpstart an autoimmune disease such as psoriasis.
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Can Diet Affect My Psoriasis
A healthy diet is important for wellbeing and can reduce your risk of many long-term illnesses. However, there is no clear link between what you eat and the severity of psoriasis symptoms.
- The British Nutrition Foundation suggests eating at least 300g of oily fish per week for general health .
- Aim to eat more green leafy vegetables, nuts, seeds and wholegrain cereals, which also contain important essential fatty acids.
- Cut back on saturated fats and vegetable oils and use more olive oil and rapeseed oil products.
- Eat fresh, homemade foods rather than pre-packaged convenience food.
- Excessive amounts of alcohol can make psoriasis worse and can also interfere with certain drug medications, for example methotrexate.
Are Cosmetic Procedures Safe To Get
Noninvasive cosmetic procedures are more popular now than ever. Injectables like Botox can improve the appearance of wrinkles, while fillers restore lost volume. Lasers can be used to even skin tone and texture, and even eliminate unwanted blood vessels or hair. These procedures are safe for people with psoriasis.
If youre interested in a cosmetic procedure, speak to your doctor about whether its right for you. In some cases, your doctor may want to hold or adjust your medications. Its important that theyre aware of your full medical history and current medications.
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Research And Statistics: Who Has Psoriasis
According to the National Psoriasis Foundation, about 7.5 million people in the United States have psoriasis. Most are white, but the skin disease also affects Black, Latino, and Asian Americans as well as Native Americans and Pacific Islanders.
The disease occurs about equally among men and women. According to the National Institutes of Health , it is more common in adults, and you are at a greater risk if someone in your family has it. A study published in September 2016 in the journal PLoS One concluded that interactions between particular genes as well as genetic and environmental factors play an important role in the diseases development.
People with psoriasis generally see their first symptoms between ages 15 and 30, although developing the disease between 50 and 60 years of age is also common.
The biggest factor for determining prognosis is the amount of disease someone has, says Michael P. Heffernan, MD, a dermatologist at the San Luis Dermatology and Laser Clinic in San Luis Obispo, California.
Does Having Psoriasis Raise The Risk Of Other Diseases As You Age
While psoriasis affects the skin, we now know that its actually a systemic disease. In psoriasis, inflammation exists throughout the body, but its only externally visible in the skin.
Especially in more severe cases, psoriasis is associated with metabolic syndrome, arthritis, and depression. Metabolic syndrome includes insulin resistance and diabetes, high cholesterol, and obesity. It increases your risk of heart disease and stroke.
The same type of inflammation that affects the skin may affect the joints, leading to psoriatic arthritis. It can even affect the brain, leading to symptoms of depression.
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Quality Of Life And Psychological Aspects Of Psoriasis
Although psoriasis generally does not affect survival, it certainly has a number of major negative effects on patients, demonstrable by a significant detriment to quality of life. Despite this, most clinical trials of new treatments for psoriasis focus on objective physical measures for the primary endpoint of efficacy. This is incongruous as it is the improvement in quality of life that patients and physicians rely upon when selecting treatment. Impairment of quality of life has been highlighted particularly by the work of Finlay. Patients with psoriasis have a reduction in their quality of life similar to or worse than patients with other chronic diseases, such as ischaemic heart disease and diabetes. That patients with psoriasis feel stigmatised by the condition is well established. This of itself contributes to everyday disability leading to depression and suicidal ideation in more than 5% of patients.
Furthermore, quality of life measures take into account the effect of the treatment on the patient. Quality of life data fulfils the role of measuring the intangible changes in a patients life that determine treatment success. For a clinically meaningful change to exist for psoriasis and other chronic, non-life threatening diseases, a treatment must provide an improvement in the patients quality of life. In an attempt to provide an holistic assessment of overall disease severity, a specific tool has been developedthe Salford Psoriasis Index :
Is It Time To Evaluate Your Psoriasis Treatment
If you are treating psoriasis and have celebrated your 65th birthday, dermatologists recommend that you get evaluated. A careful evaluation will make sure that you are using an appropriate treatment at a dose thats right for you.
Having an evaluation also helps prevent possible side effects and interactions with other medications that you take.
If you need to find a board-certified dermatologist, you can search for one in your area at: Find a dermatologist
ImagesGetty Images
ReferencesGrozdev IS, Van Voorhees AS, et al. Psoriasis in the elderly: From the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol 2011 65:537-45.
Hodak E, Gottlieb AB, et al. Climatotherapy at the Dead Sea is a remittive therapy for psoriasis: Combined effects on epidermal and immunologic activation. J Am Acad Dermatol 2003 49:451-7.
Kushelevsky AP, Harari M, et al. Climatotherapy of psoriasis and hypertension in elderly patients at the Dead-Sea. Pharmacol Res. 1996 34:87-91.
Papp K, Reich K, et al. Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate to severe plaque psoriasis: Results of a phase III, randomized, controlled trial . J Am Acad Dermatol. 2015 73:37-49.
Rich, P, Gooderham M, et al. Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with difficult-to-treat nail and scalp psoriasis: Results of 2 phase III randomized, controlled trials . J Am Acad Dermatol2016 74:134-42.
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Key Points About Psoriasis
- Psoriasis is a chronic skin condition. It causes inflamed, red, raised areas of skin that often develop dry, silvery scales called plaques.
- Psoriasis is not contagious. It is an autoimmune skin disease.
- Psoriasis is a long-term disease. You will have flare-ups that come and go over time.
- There is no cure, but treatments can help relieve symptoms. Treatment can include creams, light therapy , and oral or injected medicine.
- Psoriasis is a chronic condition. But you can manage it by working with your healthcare provider to create a long-term treatment plan and self-care routine that includes attention to both physical and emotional needs.
What Is Cdc Doing About Psoriasis
In 2010, CDC worked with experts in psoriasis, psoriatic arthritis, and public health to develop a public health perspective that considers how these conditions affect the entire population. The resulting report is Developing and Addressing the Public Health Agenda for Psoriasis and Psoriatic Arthritis pdf icon. You can read a short article about the agendaexternal icon in The American Journal of Preventive Medicine.
CDCs National Health and Nutrition Examination Survey , an intermittent source of national psoriasis data, has included questions about psoriasis as late as the 2013-2014 cycle. A recent analysis of NHANES data estimates that 7.4 million adults had psoriasis in 2013external icon.
- Psoriasis causes patches of thick red skin and silvery scales. Patches are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places . The most common type of psoriasis is called plaque psoriasis.
- Psoriatic arthritis is an inflammatory type of arthritis that eventually occurs in 10% to 20% of people with psoriasis. It is different from more common types of arthritis and is thought to be related to the underlying problem of psoriasis.
- Psoriasis and psoriatic arthritis are sometimes considered together as psoriatic disease.
Who is at risk for psoriasis?
Anyone can get psoriasis. It occurs mostly in adults, but children can also get it. Men and women seem to have equal risk.
Can I get psoriasis from someone who has it?
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