Talk With Your Doctor
You can try several different treatment options to manage a flare.
For example, a topical steroid may be available as an ointment, cream, or lotion. Since the skin absorbs ointments more easily than creams or lotions, per 2017 research , these formulations are often the best choice for treating a psoriasis flare.
Your doctor can help you weigh the risks and benefits of any prescription medications. Work with your doctor to come up with a plan to treat flares in the short term, as well as a long-term treatment plan to help you achieve and maintain remission.
How Do Foods Cause Inflammation
Studies are ongoing about how certain foods trigger an inflammatory response. Research suggests that some foods, especially highly processed ones, put your bodys defense mechanisms into overdrive.
For example, fatty foods can increase inflammation in adipose tissue , which is throughout your body. Ongoing fat tissue inflammation greatly increases your risk of psoriasis. It also increases your risk of type 2 diabetes, heart disease and other chronic health conditions.
Clinical Trials For Psoriasis
Before a new treatment can be registered in Australia it must undergo extensive testing. Clinical trials are used to determine the safety and effectiveness of new treatments for psoriasis. The regulations governing clinical trials in Australia make the process as safe as possible for clinical trial participants. People with psoriasis may consider volunteering to participate in a clinical trial. Participation provides volunteers with access to cutting edge treatments that are not otherwise available. General information about being part of a clinical trial can be found here. Internationally, ClinicalTrials.gov provides patients, their family members, and the public with easy and free access to information on clinical studies for a wide range of diseases and conditions. If you are interested in participating in a clinical trial, talk to your doctor.
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Consider Whether You Need An Over
Depending on the severity of your flare, you may need to apply an over-the-counter product to treat the psoriasis. Several options are available. You should follow the instructions on the package of the products or consult your doctor before using them because they may have strong side effects. Some of these products include:
- Keratolytics, such as salicylic acid, lift the scale from your skin.
- Tar may help restore your skin after a flare. It may also help with itching, scales, and inflammation.
- Hydrocortisone is a very mild steroid available over the counter. It targets the inflammation and redness caused by the flare. However, keep in mind it likely wont be strong enough to clear your skin.
Make sure to take the medications prescribed by your doctor. Your doctor may recommend a regular oral medication to combat moderate or severe psoriasis, or a stronger topical medication to help with flares.
Your doctor may also recommend a good over-the-counter pain reliever or antihistamine to relieve psoriasis symptoms.
Foods To Eat If You Have Psoriasis
Just as some foods trigger inflammation, others can help combat inflammation. In general, having a balanced whole-foods diet is the best approach to reduce inflammation throughout the body. It may reduce psoriasis flare-ups or make your symptoms less severe. Following a Mediterranean diet for psoriatic arthritis or psoriasis can also reduce chronic inflammation that contributes to heart disease, type 2 diabetes, cancer and other conditions.
The best foods if you have psoriasis include:
- Fish, lean protein or plant-based proteins such as tofu or tempeh
- Fruits and vegetables
- Small amounts of low-fat dairy
- Whole grains
Theres no evidence that vitamins or supplements help ease psoriasis symptoms. The best way to get all the vitamins and minerals you need is from the foods you eat. But its generally safe to take a daily multivitamin. Talk to your doctor or a registered dietitian about other supplements that might be right for your needs.
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Can Smoking Trigger Psoriasis
Smoking is well known to be a risk factor for developing psoriasis, says Dr. Fernandez. But he notes that once you have psoriasis, theres no scientific evidence that stopping smoking will make the condition go away. In general, we cannot convincingly tell you that if you stop smoking, your psoriasis will improve There is no study that has really supported that.
Its not out of the realm of possibility, however, that being around cigarette smoke could cause discomfort. If someone comes to see me and says, My psoriasis does well until I go visit my brothers family. He and his wife smoke and my psoriasis flares, were going to take that seriously, says Dr. Fernandez. In that case, were going to recommend avoiding cigarette smoke and see what happens.
What Are The Symptoms Of Psoriasis
Symptoms of psoriasis can vary from patient to patient. Some will have fewer flare-ups than others and may enjoy periods of remission for months or years. Because there are several different types of the condition, you may experience some of the following common symptoms:
- Patches of plaque that are characterized by red areas on the skin covered with silver-colored scales
- Scaly patches that are small and round
- Bleeding skin that is dry and cracked
- Intense itchiness or burning sensations
- Fingernails that are thickened and ridged
- Painful joints
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Nosh On Nourishing Foods
If youre aware of any dietary psoriasis triggers, obvi avoid em. But eating more nutritious foods doesnt have to be a chore, either. Just try to meet your veggie, fruit, and lean protein quota in a way that jibes with your tastes. Pinterest-worthy breakfast bowl, anyone?
A Timely Message From My Dermatologist
During lockdown Ive postponed visiting my dermatologist in person to avoid possible exposure to the coronavirus instead, I’ve been sending her messages via a secure patient portal. After my skin flared, I wrote a detailed account of what happened and attached photos of my skin with the new, red, irritated plaques.
Within hours she replied. She first affirmed that most probably the phototherapy damaged my skin, which led to my psoriasis outbreak. Then she thought I might need to take Skyrizi even earlier than previously scheduled. Third, she laid out a plan for me to use phototherapy at a reduced dosage.
In my message I asked her if I should take Skyrizi later that week about a week earlier than scheduled. She replied that I could inject it as soon as that day, which I did.
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Make Time For Bathtime
Light a candle, grab a magazine , and soak in a lukewarm bath for about 15 minutes.
Cleanse with a gentle fragrance-free body wash, and when your 15 mins are up, gently pat your skin dry to help seal in moisture. Apply a thick, derm-approved moisturizer and enjoy your newly-soothed skin.
Psst: Try adding in some colloidal oatmeal for extra itch relief.
Exercise Eat Right And Maintain A Healthy Weight
Although no studies have shown a link between diet and psoriasis, experts recommend that people with the condition eat a well-balanced diet that’s high in fruits and vegetables. Some people say their symptoms improve when they remove dairy or gluten. Exercise may also help. Some studies show excess weight can trigger flares, so stay at a healthy weight.
Bruce E. Strober, MD, PhD, associate director of dermatopharmacology, Department of Dermatology, New York University School of Medicine co-director of the Psoriasis and Psoriatic Arthritis Center consultant for Amgen, Biogen, Genentech, Fujisawa, and 3-M.
Jeffrey M. Weinberg, MD, director of the Clinical Research Center, St. Luke’s and Roosevelt Hospital Center, New York City associate clinical professor of dermatology, Columbia University College of Physicians and Surgeons consultant for Amgen and Genentech.
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “What Is Psoriasis?”
American Academy of Dermatology: “Psoriasis.”
National Psoriasis Foundation: “Psoriasis,” “How Cigarettes and Alcohol Affect Psoriasis” and “Weight loss greatly improved psoriasis.”
Abel, E. “Dermatology III: Psoriaisis ACP Medicine, April, 2005.
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Sneaky Trigger: Prescription Meds
While your medication may fix one problem, it could be causing another. Dr. Friedman advises those with psoriasis to steer clear of beta blockers, anti-malarials and lithium. Oral steroids are also a big no-no, he adds, as they can cause a severe flare when going off of them. It is important to speak with your physician before starting or stopping any medications.
Not Taking Meds On Time
Even if you feel fine, its still important to take your medication as prescribed to prevent psoriatic arthritis from flaring up again. Sometimes people miss some medication doses and they flare, Dr. Husni says. Then we look back with the patient to figure out why and they say, Oh, I was a little late taking it.
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Dont Freak Over That Flare
Outside of your doctor-recommended treatments, here are some other alternative treatments that may help improve symptoms:
- Acupuncture.Several studies have found acupuncture to be pretty effective at treating psoriasis, as well as soothing the underlying joint pain related to psoriatic arthritis.
- Vitamin D supplements.Vitamin D is known to help treat autoimmune conditions, psoriasis included. In addition to getting natural sunlight, you also may want to take a supplement especially if you live a place a Twilight character could thrive.
- Indigo naturalis. Research shows that both topical and ingested Indigo naturalis, a plant extract often used in ancient Chinese medicine, may benefit psoriasis and nail psoriasis in particular.
- Turmeric. A 2018 review concluded that curcumin, a chemical compound found in turmeric, helps treat psoriasis symptoms. BRB, time to serve up some curry.
- Fish oil. That same 2018 review found daily fish oil supplementation to be effective at soothing psoriasis symptoms.
Psoriasis treatment is a total health and wellness journey, from nurturing the skin to mental health.
If you need a little extra support, consider the following:
Or Try One With Vitamin A Or D
Meanwhile, products containing vitamins A or Dincluding their synthetic versions and derivativescan also reduce the symptoms of a flare-up thanks to their anti-inflammatory effects, Dr. Stein says.
For example, your derm may recommend trying a prescription retinoid, a derivative of vitamin A, like tazarotene. Medications like this increase cell turnover while reducing the buildup of psoriasis scales, making retinoids a great option for those who deal with thick plaques during flares.
Synthetic forms of vitamin D can also be useful because they help regulate the cell turnover process and, therefore, help reduce scales.
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Sneaky Trigger: Secondhand Smoke
And yet another reason to steer clear of cigs: Cigarette smoke, whether its from you or someone else, is a proven psoriasis trigger. Not only can it kickstart inflammation, but one study published in the American Journal of Epidemiology found that people who were exposed to secondhand smoke as kids had an increased risk of developing psoriasis later in life.
Overcoming A Psoriasis Flare
Trying to determine the reason for a psoriasis outbreak and figure out a fix can sometimes turn you into a disease detective. You and your dermatologist can work together to solve the mystery.
My skin felt sensitive to the touch.
When skin irritation and burning woke me at the break of dawn, I knew I was dealing with overexposure to narrowband ultraviolet light from my phototherapy treatment the evening before. A couple decades of experience with light treatments told me as much.
After a bad skin burn, Id avoided NUVB for a few years, until my doctors convinced me to try it again. When they explained how we could start at a lower dose than normally prescribed, then increase in small increments, I reluctantly agreed.
For almost two years this cautious approach helped me dodge a burn. I also felt incredibly fortunate to have calm skin during the first month of the coronavirus shelter-in-place orders. I did wonder, though, when my good fortune would come to an end. That night it came to a screeching halt.
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Managing Psoriatic Arthritis Flares
When Julie Cerrone developed psoriatic arthritis , she didnt know what it was. Shed had knee problems and chronic pain for years but wasnt diagnosed with PsA until she was in her late 20s. Even after the diagnosis, she didnt immediately connect the profound fatigue she sometimes felt with flaring PsA.
Its a bone-chilling fatigue that has me in bed all day, says Cerrone, a health and wellness consultant in Pittsburgh. Walking up my front steps feels like Im hiking Mount Everest.
Flares for Cerrone can also mean painful, swollen joints and widespread discomfort. It may start in my hands but can travel up my forearm, and all the way to my neck, she says. “Its like my bones hurt.
More than Skin and Joints
Although Cerrones symptoms arent unusual, rheumatologist Philip Mease, MD, says flares can vary widely.
Tips To Manage Common Psoriasis Triggers
When you have psoriasis, there are certain things, events, or conditions that can make the disease flare up or cause your symptoms to worsen. These are called triggers. You can get a better handle on staying well if you find out what your triggers are and how to manage them. Not everyone has the same triggers. Some, though, are common.
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What Can You Do To Treat A Psa Flare
Its important to call your provider and let them know you are having a flare. They may need to prescribe a short-course of new medication or change what youre currently taking.
Some PsA flares can improve with just 1 to 2 weeks of nonsteroidal anti-inflammatory drugs or steroids to stamp out the extra inflammation. Your provider may be able to prescribe these without seeing you in person. But if your flare isnt getting better after 1 to 2 weeks with these, this could be a sign that your PsA medications arent working as well anymore. You should schedule an appointment so your provider can take a closer look. You might need a change in your PsA medications to get things back under control.
There are also some things you can do on your own to feel better sooner:
Take it easy on swollen and painful joints. Give them time to heal.
Ice swollen and painful joints. Ice can temporarily decrease warmth, pain, and swelling in joints that hurt the most.
Take your medications as directed.
Rest and sleep. This might mean taking some time off of work or asking for extra help from family or friends.
Try to focus on decreasing stress levels. This could include self-care, exercise, mindfulness, or a number of other options.
Lean on your support system. An arthritis support group can also be a great resource.
Injuries Or Damage To Your Skin
Though a minor cut or scrape may not seem like a big deal, it can potentially lead to a flare-up according to Dr. Feinberg, who says that skin lesions are a common source of local flares.
Almost anything that causes damage to an area of skin can cause psoriasis to come out when were dealing with an overall flare-up of the disease, he explains. It can be any type a small cut or injury.
Getting a sunburn can also be the cause of flares. As AAD points out, even a mild sunburn can worsen existing psoriasis and cause new psoriasis to form.
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Employ Some Life Hacks
Crow also advises taking shortcuts that can make living with PsA flares easier. These life hacks can help minimize fatigue or joint pain, she says. If your joints hurt, you can change the stuff you are using in your daily life for example, if your hands hurt, you can use a wide-grip fork while eating. You can also change how you interact with stuff, such as choosing to have grocery delivery rather than exerting the energy required to go to the store and bag all the items yourself.
What Causes Psoriasis To Flare
Casey Gallagher, MD, is board-certified in dermatology and works as a practicing dermatologist and clinical professor.
Most psoriasis sufferers know that the condition can flare and improve, sometimes seemingly for no reason. The unexpected nature of the flares can be particularly frustrating, you can be doing well one minute and then poorly the next. Certainly, not all flares can be predicted. Controlling the known triggers of psoriasis in your life, however, can help prevent some of them.
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Apply Lotions And Creams To Calm Your Skin
After bathing or showering, you need to moisturize your skin. You should use fragrance-free, gentle products. You may just need a thin layer of lotion or a thicker cream or ointment.
If your psoriasis is very painful and inflamed, put your moisturizer in the refrigerator and apply it when it cools.
After you apply the emollient, consider whether you should try occlusion. This process covers moisturizers so they can be better absorbed by your body. Items that can occlude your moisturizer include plastic wrap and waterproof bandages.