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When you have a chronic skin condition like psoriasis, which can be uncomfortable and embarrassing, you want to do everything right to lessen its severity and keep things from flaring up. But you might be unintentionally doing things in your day-to-day routine that make your psoriasis more likely to flare. The good news: It’s easy to right most of the common wrongs you might be making in your psoriasis management and get back on the path toward clear skin.
It’s natural to want to “pick” off the scaly plaques that are hallmark symptoms of psoriasis, but that’s one of the worst things you can do to make your psoriasis worse. “Picking at or trying to scrub off the thick scales can exacerbate the problem in those areas because it traumatizes the skin,” explains Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine.
Psoriasis tends to develop in sites of skin trauma, including cuts and scratches. “Any sort of physical trauma—be it a scrape on your knee or nick caused by shaving—can lead to what’s called the Koebner phenomenon, which is when you get a flare of psoriasis where the skin has been injured,” says dermatologist Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital in New York City. “You can even develop it in areas where you’ve never had it before.” Here's what to do to help a cut heal quickly and prevent a cut from scarring.
Regular use of a moisturizer to keep the skin lubricated can reduce redness and itching and soften scales; exfoliating products can help to dissolve “crusting.” The National Psoriasis Foundation provides some inexpensive options, but talk to your doctor about which products are best for your skin.
Dermatologists don’t usually encourage unprotected sun exposure because UV rays are known to cause skin cancer. But for people with psoriasis, the sun is a natural medication, says Dr. Zeichner. “Ultraviolet B light is anti-inflammatory and can calm the skin and improve lesions.” Short, multiple exposures of sunlight—say, five to 10 minutes—to affected areas are recommended, according to the National Psoriasis Foundation.
But don’t overdo it: One of the worst things for your skin is a sunburn, which can actually make your psoriasis worse. Remember to wear sunscreen on areas of your skin that are not affected by psoriasis. And keep in mind some medications can make you more sensitive to the sun, so if it’s a good idea to ask your dermatologist for the appropriate UV exposure “prescription” for *your* skin.
Changing your diet isn’t going to cure your psoriasis, but, as the National Psoriasis Foundation points out, eating healthier may help. “Psoriasis has been shown to be related to obesity, and eating a poor diet, along with a lack of exercise, may lead to weight gain,” says Dr. Zeichner. “We know that fat cells generate inflammatory signals that can make psoriasis worse.”
There’s no such thing as a “psoriasis diet,” but since psoriasis is a chronic inflammatory disease, eating a balanced diet primarily composed of lean proteins, whole grain, fresh produce, and healthy fats—what’s commonly referred to as an “anti-inflammatory” or Mediterranean diet—may help reduce symptoms. And, as a bonus, it may also lower your risk of developing chronic conditions related to psoriasis, such as heart disease, obesity, and diabetes.
Talk about getting under your skin: For about 60% of people with psoriasis, stress is a major trigger for a skin flare, according to one review study. The stress connection is so powerful, in fact, that many people report that their psoriasis first came on during a stressful time. What’s the link? “It may be that the increase in stress hormones promotes inflammation in the skin,” says Dr. Zeicher.
Stress can also impair the barrier function of the skin’s protective outer layer, making it more permeable, more sensitive, and more reactive, Richard Fried, MD, PhD, a dermatologist and clinical psychologist in Yardley, Pennsylvania, explained in an American Academy of Dermatology news release. That, in turn, can worsen skin conditions like psoriasis.
There’s a slew of ways to help manage stress, including exercise, meditation, psychotherapy, cognitive behavioral therapy, and medication like antidepressants. Figuring out a stress-fighting strategy is key for clearing your skin, says Dr. Fried. “Stress management makes patients feel more empowered and in control, which makes them more likely to comply with treatment and see improvement.” Try this yoga routine designed to soothe stress and anxiety.
Alcohol and psoriasis seem to be a bad mix. One review of studies found that alcohol consumption seems to be greater in people with psoriasis than the generally population, but there’s not enough evidence to establish whether alcohol is actually a risk factor for psoriasis. Other research shows that obstaining from imbibing can improve the severity of the disease. The National Psoriasis Foundation recommends that if you drink, do it in moderation—heavy drinking may trigger psoriasis, interfere with your response to treatment, and prevent remissions.
Reviewed by: Preeti Parikh, MD . Review date: April 19, 2018