a woman in a doctor's office

7 Ways to Reduce Your Risk for Psoriasis Complications

By Corinne O’Keefe Osborn
September 14, 2021

If you are one of the millions of Americans living with psoriasis, then you know that it’s way more than just a skin disease. This chronic condition can affect your body—and your lifestyle—in countless ways. From itching and pain to fatigue and embarrassment, at times it can feel as though psoriasis is controlling your life.

To make matters worse, the inflammation of psoriasis can affect not only skin, but joints, tissues, and organs. And because of that, people with the condition also have a heightened risk of developing several serious conditions, including psoriatic arthritis, coronary artery disease, high blood pressure, type 2 diabetes, fatty liver, and high cholesterol. They sound scary, but know that they’re not a given.

Early and effective treatment strategies can not only provide you with relief, but also help reduce your risk of complications. Plus, there are steps you can take to reduce your risk factors and increase your odds of leading a long and healthy life.

Get Regular Checkups

Let’s say you’ve spent the last six months in remission. Or maybe your psoriasis only affects your elbows. Do you really need to see a doctor on a regular basis? Yes! Here’s why.

The more researchers learn about psoriasis, the more they have come to regard it as a systemic (full body) inflammatory disease. Doctors used to think that psoriatic inflammation was limited to the skin and joints, but we now know that psoriatic inflammation exists throughout the entire body.

“This high inflammatory state is what leads to the other known side effects of psoriasis,” explains Susan Bard, M.D. of Vive Dermatology in Brooklyn, NY. “The cardiovascular risks, the increased weight, the increased risk of diabetes.”

The single best step you can take toward preventing these serious complications is to commit to regular checkups with your primary care physician. Regular checkups can catch things like psoriatic arthritis and high cholesterol and treat them before they cause permanent damage.

Prioritize Your Mental Health

For some people with psoriatic disease, getting through the day can be a struggle. When you’re exhausted, swollen and bleeding, it’s hard to put on a happy face—and even harder to mean it.

Studies have shown that people with psoriasis are more likely than other people to experience depressive symptoms and to be diagnosed with clinical depression.

Symptoms of depression include feelings of hopelessness, worthlessness, and guilt. A depressed person might lose interest in activities that used to bring them joy and pleasure, feel fatigued all the time, or have frequent episodes of frustration, irritability, or anger.

When you’re depressed, anxious, and stressed out, your health suffers. At that point, the best thing you can do for your body is to seek help and support. This can include medication-based treatment from a psychiatrist, counseling with a therapist, or camaraderie through a psoriasis support group.

Pay Attention to Your Joints

Sometimes an aching back is just a normal part of aging. Other times, it’s indicative of a larger problem. If you have psoriasis, you have about a 25 percent chance of developing psoriatic arthritis, an inflammatory condition affecting the major joints. Left untreated, psoriatic arthritis can cause permanent joint damage, which can be very painful and may even impair your mobility.

Sonya Johnson, M.D., of Dermatology Associates in Indianapolis, Indiana, says that all too often her patients fail to connect the dots between their joint pain and their psoriasis.

“They think it’s just a little old age,” Johnson says. “Or they’ve just had it for so long that it has become commonplace for them. After a while, you just get used to it. You don’t complain about it.”

It’s often not until her patients go on medication for their skin symptoms that she discovers their psoriatic arthritis—because, all of the sudden, their pain disappears. But by that time, it may already be too late.

“Once the joint starts to get damaged, it’s pretty much irreversible,” says Tina Bhutani, M.D., co-director of the Psoriasis and Skin Treatment Center at the University of California San Francisco. “If you can stop it at the inflammation stage, before you get any damage, that’s key.”

So, pay attention to the signals your body is sending you. Signs of psoriatic arthritis include:

  • Pain or swelling in one or more joints
  • Swelling that makes a finger or toe appear sausage-like
  • Joints that are red or warm to the touch
  • Frequent joint tenderness or stiffness

If you’re experiencing any of those symptoms, tell your doctor as soon as possible.

“The earlier you detect psoriatic arthritis, the earlier you can treat it,” says Bhutani.

Keep an Eye on Your Fingernails

Studies have found that nail changes are a strong predictor of psoriatic arthritis, and that these nail changes often appear years before other symptoms arise. It’s important to keep an eye out for changes like crumbling, separation from the nail bed, and nail pitting.

Not sure what to look for? Bhutani says nail pitting “kind of looks like somebody took an ice pick to one of the nails.”

She also tells patients to look out for salmon patches, which are little red spots under the nails, and oil drops, which are where it looks like somebody dripped some oil under the nails.”

These are also reason to get checked out by a doctor.

Get Heart Smart

Researchers have found a link between psoriasis and heart attacks. While the risk is higher for those with severe psoriasis, any type of psoriasis counts as a risk factor.

“All of my psoriatic patients get counseling about the increased cardiovascular risks,” says Bard. “They get counseling on diet modification, smoking cessation, and healthier lifestyles in general.”

The goal is to avoid a situation in which risk factors are piling up on each other, increasing the odds that you will experience a cardiac episode. Minimize your risk by adopting a heart-healthy diet, losing weight (if you’re overweight), and getting a minimum of 150 minutes of moderate exercise per week.

Shed Those Extra Pounds, for Good

No one likes to be told they should lose weight, but research has established a strong relationship between obesity and psoriasis. Although the exact nature and direction of that relationship remains a mystery, we do know that people with psoriasis are much more likely than other people to be overweight or obese and that people who are obese are more likely than others to have or get psoriasis.

“We know that adipocytes, which are fat cells in the body, produce some of the same inflammatory cytokines that drive psoriasis,” explains Bhutani. “By decreasing those fat cells, we are decreasing overall inflammation.”

“We definitely know that losing weight will improve your psoriasis [if you’re overweight or obese], it won’t take it away, but it will improve it,” Bhutani adds.

She goes on to explain another major benefit of weight loss: improved treatment outcomes. Studies have shown that not only is psoriasis likely to improve after weight loss, but that the medication is more likely to effectively manage your remaining symptoms.

Eat Heathy Foods and Cut Out the Junk

There is a lot of conflicting information out there about what type of diet is best for people with psoriasis. Some people find that a gluten-free diet helps reduce their symptom severity. Others find it helps to cut out things like dairy, meat, or junk food.

“So far, the only diet that consistently has shown some improvement in psoriasis is the Mediterranean diet,” says Bhutani.

New research supports the use of the Mediterranean diet and suggests that foods with anti-inflammatory properties may be effective for a wide range of people. The Mediterranean diet is high in anti-inflammatory foods like fruits, vegetables, olive oil, and Omega-3 fatty acids.

It might benefit you to experiment with some of these dietary changes; but in the end, the best diet is a well-balanced one that you can stick to long-term. That way, you can maintain a healthy weight while also cutting down on psoriasis flare-ups.

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