How to Care for Your Skin Between Psoriasis Flare-Ups
When you have psoriasis, it’s common to experience an ebb and flow of symptoms: Flare-ups are times when itchiness, pain, and discomfort are at their worst—and then there may be lulls, when you feel noticeably better.
“If you are not having a flare-up, that is wonderful news,” says Loretta Pratt, M.D., a board-certified dermatologist at Advanced Dermatology PC in Chadds Ford, Pennsylvania. You may enjoy these periods without symptoms.
But although clear skin is often cause for excitement and relief, it’s not a good idea to skip caring for your skin during this time, says Anna Chacon, M.D., a board-certified dermatologist based in Miami. “This condition is unpredictable. Flare-ups may appear anytime, and disregarding skincare may lead to severe flare-ups,” she says.
In other words, maintenance matters for reducing or even preventing future symptoms. Here’s how dermatologists recommend caring for your skin between psoriasis flare-ups.
1. Keep Your Skin Hydrated
Experts agree: Don’t skimp on the moisturizer. Hydration is key if you have psoriasis, even between flare-ups.
“I always encourage my psoriatic patients to moisturize daily, particularly after they shower,” says Saurabh Singh, M.D., a board-certified dermatologist in Silver Spring, Maryland. Dry skin can lead to scratching, which can lead to a flare-up on that skin, he notes.
Keeping your skin hydrated is also important for maintaining a healthy skin barrier, which helps protect you from environmental factors that could lead to further irritation. Research suggests that people with psoriasis have impaired skin barrier function—even on asymptomatic skin—which makes moisturizing all the more crucial.
“Use a bland daily moisturizer, or one prescribed by your doctor, if your skin feels rough or dry,” Pratt recommends. A “bland” product may be gentle, unscented, and generally nonirritating.
You should opt for a moisturizer that doesn’t have a fragrance, and choose a thick cream or ointment rather than a lotion, according to the American Academy of Dermatology Association (AAD). That’s because fragrance-free products may be less irritating, and thicker creams tend to be more effective moisturizers than lotions. You can also seek out moisturizers with a Seal of Recognition from the National Psoriasis Foundation.
It’s not just moisturizer that matters in keeping your skin hydrated, either—you’ll also want to avoid factors that can lead to dry skin, like using harsh soap or showering too often, Pratt says.
Winter’s dry weather and lack of sun exposure can be particularly challenging for people with psoriasis. Consider getting a humidifier, Singh says, which will add moisture to the air. The AAD also recommends keeping your distance from radiators and other drying heat sources to help keep your skin from getting dehydrated. If you can feel the heat directly on your skin, you’re likely too close.
2. Stick with Your Treatments
Even if you’re symptom free, keep taking any medications your healthcare provider has prescribed.
“It may look like the psoriasis is gone, but it will return if you don’t stay on therapy,” Singh says. “We do not have a cure for psoriasis at this point, but we have many great treatment options available that should be able to completely clear a patient’s skin.” These range from topical treatments to systemic medications (including oral and injectables) to phototherapy.
Whatever your treatment plan, always speak with your healthcare provider before stopping that treatment—even if you’re not symptomatic. Sometimes your doctor may switch you from an active treatment to a maintenance treatment regimen. For example, active treatment may include topical steroids, whereas maintenance treatment may include nonsteroidal topicals such as calcipotriene cream.
3. Avoid Skin Injuries
Skin injuries can lead to psoriasis flare-ups, an occurrence known as the Koebner phenomenon. When this happens, you may spot new lesions a few weeks after the injury, but it’s also possible to see them as soon as three days afterward—or as far out as 20 years later.
“Avoid getting scrapes, cuts, and bumps, as trauma in the skin can also lead to flare-ups,” Chacon advises. Accidents happen, and injury isn’t always preventable, but you can try to avoid actions that cause trauma to the skin, like picking or scratching.
Other steps can help protect your skin from minor injuries, too. Those include using insect repellent or staying inside at dusk and dawn, when insects are likely to bite. And be gentle with your skin when you shave, moisturizing beforehand and using a shaving gel before running a razor along your skin. You'll also want to use a high-quality, clean razor.
In general, embrace moisturizer. By keeping your skin moisturized, it’ll stay smooth and be less likely to become injured.
4. Manage Your Stress
When it comes to common psoriasis triggers, stress tops the list. In fact, up to 88% of people with psoriasis identify stress as a trigger, according to a 2018 review in the International Journal of Dermatology.
“I do not think patients realize that psoriasis is a systemic inflammatory condition. It is not just a skin disease,” Singh says. The inflammatory quality is part of why stress levels may be so meaningful, he notes.
When people feel stressed—whether it’s chronic or acute—it can lead to inflammation. It’s not totally understood how stress can exacerbate psoriasis specifically. But the fact that there is some kind of connection is clear.
And keep in mind that there tends to be a cyclic relationship between psoriasis and stress. Stress may lead to flares, and dealing with flares may also lead to feeling stressed out.
“Talk with a dermatologist to address [your stress levels] and build a support system,” Chacon says. A dermatologist can help you manage stress levels related to living with the chronic condition by helping to keep your psoriasis as controlled as possible. And a support network of friends, family, doctors, and other people who care for you can help you manage stress, whether it’s related to your psoriasis or not.
5. Get Some Sun—but Not Too Much
If you have psoriasis, getting some sun can be helpful in keeping your skin healthy. “The ultraviolet light in sunlight can slow the growth of skin cells,” Chacon says.
But moderation is key. “Excessive sun exposure is never beneficial,” Singh says. In fact, a sunburn has the potential to trigger another flare because of the Koebner phenomenon.
So if you find that the sunlight is helpful for your symptoms, enjoy some time outside with proper precautions. “Try to get some sun two or three times a week, but remember to use sunscreen on your healthy skin,” Chacon says. Your dermatologist can recommend a sunscreen, but in general you’ll want to seek out a fragrance-free broad-spectrum option with a sun protection factor (SPF) of 30 or higher, according to the National Psoriasis Foundation.
And don’t stay in the sun for hours. It’s small doses of sun that are helpful—emphasis on “small,” Chacon notes. For example, less than 15 minutes of daily sunlight may be sufficient to boost natural vitamin D levels, which may be especially helpful for people with psoriasis.
Bottom line: With psoriasis, clear skin can be a goal. But even when you’re free from symptoms, taking special care of your skin can pay off in the long run. And remember, many of the healthy habits that everyone should follow—like taking it easy with alcohol, maintaining a healthy diet, and avoiding smoking—are of extra importance for people with psoriasis, since many unhealthy habits can be common triggers for symptoms.
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