9 Ways to Help Prevent a Psoriasis Flare
A psoriasis flare can really get in the way of living your best life. This is an unpredictable disease, and you may not always know when your next flare is coming—but what if you can take steps to help prevent it?
We turned to the experts and medical research to share which healthy habits may give you the best chance of avoiding flares or having less severe symptoms when they do happen, so you’re more comfortable in your skin.
1. Find the Right Treatment—and Follow It Closely
No. 1 on the list is to closely follow your treatment plan, if your doctor has given you one, says Paul Yamauchi, M.D., a board-certified dermatologist at the Dermatology Institute & Skin Care Center, in Santa Monica, California.
“Even if your psoriasis is clear or almost clear, continue taking your medications as recommended by your provider to maintain that clearance,” Yamauchi says. “You want your body to be in a low state of inflammation by being adherent to your medications.”
On the other hand, says Jerry Bagel, M.D., a board-certified dermatologist in East Windsor, New Jersey, and a member of the National Psoriasis Foundation’s board of directors, you should talk to your healthcare provider about making tweaks or trying a different treatment plan if yours isn't clearing your skin.
If this is the first flare you’ve had in a long while, then your doctor may suggest a short-term regimen to calm down the flare. However, if you’re getting frequent flares and you’re already on a long-term treatment regimen, such as a systemic therapy (e.g.., orals or injectables), then it may be time to switch to a different regimen.
There are many treatment options available for mild, moderate, and severe psoriasis, so if something isn’t working, then consider discussing with your doctor whether it might be the right time to try something new.
Whether you’re taking an oral, injectable, or topical treatment (or a combination of two or more of those), its effectiveness depends on taking it according to the instructions. If you’ve fallen off the wagon and missed a few doses, it’s important to be open and honest with your doctor about it. This will help them guide you on how to be more consistent with treatment or how to switch treatments if it’s too difficult for you.
2. Keep Your Skin Moisturized
The American Academy of Dermatology recommends using a moisturizer daily as part of your defense against flares. Dry skin is more likely to flare, Yamauchi says, and also more likely to crack and bleed.
Opt for moisturizers that are heavier than lotions, like a cream, ointment, or oil, and apply your product liberally once a day or more. Look for ingredients that may be particularly soothing, such as petrolatum and aloe vera. Hypoallergenic products are often best, since people with psoriasis tend to have sensitive skin. Vanicream Moisturizing Cream, CeraVe Moisturizing Cream, and Cetaphil Moisturizing Cream all fit the bill.
3. Manage Your Stress As Best You Can
“Stress is probably the leading culprit for a flare-up of psoriasis,” Yamauchi says. A 2018 review in the International Journal of Dermatology found that up to 88% of people with psoriasis report that stress is a significant trigger for their flares.
Stress can cause an imbalance in the immune system, leading to increased inflammation, Yamauchi says. Reducing stress is easier said than done, however. Yamauchi recommends finding relaxing activities and hobbies that you enjoy. For some, that may include yoga, exercise, and/or meditation. The above review also found that hypnosis, biofeedback, and behavioral and cognitive stress management therapies can be effective for some people with psoriasis.
Bagel tells his patients to talk to a trusted friend or family member. “Sometimes, just talking about what’s stressing you out can help a lot,” he says.
4. Watch What You Eat
Many of Yamauchi’s psoriasis patients ask him whether diet matters. His answer: It depends. “Every individual is different, so just because one food group makes one person’s psoriasis worse, it doesn’t mean it happens to everyone.”
Should you notice that a certain food group or ingredient seems to make your psoriasis flare, then avoid or minimize intake of it, he advises. Common food triggers include sugar, fatty foods, and processed foods.
“It also has been demonstrated that a diet that is good for the heart, such as a Mediterranean diet, can improve your psoriasis by reducing inflammation in your body,” Yamauchi says. A Mediterranean diet is full of vegetables, fruits, whole grains, nuts, and legumes and is considered anti-inflammatory.
5. Maintain a Healthy Weight
According to a 2016 study in Dermatology, being overweight or obese can aggravate psoriasis symptoms. The issue may be that fat tissue can put overweight people in a chronic inflammatory state, and psoriasis is a disease of inflammation, the study says. Excess weight can also interfere with the effectiveness of medications.
Researchers suggest that losing weight can have a substantial positive effect in managing psoriasis symptoms and that seeing a dietitian for nutrition care could help.
6. Quit Smoking
According to the National Psoriasis Foundation, smoking may make your treatments less effective—which may make you more vulnerable to flares. Dermatologists also believe that smoking can damage cells, increase inflammation in the body, and aggravate existing psoriasis.
“Cutting down or stopping smoking can help improve psoriasis,” Yamauchi says. Quitting is never easy, though. The Centers for Disease Control and Prevention and National Cancer Institute have free online resources that may help.
7. Cut Back on Drinking
Alcohol, too, can be a trigger for psoriasis flares in some people. “Alcohol opens up blood vessels in the skin, which can make your psoriasis flare,” Bagel says. Alcohol may also increase inflammation, according to a study in Psoriasis: Targets and Therapy.
Although drinking may affect some people more than others, it’s generally best to limit or avoid alcohol, Bagel says. According to dietary guidelines from the U.S. Department of Health and Human Services and U.S. Department of Agriculture, all adults should limit their drinking to up to one alcoholic beverage per day for women, or up to two drinks per day for men, and some people with psoriasis find it helpful not to drink at all.
Talk to your doctor about whether that glass of red may be connected to your red, itchy skin, and ask them for tips to decrease your consumption if you need guidance.
8. Protect Yourself from Cold Weather
Some people find that they have more severe psoriasis or more frequent flares in the wintertime. A 2015 study suggests that it’s due to less sunlight exposure, cold temperatures, and low humidity, which can cause psoriatic skin to thicken and become inflamed.
It’s not reasonable for everyone with psoriasis to move where it’s warmer year-round, but you can keep your skin well covered and protected when you venture out in the cold, Bagel says. Using a humidifier to add moisture to dry air may be beneficial, too.
See your dermatologist if you tend to experience more severe psoriasis during cold weather, as they may be able to change your treatment to help you prevent seasonal flares.
9. Pay Attention to Your Overall Health
Certain medications, such as beta blockers for high blood pressure, or lithium for psychiatric conditions, may worsen psoriasis in some people. “Ask your provider if your medications could be triggering your psoriasis,” Yamauchi says. And if the answer is yes, ask what alternatives are available to you.
Maintaining your overall health is also important, as some illnesses can trigger a flare, according to the National Psoriasis Foundation. If you develop an infection such as strep throat, it’s important that you seek treatment right away, Bagel says. “Be on the side of caution and treat strep and other infections to prevent them from inducing a flare,” he says.
If you work with your healthcare team, follow your treatment plan, and be kind to your skin, you’ll set yourself up to minimize your psoriasis flares. It takes a healthy lifestyle and some determination, but it’s worth it when your efforts pay off.
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