ARTICLEPSORIASIS

Your 5-Step Guide to Managing a Psoriasis Flare

By Claire Gillespie

Reviewed by Allison Truong, M.D.

September 14, 2022

No matter how committed you are to your treatment plan and how careful you are to avoid triggers, sometimes a psoriasis flare simply can’t be avoided. Scientists are still trying to figure out exactly what causes some psoriasis symptoms to worsen at certain times. But if you know what to do when your psoriasis flares, you’re more likely to minimize its impact.

Here’s your step-by-step guide to psoriasis flare-up relief, helping you reduce pain and itch—and hopefully stop the flare in its tracks.

Step 1: Contact Your Dermatologist

The first thing you should do when your psoriasis flares up is make an appointment with your dermatologist, says Susan Bard, M.D., a board-certified dermatologist at Vive Dermatology, in New York City. Even though you probably have a busy schedule, this step is important, and it may be easier than you think. Many dermatologists offer virtual visits, meaning you don’t even need to leave your home to get advice and support during your psoriasis flare-up.

Your doctor can help you assess your flare and decide whether you need a prescription medication to help ease your symptoms.

You may have a long wait to be seen by some dermatologists, so it’s important to do this step first to increase your chances of securing an appointment. Explain your situation and ask the receptionist if there’s any way you can get an earlier appointment. They may be able to squeeze you in if there’s a cancellation or a slot available for urgent situations.

Step 2: Care for Your Skin

Your dermatologist is likely to ask you about your current skincare regimen and may recommend tweaks to your plan to help shorten the psoriasis flare-up. Make sure you’re consistent in using any topical treatments you’ve been prescribed—and moisturize.

“If your dermatologist has prescribed topical treatments, you can apply those along with a bland moisturizing cream or ointment on top,” says Tanya Nino, M.D., a board-certified dermatologist at Providence St. Joseph Hospital in Orange County, California.

Most dermatologists prescribe topicals to be used daily or twice daily. As symptoms resolve or disappear, your doctor may tell you to stop using prescription topicals altogether and start using over-the-counter moisturizers. While you’re waiting to see the doctor after a flare-up, it’s often recommended to restart the regimen that was given to you the first time you saw your dermatologist.

Keeping your skin hydrated really helps to prevent dry, itchy skin and can also reduce redness and accelerate healing. The following are a few over-the-counter hydrating moisturizers that have the National Psoriasis Foundation Seal of Recognition:

Note: If you’re doing exactly what your dermatologist told you to do, and your symptoms aren’t getting better after about two weeks, then they may not be due to psoriasis; there may be a different cause altogether. At this point, it may be best to stop any prescription or OTC remedies and wait to see the doctor.

Step 3: Fight the Itch

It’s really important to avoid scratching your skin during a flare-up, Nino says. “Scratching or rubbing can cause breaks in the skin, which can lead to [more] painful psoriasis plaques,” she explains.

If you’re feeling itchy, add Epsom or Dead Sea salts to your bathwater, soak for no longer than 15 minutes in warm (not hot) water, and moisturize immediately afterward to soothe your skin.

You can also try an over-the-counter antihistamine like Allegra (fexofenadine), Benadryl (diphenhydramine), or Zyrtec (cetirizine) to calm the itch from the inside out. Cool towels or ice cubes may also provide relief.

Step 4: Manage Stress

Don’t overlook your emotional state as you consider what to do when your psoriasis flares. Stress levels can affect your symptoms, so it’s a good idea to find ways to reduce or manage the stress you’re experiencing.

“Stress management is important for people with psoriasis, as we know that this can be a trigger for symptoms,” says UK-based psychodermatologist Alia Ahmed.

If you need some new stress management techniques in your psoriasis toolkit, Ahmed suggests relaxation techniques like breathing exercises or muscle relaxation. It can also be helpful, she says, to start and end your day with a moment of reflection about what you have to be thankful for, and to take short breaks regularly to engage with a positive activity to re-energize, such as a brisk walk.

If you have persistent feelings of stress, take some time to analyze what’s causing them and think about developing skills to deal with or reduce those stressors. “For example, [consider] better time management if you are always rushing or late,” Ahmed says.

If you know other people with psoriasis, for instance, through a local support group or our psoriasis community, it might help to check in with them during a flare-up. If there’s anyone who can offer support and understanding, it’s someone who’s been through the same thing.

And if you’re struggling to control your stress levels, your doctor may be able to refer you to a mental health professional, such as a therapist, who can provide you with additional support.

Step 5: Avoid Other Triggers

If you know what your personal psoriasis triggers are, take extra care not to expose yourself to them during a flare so you don’t prolong your symptoms. Case in point: For some people, the colder, drier weather in fall and winter can trigger flares, so it’s important to apply moisturizer whenever your skin feels dry, avoid clothing with rough textures (such as wool), and use a humidifier to add moisture to your indoor air, says Nino.

Others may find that alcohol or certain foods trigger flare-ups, so it’s important to avoid anything you may be sensitive to. Plus, eating nutritious, anti-inflammatory foods may help.

“By changing the way we eat to incorporate more anti-inflammatory foods, more vegetables to feed the microbiome, and more foods to support the liver, our skin will love us,” says UK-based registered nutritional therapist Emma Gould, who specializes in working with people who have psoriasis and other skin conditions.

But remember that diets aren’t one-size-fits-all. “The best way to make sure you are eating the right foods for you is to consult a professional and get a personalized nutrition plan,” Gould says.

It’s difficult to know exactly what to do when your psoriasis flares. But by giving yourself some TLC in eating right, reducing stress, caring for your skin, and sticking with prescribed treatments, you’ll know you’ve done everything you can to help your skin heal and get over your flare as soon as possible.

You May Also Like: