9 Psoriasis ‘Mistakes’ and How to Avoid Them

From everydayhealth.com

Psoriasis is an inflammatory condition that speeds up the life cycle of skin cells, causing red, scaly patches that can be itchy, painful, or cracked. 

Managing psoriasis can be tricky: There are oral, topical, and injectable therapies to try, a daily skin-care routine to maintain, and lifestyle habits to keep front of mind. And even with the best intentions, flare-ups can still occur. 

To keep psoriasis in check and improve your overall health, experts recommend avoiding the following common mistakes.

1. You Delay Seeking Help During a Flare or When Symptoms Worsen

Whether it’s a busy schedule, procrastination, or the hope that psoriasis symptoms will simply go away on their own, it’s common for people to put off seeing a dermatologist when new spots appear, says Lawrence Green, MD, a clinical professor of dermatology at the George Washington University School of Medicine in Washington, DC.

But delaying care often means inflammation has more time to escalate, which can make symptoms harder to control. “The earlier you can treat it, the easier it is to treat — and the less stress it’ll be on your body,” Dr. Green says.

Schedule an appointment with your dermatologist if you see changes in your skin, such as a rash that’s not going away, a rash that’s worsening, or flare-ups that are becoming more frequent, severe, or widespread.

Even if plaques aren’t itchy or bothersome, getting them checked early puts you on the front foot before they get more difficult to manage, Green says. 

It also gives your doctor a chance to reassess whether your current treatment plan is still appropriate or needs adjusting.

2. You Don’t Give a New Medication Enough of a Chance — or You're Reluctant to Try New Therapies

Finding the right psoriasis treatment takes patience — and some trial and error.

While it’s tempting to stop a new medication if you don’t see immediate results, it’s worth the wait to find the right combination of therapies for you, according to Steven Daveluy, MD, a professor and the program director at Wayne State University’s School of Medicine in Detroit, where he specializes in treating patients with skin diseases such as psoriasis and eczema.

That’s because — with the right combination of therapies — psoriasis should be contained to 1 percent of your skin or less. “That’s the size of the palm of your hand, including fingers and thumb. If you have more than that, it’s time to do something to reach that goal,” Dr. Daveluy says.

Different treatments work at different speeds, taking between weeks or even months to show their full effect. But by the three-month mark, the target for a new treatment is a 75 percent improvement or for psoriasis to cover 3 percent or less of your body. By six months, you should hit the 1 percent threshold.

Stick with a treatment for this recommended period — often three months — before making changes, Daveluy says.

3. You Neglect Daily Skin Care

Daily skin care is crucial for managing psoriasis, but it takes time and commitment. And it’s easy to overlook when you’re not battling flare-ups.

But your skin-care routine helps to keep plaques at bay, Green says. “If you’re not moisturizing on a regular basis, especially on dry skin areas like the arms and legs, you’re more likely to get psoriasis there,” he says.

Take a bath or shower for about 5 to 15 minutes a day using warm — not hot — water, then follow up with a fragrance-free moisturizer.

For the winter months, Green recommends using thick, heavy creams or ointments over lighter pump lotions, which can be saved for warmer temperatures. 

This applies to your topical prescription medications, too. “Some patients use their topical medications sporadically and wonder why they don’t work. You have to use the medicine as directed in order for it to work,” he says.

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4. You Forget to Apply Sunscreen

Psoriasis can flare up if you get a sunburn. This is why protecting your skin from the sun is important, says Marisa Garshick, MD, a dermatologist in New York and New Jersey, and a clinical assistant professor of dermatology at NewYork-Presbyterian Weill Cornell Medicine.

Severe sunburn can lead to skin injury, which may create new plaques or worsen existing ones. But while sun exposure can trigger short-term problems, it can also lead to long-term skin damage and risk of skin cancer. 

Medications commonly prescribed to treat psoriasis — like acitretin or methotrexate — can increase sun sensitivity, making the skin more vulnerable to burning and damage. People who have undergone extensive UVB phototherapy may also face a higher risk of skin cancer, making daily sun protection even more important.

When choosing a sunscreen, look for a broad-spectrum formula with SPF 30 or higher, ideally containing zinc oxide or titanium dioxide, which help block harmful UV rays. Sunscreen should not be applied to open wounds or actively inflamed, cracked plaques, as this can cause irritation or stinging.

“It’s always a good habit to get into to maintain the healthiest skin you can,” Dr. Garshick says.

5. You Don’t Take Your Mental Health Seriously

Psoriasis affects more than just the skin. Research shows that anxiety and depression are more common in people with psoriasis than in the general population, and the emotional burden can be just as challenging as the physical symptoms.

Mental health is an important part of psoriasis treatment, and it’s worth discussing with your doctors, including your dermatologist and primary care provider, if symptoms are affecting your daily life, Daveluy says. While it can feel awkward to bring up, addressing mental health early can lead to better overall care and support.

Daveluy checks in on his patients but suggests patients be proactive. Patients can initiate the conversation by asking, “I heard that psoriasis and mental health can be related. Would it be all right if we discuss my mental health?”

Support extends beyond the doctor’s office, too. There are resources like patient support groups, such as those offered by the National Psoriasis Foundation, Daveluy says. “Talking to someone who truly understands the lived experience of psoriasis is so valuable,” he says.

6. You Rely on Unproven Treatments or Home Remedies Rather Than Medical Treatments

Home remedies and internet “hacks” can be tempting when psoriasis is frustrating or slow to improve, but many of these approaches are unproven and may do more harm than good.

Psoriasis can worsen with skin injury, a process known as the Koebner phenomenon, where skin trauma — like scratches — can cause plaques to spread to unaffected areas. “If you irritate the skin by applying some kind of at-home remedy or concoction, it actually can make the psoriasis worse,” Garshick says.

Green has also dissuaded his patients from trying things like applying apple cider vinegar to plaques. “As a physician, we give things that we know work,” he says. “We want things that the [U.S. Food and Drug Administration] FDA approves or we know there's scientifically sound evidence that it works.”

7. You Focus Only on Psoriasis Control and Neglect Overall Health

It’s easy to focus all your attention on managing psoriasis itself, especially if you’re seeing a dermatologist frequently. But this can sometimes lead people to overlook other important aspects of their health, such as regular primary care visits or recommended screenings.

Research shows that psoriasis is linked to a higher risk of several other conditions, including high blood pressure, heart disease, diabetes, and psoriatic arthritis.

“It’s very important that everyone with psoriasis has a primary care provider to help detect and manage any of these other problems,” Daveluy says. If you’re at an increased risk of skin cancer because of medications or phototherapy, make sure you’re getting your skin and moles checked regularly, too, Garshick says.

Don’t look at psoriasis in a silo, and take account of your overall physical and mental health, Daveluy says. “Diet, exercise, mental health, and psoriasis are all connected, so it's really important that patients are addressing their whole health. It can be intimidating, but you don't need to change everything at once,” he says.

8. You Don’t Follow a Healthy Diet

If you’re not paying attention to what’s on your dinner plate, you may be making psoriasis harder to manage. 

Nutrition plays a real role in inflammation, weight, and overall health — all of which can influence symptom severity and how well treatments work, according to Caylee Clay, RDN, a registered dietitian-nutritionist in Brooklyn, New York, who has psoriasis and specializes in helping clients manage autoimmune diseases.

Diet also affects psoriasis patients’ risk of developing comorbidities like heart disease and diabetes, Clay says. 

Despite this, researchers say that many people with psoriasis have “imbalanced” diets, leaning toward carbohydrates, sugar, and fried foods, that can fuel inflammation.

An anti-inflammatory eating pattern, such as the Mediterranean diet, is a strong place to start when making changes to your eating habits. Clay suggests taking elements from the diet that work for you, such as a focus on fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil, while limiting ultra-processed foods, excess sugar, and alcohol.

9. You’re Still Smoking and Drinking Alcohol

Smoking or having a glass of wine may feel like a way to de-stress during a flare, but these habits can make psoriasis worse.

“Unfortunately, smoking and alcohol are linked to more severe psoriasis, poorer treatment response, and higher risk of comorbidities like heart disease. Both smoking and alcohol increase inflammation plus add toxins to our system that strain our organs and immune system,” Clay warns.

Cutting back or quitting isn’t easy — Clay suggests turning to healthier ways to unwind, such as journaling, going on walks, seeing a therapist, or exploring your religion or faith.

The Takeaway

• Effective psoriasis management involves regular consultation with your healthcare providers, especially during flare-ups, to adjust any treatment plans as necessary. 
• Commit to daily skin care and consistently use prescribed topical treatments to keep psoriasis under control, even if symptoms aren’t currently present. While treatment for psoriasis may involve some trial and error, it’s important to give medical therapies time to work. 
• If psoriasis is taking a toll on your emotional health, don’t hesitate to tell your doctor and seek help from mental health professionals or peer support groups.

https://www.everydayhealth.com/skin-condition/psoriasis-mistakes-and-how-to-avoid-them/ 

Do Supplements Help Psoriasis? What the Research Shows

From healthcentral.com

Vitamin D and curcumin show some promise—but the evidence is mixed. Here’s what to know before adding supplements to your psoriasis treatment plan 

Psoriasis is an immune-related condition that causes inflammation in the body. Because of that, many people wonder if changing what they eat—or taking certain supplements—might help. Some nutrients are known to fight inflammation, and a few have been studied in people with psoriasis. So it seems logical: If you can’t perfectly follow a Mediterranean or DASH diet, could a daily supplement help calm inflammation instead?

It’s not that simple. Supplements can be expensive, and so far, research on whether they improve psoriasis symptoms has been limited and mixed. To get clearer answers, researchers recently reviewed more than 20 clinical trials, published in Frontiers in Nutrition, that looked at popular supplements for psoriasis. Two showed the most promise—but results varied, and none worked for everyone. Here’s what to know before adding anything new to your routine.

Weighing the Evidence

The review examined seven commonly discussed supplements:

• Curcumin

• Fish oil

• Multivitamins

• Probiotics

• Selenium

• Vitamin D

• XP-828L (whey protein extract)

Each of these has anti-inflammatory properties that could, in theory, help psoriasis.

“Omega-3 fatty acids [in fish oil] have the most acceptable data to support use in psoriasis, and oral supplements containing antioxidants such as vitamins A, C, E, and selenium may help promote anti-inflammatory pathways that counter the pro-inflammatory ones in psoriasis,” says Rosanne Paul, D.O., an assistant professor of dermatology at Case Western Reserve University in Cleveland, OH who was not one of the study’s authors.

Still, the overall evidence wasn’t strong enough to clearly recommend most of them. Multivitamins appeared to show the biggest improvement, but results differed greatly between studies, making it hard to trust the finding. XP-828L, a whey protein extract, showed some possible benefit, but it isn’t available in the U.S.

                                                                                    GettyImages/smirart

That left two supplements that stood out: vitamin D and curcumin.

Vitamin D

Vitamin D is often called the “sunshine vitamin.” It plays a role in skin cell growth, helps regulate immune cells in the skin, and reduces inflammation. It’s also used in some prescription topical psoriasis treatments. People with psoriasis are more likely to have low vitamin D levels, and sunlight exposure often improves symptoms.

When it comes to taking it in oral form, the review found that vitamin D supplements led to mild to moderate improvement in psoriasis symptoms overall. However, study results were inconsistent. “There is a small improvement in PASI [Psoriasis Area and Severity Index] scores, but because the studies are all over the place, it’s not clear if this is actually clinically significant,” says Jessica Kaffenberger, M.D., a board-certified dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center in Columbus, OH who did not author the study. “It’s reasonable for patients to make sure they’re getting the recommended amount of vitamin D, but I wouldn’t recommend high doses.”

Adults under 50 should aim for 600 IU of vitamin D daily. Those 50 and older should aim for 800 to 1,000 IU daily. The safe upper limit is 4,000 IU per day.

Curcumin

Curcumin is the main active compound in turmeric. It gives the spice its bright yellow colour and is known for its anti-inflammatory effects. “Curcumin has been shown as a potentially effective adjunctive treatment for psoriasis in both topical and oral formulations,” says Dr. Paul.

In the review, people who took curcumin along with their usual psoriasis treatment had lower levels of interleukin-22 (IL-22), a protein that drives inflammation in psoriasis. They also showed some symptom improvement. It’s thought that it may calm the immune signals that tell your body to make the pro-inflammatory proteins in the first place.

Curcumin in food and most supplements is generally safe (up to 4 grams of concentrated curcumin supplements per day). However, some highly concentrated forms may carry a risk of liver injury. Always talk with your doctor before starting a new supplement.

The Bottom Line

Research on supplements for psoriasis is still evolving. Of those studied, vitamin D and curcumin show the most potential—but neither replaces standard treatment. If you’re thinking about adding a supplement, talk with your dermatologist first. Together, you can decide what fits safely into your overall care plan.

https://www.healthcentral.com/news/psoriasis/do-supplements-help-psoriasis-research?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGgUy_I1XOw_oTHunbiI9SEpTHxKxIz3oPjWyrOzd7X1UCqn4qP72YGnGkjdpRrMHbA6ibVdLeDKHYgjUjF0-UWL3TRci7NwD2_Fz5oxUnLW8v2dYk

Is red light therapy good for psoriasis?

From glamourmagazine.co.uk

By Elle Turner

Kim Kardashian's a fan. Here's what you need to know 

If you’re Googling “Is red light therapy good for psoriasis?” you’re probably all too familiar with the complexities of finding a treatment that works for the chronic condition.

Alongside other idiopathic conditions, like stress, or irritable bowels, it's often all but impossible to pin down a specific reason for its trigger. Likewise, it’s aggravatingly difficult to find a cure. And, to make it especially unpredictable, what helps one person, may not help another. So if you can relate, we're truly sending love and luck that you get to the bottom of what works for you.

Dermatologists and rheumatologists have been working for years towards making psoriasis easier to manage and red light therapy, in particular, has been getting a lot of attention. Of course, it helps that it has a very high profile fan in its corner. Kim Kardashian has spoken previously, about using red light to help calm her psoriasis flare ups.

So, we spoke to the experts to find out more about how red light therapy can help.

                                                                                                                golubovy/Getty Images

What is psoriasis?

“Psoriasis is a chronic inflammatory skin condition that causes skin cells to renew too quickly,” says Sophie Smith, Aesthetician, Laser & Skin expert and Co-Founder of Grand Aesthetics Clinic. Specifically, “skin cells can multiply up to 10 times faster than normal,” notes Board-Certified Dermatologist and Cosmetologist, Dr Aiza Jamil.

It can also have a knock-on effect to other parts of the body. For instance, “it can affect joints, causing arthritis,” explains Dr Ahmed El Houssieny, Aesthetic Doctor & Founder of Bank Medispa on behalf of Allergan Aesthetics.

What does psoriasis look like?

“Psoriasis is mainly characterised by lesions in the skin, and these lesions tend to be a thickened top layer of the skin. They can appear silver/white, alongside redness. It is not contagious, and it can typically affect the face, elbows, back and anywhere on the body,” says Dr El Houssieny.

What does psoriasis feel like?

"Patients can experience itching, discomfort and pain from psoriasis, especially during flare-ups.’ says Dr Jamil.

What causes psoriasis?

“No one really understands why you get psoriasis, but the main reason is due to increased production of skin cells,” explains Dr El Houssieny. As for why this happens, “flare-ups [can be] triggered by stress, illness, hormonal changes or even the weather," says Sophie. "I’ve lived with psoriasis since childhood, so I understand first-hand how unpredictable those cycles can be, not just physically, but emotionally too,” she adds.

Does psoriasis go away?

“Many people experience cycles where their skin is relatively calm, followed by flare-ups,” notes Sophie.

Can red light therapy help with the skin condition?

The short answer is, it may help with symptoms but it can't cure the condition. “There is not enough evidence to suggest that it can penetrate deep enough to alter immune responses,” says Dr Jamil. But it can support by reducing inflammation and promoting repair.

“Red light therapy can work well for psoriasis, as it has an anti-inflammatory effect and can improve and repair the skin barrier,” confirms Dr El Houssieny. “It can also reduce the scaling and redness,” he adds. "As psoriasis is driven by inflammation, reducing that inflammatory response is key," agrees Sophie. As for who may benefit. “It’s best used for mild cases or as a supplement to other treatments, such as corticosteroids,” says Dr El Houssieny.

“In my experience and personally managing my own psoriasis, I’ve found consistent red-light therapy helps to reduce redness, soothe irritation, and support the skin’s recovery during flare-ups. While it isn’t a cure, it can be a powerful, non-invasive addition alongside medical advice,” says Sophie.

What to know about red light therapy

“For psoriasis, red light (around 630–660nm) and near-infrared light (around 830nm) are most commonly used. These wavelengths penetrate the skin to help reduce inflammation and promote healing," explains Dr Sonia Soopen Dentist & Medical Aesthetics Doctor of Grand Aesthetics. “In-clinic LED treatments offer a more powerful, medical-grade device with tailored settings for your specific skin needs. They are ideal for kickstarting treatment or managing flare-ups under the guidance of a professional. However, at-home LED masks or panels can be a fantastic way to maintain results between sessions. They're generally lower in intensity but, when used consistently and correctly, can be an excellent addition to your psoriasis management plan. We always recommend patients check with their clinician before starting at-home treatment to ensure they’re using the right device for their condition," she adds.

Is blue light better?

“In clinic, we typically use blue light for breakout-prone or acne-affected skin because it has antibacterial properties. It helps target acne-causing bacteria and regulate oil production, which makes it ideal for congested complexions,” says Sophie. Therefore blue light is not traditionally considered to be a psoriasis treatment.

However, “evidence suggests that blue light can have a strong biological effect on immune cells, bacterial populations and inflammatory pathways, so it may be beneficial for those with mild psoriasis,” notes Dr Jamil.

Before pursuing any treatment however, it's important to seek medical advice to ensure your condition has been properly identified, and therefore can be properly treated. “I would recommend speaking with a dermatologist beforehand if you suspect or are diagnosed with psoriasis,” says Dr Jamil.

How does Kim Kardashian treat her psoriasis?

Kim has been open about suffering with the skin condition for years and shared her experience of psoriasis in an in-depth interview with She MD, alongside her rheumatologist, Dr Daniel Wallace, who was able to shed more light on the condition.

Kim's first psoriasis flare-up happened when she was 30, but it was managed with a cortisone shot which suppressed the condition for around five years. “It came back maybe five years later, and I’ve never gotten rid of it again,” she explained. “I always have one [plaque] on my leg – my right leg [and] there’s always one on my stomach," she said. "There will be times when it gets really bad and it covers my legs and my butt and my stomach, but it’s only this one spot [on her leg] that will itch. And it will really, really itch when it does. When I started to get a little bit desperate is when it started to cover my face and there was a spot really close to my eye and it would just burn a little bit. I remember I had the Met Ball coming up that week and it was covering my face,” she shared.

Red light therapy

As for treatments, she revealed she's “tried everything," and shared “I really do believe so much in self care. I do red light saunas, I have a red light bed.” She also previously wrote on her now-deleted website in 2018 "there isn't a cure for psoriasis, but there are treatments that can help ease the symptoms." In particular, she uses the Clarify Home Light Therapy System. "I love it because it's a handheld, at-home treatment that syncs with your phone to give you step-by-step instructions and tells you when to do treatments and take progress photos," she said. "The device uses UVB and LED phototherapy to treat the skin. It's been one of the only things that has helped clear my psoriasis. I'm so happy that I finally found something that works," she said. At around a thousand dollars, it's not he most accessible tool, nor is the red light bed that she revealed she owns, in her 2024 office tour. However, in her more recent interview, Kim did admit that consistency is key and she's not always great at keeping up with red light therapy. “I’ve the red light [and] I’ve tried lasers that supposedly help,” she said, noting “I think if I was maybe a little more consistent with that, that could have worked.”

Topicals

Kim explained that when her psoriasis came back after five years, her first step was to go to a dermatologist, “so I went to Dr Lancer in Beverly Hills” for ”topicals" a drug applied directly to the skin in the form of an ointment, lotion or cream.

“When it gets bad [my doctor] would prescribe me Prednisolone. [It’s] a little steroid pack [that] calms everything down [so it] starts to go away with some topicals," said Kim. She shared that Dr Lancer also mixed her a “magical formula called T4 and the best advice he ever gave me was taking the cream, putting saran wrap around it and sleeping with it. So when it was on my legs, I’d put the cream on, saran wrap it, put socks on, go to bed, do my elbows, because it would get on my elbows, put a hair tie around the saran wrap so it wouldn’t come out and I would sound like the tin man, like super crunchy and it would take it away.”

However, if you're using topicals, it's worth consulting with your doctor about how best to apply it as many formulas may be too strong to use with this method and they can thin your skin, so this method works better with gentle emollients.

Medication and biologics

Kim shared she prefers not to use medication if she doesn't have to, but confirmed that medication is what ultimately helped her manage her psoriasis.

“More recently it got really bad and I called [my] doctor. I don’t like to be on medication, but sometime you just have to. This is the first time where I said I need to try something a little bit more than a topical and I did and it’s worked and this is one of the first times it’s completely gone. I don’t have one spot,” she shared. "I was lucky that after one shot, it completely went away."

Her rheumatologist, Dr Daniel Wallace, revealed Kim used a biologic, which according to the NHS, is usually given as an injection and “reduces inflammation by targeting overactive cells in the immune system. They are usually used if you have severe psoriasis that has not responded to other treatments, or if you cannot use other treatments.” The American Academy of Dermatology Association explains “biologics are newer, stronger medicines. A biologic can target, or quiet, only the part of the immune system that is overactive because of psoriasis.”

Lifestyle changes

Aside from taking a medical route, Kim has tried lifestyle changes. When she first posted about having psoriasis, she noticed “everyone under the sun was sending me home remedies. I tried drinking tar tea, special herbs. I tried the holistic way. I tried the celery juice diet for six weeks. I tried every topical cream, every soap, from natural, to unnatural. At some points I was just like, I’ll do anything," she revealed. But ultimately, “I couldn’t figure out anything. Everyone says different things. So it would be cut out the citrus, cut out any acid food. I didn’t see anything," notes Kim.

https://www.glamourmagazine.co.uk/article/red-light-therapy-psoriasis-treatment-benefits

Can losing weight improve psoriasis? What the evidence shows

From theconversation.com

For many people living with psoriasis, the red, scaly skin patches are only part of the story. Another challenge is the uncertainty about whether there is anything they can do themselves to help manage their skin.

Treatments have improved greatly in recent years. Creams, tablets and injectable medicines can all help control symptoms. Even so, many people still ask a straightforward question in clinic: is there anything I can do alongside my medication that might make a difference? Weight often comes up in that discussion. Psoriasis is more common in people who are overweight or living with obesity.

Research now shows that, for people who are overweight, losing weight can improve both the severity of psoriasis and overall quality of life.

Doctors have long suspected that weight loss could help, but earlier research was inconsistent. Many studies were small, short term and did not always measure how people felt in everyday life. As newer weight loss treatments have become more widely available, it has been important to take another look at the evidence.

Body weight and psoriasis severity

To provide a clearer picture, my colleagues and I reviewed the highest quality studies available on weight loss support for people with psoriasis. In these studies, participants were randomly assigned to one of two groups. One group received structured support to help with weight management alongside their usual psoriasis care. The other group continued with usual care alone. Random assignment helps ensure that any differences seen are likely to be due to the support itself, rather than other factors.

The programmes varied. Some focused on reduced calorie diets. Others combined diet with exercise or behavioural support, such as coaching and goal setting to help people stick with changes. A small number included weight loss medicines. In all cases, researchers carefully measured both weight change and changes in the skin.

               Some weight loss programmes included exercise as well as reduced calorie diets. NinaKulagina/Shutterstock

Across the studies, people who received weight management support lost about seven kilograms more on average than those who did not. Their psoriasis improved more as well. Doctors’ assessments of skin severity showed greater improvement, and participants were more likely to experience a substantial reduction in their plaques, which are the thick, inflamed patches of skin typical of psoriasis. They also reported better day to day wellbeing, suggesting the changes were noticeable in everyday life, not only in clinical measurements.

Two patterns stood out. Greater weight loss was generally linked with greater improvement in psoriasis. People who started with more severe psoriasis often saw larger benefits.

This does not mean weight is the sole cause of psoriasis. Psoriasis is a complex condition involving the immune system, which is the body’s defence against infection, and it is influenced by both genetics and environmental factors. However, body fat is biologically active. It produces chemicals that promote inflammation, which is the body’s response to injury or illness. These chemicals circulate in the bloodstream and can affect many organs, including the skin. Reducing excess weight may lower this background inflammation and help calm the overactive immune response seen in psoriasis.

No single diet emerged as clearly superior. The studies used different approaches, yet the common factor linked with skin improvement was weight loss itself. This suggests there is no single diet that everyone must follow. Instead, supported and sustainable weight loss appears to be the key factor.

                                      The common factor linked with skin improvement was weight loss. Ljupco Smokovski/Shutterstock

For patients, this is important. People with psoriasis were involved in shaping how we interpreted the findings. Some said they had wondered whether changing their diet or losing weight might help, but were unsure whether there was solid evidence. Others said they would feel more motivated knowing that weight management could benefit both their general health and their skin.

For clinicians, clearer evidence also helps. Conversations about weight can be sensitive. Without strong data, it can be difficult to raise the topic in a confident and constructive way. Bringing together the available trial evidence provides a stronger basis for these discussions when they are relevant to the person.

Another treatment tool

There are still limits to what we know. Most of the studies lasted only a few months. Psoriasis is a long term condition, and maintaining weight loss over time can be difficult. We cannot yet say with certainty how long the skin improvements last over several years.

Weight management is also shaped by many factors, including access to affordable healthy food, safe places to exercise, mental health and other medical conditions. Support needs to be practical, realistic and free from judgement.

Even with these limits, a consistent picture emerges when the trials are considered together. Adding structured weight management support to usual psoriasis treatment is likely to improve skin severity and quality of life for many people who are overweight.

This does not replace medical treatment. It also does not mean that everyone with psoriasis needs to focus on weight. But for those who are interested, there is now clearer evidence that weight loss can form part of overall care.

For someone living with psoriasis, that knowledge can change how much control they feel they have. Alongside prescribed treatments, there may be another tool available that benefits both the skin and overall health.

https://theconversation.com/can-losing-weight-improve-psoriasis-what-the-evidence-shows-276113

Psoriatic Arthritis: Hand Strength, Dexterity, and Fine Motor Control

From everydayhealth.com

If you have psoriatic arthritis (PsA), you may be familiar with sore fingers, stiff wrists, and the frustration of struggling with formerly simple tasks like buttoning a shirt or chopping vegetables. Psoriatic arthritis is an inflammatory form of arthritis that causes painful, swollen joints. It frequently affects the hands.

When PsA impacts your hands, this can reduce strength, dexterity, and fine motor skills, all of which can interfere with your daily life.

“In severe cases, it may be almost impossible to open and close the hand or make a fist,” says Norman Gaylis, MD, a rheumatologist and board member of the American College of Rheumatology in Miami. “This drastically reduces the quality of life when people are unable to complete household chores, pursue hobbies they enjoy, or take care of their daily hygiene needs because they are unable to use their hands.”

How PsA Takes a Toll on Hand Function

In the most basic terms, psoriatic arthritis affects hand function through chronic inflammation. This can degrade cartilage and bone over time.

These are the ways that PsA can change your hands:

• Reduced Strength and Muscle Atrophy When your hands are painful, swollen, or stiff, you might use them less. This can lead to a loss of strength and muscle mass.
• Stiffness Inflammation from psoriatic arthritis can make your hands feel stiff. This is due to synovitis (inflammation of the joint capsule) and enthesitis (inflammation where your tendons and ligaments attach to your bones).
• Difficulty Gripping Grip strength decreases as the severity of psoriatic arthritis increases. This affects the ability to both grasp an object with your whole hand, like when you pick up a water bottle, and pick up small items with your thumb and index finger.
• Swelling Psoriatic arthritis can cause severe swelling in the fingers, called dactylitis. You might also hear this called “sausage fingers.”
• Nail Changes Up to 80 percent of people with PsA experience changes in their fingernails. “With some patients, nails start to look broken, become brittle, and even separate from the nail bed,” says Dr. Gaylis. Not only can this feel embarrassing but it can be painful and make it difficult to use the tips of your fingers (like you do when typing on a computer or phone).
• Deformities Actual deformities in the hands are rare these days, thanks to better treatment. However, they can still develop if psoriatic arthritis isn’t treated. “In the most severe cases, arthritis mutilans develops and dissolves tissue and bones in the fingers,” says Gaylis. This occurs in about 5 percent of psoriatic arthritis cases.
• Loss of Fine Motor Skills Hand swelling, pain, and stiffness can all make it challenging to perform tasks that require precision, dexterity, and coordination. You might find it increasingly difficult to manipulate small objects like zippers or buttons.

All these symptoms add up to real difficulty completing functional tasks in your everyday life.

Who Can Help Restore Hand Function

There are a few health professionals you can reach out to if psoriatic arthritis is affecting your hands. The primary ones are rheumatologists and certified hand therapists (CHTs).

Rheumatologists are doctors who specialize in autoimmune diseases and inflammatory diseases that affect the joints, bones, and muscles. If you’re diagnosed with PsA, you’ve most likely already seen a rheumatologist.

“Fortunately, rheumatologists can treat psoriatic arthritis with many new biologics and medicines that are very effective,” says Gaylis. These medications help manage inflammation and swelling from psoriatic arthritis, which can noticeably improve hand function.

CHTs are also an essential part of the team for anyone with psoriatic arthritis affecting their hands. These health professionals can either be occupational therapists or physical therapists who’ve gone through extra training to specialize in treating hand conditions like psoriatic arthritis.

A CHT will assess your mobility and function and give you tailored treatment that might include splints, exercises, and assistive devices. You can ask your doctor to refer you to a CHT, or depending on your health insurance, you may be able to make your own appointment.

Strategies to Improve Strength and Control

We use our hands constantly, from turning on the tap at a sink to sliding a credit card out of a wallet. Bringing back strength and control to your hands can improve your quality of life.

Therapeutic Exercises

Therapeutic exercises can reduce pain and improve coordination, strength, and function. Common exercises for PsA include the following:

• Isometric Exercises These are static exercises during which your muscles stay the same length. “Isometric exercises are safer for the arthritic hand to perform because the joints are not moving,” says Kristin Valdes, a certified hand therapist and professor at Touro University Nevada, in Henderson, Nevada. In this type of exercise, you squeeze an immovable object, and your joints are supported by the object you’re holding. Valdes suggests squeezing a firm racquetball or tennis ball to improve grip strength.
• Passive Range of Motion With psoriatic arthritis, the fingers can flex (or “claw” inward) over time as the skin contracts. Anyone experiencing this “should use the other hand or pull their fingertips over the edge of the table to try to straighten out the fingers daily,” says Valdes.
• Tendon Gliding This set of exercises encourages smooth movement of your finger tendons within their sheath.

Be cautious when starting hand exercises with psoriatic arthritis. “If treatment is too aggressive, it can increase hand pain and cause skin breakdown,” says Valdes.

Consider seeing a CHT for a personalized program of exercises, since everyone’s psoriatic arthritis is different.

Assistive Tools

When your wrist is sore, twisting open a jar can be very painful. And when your fingers are stiff, it can feel near impossible to pick up small items. Assistive devices can help you achieve these everyday tasks with less effort and therefore less pain.

Assistive devices for psoriatic arthritis include these examples:

• Wide-grip pens or utensils
• Electronic jar or can openers
• Ergonomic kitchen tools
• Button hooks
• Elastic shoelaces
• Electric toothbrushes
• Gripping materials (to hold a mixing bowl in place, for example, or grip a lid)
• Tap turners or lever handles (to avoid twisting)
• Tongs
• Adaptive cutting boards
• Motion sensor dish soap or shampoo dispensers

Orthoses

For those seeing a hand therapist for treatment, “The therapist can also fabricate a custom orthosis to rest the joints,” says Valdes. This might look like a ring to keep your finger joint straight or a brace that wraps around your thumb.

You can also get premade orthoses like wrist splints online or in pharmacies, but talk to your hand therapist or doctor first to ensure that you’re getting the right one.

Joint Protection and Skin Protection

Joint protection techniques, which are usually taught by a CHT, are ways to perform daily tasks so that less stress is applied to your joints. The following techniques are common:

• Practice the large joint rule. Use larger and stronger joints for tasks instead of smaller ones. Valdes gives the examples of pushing instead of pulling, carrying bags with your forearm instead of hands, and using a shoulder bag rather than a handbag.
• Limit repetitive hand movements. For example, use an electric can opener instead of a hand-operated one. You can still knit or do hobbies involving your hands, but Valdes recommends limiting these to no more than 30 minutes at a time.
• Use a light grip. “Try not to grip so forcefully that the hand fatigues easily,” says Valdes. One way to achieve this is to bulk up the handles of tools or utensils. For example, when cooking, wrap a potholder around a pot handle to make it larger; that reduces the pressure on your hand.
• Don’t forget skin protection. Applying cream to tight skin can help protect both the skin and joints.

Heat and Cold Therapy: Using Paraffin Baths for Stiffness vs. Ice for Acute Inflammation

If your fingers are swollen, try cold therapy with a cold cloth or ice pack. This can help reduce inflammation in the affected joints.

Heat therapy can’t bring down acute inflammation, but it can provide pain relief. If your hands are stiff or painful, consider applying a warm cloth or heating pad.

Warm paraffin, or wax, baths, which a CHT can perform, can also be soothing. A hand therapist might do this to loosen up your joints before exercising them. However, you’ll want to avoid paraffin baths if you have any open cuts or inflamed skin on your hands.

Lifestyle and Daily Habits

Breaking tasks into smaller, more manageable steps can help you conserve energy and manage pain. Be sure to take frequent breaks to rest your hands. “For example, when making a meal, break up cutting or chopping tasks throughout the day,” says Valdes.

You’ll also want to make a daily habit out of your therapeutic exercises, particularly stretching and range of motion exercises. However, avoid strengthening exercises when your hands are painful, says Valdes.

Overall, do your best to maintain an active lifestyle and keep up with the activities that bring you joy and meaning. You can also try new hobbies that don’t tax your hands as much, such as singing, line dancing, learning a language, or hiking.

If you’re struggling with hand pain or stiffness, talk to your rheumatologist or CHT. Your rheumatologist may adjust your medication, and your CHT can strategize personalized solutions, whether that’s a new hand splint or exercise program.

The Takeaway

• A rheumatologist can help you manage psoriatic arthritis hand symptoms with newer biologics and medications that control inflammation.
• Certified hand therapists can tailor exercises to your specific hand symptoms, recommend assistive tools, and educate you on joint protection to preserve and restore hand function.
• Therapeutic hand exercises can help enhance grip strength, dexterity, and control for performing daily tasks.

https://www.everydayhealth.com/rheumatic-conditions/psoriatic-arthritis-hand-strength-and-dexterity/