This Is the Skin I’m In: Embracing Your Psoriasis

From healthcentral.com

Four psoriasis warriors share how they found their confidence 

Psoriasis can be challenging and it can threaten your self-confidence, especially when your plaques are visible. But it doesn’t have to. Meet four psoriasis warriors who have found unique ways to feel comfortable in every situation—from dating to working. If you're ever having one of those days with your PsO, you'll find comfort and inspiration in this roundtable of body-positive tips:

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Meet Our Four Warriors

• Jill Leonard, 52, Vancouver, Canada

• Sam Howe, 33, Lynchburg, Virginia

• Jill McMahon, 38, Robbinsville, New Jersey

• Aya Lew, 38, Tulum, Mexico

HeathCentral: How long have you had psoriasis and what are your main symptoms right now?

Jill L: I’ve had psoriasis for seven years. After periods of intense or prolonged stress, flare-ups of blisters full of puss appear on my feet and palms. Luckily, they’re not painful, but they’re terribly itchy so I unconsciously scratch them in my sleep until they pop. Sometimes they get infected.

Sam: I’ve had psoriasis since I was a toddler. I currently have patches that cover some of my legs and arms.

Jill M: I’ve had psoriatic arthritis for 23 years. I’m on a new biologic and the plaques are lessening even in this first month of treatment. However, upwards of 75% of my body is still covered with psoriasis spots.

Aya: I’ve had psoriasis for six years. My main symptom these days is one small spot on my lower back.

HC: Is there a social or work situation in which you feel the most self-conscious about your psoriasis? If so, how do you handle those feelings?

Jill L: Prior to the pandemic, I was self-conscious every time I shook hands with anyone, which happens a lot on a normal day. Of course, most people don’t have the habit of gawking at one’s hands, but I knew they could feel the blisters and scales. I’m the only person I know who welcomed the new social norm of not shaking hands!

I have spent years putting in considerable effort to overcome this feeling. One day, I decided to just start openly excusing myself for not shaking hands by explaining that I have psoriasis on my palms, which is not contagious. Branding myself in this way doesn’t feel comfortable, but I think it’s a good thing because I am doing my small part to help raise awareness that psoriasis is there, can happen to anyone, and it’s not a sign of poor personal hygiene.

Sam: When I was younger, especially in middle school, I was really self-conscious about my skin. I would wear long pants in the summer so people wouldn’t see my psoriasis. By the time I reached high school, I realized I would rather be comfortable than hide my skin. Now as an adult I don’t really notice my psoriasis, except when it occasionally flares up.

Jill M: I’m a single woman and my psoriasis makes me most self-conscious when I’m dating someone new. Even in the summer months, I can often hide the major sections with my fashion choices. When it comes to being intimate, there’s no getting around having to prepare my partner that my body or skin looks different and what psoriasis actually is. I find men often have dark coloured sheets and nothing makes me panic more than feeling like I’m leaving behind body dandruff all over his bed. It’s more embarrassing because it feels like I’m dirty. I handle these insecurities by sharing the reality of my psoriasis with the person prior to being intimate.

It also helps that I’m so open with my friends and family and on social media. Talking about it and being connected with the psoriasis community really helps remind me that I’m not alone. Whenever I come in contact with another person with psoriasis who is struggling with their self-confidence, I feel so much love for them. I try to remember that I need to turn that love inwards as well.

Aya: When my psoriasis was at its worst a few years ago, I was the most self-conscious about going swimming as I was in bandages and was unable to wear a bikini for years. I handled it by always telling myself that my body was just communicating, and I had to become a better listener to what it needed. By listening and being more compassionate to myself I created space for healing and taking my health back into my own hands.

HC: Can you share any great advice you’ve received or ideas you lean on?

Jill L: A very close friend of mine was a victim of sexual abuse early in her life. After long years of therapy, she finally felt empowered enough to tell me the following: ‘I suffered through it and I still suffer because of it today, but thanks to my own strength, there is someone left to suffer.’ These two experiences are not comparable in any way. But it’s a truth that can be applied to so many different situations. Whenever I get overwhelmed with insecurity, it helps me get back on my feet, blistered though they are!

Sam: I’ve come to realize my skin only has as much impact on my life as I allow it to have.

Jill M: I saw this quote on Instagram: “What makes you beautiful has nothing to do with how you look.” I’m kind, thoughtful, smart, dynamic, artistic, funny, and so much more. None of my value has anything to do with the flakiness or redness of my skin.

Aya: When I was depressed, I would remind myself that life is short, and I am grateful to be alive as others have it harder. Gratitude has brought me back from my most difficult times.

HC: How do you tap into your self-confidence when you're feeling self-conscious?

Jill L: I keep repeating to myself: People don’t react the way they do because they are mean or want to hurt me. It’s their brain that is hardwired to shrink back from anything that resembles “disease.” It’s an evolutionary trait that has probably kept us out of harm’s way more times than we can imagine. With psoriasis, as with many other things, education can help. And it’s up to us to make that happen!

Sam: I go for a run. I find exercising to be a great way to clear my head and focus on what really matters.

Jill M: If I ever feel my self-confidence waning, I try to take a few deep breaths. This simple process helps me check back in with the inner me. Often when I feel self-conscious, I’m focusing too much on the outside world and what people around me might be thinking.

Aya: Being confident in life means always showing up from a place of love, especially when you are at your worst. No matter how much pain and suffering you are going through, to know and to love yourself is the only thing that matters.

HC: What's your number-one tip to other psoriasis patients about how to feel comfortable in any situation where their psoriasis is evident?

Jill L: In life, there are things you can control and those you can’t. Psoriasis is somewhere in between: You can’t really control it, but you can manage it and learn to live with it. Instead of soaking up the perceived negativity derived from people’s instinctive reactions, change the name of the game, and open up the “p” conversation whenever you can. You will be amazed at how a person can react normally after they backed away from you only yesterday. And, you will feel good, because the same person will never make another psoriasis patient feel bad.

Sam: Self-love goes beyond skin deep. When my daughter was five years old, she developed spots all over her body and my wife and I quickly realized it was psoriasis. Once she got that diagnosis, we tried to treat it with different medications and creams, but our daughter hated the medicines, and her skin didn’t bother her. We stopped aggressively treating it and instead focused on teaching her to love herself. We helped her and those around her (teachers, other parents, etc.) understand her spots through education and awareness. One day we overheard our daughter singing a song about a cheetah with beautiful spots. In the song my daughter had named the cheetah with her name. Much like a cheetah, anyone with psoriasis can be strong, resilient, and beautiful just the way they are.

Jill M: To feel confident in situations where your skin spots are on full display, check in with yourself just before you enter the social environment and remind yourself that YOU are not your skin. I find that after a few minutes my self-consciousness and feelings of anxiety slide into the background and my personality can shine.

Aya: Own where your body is, know that it does get better, and never lose hope. Remember: When you speak about psoriasis to people who don’t understand it, you are speaking for all the silent psoriasis warriors out there who don’t have a voice.

https://www.healthcentral.com/article/body-confidence-advice-psoriasis

Why Doctors Are Excited About Icotyde, a New Psoriasis Pill

From everydayhealth.com

The new medication could replace injectable treatments for some patients, dermatologists say 

Key Takeaways

• The FDA has approved Icotyde, a once-daily oral pill to treat moderate to severe psoriasis.
• This is the first pill in the IL-23 class of medications, which include many blockbuster injectable drugs.
• Dermatologists say it could be an effective new option for psoriasis patients.

The U.S. Food and Drug Administration (FDA) has approved a new daily pill to treat moderate to severe plaque psoriasis, offering people with thick, scaly skin lesions another alternative to injectable medications.

Icotyde (icotrokinra) is not the first oral drug to treat plaque psoriasis, a chronic autoimmune condition. But it is the first in the interleukin-23 (IL-23) receptor antagonist class of medications, which are dominated by injectable drugs like Skyrizi (risankizumab), Tremfaya (guselkumab), and Ilumya (tildrakizumab).

“It’s the first in its class to be oral. That’s a big deal,” says Ife J. Rodney, MD, the founding director of Eternal Dermatology + Aesthetics in Fulton, Maryland. 

Adam Friedman, MD, a professor and the chair of dermatology at GW Medical Faculty Associates, agrees. “For the first time, we have a targeted oral therapy hitting the IL-23 pathway, which we know is one of the most effective mechanisms in this disease,” he says. “Historically, that level of precision, and in turn, effectiveness, has been reserved for injectables, but now we can offer it in a pill.”

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How Icotyde Works to Treat Plaque Psoriasis

Icotyde binds to the interleukin-23 (IL-23) receptor, blocking it and thus interrupting the signalling pathway in the body that drives inflammation. The result is clearer skin.

Icotyde performed well in four phase 3 clinical trials that included 2,500 patients. After 16 weeks on the medication, about 70 percent of patients developed clear or nearly-clear skin, and 55 percent had a 90 percent reduction in their psoriasis severity. 

Johnson & Johnson, which makes Icotyde, tested the drug in patients ages 12 and up. “It is approved down to age 12, which is a good option for kids,” says Cindy Wassef, MD, a dermatologist at Premier Health Associates in Randolph, New Jersey. 

Icotyde takes time to kick in. “The medicine requires a few weeks to start exerting its effect,” says Joshua Zeichner, MD, the director of cosmetic and clinical research at Mount Sinai Hospital in New York City. “Studies have shown that it gives significant benefits that are long-lasting with continued use.” 

Side Effects Were Minimal

In all the phase 3 clinical trials, side effects for patients treated with Icotyde were within 1.1 percent of what people on a placebo experienced through 16 weeks on the medication. There were no new safety issues reported through 52 weeks on the medication. 

The most common side effects included headache, nausea, cough, fungal infection, and fatigue. Johnson & Johnson notes that medications like Icotyde that interact with the immune system may lower your ability to fight infections and increase the risk of infections.

“It’s effective, targeted, oral, and safe,” Dr. Friedman says. “The label also requires less rigorous, and often overkill, laboratory tests prior to starting, which can be a roadblock for some. Overall that means less time undertreated, faster control of disease, and ultimately better outcomes.”

Icotyde Offers an Alternative to Injectable Biologic Medications

Skyrizi, Tremfya, and Ilumya each have slightly different dosing; patients needs to take an injection every 8 to 12 weeks. 

“A once-daily pill is very appealing compared to some of the injectables and biologics,” Dr. Rodney says. “Not everyone likes an injection.” 

People with psoriasis who prefer a pill to an injection also have the option of taking Otezla (apremilast) or Sotyktu (deucravacitinib).

“For some people, taking a pill is super easy; others prefer an injection that’s less frequent. Either way, it’s good to have choices,” Rodney says.

Price and Availability

Johnson & Johnson has not released details about when Icotyde will be available to patients or how much it will cost.

https://www.everydayhealth.com/skin-conditions/fda-approves-daily-pill-for-moderate-to-severe-psoriasis/

Should You Try a Special Diet for Your Psoriasis?

From healthcentral.com

A first-of-its-kind study shows that an anti-inflammatory eating pattern may dramatically improve psoriasis symptoms 

A new treatment is making waves in the psoriasis community and it doesn't involve drugs. Researchers behind a randomized clinical trial published in JAMA Dermatology found that following a Mediterranean diet rich in extra virgin olive oil, polyphenols, and omega-3 fatty acids led to dramatic improvements in psoriasis severity in just 16 weeks. The findings add weight to growing evidence that nutrition could be a powerful tool in managing the condition and offer people with psoriasis an effective way to take control of their health.

How Diet and Psoriasis Are Connected

Psoriasis happens when the immune system mistakenly attacks healthy skin cells, triggering chronic inflammation and causing thick, scaly patches called plaques. While this immune misfire isn’t fully understood, its effects go far beyond the skin. Psoriasis is now recognized as a systemic inflammatory condition that can affect the heart, metabolism, and other organs.

People with psoriasis face higher rates of high blood pressure, high cholesterol, and high blood sugar, all of which raise the risk of type 2 diabetes, cardiovascular disease, and stroke. That’s why lifestyle approaches that calm inflammation can be especially meaningful.

“Improving blood sugar control may reduce systemic inflammatory signalling that sustains the disease,” says Javier Pérez Bootello, M.D., dermatologist at Hospital Universitario Ramón y Cajal in Madrid and lead author of the MEDIPSO study. One of the most effective ways to lower inflammation levels? Rethinking what’s on your plate.

Powerful Proof: Food Matters

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In the new study, 38 adults with mild to moderate psoriasis who were already using topical medications were split into two groups. One received standard low-fat diet advice. The other completed a 16-week Mediterranean diet program with ongoing nutrition counselling.

The results? Nearly 70% of participants following the Mediterranean diet saw at least a 50% reduction in psoriasis severity, without changing their medications. Almost half saw a 75% reduction. (By comparison, none of the control group reached that level of improvement.)

The more closely someone followed the diet, the better their psoriasis became. Participants also reported less anxiety and insomnia and an overall boost in quality of life.

An added bonus: The Mediterranean diet group improved their A1C, which measures long-term blood sugar and corresponds to heart disease risk. “This dietary pattern simultaneously targets inflammation—the core of psoriasis biology—and addresses an additional major disease burden that affects long-term prognosis,” says Dr. Bootello.

And importantly, people didn’t need to lose weight to benefit. “The Mediterranean diet group showed a significant reduction in A1C despite minimal weight change,” Dr. Bootello says. “This suggests that improved metabolic control, not just weight loss, may be one of the mechanisms through which diet helps improve psoriasis.”

Why Go Med?

While previous research has suggested that very low-calorie diets may help reduce psoriasis (weight loss alone has also been linked to symptom improvements), simply trying to “eat healthier” doesn’t always lead to measurable changes, says Jessica Kaffenberger, M.D., a board-certified dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center.

That’s where the Mediterranean diet comes in. “Psoriasis is a chronic, immune-mediated inflammatory disease, and the Mediterranean diet has a well-documented anti-inflammatory and antioxidant profile,” says Dr. Bootello. Its abundance of extra-virgin olive oil, omega-3s, fibre, polyphenols, and antioxidants helps lower oxidative stress, metabolic dysfunction, and inflammation—all key pathways involved in psoriasis.

Try It Yourself

The Mediterranean group didn’t count calories or track macros. Instead, they focused on eating more of certain foods and less of others. Key guidelines included:

• 4+ tablespoons of extra virgin olive oil daily

• 3+ servings of vegetables (at least one raw) a day

• 3+ pieces of fruit daily

• 3+ servings each of legumes and nuts weekly

• 2+ servings of fish or seafood weekly

• Dairy products (cheese and yogurts) should be eaten in moderate amounts

• Pick poultry and lean meats over red or processed meat

• Choose whole grains, not refined ones

• Avoid sugary drinks, pastries, and ultra-processed foods

While those guidelines led to symptom improvement in the study, it’s still important to stick with your current psoriasis treatments, says Dr. Kaffenberger. Dietary changes work best alongside prescribed therapies, not instead of them.

Still not sure what to eat? Get guidance if you can. Nutrition counselling helped participants turn the diet into real, sustainable habits. Monthly check-ins with a dietitian made it easier to personalize goals, troubleshoot challenges, and stay motivated.

Bottom Line

Early research suggests the Mediterranean diet may be a powerful add-on to standard psoriasis treatment, helping lower inflammation and support overall health. It’s not a cure, and it doesn’t replace medication, but it may offer a meaningful, everyday tool to help people feel and function better. If you’re considering a dietary shift, work with a dermatologist and a registered dietitian to help tailor a plan that fits your personal health needs and long-term goals.

https://www.healthcentral.com/news/psoriasis/mediterranean-diet-for-psoriasis?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGgmxXdJZ4--lZZAfFghk2Ec9NY6iCPVBJ3Zc8N9strb102PWLYwBdEKHkKa1lBE8krMt2X-Cy6KHCptNIap6c5_ifZV_T96clRuDGETgHsVuT2l7U

Surprising Signs of Psoriatic Arthritis

From healthcentral.com

Best known for causing joint pain and skin issues, PsA can also bring on dizziness and low libido 

With psoriatic arthritis (PsA), the most common symptoms are joint pain and skin issues, like plaques, according to Zhanna Mikulik, M.D., a rheumatologist at The Ohio State University Wexner Medical Center in Columbus, OH. But other less-common symptoms can sometimes appear. “In some cases, you may have only one issue, like eye disease, or stiffness without pain,” she says. “That’s why it’s important to know all the potential symptoms, rather than waiting for plaques or aching joints.” If you’ve already been diagnosed with PsA, you’ll want these lesser known symptoms on your radar.

Hearing Loss

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In a study in The Journal of Rheumatology, researchers looked at 60 people with PsA with no history of problems with inner ear infections or other conditions that might affect hearing. They found that 60% of participants had abnormal hearing loss, which suggests PsA may contribute to inner ear damage. Another study of more than 10,000 people found similar results; those researchers suggested chronic inflammation from PsA affects the structure of the inner ear. The researchers noted that hearing loss may impact mental health, too. If you’ve been diagnosed with PsA and are having trouble hearing, talk to your doctor.

Dizziness

Your inner ear is responsible for preventing dizziness and vertigo. So along with hearing issues, inner ear inflammation can lead to other symptoms such as poor balance and dizziness. These effects can be particularly pronounced if you're taking medications such as antidepressants, sleep aids, or blood pressure drugs, according to Anca Askanase, M.D., a professor of medicine in the division of rheumatology at Columbia University College of Physicians and Surgeons in New York City. Dizziness can also worsen if you're dealing with dehydration, low blood sugar, or low blood pressure, in addition to your PsA, she adds.

Low Libido

Recent research suggests that people with psoriatic arthritis are more likely to experience sexual dysfunction than those without the condition. Physical discomfort during intimacy, anxiety about lack of desire, and side effects from treatment can play a role, says psychotherapist Lee Phillips, Ed.D, a certified sex and couples therapist in New York City and Washington DC, and host of the Sex and Chronic Illness podcast. “PsA and other chronic diseases tend to disrupt the desire and arousal phases of the sexual response cycle,” Phillips says. “Talking to your health provider or a therapist can be hugely helpful for navigating this issue.”

Tendon Pain

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Enthesitis, which is inflammation at the insertion sites of tendons and ligaments into the bone (called entheses), is seen in up to 40% of people with psoriatic arthritis, says Dr. Mikulik. Unlike joint pain, which can feel sharp and deep within a joint, enthesitis is usually an ongoing ache that comes with tenderness. One common example in people with PsA is plantar fasciitis, which causes a “stretched too tight” feeling in the tendon on the bottom of the foot. Enthesitis can also target the shoulders, elbows, hips, knees, and heel of the foot. Stretching, meds, and ice can all help.

Dactylitis (a.k.a. Sausage Fingers)

Sometimes called “sausage fingers,” dactylitis is characterized by swollen, painful fingers and toes. This can affect just one digit or several, says Dr. Mikulik. Unless it’s managed, she adds, ongoing swelling may cause damage to the affected joints and make it difficult to do everyday activities. Usually, with PsA, the swelling is asymmetrical—for example, you may notice issues with your right hand and left foot. Research suggests about 40% of people with PsA deal with dactylitis. Like other PsA symptoms, dactylitis is related to uncontrolled inflammation, so treatment options address that cause.

Eye Issues

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Inflammation with psoriatic arthritis can also severely affect the eyes. The most common outcome is conjunctivitis (a.k.a. “pink eye”), which is seen in around 20% of people with PsA, says Dr. Mikulik. “This presents as redness, itching, tearing, and possibly crusting of the eye,” she notes. “It happens when the outer membrane of the eyeball and inner eyelid become inflamed.” Another concern is uveitis—a condition that can cause redness, eye pain, light sensitivity, and blurry vision. Dr. Mikulik says it occurs in about 7% of those with PsA. Conjunctivitis is usually treated with an antibiotic, while steroids are typically prescribed for uveitis.

Depression

Any chronic disease can prompt emotional health challenges, and PsA is no exception, says Dr. Phillips. A study in Rheumatology and Therapy found depression affects about 20% of those with PsA—but that number may be higher, as not everyone with psoriatic arthritis and depression gets diagnosed. The study suggests that depression is more likely if PsA is accompanied by an additional chronic disease, known as a comorbidity. If you’re struggling with sadness, anger, or irritability, be sure to bring it up with your doctor so you can start on the path to feeling like yourself again.

Lower Back Pain

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As a result of PsA, you may develop a condition called spondylitis, which involves inflammation in the joints of the vertebrae. Spondylitis causes stiffness, Dr. Mikulik says, which tends to be worse in the morning, but gets better with activity. For this reason, gentle stretching and regular movement is recommended. This type of pain and stiffness is most common in the lower back, but can occur anywhere in the spine, including the neck.

High Blood Pressure

The risk of heart disease may be nearly double in people with psoriatic arthritis, according to the Arthritis Foundation, due to body-wide inflammation that can lead to high blood pressure and high cholesterol. Because of this, it’s crucial to get regular check-ups and manage your PsA well, says Dr. Askanase. Uncontrolled inflammation can narrow arteries and reduce the flow of blood to the heart and other organs, putting you at higher risk for a cardiovascular event like heart attack or stroke. Bottom line: If you’re experiencing any of these symptoms, talk with your doctor. Together you’ll come up with a plan to keep PsA at bay.

https://www.healthcentral.com/slideshow/ways-psoriatic-arthritis-affects-your-body?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGgmxXdJZxhTum4Nzb_JpUkx8UCUV9uREXlc31mwz374IoHVkX9YIqw0VzKGl_1o6bD0mulCkZLRqH_J2GmXVgB7tyf0xpWcFNDm9Zl24bxg_ayHXU 

Psoriasis and Your Diet

From gcnews.com

By Charlyn Fargo

Can what you eat help calm psoriasis, a chronic inflammatory disease that affects the skin? It’s identified by the development of thick, red patches with silvery scales, causing the area to itch or become sore. And it can occur anywhere on the skin, but it typically affects the scalp, face, elbows and knees.

As with other autoimmune diseases, the exact cause of psoriasis is not known. In many cases, it appears to be influenced by genetics and environmental aspects, according to the Academy of Nutrition and Dietetics. Risk factors for individuals with psoriasis include an elevated body mass index, metabolic syndrome, cardiovascular disease and psoriatic arthritis.

According to research, carrying excess body weight is associated with more severe psoriasis symptoms as well as a decreased response to medication and other treatments. A 2018 systematic review, published in JAMA Dermatology, looked at several diet-related factors and how they impact psoriasis severity. Researchers found that weight loss among individuals with a BMI in the overweight or obese range was associated with improved psoriasis symptoms. The researchers also found that despite an increased risk of celiac disease among individuals with psoriasis, evidence did not support the use of a gluten-free diet for controlling psoriasis severity among these individuals without confirmed celiac disease or gluten sensitivity.

Some studies have found that foods with anti-inflammatory properties may help in the management of psoriasis severity. Obtaining the recommended amount of omega-3 fatty acids has been considered beneficial; however, results have been mixed when evaluating the effectiveness of oral fish oil supplements and psoriasis severity, so obtaining them through dietary sources is better. Additional studies have investigated the effect of a Mediterranean dietary pattern in patients with psoriasis, so a trial of this type of eating style may be considered along with conventional treatment. Additionally, vitamin D deficiency is associated with increased severity of symptoms. However, studies have not found vitamin D supplementation to be helpful in managing psoriasis in the absence of a deficiency.

The bottom line? Choosing more fruits, vegetables, fish, nuts, seeds, whole grains, lean meat and low-fat dairy is a healthy way to eat and may even help lessen symptoms of psoriasis. Choose the whole foods rather than supplements to get the most benefit.

Charlyn Fargo is a registered dietitian with SIU School of Medicine in Springfield, Illinois, and the current president of the Illinois Academy of Nutrition and Dietetics. .

https://www.gcnews.com/articles/psoriasis-and-your-diet/ 

Psoriasis and Allergies: What’s the Connection?

 From everydayhealth.com

Psoriasis — a skin disease in which cells build up quickly, typically causing red or discoloured, scaly, and itchy patches — is often seen in people with other allergic or inflammatory conditions. These conditions include eczema (atopic dermatitis), nasal or respiratory allergies (allergic rhinitis), and asthma.

While estimates vary, one study found that among U.S. adults, people with psoriasis were more than twice as likely as those without psoriasis to have asthma or allergic rhinitis. And while psoriasis and eczema are distinct skin conditions, research shows they share some common features, including skin barrier dysfunction.

Here’s what you should know about the connection between psoriasis and allergies, including how treating or controlling one condition could affect the other.

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The Psoriasis-Allergy Connection

There are some notable similarities and differences between psoriasis and allergic conditions.

“Psoriasis, seasonal allergies, and eczema are all immune-mediated. They are attributed to immune system dysfunction,” says Lauren Taglia, MD, PhD, a dermatologist at Northwestern Medicine in Geneva, Illinois.

But psoriasis tends to involve different pathways in the immune system compared with allergic conditions. For example, one analysis found that in skin biopsies (tissue samples) from people with psoriasis or eczema, different kinds of immune cell clusters were found for each condition. What’s more, inflammation was seen in different kinds of cells in blood samples taken from people with each condition.

Both genetic and environmental factors may contribute to psoriasis as well as conditions like eczema and allergic rhinitis. People with one allergic condition are also more likely to develop another allergic condition, possibly due in part to genetic factors.

Allergic conditions are often activated by a known allergen, such as pollen, foods, or substances that contact your skin. Psoriasis flares can also have a known trigger, but these triggers may be less specific and predictable than is typically seen in allergic conditions. Psoriasis triggers can include infections, skin injury, weather conditions, smoking or second-hand smoke, alcohol consumption, and certain prescription drugs.

For allergic conditions, treatment typically focuses on preventing exposure to known allergens and possibly taking medicines to reduce your immune system’s reaction and improve symptoms. For psoriasis, there are medications that treat disease flares as well as injected or infused medications that can keep some people symptom-free for months or even years.

Does Controlling One Help Control the Other?

For people with both psoriasis and allergies, it’s possible but not a certainty that the two conditions could interact.

“Skin allergies can exacerbate psoriasis” by increasing inflammation in the body, says Jeffrey Weinberg, MD, a clinical professor of dermatology at Mount Sinai in New York City. “If we minimize allergies, it could minimize flares of psoriasis because of that inflammatory effect.”

But allergies are typically considered a less common psoriasis trigger, so there may be limited interaction between the conditions in many people. “Allergies typically do not play a role in psoriasis, as a cause or as part of therapy,” says Kim B. Sanders, a certified physician assistant and associate professor of dermatology at Oregon Health & Science University in Portland.

It’s unlikely that most medications for psoriasis will directly help with allergies, or vice versa. “Because they use different ‘highways’ in the immune system, a treatment for one doesn’t always help the other,” says Soo Jung Kim, MD, PhD, an associate professor of dermatology at the University of Washington School of Medicine in Bellevue. That’s particularly true when it comes to biologic drugs for psoriasis, Dr. Kim says.

But some treatments could be beneficial for both psoriasis and eczema, in particular. These include topical steroid creams and ointments, light therapy, and skin moisturizers and protectants.

Risk of Drug Interactions

In some rare cases, taking a biologic drug for psoriasis could increase your risk for allergic conditions — especially eczema.

“Biologic medication that successfully shuts down the psoriasis pathway might ‘tilt’ the immune system, potentially triggering or worsening eczema symptoms,” says Kim. When this happens, it’s known as paradoxical eczema.

One study found that about 1 percent of biologic drug injections or infusions for psoriasis resulted in paradoxical eczema. This risk was lower for IL-23 inhibitors compared with tumour necrosis factor inhibitors (two groups of biologic drugs), and higher for people with a history of eczema or respiratory allergies.

The opposite effect may also happen, Kim says, with biologic drugs used to treat allergic conditions potentially causing psoriasis or making it worse — although this evidence is currently limited to case reports.

But in most cases, it’s unlikely that a treatment for psoriasis or allergic conditions will have any effect on the other disease. “Overall, high-quality evidence that treating one condition reliably improves or worsens the other remains limited,” says Kim.

Lifestyle Modifications That Could Help Both

Certain lifestyle measures could be beneficial for both psoriasis and allergic conditions:

• Optimize skin care. Avoiding harsh cleansers and regularly using a moisturizer can be helpful for both psoriasis and eczema, according to Kim.
• Be aware of triggers. Knowing what activities or environmental exposures tend to make your psoriasis or allergies worse can help you avoid them, or at least plan ahead to make sure you’re treating them effectively.
• Focus on a healthy diet. Following a Mediterranean-style diet and “eating the rainbow” of fruits and vegetables can help ensure you get the nutrients needed to support your immune system and may help reduce inflammation, says Dr. Taglia.
• Manage a healthy body weight. “Obesity is strongly associated with psoriasis severity,” says Kim, adding that body fat is linked to pro-inflammatory immune system proteins. “Obesity also worsens asthma and allergic rhinitis outcomes,” she adds.
• Don’t smoke. Smoking is linked to more severe psoriasis and worse asthma control, and quitting can help with both conditions, Kim says.
• Minimize stress. To help reduce stress, “I think how we move our bodies matters,” says Taglia, which can mean getting regular exercise or performing mind-body practices like yoga. “And just making healthy choices in how we consume the world,” when it comes to things as varied as food, alcohol, and information.

The Takeaway

• Psoriasis and allergic conditions like asthma or eczema are both immune-mediated, and people with psoriasis are significantly more likely to have these co-occurring conditions.
• While treating one condition rarely controls the other, managing skin allergies may help reduce psoriasis flares by minimizing overall body inflammation.
• In rare cases, certain biologic medications for psoriasis can trigger eczema symptoms, a reaction known as paradoxical eczema.
• You can support your immune system and help manage both conditions by maintaining a healthy weight, avoiding smoking, and using gentle skincare products like moisturizers and mild cleansers.
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• https://www.everydayhealth.com/skin-conditions/psoriasis-and-allergies-connection/