Sleeping with the heating on could be causing your skin to flare up

From glamourmagazine.co.uk

Time to take the heat off

We don't know about you, but when it's cold and drizzly outside, all we want to do is crank up the heating, snuggle down in bed and hibernate until Spring (waking up momentarily for Christmas, of course). But as cosy as a warm house sounds, it could be causing all manner of skin concerns, including making existing issues like eczema and psoriasis worse.

According to experts, central heating is one of the biggest contributing factors to dry skin over the winter months. "It is really our lifestyle habits that change with the season, not our skin itself," says Olivia Thorpe, Founder of Vanderohe. "Alongside exercising less and eating less healthy food, we are also exposed to skin-drying central heating - and the colder it gets outside, the worse it gets."

Similarly to air-conditioning, central heating reduces the moisture levels in their air, causing skin to become dry and tight. "Central heating adds an extra level of stress to managing dry skin, which is especially problematic when you have a pre-existing skin disease such as psoriasis or eczema," explains Dr Adam Friedmann, Consultant dermatologist for Stratum Dermatology Clinics. "Warning signs that your skin might be too dry are if it feels rough to the touch, looks scaly or begins to flake."

As well as causing dry conditions inside, central heating also causes problems due to the contrast in temperatures from outside. "The temperature changing from warm and cosy inside to chilly outside, also causes blood vessels to dilate, making the redness of acne and rosacea appear much worse," says Dr Friedmann.

Rather than sit at home shivering, there are some helpful alternatives to try and alleviate problems caused by central heating. For starters, it could make a huge difference to your skin if you simply turned your heating off at night. "Making sure the heating is off during the night is an excellent way of easing skin dryness (especially if you have any skin conditions such as eczema or other inflammatory issues) as well as saving you a bit of money," says dermatologist Dr Hiba Injibar from Dermasurge Clinic on Harley Street.

It might also be a good idea to try and replenish the moisture levels in the air: "If you have dry and dehydrated skin, you should use a humidifier, especially in the winter months when the air is drier," recommends Dr Friedmann. A humidifier is a simple device which help to regulate the moisture levels in the air. Traditional humidifiers rely on a tank of water, which boils to emit steam into the air, while more advanced devices use ultrasonic vibrations to create water vapour for a more hygienic and a safer option.

It's also beneficial to avoid exposing skin to either very hot or cold water: "The mixture of hot water and cold temperatures can leave your skin feeling raw and exposed," says Dr Friedmann. Make your showers shorter and cooler and stick to warm baths to help you relax and moisturise your skin, especially if you add some nourishing bath oils.

And finally, remember as a general rule - if you have very dry skin, the thicker the cream the better. "If moisturisers are too thin, they will evaporate very quickly and leave skin drier," explains Dr Friedmann. Of course, very thick creams are also more difficult to tolerate as they can feel greasy but it's well worth trying in order to soothe the skin.

https://www.glamourmagazine.co.uk/article/central-heating-skin-problems

Coping With Psoriasis At Work

From psoriasis360.co.uk

Managing psoriasis whilst working can feel overwhelming at times. It is important to understand your condition, the resources you have available to you, and how to discuss your condition with others if you choose to. By being informed on what aspects of work would be a problem for you and how you can be supported, you will be able to take more control of your condition’s impact.

You may not want to disclose your condition to your manager – however, some people with psoriasis find it helpful, so they can access support at work.

If you want to discuss your condition with your manager, try to do so during a time when neither of you are under any pressure. Be open and describe to them how your psoriasis can affect your performance (for example, if you experience joint pain), what reasonable adjustments could help, and what you need to do to look after yourself (e.g. regular breaks or time off to attend appointments). By remaining upfront and specific with your employers, you can find ways to resolve any problems you are facing, improve your productivity and wellbeing.

Everyone with psoriasis has different needs for reasonable adjustments. Nevertheless, there are a few adjustments which it is likely someone with psoriasis – including joint pain - may need:

• Assistive devices to make your workspace more comfortable.
• Protected time for scheduled skincare routines to keep your skin moisturised.

Support from your organisation can be really helpful, but there are also things you could try to look after yourself at work:

• Keep a stash of topical treatments and itch-relieving medications where you work, so you always know you have something to hand that can help your symptoms.
• Put a cold pack in the workplace fridge to help with itch when you need relief.
• If possible, vary your activities throughout the day so that you avoid sitting or repeating the same action for too long to minimise pressure on your body.

https://psoriasis360.co.uk/lifestyle-advice/index.html

Psoriatic Arthritis Medication: What You Need to Know

From self.com

The right treatment can put your condition into remission

Psoriatic arthritis may be a frustrating condition with no cure, but a diagnosis doesn’t necessarily mean you’ll experience terrible symptoms like joint pain every night. The right psoriatic arthritis medications can put the disease into remission, meaning you have virtually no symptoms, according to the Mayo Clinic.

Psoriatic arthritis is a form of arthritis that’s more likely to develop in people who have psoriasis (a skin condition that causes scaly patches and discomfort like itching) or a family history of psoriasis. It commonly causes joint pain in your fingers, toes, wrists, knees, ankles, or lower back. Left untreated, the autoimmune disorder can lead to permanent joint damage, which is why early care is so important, according to the Mayo Clinic. It’s helpful to understand your options so you can work with your doctor to create a plan that suits your needs. 

There’s no one-size-fits-all solution to treating psoriatic arthritis—rather, deciding to use any particular medication is a careful balance of the potential benefits versus risks to your body. Ultimately, there is no magic medication that treats the disease without side effects, says David M. Wanalista, D.O., who specializes in rheumatology at Atlantic General Hospital. “There may be bumps in the road as you treat psoriatic arthritis,” he tells SELF.

However, there are several promising medications that may reduce symptoms and protect your body from long-term damage. Choosing the right psoriatic arthritis medication depends on the severity of the disease, the number of affected joints, and whether your skin is affected by psoriatic arthritis. Keep in mind you may need to take a combination of treatments to alleviate your symptoms. Over time, your plan may evolve. “Medication that was working at first may lose effectiveness over time, and, in some cases, the disease does become more active, and so a change in treatment may be necessary,” Eric M. Ruderman, M.D., professor of medicine in the rheumatology division at Northwestern University Feinberg School of Medicine, tells SELF. Here are a few types of psoriatic arthritis treatment to know.

Non-steroidal anti-inflammatory drugs (NSAIDs)

You may already have one common treatment for psoriatic arthritis in your medicine cabinet: Non-steroidal anti-inflammatory drugs. These mild pain relievers, like ibuprofen and naproxen sodium (or Aleve), are available without a prescription (except for more powerful NSAIDs that do require a prescription), and work by blocking inflammation-causing compounds, says Kristi Kuhn, M.D., Ph.D., rheumatologist with UCHealth Rheumatology Clinic–Anschutz Medical Campus.

NSAIDs are best reserved for people with mild symptoms, and they won’t prevent joint damage or stop the disease from becoming worse over time, according to NYU Langone Health. It’s worth noting that NSAIDs are typically meant for short-term use, so you’ll want to work with your doctor to determine the best frequency and dosage for you.

Disease-modifying anti-rheumatic drugs (DMARDs)

DMARDs are the most common medications used to treat psoriatic arthritis, according to NYU Langone Health. Up to 30 percent of 80 people treated with DMARDs sustained remission of their psoriatic arthritis, according to a 2019 study published in Rheumatology and Therapy.

This treatment helps prevent inflammation from spreading through your body—ultimately slowing the progression of the disease. Doctors often rely on a weekly tablet of methotrexate as the first-choice DMARD for psoriatic arthritis. Be aware that this drug may contribute to liver damage, so you may need to cut back on alcohol and get regular blood tests to monitor your health, explains Joseph F. Merola, M.D., M.M.Sc., associate professor of dermatology at Harvard Medical School and associate physician at Brigham and Women’s Hospital. Luckily, there are other forms of DMARDs, such as JAK inhibitors, that may be an option if methotrexate isn’t effective enough. (“JAK” refers to Janus kinase, an enzyme related to inflammation.)

Depending on your situation, your doctor may recommend taking DMARDs alone or with another drug.

Biologics

Biologics are a type of DMARD doctors use to treat moderate to severe psoriatic arthritis. These drugs can be more expensive and invasive to use than other treatments (some need to be self-injected or administered through an IV drip at a doctor’s office). But they also come with one major upside: Some biologics can reduce the severity of the disease in up to 50 percent of the patients who try them, according to a 2016 study published in The Journal of Rheumatology.

There’s a variety of biologics available, including TNF inhibitors that block activity from tumour necrosis factor, a protein responsible for inflammation. Dr. Wanalista tells SELF these “have revolutionized the treatment for psoriatic arthritis.”

“When started early in the disease process, [TNF inhibitors] can preserve joint space and help patients achieve disease remission,” Sana Makhdumi, M.D., rheumatologist at Baylor Scott & White Hospital, tells SELF.

Biologics work by suppressing parts of your immune system, so you have a greater risk of developing infections, like the common cold, when taking these drugs.

Small molecule medications

These newer medications target the parts of the immune system that cause inflammation and experts often recommend them for people who don’t respond to other treatments. Some DMARDs, such as JAK inhibitors, are also small molecule medications. 

The medications enter your cells and block substances that cause inflammation in your body. Generally, these are affordable compared to other types of medications and have simple dosing instructions.

How to know which psoriatic arthritis medication is best for you

The right therapies can ease pain, optimize your quality of life, and protect your joints from long-term damage. But achieving this mission is complex, and no two patients have the same treatment needs over the course of their disease, says Dr. Kuhn.

It’s important to work with a rheumatologist who can assess the severity of your condition and develop a plan for you, says Dr. Ruderman.

“While treatment is often focused on achieving the best long-term outcomes, it is important that your doctor know which particular manifestations are most bothersome for you,” he says.

Your preferences are important, too—especially when it comes to how the treatment is administered, says Victoria Seligman, M.D., M.P.H., rheumatologist with the UCHealth Rheumatology Clinic in Denver. A biologic might not be the best option if you hate needles, for instance. Likewise, you should tell your doctor if you have trouble following a daily pill schedule.

Once you and your care team have weighed the risks and benefits of a potential treatment and you’re ready to get started, Ana-Maria Orbai, M.D., M.H.S, director of the psoriatic arthritis program at Johns Hopkins University School of Medicine, recommends tracking your psoriatic arthritis symptoms so you can look for changes during treatment.

Overall, stay persistent and try to advocate for yourself. “The physician and patient should work together as a team. Don’t take a single treatment recommendation as an option. Push and ask for alternatives. You have a right to that information,” says Dr. Makhdumi.

https://www.self.com/story/psoriatic-arthritis-medication

Increasing Connection Between Poor Oral Health and Harmful Conditions Like Psoriasis Highlights Need for Good Dental Routine

From prweb.com

Dr. Sahar Verdi of Thousand Oaks-based dental centre Dental Specialists of California comments on a recent article that the simple act of brushing teeth can have a significant impact on an individual’s health and well-being

An October 13 article on WMC 5 Action News reports on a potential link between poor oral health and psoriatic arthritis. The exact nature of this link is still being determined but may involve bacterial infections in the mouth and the subsequent response from the body’s immune system. According to the hypothesis laid out by researchers, the body’s immune response to the bacterial infection may somehow be targeting the patient’s skin as well, causing the characteristic swelling and inflammation associated with psoriasis. Board-certified periodontist Dr. Sahar Verdi of Dental Specialists of California says that while it may still be too early to definitively say that poor oral health directly causes psoriasis, there are still many established links between unhealthy teeth and gums and other adverse conditions such as heart disease.

The Thousand Oaks-based periodontist notes that if individuals need any more convincing that their after-meal brushing routine makes a difference, this is it. Dr. Verdi says with the proven connections between poor oral health and deteriorating vitality in other areas of the body, daily dental care and maintenance should be taken very seriously.

People should be brushing their teeth for two minutes, roughly 30 minutes after every meal, she adds. Dr. Verdi notes that the first figure ensures a complete cleaning while the second figure provides ample time for tooth enamel to re-mineralize and harden after eating. Dr. Verdi says that while it may sound counterintuitive, brushing immediately after eating or drinking sugary or acidic foods could actually damage just-softened tooth enamel. The board-certified periodontist adds that stripped and weakened teeth are more vulnerable to tooth decay and may lead to diseases of the gums. If left unchecked, these oral ailments may increase the chances of individuals suffering other harmful conditions like stroke.

Dr. Verdi says even the increased chance of having to deal with something so serious should be enough to warn patients about the dangers of poor dental hygiene. The notes that patients who regularly brush and floss are significantly less likely to experience discoloured or stained teeth, and that the prospects of breaking or cracking a tooth are also notably lesser.

https://www.prweb.com/releases/increasing_connection_between_poor_oral_health_and_harmful_conditions_like_psoriasis_highlights_need_for_good_dental_routine_says_dr_sahar_verdi/prweb17527837.htm

Psoriasis Vs Eczema: Here's How You Can Spot The Difference

From doctor.ndtv.com

These two skin conditions can be mistaken easily. Read here to know difference between psoriasis and eczema as explained by expert

Eczema and psoriasis are two skin conditions which may look very similar but are technically different. Both of these conditions are chronic which can get worse if not treated properly. Psoriasis is a chronic condition autoimmune condition which can leads to deposition of dead cells. Eczema, also known as atopic dermatitis is also a long-term condition which can be a result of hypersensitivity reaction. These conditions can cause discomforts which can affect one's quality of life. To understand the difference between these two skin conditions, we spoke to Dr. Deepa Krishnamurthy who is a Dermatologist at Columbia Asia Hospital.

  Psoriasis vs eczema: These two skin conditions may show similar symptoms

Psoriasis vs eczema: Here's how you can differentiate

"Eczema and psoriasis look very similar with red, itchy, scaly rashes but they are fundamentally different. A dermatologist can point out the differences," says Dr. Krishnamurthy.

Psoriasis is a chronic inflammatory autoimmune skin condition. It is a disease of epidermal hyperproliferation and decreased epidermal turnover. It makes skin cells to multiply up to 10 times faster than normal leading to build up of bumpy red patches covered with white scales.

Eczema means 'boil out'. The term denotes skin condition where skin turns red with eruptions containing liquid that oozes out. Genetic and environmental factors play an important role here.

Age

Psoriasis: Most common in 15-35 years

Eczema: Most common in children where they present as atopic eczema which is a type of endogenous eczema. Among adults, exogenous eczema is commonly present as allergic contact dermatitis, irritant contact dermatitis, photodermatitis and infective dermatitis.

Triggers

For psoriasis: Pressure sites, seasonal variation- worsen in winter, stress, infections (URTI), certain medicine, alcohol and smoking

For eczema: Irritants (soap, detergents, and disinfectants), allergens (dust, pets, pollen, and dandruff), infections, stress, sweating, heat and humidity.

Clinical features

Psoriasis

• Present with symmetrical, red, well defined, scaly patches
• With silvery white scales
• Itching present but mild
• Sites- Elbows/ knees/ scalp, face, palms, soles, nails
• Different types- Guttate psoriasis, chronic plaque psoriasis, pustular psoriasis, exfoliative psoriasis, mucous membrane psoriasis, nail psoriasis and Psoriatic arthritis

Eczema

• Itching is a predominant symptom
• Acute stage- red papulovesicles, oozing patches with edema
• Subacute stage- Crusting and scaling
• Chronic - dry, rough and thickened
• Sites- Folds (inner elbow, behind knees, neck, wrists and ankles)
• Subacute stage patches are very similar to psoriatic patches

Proper history into chronology of events, site of involvement and triggers help in diagnosis.

(Dr. Deepa Krishnamurthy, Consultant, Dermatologist, Columbia Asia Hospital Sarjapur Road)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

https://doctor.ndtv.com/skin/psoriasis-vs-eczema-heres-how-you-can-spot-the-difference-2323446

What You Need to Know About Psoriasis

From india.com/lifestyle

A dermatologist explains key facts about psoriasis

Psoriasis is a chronic and recurrent inflammatory skin condition caused by an overactive immune system. Incidence of psoriasis occurs with equal frequency in men and woman. Mean age of onset is 27 years of age but can range between neonates to geriatrics. Psoriasis is an inherited skin disorder. Dr Pallavi Sule, dermatologist and aesthetic physician explains, “The symptoms of Psoriasis, are red inflamed patches with thick silvery white scales. The areas involved can vary from localised to generalised patches. But the disease has a predilection for the scalp, nails, extensors of the limbs, umbilical region and sacrum. Subjective symptoms like itching, burning may be present and may cause extreme discomfort to the patient.”

Here are the different types of psoriasis, diagnosis, triggers, treatment and diet.

· Guttate psoriasis: Typical coin like or water drops like lesions of size 2-5mm in diameter appear as an abrupt eruption following acute infection (respiratory infections). The age group affected is generally below 30 years.

· Pustular psoriasis: Lakes of pus develop on palms of hands and soles of feet. The patient is frequently ill with fever, redness of skin and cachexia.

· Inverse psoriasis: This variant selectively involves the folds, recesses and flexor surfaces that is ears, axillae, groins, inflammatory folds, navel, lips, web spaces.

· Napkin psoriasis: Psoriasis in the diaper area, affects the infants, ages 2months to 8 months of age. Bright red patches in the diaper area, which respond to creams but psoriasis may appear in adulthood.

· Psoriatric arthritis: The variant affects the joints of the fingers and feet which may result in permanent deformity.

· Erythrodermic psoriasis: Patients with psoriasis may develop generalised erythroderma.

COURSE: The course of psoriasis is unpredictable. The onset may be sudden and widespread. It usually begins on the scalp or elbows with symmetrical involvement of the body parts.

TRIGGERS: Psoriasis is a majorly an inherited inflammatory skin disorder. Few triggers are respiratory infection caused by streptococci bacteria, stress, drugs like beta-blockers, antimalarials, lipid-lowering drugs, cold climatic conditions.

TREATMENT: Psoriasis is treated according to the extent and severity of the disease. Local applications of steroid-based creams and ointments are recommended for limited plaque psoriasis. At times keratolytic agents like salicylic acid can be included. An ultraviolet light or phototherapy is another modality of treatment. For generalised psoriasis oral steroids, methotrexate, cyclosporine or biologic agents can be included.

DIET: Including inti inflammatory fish oils and polyunsaturated fatty acids helps.

https://www.india.com/lifestyle/what-you-need-to-know-about-psoriasis-3756184/

Six Steps to Keep Psoriasis From Becoming Psoriatic Arthritis

From healthcentral.com

If you have psoriasis, these doctor-recommended lifestyle tips could help minimize your odds of developing PsA later on.

                                    iStock

An unlucky 30% of people living with psoriasis eventually develop psoriatic arthritis. This chronic autoimmune condition causes inflammation and swelling in the joints, usually around your fingers and toes. While psoriasis doesn’t always precede it, studies show that the vast majority of folks with psoriatic arthritis had psoriasis for years or even decades before their joint symptoms began.

The mysterious connection between these two conditions is a topic of ongoing study. “Exactly who’s going to get [psoriatic arthritis] is hard to say, but they both appear to be autoimmune conditions where the body is fighting itself,” says Stuart Kaplan, M.D., chief of rheumatology at Mount Sinai South Nassau Hospital in Oceanside, NY and partner at Rheumatology Consultants, LLC. With psoriasis, the immune system is attacking the skin, leading to the characteristic rash. With psoriatic arthritis, the immune system goes for the joints, causing pain, swelling, and stiffness. While both conditions have similar triggers, the symptoms and day-to-day challenges facing patients are distinct.

Now, a new study review in the Journal of the American Academy of Dermatology is shedding light on an intriguing concept: Circumstantial factors like obesity or physical trauma may play a role in psoriasis patients developing psoriatic arthritis. What does this mean? For folks with psoriasis, maintaining a healthy lifestyle (to the extent that you can control) could be key to reducing your likelihood of disease progression into psoriatic arthritis.

What the Research Says

In this review, researchers looked at 16 different studies examining psoriasis patients who develop psoriatic arthritis to try to understand which environmental factors might link the two. They found no evidence that alcohol, smoking, or psychological trauma played a role, but they did find that psoriasis patients with obesity, and those who had a history of physical trauma (like broken bones, major wounds, or other serious injuries), were more likely than others to develop psoriatic arthritis.

This aligns with existing data on psoriatic arthritis and obesity. “We know that epigenetic, lifestyle, and environmental factors play a role in autoimmune diseases,” says Navya Parsa, M.D., a rheumatologist at Columbia Arthritis Centre in Columbus, OH. A study in Autoimmunity Reviews found that obesity plays a major role in the onset and progression of autoimmune diseases (including psoriatic arthritis), due to the production of adipokines, fat cells that contribute to chronic inflammation in the body.

Other studies have also looked at body mass index (BMI) and the development of psoriatic arthritis. Dr. Parsa cites one study in Annals of the Rheumatic Diseases that found that people with higher BMIs have a significantly higher risk of developing psoriatic arthritis. “This increased risk of psoriatic arthritis development in obesity can be due to a number of factors, such as the perpetuation of a chronic inflammatory state, physical trauma, and increased weight bearing load on the joints,” she says.

There is also more research to suggest that previous injury or other physical trauma may contribute to psoriatic arthritis onset. Another study in Annals of the Rheumatic Diseases found that patients with psoriasis who experience physical trauma have an increased risk of developing psoriatic arthritis later in life.

What You Can Do

To reduce your personal risk of developing psoriatic arthritis, try putting these practices into play.

• Watch your weight. Dr. Kaplan notes the research on obesity, physical trauma, and psoriatic arthritis still has a long way to go. “These studies are far from conclusive,” he says. “But with that said, it certainly behoves just about everyone with arthritis to keep their weight under control. We know that being overweight does put stress on the joints.” Obesity is bad for your health in more ways than one—and particularly for autoimmune folks, an active life can be your best tool for fighting disease.
• Know your genetic risk. For those with genetic predisposition to psoriatic arthritis, it’s especially critical to pay attention to your weight and your diet. “In general, autoimmune disease tend to run in families, although there’s no way to predict exactly who is going to get it,” Dr. Kaplan says. It is estimated that around 10% of the global population has specific genes that denote a predisposition to psoriasis. If an immediate family member has psoriasis, psoriatic arthritis, or another autoimmune condition, you should consider yourself at elevated risk. “People who are at risk because they have a family member with an autoimmune disease should be even more vigilant about maintaining their general state of health with exercise, good nutrition, [and making] sure they stay at the proper weight,” Dr. Kaplan suggests.
• Do double duty. Luckily, the lifestyle changes that can help reduce psoriasis are the same ones that can help minimize psoriatic arthritis onset and progression. The American Academy of Dermatology recommends that psoriasis patients quit smoking, reduce alcohol intake, maintain a healthy weight (which can be done by working out and eating well), exercise regularly, and maintain a healthy, whole-foods diet. These choices can help reduce your flares and improve the speed and effectiveness of your treatment plan.
• Diversify your workout routine. “My recommendations for those with psoriasis, psoriatic arthritis, or a genetic risk for these diseases is to focus on a heart-healthy lifestyle,” Dr. Parsa says. “This includes weight control with diet and exercise.” She tells her patients to aim for 30 to 40 minutes of exercise three to four times per week, at minimum. This can be aerobic exercise like running or cycling, strength exercise like weightlifting or barre class, or flexibility and stretching exercise like yoga.
• Go for the greens. Your diet can also be your secret weapon for better health. “I also recommend heart-healthy and anti-inflammatory diets,” Dr. Parsa suggests. “These diets avoid red meat, processed meats and foods, refined grains, excess sugar, and trans-fats. A diet with a lot of green-leafy vegetables, white meat, fish, whole grains, and fruits high in antioxidants is ideal.”
• Find your zen. “Stress affects the immune system and has been shown to exacerbate various types of inflammatory arthritis,” explains Dr. Kaplan. There is clinical evidence to suggest that stress plays a role in sending your immune system into overdrive, exacerbating the inflammatory reaction that triggers your flares. “For people who have psoriatic arthritis, stress is only going to make that worse,” Dr. Kaplan says. Try to incorporate practices like meditation, yoga, and daily movement into your life to keep your mental health in tip-top shape.

Ultimately, the best defence is a good offense. While it’s hard to predict your individual likelihood of developing psoriatic arthritis, you can start reducing the damage before it begins. “Unfortunately, we cannot beat our genetics, but we can change our lifestyles,” Dr. Parsa says. Follow your psoriatic-arthritis treatment plan, keep up with your doctor, and take small steps toward a healthier, more functional you.

https://www.healthcentral.com/article/preventing-psoriatic-arthritis-when-you-have-psoriasis