“Psoriasis presents as a build-up of skin cells, which create scaly, patches that can itch, hurt, crust up, and bleed,” she says, explaining that day-to-day management of the disease can be key to easing symptoms. “For those with psoriasis, increased inflammation in the body throws off the body's ability to regulate the immune system, which leads not only to getting sick more often, but also to flares of immune-related skin diseases, such as psoriasis and eczema.”
Engelman adds that psoriasis is not just a skin disease but also an indication of general body inflammation.
On paper, figuring out just how to cut down on inflammation in your body and address other sneaky factors that might be causing (or worsening) your psoriasis may seem overwhelming. However, as the below experts will point out, some of these changes are as simple as taking a cooler shower or wearing a different type of clothing when exercising. While none of these changes are a cure for psoriasis, they’re all still worth keeping top of mind if you’re in search of relief.
Miami-based board-certified dermatologist Shasa Hu says that psoriasis can be triggered by something as mundane as a repetitive motion in our everyday lifjhhgghbfdne. Because psoriasis often has a unique feature known as “koebnerization,” as Hu explains, it can appear at the site of any minor skin trauma, like a scratch or mosquito bite. Koebnerization, or Koebner’s phenomenon, means that someone’s skin is vulnerable to a psoriasis outbreak anywhere a minor injury or trauma occurs, even if that area wasn’t previously affected by psoriasis symptoms. Notably, though, only about 25 to 30% of all psoriasis patients experience the phenomenon, according to research published in Dermatologic Therapy Journal.
Having said that, Hu notes that repetitive motions of body parts with “increased exposure to friction and pressure” can cause painful flare-ups. While activities like tennis or yoga can be culprits of flare-ups, there are other repetitive motions to watch out for, too, such as leaning on our elbows at a desk all day.
Eliminating or cutting back on certain motions can help, of course, but that’s not always possible, and physical activity and exercise are also helpful for general health and preventing psoriasis over time.
“For people with psoriasis and an active lifestyle, it gets more difficult to avoid sports-related Koebner’s phenomenon,” Hu says. “This is why wearing long-sleeve shirts, long pants, and comfortable, well-fitted shoes can be very helpful in reducing pressure and skin trauma.”
Focusing on prevention can have a bigger impact on your experience with psoriasis than you might think. Engelman suggests hydrating your skin and locking the moisture in regularly to help prevent cracking, tearing, and bleeding.
“The more pliable your skin is, the less likely it will be to crack or tear. When your barrier is compromised, it is more prone to infection, irritation, redness, etc.,” she says, recommending that those dealing with psoriasis use products with ingredients that support, soften, and nourish the skin barrier, such as ceramides, hyaluronic acid, peptides, and niacinamide.
Sandy Skotnicki, a board-certified dermatologist in Toronto, Canada, and author of Beyond Soap, echoes Engelman’s advice. Proper moisturization, she says, can also help the skin better absorb topical psoriasis medication.
If you love nothing more than a steaming hot shower, few people can blame you — but it might not be helping your psoriasis, says Engelman.
“Avoid taking hot showers, which strip the skin of natural oils,” she says, adding that she often recommends patients invest in a humidifier. “In sub-optimal humidity environments, we can experience major transdermal water loss because the environment is pulling moisture from our skin all day long,” she says. “A humidifier adds clean moisture back into the environment therefore supporting skin barrier function and reducing dryness, redness, and texture.”
Taking a shower may be one of the most mindless parts of most of our daily routines, but for those with psoriasis, it’s worth taking a second look at your bathing habits. This isn’t just true when it comes to temperature, but also regarding body wash choice.
All three dermatologists noted that avoiding harsh soaps and body washes with fragrances is a good choice, with Skotnicki adding a suggestion to “not cleanse your whole body if not dirty, only wash your bits (underarms and private parts).”
For a quick list of ingredients to watch out for on product labels, cosmetic chemist Ginger King says to stay away from ingredients such as sulfates, fragrance, and SD-alcohol. On the flip side, products made with ceramides, squalane, licorice, and shea butter are all great options.
For those with psoriasis, moisturizing is key, but there are ways to optimize the product’s effect and absorption, says Engelman.
“I recommend my patients apply moisturizer immediately after showering or cleansing because it allows the product to trap some of the water on your skin, keeping it from evaporating,” Engelman explains. “This is where an occlusive, like glycerin, will be beneficial.”
Products like Skinfix’s Barrier+ Triple Lipid Peptide Cream, which contains glycerin, could be a good fit for those looking to heed Engelman’s advice.
Engelman also notes layering as an important part of optimizing how much moisture your skin isr receiving. “Just like you layer thin, quality pieces to keep warm, the same should be done for skin-care products,” she says. “Start with the products that have the lightest consistency (oils) and finish with the thickest (creams).”
Another common piece of advice from each dermatologist was to avoid excessive sun exposure at all costs. This, of course, is a common rule of thumb for most people trying to take care of their skin, but is especially true for those with psoriasis.
“A blistering sunburn can trigger a whole body psoriasis flare, as sunburn can be thought of as systemic injury to the skin,” Hu says. “This is why, although natural sunlight at a very low dose and medical UV therapy are known treatment for psoriasis, sunburn is a big no-no for psoriasis patients. The same goes for tanning bed use.”
For those with psoriasis, look for a sunscreen made specifically for sensitive skin, like Neutrogena’s Sensitive Skin Sunscreen or La Roche-Posay’s Anthelios Ultra Light Mineral Sunscreen SPF 50.
All three experts agreed that harsh exfoliation, whether in the form of loofahs, scrubs, or other treatments is a big no-no for those with psoriasis.
“They can cause trauma to the skin,” Skotnicki explains, naming dry brushing and mechanical exfoliation devices as other exfoliation treatments that are best to be avoided. Though dry, flaky skin can make it tempting to reach for something to buff the skin away, the key here is more moisture and less friction.
Your beauty routine might feel like a form of relaxation — always a good thing when it comes to battling the stress that sometimes inflames psoriasis — but it can always be a trigger, explains Hu.
“Scalp psoriasis can be exacerbated by harsh hairstyling habits or chemical treatments. I often advise patients to resist the urge to use boar-hair bristle brushes or other stiff-ended brushes to descale their psoriatic plaques on the scalp,” Hu says. “Instead, use soft brushes with rounded tip, and apply scalp oil, or prescription psoriasis oil to loosen up the scale.”
Other beauty treatments that you should adjust when dealing with psoriasis? Waxing, hair-colouring, and cuticle trimming, which can trigger psoriasis of the hands and nails, says Hu.
“I also advise my psoriasis patients to avoid beauty routines such as waxing (imagine the pulling on the skin and the amount of trauma associated with it) or threading,” Hu explains, suggesting alternatives like avoiding root contact when having hair colour processed or avoiding harsh or aggressive cuticle treatments during manicures.
While most of us know stress can be a mental and emotional challenge, it can wreak havoc on your body as well, and that includes your skin. As Hu explains, stress management is very important when managing psoriasis as well as other skin conditions such as acne and eczema.
“For people with high stress on a daily basis, seeking mental health support and practicing meditation may provide significant benefits that supplement the benefits of their psoriasis medication,” Hu suggests.
Seeking out resources like therapy and support groups can make a huge difference in feeling less alone while treating and living with psoriasis.
For those in search of another reason to finally start running again or invest in some at-home workout equipment, preventing psoriasis flare-ups might just be an added bonus.
“Multiple studies have shown that obesity, smoking, and cardiovascular disease is linked with psoriasis and disease severity, possibly due to the shared inflammatory pathway,” Hu explains, noting that they often perform a cardiovascular health screening when treating psoriasis patients.
Focusing on daily nutrition and exercise as well as cutting back on alcohol/smoking are all things that can have a great impact on psoriasis patients — in both the short term and the long term, says Hu.
Engelman explains that something as simple as adjusting your food and nutrient consumption can also make a difference in preventing or healing painful psoriasis breakouts.
“Diet is very important in a couple ways. First, food contains nutrients we need to fight and kill bad bacteria,” she says. “Without them, the skin feels threatened and becomes inflamed.”
That’s because gut health and skin health are closely intertwined. “Second, your diet supports [skin health],” Engleman says. “Diets rich in antioxidants, vitamins, proteins and healthy fats support healthy skin cell turnover.”
For those with an unbalanced gut environment, Engelman explains, toxins can be released into the bloodstream and promote inflammation throughout the body (including in the skin).
Along with eliminating smoking, as Hu mentioned, limiting your alcohol intake can also make a big difference when it comes to psoriasis flare-ups (and overall inflammation).
Both Skotnicki and Engelman listed alcohol as a common trigger for psoriasis, echoing Hu’s overarching message about the link between lifestyle choices and the skin ailment.
“Interestingly, instead of focusing on the link of mechanical trauma and psoriasis flare, one of the most impactful changes people can make to decrease their disease activity is actually activities and lifestyle choices that improve their cardiovascular health,” Hu says.
Definitively treating psoriasis is not a one-size-fits all endeavour — different lifestyle changes might work more effectively for different people. However, if you are looking for relief and have yet to explore some of the above lifestyle changes and tweaks, they could be worth exploring or talking about with your dermatologist.
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