Managing Symptoms of Psoriasis: One Woman’s Story

From healthline.com

Over more than a decade, Steph Keever has tried every psoriasis treatment from immunosuppressants to topical treatments.

When Stephanie (Steph) Keever was a teenager, she began noticing deep ridges and pits in her fingernails. It was a precursor to the psoriasis she would develop later in life.

Today, at age 47, Keever navigates the symptoms of both inverse and plaque psoriasis flares, as well as the beginnings of psoriatic arthritis. That makes her one of the more than 7.5 million Americans living with this immune-mediated disease.

There’s no cure for psoriasis, but according to the National Psoriasis Foundation, there are now more effective treatments than ever before.

To help manage her symptoms, Keever has explored countless topical products, oral and injectable medications, diet and lifestyle changes, and alternative treatments. Some have been helpful, and others less so.

Still, her seasoned advice to anyone who was recently diagnosed, or who is currently managing flares, is simple: “Try everything! Just because someone says it doesn’t work for them, it doesn’t mean it won’t work for you.”

A family history

Twelve years ago, when Keever’s daughter was 2, she found a small plaque patch on her back, by her waistline. Within the year, she had developed plaques on her elbow, knee, stomach, and legs.

“Psoriasis is hereditary,” she explains. “My father has it a little on his head and elbow, and my brother has a small patch on his knee once in a while. My grandfather also had psoriasis. But nobody in the family has it covering their body like I do.”

Psoriasis can appear anywhere on the body, with plaques presenting as a few small patches or across larger areas. In Keever’s case, she has inverse psoriasis beneath her breasts, along her bikini line, and in her genital area.

“The skin rips with this kind of psoriasis,” she explains. “I found out I had [inverse psoriasis] when I was exercising a lot and couldn’t figure out why my groin was burning.”

After a trip to the OB, it was decided that she shouldn’t walk, bike, or move much at all during a flare. Now, when she’s experiencing a flare, she rests rather than moving around a lot.

Keever also has plaque psoriasis, known as psoriasis vulgaris, on her head, ears, on her face from her eyebrows up into the hairline, neck, arms, legs, and trunk areas.

“It’s like having a constant flaking scab that snags on clothes,” she says. “Sometimes it’s just white with scales. Other times, when it’s ‘pissed,’ as we so lovingly call it, it’s beet red or purplish in color. The constant flaking of the scab-like skin means the air is always touching the new skin underneath, and it stings like a paper cut.”

When a patch of psoriasis grows, she describes it as a hot poker burning the skin.

Scientists still aren’t sure what causes psoriasis, but they know that both the immune system and genetics play a role. Triggers vary from one person to the next, but often include:

• stress
• injuries to the skin
• weather

Unless actively taking an immunosuppressant drug, “I think I’m always in a constant state of flare-ups simply caused by just living,” Keever says. “There isn’t always a rhyme or reason for the flare-up. I do notice I have more burning, pain, and an increase in the size of the patches when I’m stressed, but this also happens when nothing noticeably stressful is going on.”

Managing symptoms

Finding a way to manage her stress motivated Keever to try Reiki as a way to relax the central nervous system. But, she says, it’s not cheap — nor is it covered by her insurance.

Reiki is just one of many, many management methods she’s explored.

“I’ve had psoriasis for so long, I forget about all the treatments I’ve tried,” she says.

Topicals

There are a number of prescription topical products marketed as treatments for managing symptoms of psoriasis, and it’s fair to say Keever has tried almost all of them.

“I’ve tried different salicylic acid [products] and corticosteroids, including Clobetasol, and various ointments, creams, foams, and gels. My husband even found a psoriasis cream at the local Dollar Tree. It didn’t help me, but it helped my dad.”

She says that the topical that seems most helpful is Taclonex Scalp, a suspension of betamethasone, a corticosteroid, and calcipotriene (synthetic vitamin D).

“However,” Keever says, “it costs $1,000 to $2,000 for 60 grams of liquid. It’s absolutely ridiculous for these medications to cost so much.”

Immunosuppressants

When the psoriasis began covering more of her body, including the upper part of her face, Keever’s Stanford dermatologist recommended immunosuppressants.

She’s tried several, but she finds the many side effects — irritable bowel syndrome (IBS), lowered immune system, and greater risk of some cancers — a source of concern.

Keever has also explored a mix of immunosuppressant prescription medications, both oral and injectable, including:

• Otezla
• Taltz
• Skyrizi
• Stelara
• Cosentyx

“The shots can be painful, causing burning at the injection site, along with nausea, dizziness, headaches, etc.,” she shares. “Unfortunately, when you stop one of these meds and then try to start up again, they don’t always work as well.”

Efficacy is important, but for many people managing their psoriasis, cost cannot be overlooked.

“Most of these expensive drugs have discount cards,” Keever says. “I’m able to get them for a fraction of the cost, as long as I have commercial insurance and not government insurance, like Medicare/Medicaid. Otherwise, they would be cost prohibitive.”

Laser treatments

Keever also shares that she was just approved to begin XTRAC excimer laser treatments.

It takes multiple treatments to begin seeing effects, and her deductible is $80 per treatment, so she’s not sure if she’s going to proceed.

Other approaches

When she finds her psoriasis is just too painful, Keever takes nerve-blocking pain medications or narcotics.

In addition to medications and Reiki for stress, she’s also tried moderating her diet.

“I tried going gluten-free and following the autoimmune protocol (AIP) diet. Unfortunately, neither have proven to be helpful with the psoriasis.”

She’s explored phototherapy, tried essential oils to no avail, and cycled through different soaps and shampoos in an effort to find something she can comfortably use.

“I found that [the Dove Sensitive Skin line] actually works great and doesn’t dry out my skin further,” she shares. “Coal tar shampoo works OK, but it strips the hair of necessary oils and smells awful.”

Symptom management tips

Keever acknowledges that it doesn’t always help to hear that you aren’t alone, and that others are going through the same thing you are. “You just want the pain and embarrassment to go away,” she explains.

Still, as someone experiencing psoriasis first-hand, she has specific advice:

• Keep the plaque as moist as possible with ointments and lotions, so they don’t hurt as much. Sometimes, she covers the ointment with a large bandage to help keep the area moist.
• Avoid lotions and foams that have alcohol. These can burn.
• Be careful with ointments. They can ruin clothing and burn when the skin is raw and new from descaling.
• Use icepacks to soothe the burning sensation.
• Try keeping your hair short, if you like that style. This has helped Keever’s father.
• Keep up with the treatments — ointments, lotions, and injections — as much as you can to avoid making your psoriasis worse.

Twelve years in, Keever has also developed a pragmatic, if weary, attitude.

“This isn’t a disease for the [self-conscious],” she says, “as it’s difficult to wear long sleeves, pants, and hair down in the summer. Generally, it’s difficult to hide your hands, face, ears, and neck.”

She’s also admirably positive: “There’s no cure for psoriasis or a magic pill to make it all go away, so I just have to remember this is just a hiccup or speed bump in life. Sometimes, it’s simply about perspective.”

Shop this story

While Keever encourages anyone navigating the symptoms of psoriasis to try everything they can, she does want people to be aware of the expense.

“The cost of treating this disease is astronomical,” she says. “From Reiki sessions to all the different topical ointments, lotions, foams, shampoos, immunosuppressant injections, and emotional toll it takes on you, your pocketbook and sanity are compromised.”

Many of the medications she uses are available by prescription only. Prices vary, depending on whether you have medical insurance. These medications include:

• Taclonex Scalp and ointment
• Otezla
• Taltz
• Skyrizi
• Stelara
• Cosentyx
• clobetasol
• XTRAC excimer laser treatments

https://www.healthline.com/health/psoriasis/products-for-psoriasis

Understanding The Psoriasis-Stress Connection

From healthcentral.com

Living with a visible skin condition like psoriasis—particularly on areas of the skin that are exposed for all the world to see—takes a daily kind of courage. Yes, there are some people in the world (who probably have a chronic condition of their own), who are thoughtful enough not to stare at your plaques or act like you have the plague. Others? Let’s just say they could use a lesson in good manners—or any manners. “We have an almost innate response to something that we suspect might be contagious,” says Ari Tuckman, Psy.D., a psychologist in West Chester, PA. “But perhaps, even more significant, the person with the visible condition may be self-conscious and have negative feelings about it, creating a self-fulfilling prophecy where the person comes across as uncomfortable or anxious and causes other people to treat them differently.” All of this becomes even more intense during a flare. It can be a vicious cycle.

The Psoriasis-Stress Connection

The fact that your skin issues mess with your self-esteem is bad enough. But get this: Stress created by your plaques can turn around and—yep—make your PsO even worse. (How’s that for irony?) “Psoriasis is a psychophysiological disorder which is exacerbated by stress,” says Mohammad Jafferany, M.D., FAPA, a clinical professor of psychodermatology and psychiatry at Central Michigan University and executive director for the Association for Psychocutaneous Medicine of North America (APMNA). “Due to its chronic and visible nature, and because it affects exposed parts of the body, it exerts a huge psychological trauma.” Patients with psoriasis can suffer from impaired quality of life, low self-confidence, poor treatment adherence, higher rates of sexual dysfunction, sleep disturbances, increased incidence of depression, anxiety, and stigmatization, and even suicidal ideations and behaviors, adds Dr. Jafferany.

Once those feelings of emotional stress pile up, it causes a boomerang effect. In fact, research shows stress is directly related to flare-ups, Dr. Jafferany says. “Stress and psoriasis are closely linked. There are more flare-ups when a patient is stressed, and psoriasis can increase your stress levels, so it is a vicious cycle,” he says. The reason for the link? People with psoriasis have an impaired hypothalamic-pituitary-adrenal (HPA) axis, the system that controls their body’s reaction to stress. They also have lower levels of the stress hormone cortisol, which normally helps decrease inflammation. “Inflammation kicks in when people are under stress, and since psoriasis is an inflammatory disease, stress causes the condition to flare up,” Dr. Jafferany says.

Depression and Anxiety Risks

Along with stress, research shows anxiety and depression rates rise in association with PsO. “Higher rates of depression, anxiety, and suicidality are reported by patients with psoriasis,” Dr. Jafferany says. “Rates of depression in psoriasis patients are higher than many other dermatological conditions and depression risk increases with greater disease burden.” Depression and anxiety disorders are particularly common in PsO patients who are younger, female, and early on in their diagnosis. The more visibly the condition, the more likely someone is to be depressed as well. (Mental health issues extend beyond just PsO: Studies show 25% of all patients with skin diseases also struggle with depression and anxiety.)

The challenge with PsO is clear: Insecurity about the appearance of plaques causes someone with psoriasis to avoid social contact or going out in public; in turn, lack of social connection and a deterioration of personal relationships leads to more insecurity, anxiety, and stress—which then increase the odds of flares and more severe appearance of plaques. “People with visible skin conditions are more likely to have social anxiety, anxiety in general, and depression,” Dr. Tuckman says. “This is especially true if they feel powerless to change the course of their skin condition and feel that their social life or mood overall hangs in the balance of what is happening with their skin condition. Feeling powerless, whether real or exaggerated, is a big contributor to anxiety and depression.”

Taking Control of Your Skin—and Brain

Of course, you want to be diligent about managing your psoriasis well. “Figure out what makes your flares more or less likely (and what doesn’t have much effect),” Dr. Tuckman says. Also, “take your treatment as prescribed, and follow up when you’re supposed to. Maintaining a regular course of treatment can help you minimize flares.”

Now that you know stress has a major effect on your psoriasis flares, it is important to try to reduce stress as much as possible. “Various therapeutic modalities such as yoga and meditation practices have shown great success in relieving stress associated with psoriasis,” says Dr. Jafferany. “Talking with a therapist on regular basis to learn coping skills to manage the level of anxiety and stress is highly beneficial in conjunction with the use of traditional antidepressant and antianxiety medications.” Consider looking for a psychodermatologist who studies the link between the mind and the skin and can work mental health treatment techniques into your skin care. Many doctors practicing this form of medicine have dual degrees in dermatology and psychiatry.

And remember, your psoriasis does not define you. “Psoriasis is something to be lived with; it’s self-consciousness that can limit your life,” Dr. Tuckman says. “The key is to separate psoriasis from self-consciousness. One of them you don’t have enough control over, but the other one is much more possible to manage.”

https://www.healthcentral.com/article/skin-brain-connection-understanding-your-psoriasis

What Are the 5 Types of Psoriatic Arthritis?

From healthline.com

Psoriatic arthritis (PsA) is a kind of arthritis that impacts individuals with the skin condition psoriasis. It’s estimated that PsA affects about 20 to 30 percent of people with psoriasis. 

PsA can cause the affected joints to become painful, stiff, and swollen. The condition is different for everyone. Symptoms can range from mild to severe and can impact only a few or several joints.

There are 5 different subtypes of PsA. These are based off of the areas of the body that are affected as well as the severity of symptoms. A person with PsA can also have symptoms consistent with multiple subtypes of PsA.

In this article, we’ll outline the different subtypes of PsA, their symptoms, and how common they are. Then, we’ll cover how PsA is diagnosed and treated. Continue reading to discover more.

1. Asymmetric psoriatic arthritis

Asymmetric PsA impacts a joint or joints on one side of your body. Typically, less than 5 joints are impacted by this type of PsA. Asymmetric PsA is more common in people assigned male at birth.

The Arthritis Foundation notes that most of the time, PsA is asymmetric. It’s estimated that about 60 percent of individuals with PsA initially present with asymmetric PsA. But over time, this can progress to symmetric PsA.

Any joint in the body can be affected by asymmetric PsA. Some areas that are more commonly impacted are the:

• knee
• feet
• ends of the fingers and toes
• large joints

Symptoms

Symptoms of asymmetric PsA can be mild to severe and can include:

• joints that are:
  • tender or painful
  • swollen
  • warm to the touch
• reduced range of motion in the affected joints
• morning joint stiffness
• swelling and redness of the fingers or toes (dactylitis)
• swelling and pain where tendons and ligaments connect to bone (enthesitis)
• nail changes, like pitting, cracking, or separation from the nail bed
• itchy, scaly skin patches
• fatigue
• eye problems like redness and uveitis

The fact the asymmetric PsA only affects one side of the body can help to distinguish it from other types of arthritis, liker rheumatoid arthritis (RA).

2. Symmetric psoriatic arthritis

Symmetric PsA impacts five or more of the same joints on both sides of the body. While this type of PsA can occur in any joint, the small joints in the hands and feet are most commonly affected. Symmetric PsA is less common in larger joints.

The incidence of symmetric PsA is estimated to range from 15 to 61 percent. Symmetric PsA is more common in people assigned female at birth.

Symptoms

The symptoms of symmetric PsA are generally the same as those observed in asymmetric PsA. They can also range from mild to severe.

Because this type of PsA is symmetrical and mainly impacts small joints, it can often be mistaken for RA. But it’s generally milder than RA and blood tests for rheumatoid factor (RF) are almost always negative.

3. Distal interphalangeal predominant psoriatic arthritis

Distal interphalangeal (DIP) predominant PsA mainly affects the distal interphalangeal joint. This is the joint that’s closest to the ends of the fingers and toes.

In someone with DIP predominant PsA, it’s estimated that over 50 percent of all impacted joints are DIP joints. This type of PsA can be either symmetrical or asymmetrical and impacts about 10 percent of people with PsA.

Symptoms

In addition to other general symptoms of PsA, nail changes are very common in people with DIP predominant PsA. These can include nail pitting, nail cracking, and separation of the nail from the nail bed (onycholysis).

4. Spondylitis psoriatic arthritis

Spondylitis PsA mainly affects the joints between your spinal vertebrae. You may also see this type of PsA referred to as axial arthritis. It’s thought that spondylitis PsA is present in 7 to 32 percent of people with PsA.

Symptoms

In addition to other general symptoms of PsA, those with spondylitis PsA also experience pain, swelling, and stiffness in the neck and back, which can make movement very difficult.

Even though spondylitis PsA primarily impacts the spine, people with this type of PsA can also experience symptoms in other joints. These can include the:

• hips
• arms
• legs
• hands
• feet

5. Psoriatic arthritis mutilans

PsA mutilans is the most severe type of PsA. It’s rare and is estimated to impact about 5 percent of all people with PsA. The small joints of the hands, feet, and wrist are most often affected.

Symptoms

In PsA mutilans, inflammation is very severe, leading to significant damage to the affected joints. This can lead to symptoms like:

• deformities of the affected joint, which can be serious
• problems with movement and range of motion
• bone loss in the affected joint, which can lead to shortening of the fingers or toes

PsA mutilans can also impact other areas as well. People with this type of PsA may also experience pain in their neck and back.

How is psoriatic arthritis diagnosed?

Early diagnosis of PsA is vital. This is because starting treatment as early as possible can help to prevent further joint damage.

A doctor will typically use the following steps to diagnose PsA:

• Medical history: To get an idea of your medical history, a doctor will ask you a variety of questions, which can include:
  • When did you first notice your symptoms?
  • How would you describe the severity of your symptoms?
  • Is there anything that makes your symptoms better or worse?
  • Do you have a family history of psoriasis or PsA?
  • What medications or supplements are you currently taking?
• Physical examination: Next, your doctor will perform a physical examination. During this time, they’ll examine your joints for any signs of tenderness and swelling. They’ll also check for movement difficulties or nail changes.
• Blood tests: Blood tests for PsA look for signs of inflammation and can include tests like those for C-reactive protein (CRP) and rheumatoid factor (RF). A negative test for RF can help to rule out RA.
• Imaging: Imaging technology can help your doctor to evaluate your joints for signs of inflammation and damage. Examples of imaging techniques that may be used include X-ray and MRI.

How is psoriatic arthritis treated?

There are several potential treatment options for PsA. What’s involved in your specific treatment plan can depend on a variety of factors, including:

• the severity of your symptoms
• how many joints are impacted
• which joints are affected
• the extent of the damage in the affected joints
• your responses to previous treatments for PsA
• your overall health
• your personal preference

Medications

A variety of medications can be used in the treatment of PsA. Some examples include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are medications that can work to ease inflammation and pain in mild PsA. They’re available either over-the-counter or by prescription.
• Disease-modifying antirheumatic drugs (DMARDs): DMARDs are drugs that help to prevent mild to moderate PsA from getting worse. Examples of DMARDs include methotrexate, sulfasalazine, and apremilast (Otezla).
• Biologics: Biologics are a newer type of DMARD. They’re proteins that target specific parts of the inflammatory process. They may be used for more severe PsA or spondylitis PsA. Examples of biologics are adalimumab (Humira) and secukinumab (Cosentyx).
• Immunosuppressants: Immunosuppressants are drugs that dampen the activity of your immune system. Due to the availability of biologics, they’re not used as often. Examples include cyclosporine and azathioprine.
• Corticosteroids: Corticosteroids work to reduce inflammation. They can be given as a pill or an injection. Due to side effects, oral corticosteroids are taken at the lowest dose for the shortest amount of time possible.

Surgery

Surgery can sometimes be used for PsA. But this type of treatment is typically only recommended when PsA has caused joints to become severely damaged.

Exercise

Engaging in regular, low-impact exercises like walking and swimming can also help to keep joints healthy. Physical therapy may also be recommended to improve or maintain strength, flexibility, and range of motion.

What causes psoriatic arthritis?

PsA is an autoimmune disease. This is where the immune system mistakenly attacks healthy tissues, leading to inflammation and damage.

What exactly causes the immune system to behave this way in people with PsA isn’t clear. It’s believed that a complex combination of genetic and environmental influences may play a role.

About 33 to 50 percent of people with PsA have at least one close relative that has either psoriasis or PsA. Additionally, several genes associated with PsA have been identified.

Environmental factors that may contribute to the development of PsA include things like infections or physical trauma.

Takeaway

PsA is a condition that can affect some individuals with psoriasis. It can cause joint inflammation and pain ranging from mild to severe. The symptoms of PsA can also impact movement and quality of life.

There are 5 different subtypes of PsA. These are divided up based on factors like the affected area and symptom severity. It’s possible for an individual with PsA to experience symptoms that align with multiple subtypes of PsA.

A variety of treatments can help to ease PsA symptoms and slow the progression of the condition. An early diagnosis is important in preventing further joint damage. See a doctor as soon as possible if you’re experiencing symptoms of PsA.

https://www.healthline.com/health/psoriatic-arthritis/5-types-of-psoriatic-arthritis

New Research Says These Are the Foods You Should Avoid If You Have Psoriasis (and What You Should Eat Instead!)

From parade.com

Psoriasis is a chronic skin condition that causes thick, scaly red blotches that can be itchy, uncomfortable, and painful. While there’s no cure for the condition, what you eat can often help the condition. New research published in the Journal of Investigative Dermatology found that eating a more balanced diet can improve gut health and decrease skin inflammation.

The study, led by researchers at the University of California, Davis found that when people eat a typical “western diet,” rich in sugar and fat, it creates an imbalance in the gut microbiome and worsens inflammatory skin conditions, like psoriasis. When people with these conditions switched to healthy, balanced diets, it helped restore the gut’s health and reduced inflammation. 

“There’s a huge link between diet and inflammation,” says Dr. Amy Kassouf, MD, a dermatologist at Cleveland Clinic. “We definitely know that processed foods, simple sugars, things like that tend to be very pro-inflammatory. Natural foods, especially, all those good brightly coloured fruits and vegetables have a very anti-inflammatory effect.” 

If you have psoriasis, here’s a look at some of the foods you should avoid and which ones you should add more of to your diet. 

How does diet affect psoriasis?

A healthy diet may make psoriasis symptoms that impact your quality of life less severe, says Dr. Melissa Prest, DCN, a spokesperson for the Academy of Nutrition and Dietetics.

“A western-style diet is typically a pro-inflammatory diet that can negatively impact the symptoms of health conditions, like psoriasis,” she says. “Psoriasis is a chronic health condition that causes widespread and sustained inflammation in your body. Our diets should be helping to lessen inflammation not to create more of it.” 

People with psoriasis also have an increased risk for cardiovascular events, Dr. Kassouf says. Losing weight can often decrease the severity of psoriasis, enhance the effectiveness of psoriasis medications, lessen skin flare-ups, and reduce your risk for cardiovascular disease. 

“It’s very hard to cure your psoriasis with food alone,” she says. “Having said that generally speaking, diets that are very good for cardiovascular health are actually good for psoriasis as well.” 

What foods should you avoid if you have psoriasis?

Highly processed foods, such as hot dogs, chips, crackers, and baked goods, should be eaten less often if you have psoriasis, Dr. Prest says, “These foods are typically higher in unhealthy fats and are lower in fibre, vitamins, and minerals which can increase inflammation.” 

Dr. Prest emphasizes that it’s OK to eat “treat foods” occasionally, but they shouldn’t make up the bulk of your diet. 

Added sugars, saturated fats, trans fats, omega-6 fatty acids, and refined carbohydrates can also increase inflammation, according to Cleveland Clinic. Some research suggests that eating a gluten-free diet if you have psoriasis and a gluten sensitivity can lead to less psoriasis and reduce flare-ups. 

What foods should you eat more of?

Anti-inflammatory foods, like fruits, vegetables, plant-based proteins, fish, nuts, and seeds, should make up most of your diet if you have psoriasis, Prest says. 

“Make your plate plant-forward by filling at least half of it with fruits and vegetables and choosing a smaller portion of plant-based or lean animal-based protein,” she says. “Fruits and vegetables are nature’s anti-inflammatory agents because they are rich in antioxidants and phytochemicals.” 

Swap saturated and trans fat for healthier options, like olive oil, avocados, cold-water fish, soy, and nuts, she adds. Add vinegar, herbs, and spices in place of added salt, and go for the lower-fat dairy. 

The Mediterranean diet, which includes lots of fruits, vegetables, healthy fats, and lean meats, is anti-inflammatory and could lead to less psoriasis on the skin. 

Fruits, vegetables, and whole grains are also fibre-rich, and fibre helps feed your healthy gut bacteria, Dr. Prest says. Probiotics, including yogurt and fermented foods, and prebiotics, such as fruits and vegetables, also improve gut bacteria. Maintaining healthy gut bacteria reduces inflammation and can minimize symptoms of psoriasis.

If your diet hasn’t been as healthy as it should be, it’s never too late to make changes. Dr. Prest says making healthy diet changes could improve your psoriasis symptoms within a few weeks.

“Go slow with the changes and focus on changing one or two things at a time,” she says. “Once those changes have become a new sustained habit, make another change.  Going slow sets yourself up for successful permanent changes.” 

https://parade.com/1234194/ericasweeney/foods-to-avoid-with-psoriasis/

Managing Psoriasis Year-Round in Children: A Caregiver’s Guide

From healthline.com

If your child has psoriasis, you might notice changes in their symptoms depending on the season and the weather.

Shifts in temperature, humidity levels, and sunlight exposure can affect the condition of your child’s skin. And some psoriasis triggers are more common during certain times of year.

Psoriasis is a chronic condition that causes skin inflammation. The most common type is plaque psoriasis, which causes inflamed scaly patches of skin.

Read on to learn how psoriasis can vary by season and how you can limit your child’s symptoms year-round.

Psoriasis in children

According to the American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF), psoriasis affects about 1 percent of children.

If your child develops psoriasis, they may experience uncomfortable skin symptoms. They may feel self-conscious about these symptoms, which may affect their self-esteem and mental health.

Getting treatment and taking steps to avoid psoriasis triggers can help prevent flares, which are periods when psoriasis symptoms get worse. This may help improve your child’s quality of life.

Some common psoriasis triggers are more common in certain seasons than in others.

Psoriasis in the winter

Some people find their psoriasis symptoms get worse during the winter. This may be due to:

• cold temperatures
• low humidity levels
• low sunlight exposure

Cold, dry air may irritate your child’s skin and dry it out. This may increase inflammation and worsen psoriasis.

To keep your child’s skin well-moisturized during the winter, follow these tips:

• Stick with your child’s psoriasis treatment schedule.
• Regularly apply a fragrance-free moisturizing cream or lotion to your child’s skin.
• Limit their baths or showers to 10 minutes each. Use warm water instead of hot water, and choose a moisturizing cleanser instead of regular soap to avoid drying out their skin.
• Dress them in warm layers when they go outside to protect their skin from cold air. Choose soft fabrics like cotton or silk instead of wool. Remove wet clothing when they come in from the outdoors.
• Install a humidifier in their bedroom.

Your child’s skin will also be exposed to less sunlight during the winter, when daylight hours are shorter and children typically wear more clothing to protect against cold temperatures.

Some exposure to ultraviolet (UV) radiation in sunlight helps limit psoriasis symptoms in many kids. Less sunlight exposure may worsen your child’s psoriasis.

Depending on your child’s symptoms, a healthcare professional may prescribe phototherapy. In this treatment, the doctor will shine UV light on your child’s skin or prescribe a light unit for home use.

Psoriasis in the summer

You may find that your child’s psoriasis symptoms improve in the summer. This may be due to increased humidity and sunlight exposure.

Though UV radiation in sunlight may help improve your child’s psoriasis, too much UV radiation exposure can cause a sunburn. Sunburns raise your child’s risk of skin cancer.

They can also cause the Koebner phenomenon. This when new psoriasis plaques form on injured skin.

Heat and sweat can also trigger psoriasis symptoms.

To reduce the risk of sunburn and psoriasis flares:

• Choose a fragrance-free sunscreen made for sensitive skin, with a sun protection factor (SPF) of 30 or higher. Apply to your child’s skin before going outside and reapply liberally every 2 hours when you’re in the sun.
• Encourage your child to wear a broad-brimmed hat and lightweight long-sleeved shirts, long pants, and closed-toed shoes outdoors. Choose breathable fabrics like cotton.
• Limit the amount of the time your child spends outside in peak sunlight hours, from 10 a.m. to 4 p.m. Try to stay inside when it’s very hot outside, preferably in a room with a fan or air conditioning.

Bug bites and stings may also trigger the Koebner response and cause new psoriasis plaques to form.

To help prevent bug bites and stings:

• Apply insect repellent that contains 20 to 30 percent DEET to your child’s clothing and exposed skin. Apply sunscreen before repellent.
• If you’ll be out in the evening or night or hiking in wooded areas, encourage your child to wear a broad-brimmed hat and lightweight long-sleeved shirts, long pants, and closed-toed shoes.
• Limit the time your child spends outdoors during times when bugs are most active, including dawn and dusk.

Parents should always help children to apply topical products, including medications, sunscreen, and insect repellents. Store these products out of reach of your kids.

Some kids find that their psoriasis symptoms improve after they swim in salt water. Others find that their symptoms get worse after swimming, which can dry out the skin. (Closely supervise your child at all times when they’re near or in the water.)

If chlorine or salt water seems to trigger your child’s symptoms, consider limiting the time they spend in pools, hot tubs, or the ocean. Rinse and moisturize your child’s skin immediately after they swim to help keep it from drying out.

Psoriasis in the spring and fall

Research from 2015 suggests that many people find that their psoriasis symptoms are better in the spring and fall than in the winter but worse than in the summer.

If your child has allergies and eczema (atopic dermatitis), they may develop skin symptoms such as hives or an itchy rash triggered by exposure to allergens, such as pollen. Rubbing or scratching the skin may worsen psoriasis symptoms.

Depending on your child’s triggers, these symptoms may get worse during the spring or fall. Tree pollen levels are high in the spring, while ragweed pollen levels are high in the fall.

These tips may help reduce your child’s exposure to seasonal allergy triggers:

• If your child is allergic to pollen or mould, encourage them to stay indoors with the windows closed when pollen or mould counts are high outside.
• If you have an air conditioner or air heater in your home, use it. Install high-efficiency filters to help remove pollen, mould, and other allergens from the air.
• Encourage your child to change their clothes and take a short shower in lukewarm water after they’ve spent time outside and may have been exposed to pollen or mould.
• Regularly dust or clean your home to reduce allergens.

Your child’s doctor may also encourage them to take over-the-counter or prescription antihistamines.

Another fall psoriasis trigger may be back-to-school stress. Psychological stress can make psoriasis symptoms worse.

Encourage your child to talk about any stress they might be feeling and problem-solve strategies to manage stressful situations. Consider signing your child up for an after-school activity or sport they enjoy, which may help boost their mood and decrease stress.

The takeaway

You might notice that your child’s psoriasis symptoms get better or worse at certain times of year.

Changes in temperature, humidity, and sunlight exposure can affect your child’s skin and psoriasis symptoms. So can seasonal hazards such as sunburn, bug bites, seasonal allergens, and back-to-school stress.

It’s important to keep your child’s skin well moisturized. Take steps to protect their skin from damage and avoid triggers that seem to make their psoriasis worse.

https://www.healthline.com/health/psoriasis/managing-psoriasis-by-season-in-children

What to Know About Psoriatic Arthritis and Pregnancy

From verywellhealth.com

Fertility, Gestation, and Postpartum

Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints and the areas where tendons and ligaments connect to bone. Inflammation with PsA can lead to swelling, pain, and stiffness of the joints. Left untreated, PsA can cause permanent joint damage and disability. 

The decision to start a family is one of the most important decisions you and your partner will ever make. But when you have PsA, there is a lot to consider when making this decision.

The good news is that for most people, PsA shouldn’t get in the way of family planning. Keep reading to learn more about fertility, pregnancy, delivery, and beyond for people living with PsA.

Psoriatic Arthritis and Fertility

Fertility is defined as the ability to conceive and the ability to become pregnant from sexual intercourse.

There is no evidence that PsA affects fertility.

The latest research on PsA and fertility finds that people with PsA can get pregnant just as easily as people without the condition. Also, having PsA doesn’t affect the health of the unborn foetus.

A study reported in 2019 in the journal Clinical Rheumatology relied on questionnaires from 74 women with PsA and 74 without PsA. The women were asked if they were diagnosed with infertility in the past, the type of delivery they had, their newborn’s weight, whether their baby was full-term, and if there were pregnancy-related complications. 

From the information received and reviewed, researchers concluded that PsA did not affect fertility and that having the condition did not lead to worse pregnancy outcomes.

The study also found 58% of people with PsA had improved joint symptoms during pregnancy. Unfortunately, symptoms returned and worsened after delivery for many of the study participants.  

While a study like this one is very promising, you should still talk to the doctor who treats your PsA if you are considering getting pregnant or you have learned you are pregnant.

A physician will need to adjust your treatment because some medications used to treat PsA, like methotrexate, can be dangerous to the foetus.

Methotrexate and Cyclophosphamide

Methotrexate is discontinued three months prior to trying to conceive given that it is teratogenic to a fetus (can cause birth defects). It would also be discontinued immediately if you are found to be pregnant while taking it.

Cyclophosphamide also is extremely teratogenic to a fetus and would not be recommended if trying to conceive or if pregnant.

There has also been some evidence that some disease-modifying antirheumatic drugs (DMARDs), including cyclophosphamide and sulfasalazine, may reduce sperm quality. Fortunately, researchers believe the effect can be reversed by stopping those treatments.

There are other therapies for treating PsA, including many different disease-modifying drugs known as biologics, that will not affect male fertility.

Psoriatic Arthritis and Gestation

Gestation is the time between conception and birth. The foetus grows and develops in the womb (uterus) during this period. At this time, there are additional considerations for people with PsA, including those related to risks, treatment, and symptoms.  

Risks 

PsA on its own during pregnancy usually doesn’t have significant negative effects on the pregnancy or the unborn foetus. But studies on pregnancy outcomes in PsA are few and most of these are small in size or have conflicting results.

A 2019 Swedish study aimed to describe maternal pregnancy and infant outcomes in people with PsA compared to people without PsA. Researchers gathered information from national and population registries on individual pregnancies and compared outcomes.

They found the majority of pregnancies with PsA were uneventful, meaning there were no harmful outcomes. However, researchers did note an increased risk for preterm birth (being born before 37 weeks of pregnancy) and the need for caesarean section (C-section) deliveries compared to non-PsA pregnancies. 

Caesarean Section (C-section)

A C-section is a surgical procedure to deliver a baby by making incisions in the abdomen and uterus. C-sections are sometimes necessary when problems arise during pregnancy or delivery or for those who have had a C-section in the past.

Some research has found that PsA might be related to an increased risk for diabetes, hypertension (high blood pressure), and preeclampsia in pregnancy.

Preeclampsia a common pregnancy complication that causes high blood pressure and protein in the urine. It can affect the unborn fetus by reducing the amount of blood that flows through the placenta. 

Findings for a study reported in 2018 in Advances in Dermatology and Venereology revealed this connection. This study also confirmed an increased need for elective or emergency C-section deliveries and a higher risk for preterm birth or low birth weight. 

According to the study authors, many of these connections had never been previously reported. They further noted unhealthy lifestyle choices can also contribute to these negative effects in people with PsA and psoriasis.

The study did offer some good news, reporting that people with PsA and psoriasis can take steps to limit outside risk factors and thereby reduce their risk for negative outcomes in pregnancy. 

Psoriasis

Psoriasis is an autoimmune skin condition in which skin cells build up and form itchy, dry, and inflamed skin patches called plaques. A 2019 review of studies estimated that PsA affects about 25% of people who have psoriasis.

Treatments

If you are pregnant, the treatment of PsA must be tailored to your needs and those of your developing foetus. Most doctors will reduce the number of PsA medications you take and their dosages during pregnancy. Your doctor might also want you to stop taking certain drugs in favor of ones that are safer during pregnancy.

Among DMARDs, sulfasalazine and cyclosporine are considered safer than other PsA treatments. One study reported 74% of women who used sulfasalazine during pregnancy did not have an increase in birth defects, confirming prior studies. 

Prednisone is safe during pregnancy but dosing would be at the discretion of your healthcare professionals (ob-gyn or rheumatologist), depending on the severity of disease and the trimester you are in. 

The National Psoriasis Foundation released treatment guidelines in 2012 for people who are pregnant or breastfeeding. In this report, the foundation concluded that some systemic and biologic drugs should be avoided during pregnancy because those drugs are linked to birth defects and miscarriage.

Newer research seems to suggest the risk of biologics during pregnancy might be overestimated. A 2018 study in Annals of the Rheumatic Diseases reports that using biologics to treat autoimmune diseases during pregnancy does not appear to increase the risk for preterm birth or low birth weight.

Certolizumab is one of the safest TNF inhibitors (drugs that help stop inflammation) and is OK to continue during pregnancy. Your rheumatologist may consider holding off the use of others, such as Humira (adalimumab), during the last one to two months of pregnancy to limit transfer to the foetus. 

Biologics that target interleukin (IL) proteins, such as Kineret (anakinra), are used with caution since there is a lack of data regarding their risks for birth defects or miscarriage. Most healthcare professionals would advise you to discontinue these drugs during pregnancy.

Your rheumatologist and obstetrician are the best sources of information when it comes to pregnancy planning and pregnancy care with PsA. They can best advise on treatments for your PsA during your pregnancy based on your unique health situation.

Symptoms 

One study reported in 2017 in the journal Seminars in Arthritis and Rheumatism, looked at 42 pregnancies in 29 women with psoriatic arthritis. That study found PsA either improved or stayed stable in 58% of pregnancies. In about 88% of cases, skin symptoms improved or stayed stable. 

PsA worsened in 32% of the pregnancies. The remainder of the pregnancies had a mixed pattern of improvement that later got worse.

If your PsA worsens during pregnancy, you might see an increase in symptoms or increase in disease severity. Joint pain and swelling might be aggravated by the weight of your developing baby. 

You might also experience PsA pain and symptoms in your back and spine because of changes related to your growing belly. And since PsA and pregnancy both cause fatigue, it is not unusual for PsA fatigue to worsen during pregnancy. 

Prevalence of Psoriatic Arthritis During Pregnancy

According to a 2015 report in the Brazilian journal Annals of Dermatology, there are 107,000 deliveries performed annually on pregnant women with either psoriasis, PsA, or both.. Of these pregnancies, up to 15,000 people have moderate to severe disease.

Pregnancy can trigger PsA in people who have psoriasis. And up to 40% of people experience a new onset of PsA during the postpartum period.

Psoriatic Arthritis and Postpartum

Most people with PsA can have safe deliveries and healthy babies. They might experience worsening symptoms after delivery, but flare-ups can be addressed before they harm postpartum recovery. There are also some precautions you will want to take if you are planning to breastfeed your baby.

Postpartum

Postpartum refers to the period following childbirth. It begins immediately after childbirth, as the mother’s body, including hormone levels and uterus size, returns to its prepregnancy state.

Impact on Recovery 

If you notice your symptoms get worse after delivery, you should reach out to your rheumatologist. Research shows that many people with PsA will experience a flare-up in their disease after they give birth, although it may not happen right away. A flare-up is a time when PsA symptoms get worse. 

A study reported in 2019 in the journal Arthritis Care & Research found that disease activity in PsA worsened about six months after childbirth. In this study, Norwegian researchers followed 100 women with PsA and evaluated them at several points before, during, and after pregnancy.

Most people studied—around 75%—experienced remission (no disease activity) or low disease activity during pregnancy and right after. But six months after delivery, disease activity was significantly increased. 

The study’s authors concluded that while disease activity increased, there is no reason to assume that symptoms and disease activity cannot be managed or reduced. Talk to your doctor about updating your treatment plan and let your doctor know about disease changes and new symptoms, including back pain and stiffness. 

Impact on Breastfeeding 

There is a lack of research about medication safety during breastfeeding. You should talk to your rheumatologist, dermatologist, or other treating physician about how PsA therapies might affect breast milk. You should also avoid using topical treatments around your nipples so your baby doesn’t ingest these products.

When breastfeeding, the first-line (initial) therapies for psoriasis are limited to creams and low-potency corticosteroids. There are no known risks from topical treatments for a breastfeeding mother and the child. These treatments should be applied after breastfeeding and removed before breastfeeding.

Phototherapy, a second-line therapy for managing skin symptoms of PsA and psoriasis, is also believed to be safe while breastfeeding. But there are no studies to confirm this.

Systemic therapies like methotrexate for managing PsA might not be safe for use while breastfeeding. Studies on systemic therapies, including biologics, have found low or minimal concentrations of these drugs in breast milk.

But because there is no consistent data on how systemic therapies might pass through breast milk, your PsA treating physician is in the best position to give you advice on the safety of these drugs and the pros and cons of each treatment.

The decision as to how to treat PsA while you are breastfeeding is a personal one. Should you need treatment after you have a baby, work with your doctor to determine which treatment options might be best for your unique health situation.

Frequently Asked Questions 

How does pregnancy affect psoriatic arthritis symptoms? 

Pregnancy could mean a reprieve from your PsA joint and skin symptoms, although there is a chance your PsA could worsen or flare up during pregnancy. The condition tends to remain stable during pregnancy. However, worsening symptoms are also common after delivery.  

Does psoriatic arthritis affect how you can care for children? 

According to the National Psoriasis Foundation, PsA tends to occur in people between the ages of 30 and 50. This means that many of the people affected by PsA are just starting their families or are parenting young children. It is challenging to juggle your care needs with those of your child.

Working with your doctor to manage PsA symptoms is vital. Remember flares are temporary and there are ways to adjust routines and activities around PsA while still caring for your child. Staying healthy and on top of your care will not only help you manage your PsA, but it will set a good example for your little ones. 

How likely is it that your baby will inherit psoriatic arthritis?

There is a genetic component to psoriatic arthritis, so it is possible for a parent to pass the condition on to a child. While an inheritance pattern for PsA is unknown, up to 40% of people with PsA have a family member with either PsA or psoriasis. 

PsA is also linked to certain environmental triggers. For this reason, it is impossible to predict whether your child will have PsA later in life. And it is important to note that many people with PsA and other autoimmune diseases do have healthy babies that never go on to develop PsA, psoriasis, or another autoimmune disease.

Summary

Psoriatic arthritis does not affect your ability to become pregnant, although some drugs used to treat it may reduce sperm quality. Some studies have shown an increased risk for certain pregnancy complications.

People often have fewer PsA symptoms during pregnancy, although they are likely to return after delivery. If you are pregnant, the medications to treat PsA may be adjusted to reduce risks to the foetus. They may also need to be adjusted if you are breastfeeding.

A Word From Verywell 

Taking care of yourself before getting pregnant, while pregnant, and after your baby is born is important if you live with psoriatic arthritis. Make sure you are taking your medicines as prescribed and that you adjust to any changes your doctor may advise.

You can also cope by eating healthy, taking naps when your baby is napping, and getting help from your partner, family, friends, and even paid help so that you can better deal with the challenges that arise.

Being a parent is difficult, but parenting comes with many unique rewards as well. Taking good care of yourself and managing your PsA can help to ensure your ability to care for your child.

https://www.verywellhealth.com/psoriatic-arthritis-and-pregnancy-5191339

 

How to Explain Psoriasis to Your Child

From healthline.com

Psoriasis is a chronic condition that causes inflamed patches of skin. Experts don’t know exactly what causes psoriasis, but genetic and environmental factors play a role.

Most cases of psoriasis appear in adulthood, but the condition sometimes affects children.

If your child develops psoriasis, you can help them understand and manage the condition by:

• explaining it in simple terms
• answering their questions about it
• offering emotional support

Read on to learn more about psoriasis and get tips for talking with your child about it.

Psoriasis in kids

Psoriasis affects nearly 1 per cent of children, reports the American Academy of Dermatology (AAD) and National Psoriasis Foundation (NPF). It’s more common in older children than in younger children.

Plaque psoriasis is the most common type of psoriasis in children. It causes raised, scaly patches of skin known as plaques. These plaques may appear red, purple, or dark brown, depending on your child’s skin tone. The plaques may be itchy or uncomfortable.

Psoriasis is a visible and chronic illness that may affect not only your child’s physical health but also their emotional and social well-being.

“Children with psoriasis and chronic conditions are more likely to experience depressive and anxiety symptoms as well as painful, self-deprecating thoughts," Leela Magavi, MD, a board certified child and adolescent psychiatrist and regional medical director of Community Psychiatry in Southern California, told Healthline.

“They often experience low self-esteem and body image concerns and may feel ostracized and alone. Some children avoid social interaction and isolate themselves,” she said.

There’s no cure for psoriasis, but getting treatment can help limit symptoms and improve quality of life.

Depending on the type and severity of psoriasis that your child has, their doctor may prescribe:

• topical treatments, such as medicated ointments or creams
• phototherapy, also known as light therapy
• oral or injected medications

You can help your child cope with the condition by explaining psoriasis in terms they can understand and providing a safe space for them to talk about their concerns and feelings.

Your child may also benefit from joining a support group for children with chronic illness or speaking with a mental health professional who has experience working with kids with chronic illness.

Explaining psoriasis to your child

A psoriasis diagnosis may make a child feel confused or afraid. They may have questions or concerns about the condition and the treatments they will need.

Their diagnosis might also be overwhelming or upsetting to you as a caregiver.

Getting the facts about psoriasis can help you to manage the condition and ease fears.

“I advise parents and their children to learn about psoriasis together, as knowledge truly equates to power and helps them regain some sense of control,” said Magavi.

Here are some tips to help you explain psoriasis to your child while providing them with the emotional support they need to cope with the condition.

Be open and honest

Talking openly and honestly with your child about psoriasis can help them to:

• understand the condition
• learn what to expect from their treatment
• explore and express their feelings about it

“If we don’t talk about the illness and treat it like a taboo topic, we don’t establish the safety and security that children most desire so they can talk about their feelings. They may take your non-talking about it as a sign that something really bad is happening to them,” said Frank J. Sileo, PhD, a licensed psychologist in Ridgewood, New Jersey, and author of the book “When Your Child Has a Chronic Medical Illness: A Guide for the Parenting Journey.”

“And if we treat it like a taboo topic, they won’t have the words to discuss it when they may be responsible for handling the condition themselves,” he added.

Avoid setting up unrealistic expectations about psoriasis, including that psoriasis will go away. This may erode your child’s trust in you when they eventually learn the truth, suggests Magavi.

Instead, explain to your child that psoriasis is a lifelong condition that they can learn to manage with help from you and their healthcare team.

Keep it simple

Although it’s important to share the facts with your child, sharing everything at once may overwhelm them.

Start with the basics by focusing on information that helps your child understand their current experiences with psoriasis. When they ask a question, try to answer it without veering off topic.

“Small amounts of information allow your child to absorb what you’re saying to them and what they’re emotionally ready to hear,” Sileo told Healthline.

It’s also important to speak in simple age-appropriate terms that your child can understand.

Perhaps you could explain to your child that skin grows just like hair does. Because they have psoriasis, their skin grows much faster than other people’s skin. This can cause an itchy and uncomfortable build-up of skin in patches called plaques.

“Medical professionals often use jargon and words you’ve never heard of, which only increases anxiety,” said Sileo.

You can share more details about psoriasis with your child as they mature.

Use books and videos

A variety of kid-friendly media on psoriasis is available, including children’s books, comic books, and online videos. These resources may help you and your child explore psoriasis with words and pictures they can understand.

“Books and pictures can help explain psoriasis in an age-appropriate manner,” said Magavi.

Here are a few resources to get you started:

• I’m Just Like You: Children with Psoriasis, a YouTube video by the National Psoriasis Foundation (NPF)
• “Soria loves winter: For children with psoriasis,” a children’s book by Lyndie Michelle Dempsey
• “Joey’s Psoriasis: Explaining Psoriasis to Children,” a children’s book by William G. Bentrim
• School Resources, a resource by the NPF featuring free downloadable children’s e-books, a PowerPoint presentation explaining psoriasis to kids, and a parent’s guide to psoriasis in kids
• PsoTeen, a website for older children and teens by the Psoriasis Association

Show your child pictures of mentors or aspirational leaders who have psoriasis to normalize their experience. Or share books and documentaries created by children who also have psoriasis, Magavi suggests.

Sileo encourages caregivers to talk with children about the characters they encounter in books and videos on psoriasis. This may help kids reflect on their own experiences.

“When you read books with kids, it opens up a dialogue between you and them. They feel safe to talk about whatever is on their mind,” Sileo said.

Encourage questions

Encourage your child to share questions that they have about psoriasis.

If you don’t know the answer to a question, be honest. You can let your child know that you will do more research or ask their doctor the next time you see them.

As your child gets older, you may invite them to join you in researching the answers to their questions. Older children and adolescents can also take a more active role in their medical appointments and treatments.

“Children and adolescents feel more in control when they are engaged in their treatment,” said Magavi.

For example, you can suggest that your child ask questions during appointments, recommends Magavi. Help them write down these questions ahead of time, so they don’t forget to ask any when they’re on the spot. You might also try to see if your child can apply creams and ointments independently.

Gradually shifting responsibility for psoriasis treatments and medical appointments to your child will help them learn how to manage this condition throughout life.

Provide emotional support

In addition to sharing information and answering questions about psoriasis, offer your child comfort and reassurance.

“Our job as parents isn’t to take away the pain and prevent it from ever happening. Instead, it’s to be available to our children to provide emotional support, as well as keeping the door open for communication,” said Sileo. “We have to help our kids navigate the thoughts and emotions that occur when they learn that they have a chronic medical illness.”

Let your child know that they can speak with you about their feelings. You might want to make an emotions wheel together to help your child identify their feelings. Acknowledge their emotions and offer to help them brainstorm strategies to manage stressful situations or feelings.

Pay attention to not only their words but also their tone of voice, facial expressions, and body language. This may help you recognize when they’re feeling upset or worried.

Along with other emotions, some kids feel guilty or ashamed when they learn they have psoriasis. “I advise parents to remind their children that it is not their fault, as many children blame themselves,” said Magavi.

Reach out for help

“When they receive a diagnosis, people will go and get the best medical care. What often gets neglected is the mental health needs,” said Sileo.

To find more information and support to help your child cope with psoriasis:

• Visit the National Psoriasis Foundation’s website and explore their resources for parents and youth.
• Reach out to your child’s doctor or other members of their healthcare team with questions about psoriasis. Ask them if they can recommend some children’s books or other educational resources.
• Consider making an appointment with a mental health professional who has experience supporting children and families coping with chronic illnesses.

A mental health specialist can:

• help you or your child work through difficult emotions, self-esteem concerns, or other psychological issues associated with a psoriasis diagnosis
• help you or your child role-play through challenging situations or feelings
• problem-solve difficulties
• develop strategies for limiting stress.

Unacknowledged psychological stress can make psoriasis worse.

“Stress can exacerbate chronic conditions,” said Sileo. “Caregivers really need to look at the mental health aspects for kids and families.”

Mind your emotional needs, too

If you feel upset about your child’s psoriasis diagnosis, they may pick up on those feelings. For your sake and theirs, it’s important to address your own emotional needs.

“Children sense our feelings through our tone of voice and our body language, so we need to be really mindful of that and make sure that we engage in self-care,” said Sileo.

Try to take time for self-care, including stress-relieving activities that you enjoy.

If you feel frequently stressed, anxious, angry, or sad, let your doctor know. They may refer you to a mental health professional for counselling or other treatment.

Also be mindful of how you and your partner approach the topic with your child.

“We also need to be good co-pilots. If you’re in a relationship, whether you’re divorced or together, this is your child, and you need to work together collaboratively as a parental unit,” suggested Sileo.

The takeaway

Talking with your child about psoriasis can help them learn more about the condition, understand their experiences, and prepare for treatments.

It can also help them develop the words and skills they need to explain the condition to other people, navigate stressful situations, and express their own emotions.

Consider reaching out to your child’s doctor, a mental health professional, or a patient organization for guidance and support. They can help you and your child find resources and develop strategies to manage your family’s needs.

https://www.healthline.com/health/psoriasis/how-to-explain-psoriasis-to-your-child

Skin inflammation could indicate serious health problems. Here’s how to tamp it down

From wmleader.com

If you struggle with inflammatory skin conditions like eczema, rosacea or psoriasis, you know the many ways that inflammation can disrupt the skin. However, did you know that skin inflammation could also be an indicator of chronic inflammation throughout your body?

Inflammation, skin and overall health

Studies have long shown that inflammatory skin conditions may increase the risk of certain adverse health conditions. Researchers now believe that the gut-skin axis, connected by a delicate microbiome of living microorganisms, could be the reason for this link.

When the gastrointestinal barrier does not function properly, “holes” in the barrier allow pathogens to escape into the bloodstream. From there, those pathogens travel to the skin, where they disrupt the skin’s delicate microbiome and protective barrier.

Thus, inflammation that is triggered by a gastrointestinal problem such as inflammatory bowel disease could show up on the skin as red, itchy psoriasis.

Psoriasis has also been linked with an increased risk of prediabetes, characterized by tissue inflammation, as well as heart disease.

Similarly, the latest research shows eczema is commonly linked with autoimmune disorders of the skin, GI tract or connective tissue, pointing to another potential gut-skin connection.

How to reduce inflammation

An overwhelming body of research shows that inflammation throughout the body and skin is connected. But there are many things you can do to reduce chronic inflammation:

▪ Eat an anti-inflammatory diet. Anti-inflammatory foods and drinks include berries, walnuts, wild-caught salmon, avocados, green tea, turmeric and others. Avoid processed and fried foods, sugary drinks and sweets and trans fats.

▪ Use anti-inflammatory skincare ingredients. Anyone with sensitive skin and/or inflammatory skin conditions like eczema or rosacea can benefit from using anti-inflammatory skincare ingredients that are a match for their skin type. Some of the most common anti-inflammatory ingredients in skincare include argan oil, green tea, chamomile, aloe, colloidal oatmeal, feverfew and resveratrol.

▪ Exercise and maintain a healthy, stable weight. Just 20 minutes of exercise per day has been shown to have an anti-inflammatory effect on the entire body, reducing inflammatory fatty tissues and increasing the production of anti-inflammatory cells.

▪ Get enough sleep. Sleep plays an important role in regulating the immune system. Poor-quality sleep and sleep disturbances can trigger an inflammatory response, leading to chronic inflammation over time. Try turning off your electronic devices 30 minutes before bed to promote better sleep.

https://wmleader.com/general-other/91532/skin-inflammation-could-indicate-serious-health-problems-heres-how-to-tamp-it-down/

What causes a dry scalp, and how can you treat it?

From medicalnewstoday.com

People can have dry skin anywhere on their body, including the scalp. Although dry scalp and dandruff have similar symptoms, they have different causes and treatments

What is a dry scalp?

andriano_cz/Getty Images

People can have dry skin anywhere on the body, including the scalp. Dry skin occurs when the skin loses water too quickly.

A person with dry skin on the scalp may notice:

• patches of itchy or scaly skin
• flaky skin with a rough texture
• skin that stings or burns
• peeling skin
• itchy skin

There are many potential causes of dry skin, such as low humidity or indoor heating. In fact, the American Skin Association notes that dry skin is not usually anything to worry about.

Sometimes, however, an underlying skin condition might be the cause of a dry scalp. When this is the case, a person might need medical treatment.

The American Academy of Dermatology (AAD) says that some people are more at risk of dry skin than others. These people include:

• those over 40 years of age
• those with brown, black, or fair skin
• those with jobs that involve their hands being in water a lot, such as nurses and hairdressers
• those who live in cold climates
• those who smoke

Causes

Lots of different things can lead to dry skin and a dry scalp. Some examples include:

• not drinking enough water
• using harsh cleaning products
• taking long, hot showers or baths
• living in cold, dry conditions
• using artificial heat sources, such as central heating and wood-burning stoves, that dry out the air.

Sometimes, underlying health conditions can also lead to a dry scalp. These might include the following.

Atopic dermatitis

Atopic dermatitis is the most common form of eczema.

In children, atopic dermatitis causes dry, itchy rashes anywhere on the body. In adults, rashes are less common, and a person may have skin that is extremely dry and easily irritated.

Contact dermatitis

Contact dermatitis, which is another form of eczema, happens when the skin has an allergic reaction to something it comes into contact with.

On the scalp, hair care products, hair dye, and hair accessories can all lead to contact dermatitis. Contact dermatitis can cause itching and burning or blistering of the skin.

Scalp psoriasis

Around 50% of people with psoriasis experience flare-ups on the scalp. A person may also experience:

• patches of skin that are violet or purple on black skin or red on white skin
• dandruff-like flaking
• a dry scalp
• itching that can range from mild to intense

Treatment

The best treatment for a dry scalp will depend on what is causing it.

In many cases, making healthy lifestyle choices will help. Some examples include:

• drinking plenty of water
• getting enough sleep
• avoiding caffeine and alcohol, which can dry out the skin
• avoiding certain heat sources, such as central heating and log fires
• not using harsh hair products and shampoos

Other causes may need additional treatment. If contact dermatitis is the cause, a person may require corticosteroids.

Treatments for other medical conditions that can cause a dry scalp include the following.

Atopic dermatitis

Doctors recommend that people with atopic dermatitis avoid triggers, or things that make the condition worse. Triggers are different for everyone, but some common ones include:

• stress
• sweat
• soaps and detergents
• hair care products

Sometimes, people may need medical treatment. Doctors might recommend special shampoos or biologic medications that help control the immune system.

Psoriasis

Over-the-counter products can sometimes help treat scalp psoriasis.

According to the National Psoriasis Foundation, people should try to look for shampoos that contain salicylic acid or coal tar.

In more severe cases, doctors might recommend phototherapy, which uses UV light to slow skin cell growth, or biologic drugs, which help control the inflammation.

How is it different from dandruff?

Dandruff is a common skin condition. It causes grey or white flakes of skin to appear on the scalp and in the hair.

Dandruff only affects the scalp, but people with a dry scalp tend to experience dry skin on other parts of the body as well.

According to the AAD, researchers are unsure of the exact cause of dandruff. However, it may be the result of other skin conditions, such as:

• seborrheic dermatitis, which is a skin condition that mainly affects the scalp
• tinea capitis, or ringworm, which is a fungal skin infection
• eczema
• contact dermatitis, which is a rash that occurs due to contact with an irritant or allergen
• psoriasis, which is a condition that causes skin cells to build up and form scales on the skin
• cradle cap, which is a skin condition that may result from excessive oil production by the glands that surround the hair follicles

The above conditions can also lead to dry skin on the scalp.

A person can use medicated shampoos to treat dandruff.

Prevention

There are lots of things that people can do to help prevent developing dry skin on the scalp. These include:

• washing their hair in warm, rather than hot, water
• only using gentle, fragrance-free hair cleaning products
• avoid sitting or standing close to certain heat sources, such as fireplaces
• avoid using products that irritate the scalp, such as hair dyes or hair accessories
• drinking plenty of water.

When to contact a doctor

Anyone who suspects that they have an underlying skin condition should talk with a doctor. This is especially true if the symptoms are interfering with their everyday life.

The doctor will assess the person’s skin and recommend the best treatment or course of action for them.

Summary

A person with a dry scalp may experience itching and flaking skin. Although it may look like dandruff, a dry scalp is different. The two conditions have different causes and different treatments.

Many dry scalp cases resolve on their own with a few lifestyle changes. These changes include drinking plenty of water and avoiding harsh shampoos and hair care products.

Sometimes, a dry scalp may be a symptom of an underlying skin condition. When this is the case, a person can talk with a doctor. They will be able to assess the skin and recommend the best course of action.

https://www.medicalnewstoday.com/articles/dry-scalp