Sunday 26 December 2021

How to Wear Makeup (Even With Psoriasis)

From healthcentral.com

For your next night out, try these skin-sensitive products and expert ideas 

PSORIASIS CAN BE tricky to deal with, especially if you’re a makeup lover. But that doesn’t mean lipstick, blush, and foundation are a no-go. In fact, some dermatologists say that makeup products and their ingredients are well-tolerated amongst people with psoriasis. For people with suspected psoriasis, patch testing products on the skin prior to regular use can help determine a person’s sensitivity to a product. However, some makeup can contain harmful ingredients that aggravate the skin and it’s important to know the difference. To keep irritated skin and psoriatic flares at bay, experts recommend the following makeup tips and products.

Makeup Ingredients to Avoid

While people with psoriasis tend to tolerate most makeup products and ingredients, reactions happen and vary on an individual basis. As a rule of thumb, Rachel Nazarian, M.D., a dermatologist in New York City and faculty member in the department of dermatology at Mount Sinai Medical Center, recommends avoiding alcohol-based products when possible because they tend to trigger a negative reaction. It “can dry skin out and worsen flaking and redness,” says Dr. Nazarian. If alcohol is in the ingredient list, it might also be labelled as “isopropyl alcohol,” or “ethanol,” she adds.

Also, steer clear of makeup made with abrasive ingredients like glitter (as pretty as it can be). According to Dr. Nazarian, these components can create skin irritation and trigger worsening of the psoriasis flare or can induce new lesions to form. Instead, Dr. Nazarian suggests looking for light powders that reflect shine, like Nars Light Reflecting Pressed Powder.

Fragrances, which are often packed with alcohol, can irritate skin, too. If you have products that contain fragrance (news flash: some foundations, blushes, and eyeshadows contain fragrance), Erum N. IIyas, M.D., a dermatologist at Schweiger Dermatology in Philadelphia, says to avoid using them on inflamed, open, or cracked skin. “Applying fragrance-containing products can be a bit uncomfortable if applied to open areas,” says Dr. Iiyas.

On the other hand, some products that contain natural fragrances like essential oils may help with psoriasis, including lavender oil. Research shows that topical application of lavender oil improved psoriasis severity by 73%.


putting on blush

Makeup Ingredients to Embrace

Because psoriasis causes redness and scaling, it can be difficult to conceal, especially with plaques (the raised, inflamed, and patchy areas of skin that are tell-tale for psoriasis). To combat this, Dr. Nazarian recommends adding products to your makeup regimen that provide full-coverage and have a hydrating element, such as dimethicone, which retains water and butylene glycol, a humectant and emollient that draws water to the skin. The CoverFX Foundation has both of those ingredients.

Moisturizing makeup kills two birds with one stone by hydrating the skin while providing medium to full coverage to conceal patchy areas. That’s why Dermablend products and the Tarte Shape Tape concealer come highly recommended by Dr. IIyas because they “provide excellent coverage and camouflage.”

Another thing to stock your makeup cabinet with: Products that contain natural oils like coconut and olive oils. “They are often anti-inflammatory and can decrease the irritation and redness associated with psoriasis flares,” says Dr. Nazarian. “Also, natural oils often soften and decrease the white scales of psoriasis which can make people self-conscious.”

To conceal inflamed flares, use concealer with green-ish undertones because it will “off-set the redness of psoriasis," she says. "This is a great trick to camouflage plaques.”

Application and Removal Tips

To apply your makeup, Dr. IIyas suggests using clean fingers or tools that are gentle on the skin, like cotton rounds, sponges, a beauty blender, or soft bristle brushes. These work best on psoriatic skin, says Dr. Nazarian, because they won’t irritate the plaques like some products that have rough or abrasive edges like cleaning brushes, beaded scrubs, exfoliating gloves, and apricot, walnut, or sugar scrubs.

Okay, so you have a big night planned and would like to wear makeup but noticed a flareup forming or a plaque spreading. What do you do? For starters, don’t stress! Next, reach for ointment-based or cream-based formulas, such as L’OrĂ©al’s True Match Lumi Glotion. “[They] apply more elegantly to psoriatic plagues,” says Dr. Nazarian. “And avoid powder-based products that can look caked-on and enhance flaking.”

When you notice flares in areas where makeup has been applied, consider switching to a different type of applicator to see if that reduces the irritation. Dr. IIyas underscores that “understanding the role of friction and irritation in the Koebnerization of psoriasis can help patients gain a better understanding of their disease.”

The Koebner phenomenon is described as the appearance of new skin lesions on parts of the body that do not typically have psoriasis. Because some makeup products can cause irritation, it can initiate a Koebner response.

As for makeup removers, avoid excess use of makeup removers as they can irritate the skin, says Dr. IIyum. Instead of scrubbing, people can gently massage a foaming cleanser into the face and rinse off with lukewarm water.

People with psoriasis can enjoy all kinds of makeup but being aware of the composition of products can prevent the exacerbation of the condition.

“Another important thing for patients with psoriasis to understand is that there are excellent effective treatment options available [that make wearing makeup easier],” says Dr. IIyas. “Talk to your dermatologist about these options that can reduce the need for makeup to conceal the plaques in the first place.”

https://www.healthcentral.com/article/psoriasis-makeup-tips

Wednesday 22 December 2021

Treatment Options for Psoriasis

From healthline.com

Plaque psoriasis is the most common type of psoriasis. It causes thick and itchy patches of dead skin cells called plaques to form on your skin.

Treatment for plaque psoriasis depends on how severe your psoriasis is and how well your body responds to certain treatment types. Treatments for psoriasis generally fall into one of three groups:

  • Topical treatments. Topical treatments are medicated creams, ointments, shampoos, and other products you put directly on your skin. Most mild to moderate cases of psoriasis are treated with some type of tropical cream.
  • Systemic treatments. Systemic treatments can be either medications you take by mouth that work to slow down how fast your body makes skin cells or injected biologics that work to reduce inflammation in your body.
  • Phototherapy treatments. Phototherapy treatments expose your skin to controlled ultraviolet light to help heal plaque patches.

Different combinations of these treatments — or different treatments entirely — might be used to treat different types of psoriasis. 

The type of psoriasis you have will help determine the right treatment for you. For example, scalp psoriasis can be treated with topical, systemic, and phototherapy treatments, but topical therapy will include medicated shampoos.

Other psoriasis types with specific treatments include:

  • Nail psoriasis. Nail psoriasis is treated with topical, systemic, and phototherapy treatments. Treatments are often applied in specific ways to treat nail psoriasis. For example, corticosteroids can be injected under the nails to reduce inflammation.
  • Psoriatic arthritis. Psoriatic arthritis is treated by managing pain and keeping arthritis from spreading. This might include medications such as nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids, and disease modifying anti-rheumatic drugs (DMARDS), well as physical therapy and lifestyle modifications. Sometimes, surgery is needed to correct painful joints.
  • Guttate psoriasis. Guttate psoriasis sometimes clears up on its own. When it doesn’t, it’s often treated with phototherapy and oral systemic medications. Severe cases might be treated with injected biologic treatments.
  • Inverse psoriasis. Inverse psoriasis s generally treated with topical creams. You might also be prescribed a cream or oral medication to help prevent yeast and fungal infections from developing in skin folds. In some severe cases, oral systemic medications might be needed.
  • Pustular psoriasis. The treatment for pustular psoriasis will depend on the severity and type of pustular psoriasis. Topical, phototherapy, and systemic treatments are all used to treat pustular psoriasis. Combinations of all three types of treatments might be used in moderate to severe cases.
  • Erythrodermic psoriasis. Erythrodermic psoriasis is a medical emergency. The first treatment goal will be stabilizing your body temperature and vital signs. Topical and other treatments are discussed once your erythrodermic symptoms have cleared up.

Some people have found success with natural remedies for psoriasis. For example:

  • The National Psoriasis Foundation reports that some herbs, including evening primrose oil, fish oil, vitamin D, aloe vera, milk thistle, and Oregon grape can help reduce the symptoms of psoriasis.
  • Getting a massage can help improve your circulation and help you relax, leading to a reduction of psoriasis symptoms.
  • Staying moisturised is a great way to help manage plaque psoriasis and keep your skin healthy.
  • Using apple cider vinegar or Epsom salts can help soothe plaque patches and might help them clear up faster.

Check with your doctor before starting any natural treatments.

There’s not a specific diet for psoriasis. However, some studies show that maintaining a moderate weight can help reduce your symptoms and avoid flare-ups.Trusted Soushow that maintaining a moderate weight can help reduce your symptoms and avoid flare-ups.

Additionally, some foods are known to be anti-inflammatory. Adding them to your diet can help reduce the overall inflammation in your body and manage your psoriasis.

Anti-inflammatory foods include:

  • fish
  • nuts
  • peppers
  • dark chocolate
  • whole grains
  • berries
  • leafy green vegetables

Finally, avoiding alcohol might be a good idea for people with psoriasis. It can trigger and cause psoriasis outbreaks for many people. There’s also some evidence, according to research published in 2015, to show it might be linked to an overall higher risk of psoriasis.

Your treatment plan for psoriasis will depend on:

  • the severity of your psoriasis
  • the type of psoriasis you have
  • how well you respond to treatments

There are multiple treatment options, but most types of psoriasis are treated with topical, phototherapy, or systemic treatments. Sometimes combinations of treatments from each category are used.

Lifestyle routines such as eating a nutrient-rich diet and keeping your skin moisturized can also help manage your symptoms.

https://www.healthline.com/health/psoriasis/psoriasis-treatment?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2021-12-21&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e

 

Sunday 19 December 2021

SKINCARE: Winter proofing

From telegraphindia.com

By Dr. Ishad Aggarwal

Give your skin the care it deserves as the mercury drops


Winter is an exciting time but with all the merriment come skin woes — dryness, itching, weeping eczema and a lot of other problems. There are certain skin-related diseases that tend to get worse during winter — psoriasis, atopic dermatitis, eczema and rosacea. If you are already suffering from these conditions, it would do you good to visit your dermatologist as soon as you experience a flare-up, instead of home remedies and self-medication.

Steps to avoid flare-ups

• Moisturise your skin well: If you have sensitive, eczema-prone skin, make sure you are using bland, fragrance- and paraben-free moisturisers, containing ceramides and natural moisturisation factors. If you suffer from psoriasis, you may want to increase the frequency of moisturisation.

• Avoid direct contact of woollens with your skin: While we love to wear coats and sweaters, if wool comes directly in touch with your skin, it can irritate, especially if you have sensitive skin. Wearing cotton clothes underneath your woollens helps prevent skin irritation.

• Avoid harsh soaps: Use fragrance-free bland soaps containing syndet if you have skin diseases such as eczema and atopic dermatitis.

• Maintain personal hygiene: Certain infectious diseases of the skin worsen during winters, such as fungal infections (like ringworm) and scabies. Personal hygiene plays an important role and daily baths are important to prevent skin infections.

• Use lukewarm water if you have sensitive skin: Avoid very cold or very hot water.

• Use humidifiers: Your skin can rapidly become dry in winters, especially if you are indoors and use a heating device. If you have sensitive, eczema-prone skin, use humidifiers to keep your skin calm and moist.

Winter skincare routines

Skincare routines can be confusing for most people. To find that perfect routine, perfect products that fit your budget and busy schedules can be a daunting task. Even people with the most well-behaved skin can face problems during winter. You can get a rash, redness, breakouts and you may suddenly see flakes of dandruff on your clothes. The most common reason for the problems is a change in skin barrier, which is a very important component of our skin. It protects our skin from environmental insults. When this barrier gets disrupted, our skin reacts and gets inflamed, which we see as rash, breakouts and redness.


Follow these tips and make adjustments in your skincare routine to prevent winter woes:

 Cleansers: Avoid harsh cleansers. You may want to get rid of cleansers containing alpha hydroxy acids and beta hydroxy acids altogether in winter. Use gentle cleansing products.

• Say ‘no’ to toners: You read it right. Ditch the CTM. Most toners are astringents and will end up drying out your skin to the point that it can become irritable.

• Moisturisers: If you want to maintain your skin’s barrier function you will need to moisturise, even if you have extremely oily or acne-prone skin. If you have very dry skin, choose thick moisturisers containing shea butter, mango butter and cocoa butter. If you have oily or combination skin, use light gel- or water-based moisturisers. If you are prone to cracked feet, use moisturisers that contain urea. Use moisturisers frequently, as many times as you need it.

• Sunscreen: Our exposure to the sun can be very high during winter because of so many outdoor activities during the day. Always load your skin with SPF every two-three hours.

• Make-up: Always take time to prep your skin before applying make-up. It can make your skin very dry and dehydrated. Ensure that you use moisturiser or primer before applying make-up and that you remove it thoroughly before sleeping. Always moisturise after removing make-up.

• Try to reduce active ingredients such as AHA, BHA, retinol in your night routine. You don’t have to give them up altogether but you definitely have to reduce the frequency and contact time. Do consult your dermatologist and ask her to guide you on how to use these products.

Winter haircare

• Dandruff can be a big problem during winter: Wash your hair with anti-dandruff shampoo or a prescription-based product. But remember to read the label on the shampoo bottle and use them as directed for maximum benefits. A common mistake people make is that they don’t rub the shampoo into the scalp for long enough.

• Always use conditioners: After shampooing, apply a conditioner to ensure manageable hair.

Skin treatments for winter

• HydraFacial: One of the most popular treatments globally, it incorporates comprehensive skin cleansing and infusion to make it healthy, clean and radiant. It’s best suited for winter because the products used are mild and not heavily exfoliating.

• Skin boosters: Hyaluronic acid is a natural polymer present in our skin. It has the ability to bind water and make skin supple and hydrated. Skin boosters containing hyaluronic acid are injected into the skin to hydrate it, resulting in fewer wrinkles and smoother, well-textured skin.

• Enzyme peels and laser toning: As a rule, we avoid harsh chemical peels and strong lasers during winter. But soft enzyme peels and gentle laser toning with Qs-ND YAG lasers can be very rewarding in winters to make skin even-toned with less pigmentation.

• Vampire facials: PRP facials or vampire facials involve collection of one’s own growth factors from their blood. These growth factors are concentrated and then infused in the skin. These natural growth factors generate collagen in the skin and hydrate it to make it look younger and more supple.

https://www.telegraphindia.com/my-kolkata/people/winter-proofing-give-your-skin-the-care-it-needs-when-the-mercury-drops/cid/1843886

Monday 13 December 2021

Psoriasis: Causes, treatments and why you can learn to live with it

From jpost.com

This skin disease isn’t contagious or dangerous. So, why is everyone afraid of it?


Psoriasis is a very common disease, which can suddenly break out at any age. Dr. Hagit Metz from Tel Aviv Sourasky Medical Centre in Tel Aviv was hosted on a podcast by a specialist clinic and explained why most people diagnosed with psoriasis are certain that their world has been destroyed, and also how one can live in peace with this annoying disease.

Psoriasis is a disease that is complex to deal with. It's itchy and annoying, and often causes great embarrassment among those who suffer from it. Dr. Hagit Metz, director of the Psoriasis and Phototherapy Clinic at Ichilov Dermatology Clinic, was a guest on the "Expert Clinic" podcast to explain how to live with this chronic disease, how to treat it, and why people are so afraid of it.

Psoriasis is a chronic inflammatory skin disease, which Metz says is very common (affects hundreds of thousands of Israelis) and can develop at any age.  It’s manifested by lesions throughout the body, most often in the elbows, scalp and knees, with coarse white scales. Metz stated that “it is a very bothersome disease.” 

She added that psoriasis can either “not itch at all or itch very much and interfere greatly with daily life."

Psoriasis is caused by a change in genes, meaning by a sudden disruption in the functioning of the immune system. “It doesn’t mean that your mom or dad had it,” Metz said.

However, "If one parent has psoriasis, it increases the risk by 15%. And if both parents have it, the chance of you developing it is almost 70%."

Is there a way to cure psoriasis?

The treatment of psoriasis ranges from ointments, in mild cases, from phototherapy treatments to biological treatments. 

In this context, Metz explained that what helps patients who visit the Dead Sea is not the mud or the salt, but rather the sun and to enjoy the benefits of the unique rays of the Dead Sea, you have to stay there for two weeks.

Why do people react so hard to being diagnosed with psoriasis?

As mentioned, psoriasis can develop at any age, but it usually happens in the fourth or fifth decade of life. Metz said in the podcast that people react very badly to being diagnosed with this skin disease. 
"Skin disease is something that is very bothersome, and a lot of times people come to me to calm down,” she said. 
Metz added that dermatologists must understand that even though they see a lot of people with psoriasis, and may not be excited about it, people must understand that the source of psoriasis isn’t known, and that as you learn to understand the chronic nature of this disease, you start imagining all sorts of things. People open up Google and see the most horrible images."

However, it’s important to remember that most psoriasis patients suffer from only a mild illness. 

"There is a solution, most patients will not develop a terrible disease," she said. "You can live with psoriasis. It isn’t a contagious disease and we have a solution today for anyone who has psoriasis - mild to severe.”


 

Tuesday 7 December 2021

Ask the Expert: How Does Psoriasis Affect Women Differently Than Men?

From healthline.com

By Sara Perkins

Sex and gender exist on spectrums. This article will generally use the terms “men” and “women” to refer to a person’s sex assigned at birth. 

Psoriasis is a common inflammatory skin condition that, though estimates vary, affects roughly 0.5% to 5% of the world population. While every individual is unique, generally speaking, psoriasis can affect men and women differently.

According to a 2006 research review, most studies have suggested that psoriasis may be slightly more common in men, though the onset of disease may be earlier in women. For women, the average age of onset of psoriasis is in the late 20s, which can coincide with reproductive years (more on this below).

Data suggests that men may have more severe disease, but according to a 2019 review, several studies have shown that women experience a significantly higher burden from their psoriasis in terms of quality of life and perceived stigmatization.

Women with psoriasis are more likely to experience decreased happiness and increased stress and loneliness than men with the condition.

There have also been increasing reports on the associations between psoriasis and many other conditions, including:

  • cancers
  • heart disease
  • obesity
  • autoimmune disease
  • psoriatic arthritis

One 2019 studyTrusted Source suggested that women with psoriasis were more likely to experience metabolic syndrome (when several risk factors occur together and increase your risk of conditions like diabetes and heart disease) than men with psoriasis.

Finally, while biologic therapies have revolutionized the management of psoriasis, women may be more likely to experience treatment limiting side effects, per a 2016 studyTrusted Source.

Skin conditions are not hidden — everyone can see them. People who have psoriasis may feel embarrassed by the appearance of the rash or note having to change clothing due to the constant flaking. Having psoriasis in highly visible locations, like the backs of the hands, can be particularly challenging.

Many people feel that others worry that their skin condition may be contagious. In administered questionnaires, people with psoriasis noted concerns about rejection, feelings of being flawed, and sensitivity to the opinions of others.

Those with psoriasis, particularly women, often feel self-conscious about their skin and fear rejection.

Psoriasis can involve many different areas of the skin, including genital skin and the gluteal cleft. A substantial portion of people who have psoriasis will experience genital involvement at some point.

This can impact sexual function. Women are more likely than men to note a decrease in sexual activity after being diagnosed with psoriasis, according to the National Psoriasis Foundation. 

Patients should discuss psoriasis with their partner whenever they feel comfortable. They can feel empowered knowing that it’s common, not contagious, and treatable.

In general, psoriasis is not thought to impact fertility. However, women with psoriasis, particularly severe psoriasis, do have slightly lower rates of pregnancy for reasons that are unclear and likely multifactorial.

The majority of women note either an improvement or no change in their skin during pregnancy. A small subset of women do experience worsening symptoms, though.

Importantly, pregnancy and lactation have implications in terms of treatment options. Many treatments are very safe throughout pregnancy and nursing, but some could result in harm to the unborn or newborn baby.

Women with psoriasis should always discuss plans for pregnancy and nursing with their doctor.

Many people with psoriasis feel that stress impacts their skin, though proving this can be challenging and studies have had mixed results.

This represents a unique challenge for women who, as detailed above, experience more stress from their psoriasis. This can potentially lead to a cycle of stress worsening psoriasis and psoriasis worsening stress.

Mental health and self-care are important for everyone, including those with psoriasis.

I advocate for a healthy, balanced lifestyle for anyone who has psoriasis, for reasons that extend beyond their skin condition.

Alcohol use may be both a risk factor for development and a consequence of having psoriasis. It’s also been shown to be a risk factor for worsening disease, treatment failure, and overall mortality.

Both obesity and smoking may be associated with the development of psoriasis, and this has been shown more for woman than for men.

Importantly, there is no diet that will cure or prevent psoriasis. However, since those with psoriasis have increased risk of cardiovascular disease, diabetes, and fatty liver disease, I do recommend diets that minimize high-glycaemic index and processed foods.

Dermatologists have so many treatment options for psoriasis. Options range from topical therapies and light therapy to pills and injectable medications.

For many, psoriasis is a chronic condition that waxes and wanes over time. Appropriate treatment can both resolve current flares and prevent future ones. Success rates in clearing the skin, particularly with newer agents, are impressively high.

Studies have shown that effective treatment can improve or stabilize the effects of psoriasis on quality of life. I strongly encourage anyone dealing with psoriasis to talk with a dermatologist regarding treatment recommendations.

Many people who have psoriasis find that lighter coloured clothing is less likely to show flaking than darker coloured clothing.

Medicated shampoos, like Neutrogena T-sal shampoo, can help to reduce flaking in the scalp.

Regular use of moisturizers can also help with the appearance of redness and flaking, and they can decrease the itching that some people with psoriasis experience.

Nail psoriasis can be particularly challenging and often requires systemic treatment (pills or injections). Minimizing trauma to the nails is important to prevent worsening.

The NPF has excellent resources and support groups for people managing with this condition.

Dr. Sara Perkins is an ABMS board certified dermatologist at Yale Medicine in Connecticut who practices general medical dermatology and has special interests in skin cancer prevention, screening, and treatment. She especially enjoys helping patients diagnosed with an aggressive form of skin cancer, melanoma, and addressing other skin-related dermatologic concerns that can result from too much sun exposure. Perkins is also an instructor of dermatology at Yale School of Medicine.

https://www.healthline.com/health/psoriasis/psoriasis-in-women?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2021-12-07&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e

Thursday 2 December 2021

Is There a Psoriasis Diet That Helps Manage Symptoms?

From self.com

Here’s what experts know about how food impacts psoriasis 

Living with a chronic condition like psoriasis affects your life in so many ways that go beyond your daily skin-care routine. Psoriasis is an autoimmune disease, meaning your immune system goes a bit haywire and mistakenly makes too many skin cells without shedding them as they pile up. As a result, psoriasis causes inflamed skin patches or plaques, which can be painful, itchy, flaky, and really frustrating to deal with.

Although there is absolutely no reason to feel bad about having a medical condition that can be so out of your control, some people may feel self-conscious about their psoriasis, since the plaques can appear in very visible areas, like the knees, elbows, and chest.

It’s common to encounter periods of worsening symptoms for days, weeks, or even months, which are called flare-ups. After your first psoriasis “outbreak,” there are a number of things that can trigger these flare-ups, which vary widely from person to person. This can include everything from stress to dry weather to an infection.

As with many other chronic conditions, there’s also the question of whether or not the foods you eat can play a role in triggering or easing psoriasis symptoms. Unfortunately, the answer isn’t so simple, but researchers are actively investigating the link between diet and psoriasis. There’s still a lot to learn, but here’s what experts know so far.

First, what are some common psoriasis triggers?

Psoriasis flare-ups are typically triggered by environmental or internal factors. It’s not clear why, but encountering one of your personal triggers can alert your immune system to kick off the early stages of the psoriasis process. According to the American Academy of Dermatology (AAD), this can include the following:

  • Drinking at least two alcoholic beverages daily
  • Smoking cigarettes
  • Skin injuries, like a cut, bruise, or bug bite
  • Infections, like strep throat or bronchitis
  • Taking certain medications
  • Having overly dry skin due to cold weather, a sunburn, or spending too much time in air conditioning

Since there are so many things that can trigger symptoms, it’s only natural to wonder whether there are any diets for psoriasis that can help with symptoms.

Can your diet affect psoriasis symptoms?

The causes of psoriasis might feel obscure, “so thinking that it might be something in the diet has some appeal," Steven Feldman, M.D., professor of dermatology at Wake Forest University School of Medicine in North Carolina, tells SELF. “There is also some scientific evidence that diet can affect inflammation in the body, and psoriasis is an inflammatory condition, so it makes sense to think the diet might have some effect.”

But science hasn’t solidified a connection yet. While there is some evidence exploring the link, there isn’t concrete data to support the theory that a person’s diet plays a role in their psoriasis, according to Dr. Feldman, who co-authored a 2019 review of 63 medical articles investigating diets for psoriasis.

In most research that has studied a person’s diet and its impact on psoriasis, he explains, the sample sizes tend to be small, so the data is limited. Further, many people who participated in these studies continued to take their prescribed psoriasis medication in addition to changing their diet as part of the research. For these types of experiments, people are asked to make detailed logs of their behaviours, which may encourage them to take their medications as prescribed without skipping doses, Dr. Feldman says—and when it feels like a researcher is “watching” you via your logs, you may be more inclined to take your meds consistently. “So while it might look like the dietary intervention was beneficial, it may have been beneficial only in that it caused people to take their other medicines better,” Dr. Feldman says.

Unfortunately, because of the way many of these studies have been designed, it’s really hard to conclude which changes, including diet changes, are responsible for certain outcomes, like worsened or improved symptoms. That doesn’t mean it’s out of the question that certain diet changes can have a beneficial impact on psoriasis—it just means that more research that addresses these issues needs to be done so scientists have more solid data to work with.

With that said, it’s really unlikely that there will ever be one “psoriasis diet” to help each person with the condition. “You’re not going to cure psoriasis with diet—this is a chronic disease,” Dr. Feldman says. “But if you find that when you eat certain things they seem to exacerbate your psoriasis, avoiding those things makes entirely good sense.”

So far, there are two main diet approaches for people with psoriasis: additive diets and subtractive diets. With an additive diet, you’d focus on consuming more of a specific food or nutrient. With a subtractive diet, you’d slowly remove certain foods or nutrients.

This is tricky territory. Any time you make a diet change, especially if you have a chronic health condition, it’s best to talk to your doctor or a registered dietitian who is familiar with the disease, so they can guide you through the process and help you avoid risky side effects, like lower energy, unintended weight loss, or nutrient deficiencies.

Here’s a closer look at some popular diet changes people make when they have psoriasis—and what the science says about each one so far:

Anti-inflammatory diet

Psoriasis lesions are set off by inflammation in the body, so it makes sense to assume that “anti-inflammatory” foods could help tame that irregular immune response. Researchers believe that foods with certain nutrients may reduce oxidative stress in your body, a process that contributes to inflammation, but it’s an area of research that is still being explored. A typical list of “anti-inflammatory” foods is pretty expansive and diverse, including berries, green leafy vegetables, nuts, fatty fish, tomatoes, and so much more. The theory is that these foods may prevent inflammation from starting in the first place or reduce its impact.

For example, a fat called eicosapentaenoic acid (EPA) that is found in fatty fish like salmon is thought to help reduce the number of inflammatory chemicals in the body, according to Dermatology Online Journal. However, in the case of psoriasis, researchers are still unsure if consuming EPA has much of an effect on a person’s symptoms. Many studies looking at EPA and psoriasis specifically involve using fish oil supplements instead of whole fatty fish, which may not offer the same theorized benefit. Dr. Feldman’s team found that fish oil studies have really conflicting results: Some people saw no improvement, some said their psoriasis got better, and others said their psoriasis actually got worse.

There’s not much existing research on other proposed anti-inflammatory nutrients, which are thought to include vitamins A, C, D, and E, as well as monounsaturated fatty acids. A 2019 review of research on the link between psoriasis and diet published in Cutis, concluded that “foods with systemic anti-inflammatory effects may be worth testing and adding to the patient’s diet,” but also noted that “no single food, supplement, or diet has been shown to have a notable positive impact on all variations of psoriasis.”

Gluten-free diet

People who have psoriasis are two times more likely to have celiac disease compared to those without psoriasis, according to a 2020 study published in the Journal of the American Academy of Dermatology. Celiac disease is an autoimmune condition that causes intestinal damage from eating gluten, which is a protein found in wheat, rye, and barley.

Although multiple studies show a correlation between the two conditions, the relationship between psoriasis and celiac disease isn’t fully understood. However, people with psoriasis are more likely to have multiple autoimmune diseases, possibly due to —you guessed it—all that inflammation in the body. So, if you have celiac disease and psoriasis, eating a gluten-free diet may help you avoid very specific celiac-related skin rashes, according to the Cleveland Clinic. 

But as for whether or not eating a gluten-free diet may help reduce your psoriasis skin symptoms, the results have been mixed so far. In Dr. Feldman’s aforementioned 2019 review, 30 people with psoriasis (a very small amount) in one study said their symptoms improved after following a gluten-free diet for three months. In the same review, a different (and again, very small) study of 16 people with psoriasis showed that only 9 of them experienced any kind of improvement after following a gluten-free diet. Both of the studies in the review aren’t recent, but there haven’t been clear answers from newer studies, either.

Of course, if you do have celiac disease, you’ll benefit from following a gluten-free diet that’s monitored by your doctor. But, as the current research is so inconclusive for psoriasis in particular, avoiding all gluten isn’t proven to positively affect your skin symptoms if you don’t have a sensitivity or intolerance to it.

Ketogenic diet

There is some research pointing to keto as a potential diet option for people with psoriasis, but it’s far from conclusive.

For example, a woman with moderate-to-severe plaque psoriasis experienced a psoriasis flare-up after her medication stopped working to improve her symptoms, according to a 2016 case study published in Obesity Research & Clinical Practice. She followed a four-week, low-calorie ketogenic diet, meaning she ate practically no carbs and lots of protein. When you eat a keto diet, the goal is to encourage your body to use fat as a primary source of energy, instead of glucose (which you get from carbs) as it normally would. After that four-week period, her medication effectively started treating her symptoms again.

With that said, one woman’s experience isn’t enough to say that a keto diet can help everyone with psoriasis. In fact, the study authors attribute her improvement in symptoms to losing weight, as there is an independent relationship between reducing body weight and improving psoriasis flares. (With that, weight is a complex topic, so it’s really best to talk to your doctor about how this specific factor relates to your condition.)

In another 2021 study published in the Journal of Proteome Research, 30 people with psoriasis who weren’t taking medication for the condition followed a non-keto diet and then a keto diet to see how it impacted their symptoms. According to the limited data, everyone’s psoriasis felt less painful and covered fewer areas of their bodies. But this is such a small study—and the participants followed a very low-calorie meal plan that’s often unsustainable for most people. The study authors even mention that the diet is feasible “with high compliance,” meaning you’d have to stick to a very restrictive diet that omits many foods to see any potential benefit, which hasn’t yet been proven with more expansive research.

Mediterranean diet

The Mediterranean diet is pretty popular for good reason. This method of eating has tons of research to back up its overall health benefits, including a reduced risk of cardiovascular disease and other inflammatory conditions like rheumatoid arthritis.

The diet is often easier to follow than other restrictive plans because it includes a healthy mix of protein, fat, and carbs, such as fruits, vegetables, legumes, nuts, whole grains, olive oil, fish, a little bit of dairy, and the occasional glass of wine in moderation. Red meats and processed foods are typically avoided, though.

Because many of these foods are thought to have anti-inflammatory properties, especially when combined, there has been some interest in whether the diet is helpful for psoriasis. Again, the results are mixed. In the 2019 Cutis clinical review, two studies (one with 62 people and the other with 3,557) that examined the relationship between Mediterranean-style eating and psoriasis failed to show a beneficial relationship between the two. That said, the larger of those two studies found that people who didn’t adhere to the Mediterranean diet very closely had worse symptoms.

It’s hard to say that the diet itself helps with psoriasis flares, but out of all the eating plans mentioned above, this one comes with the least amount of risk overall—it’s often seen as a “gold standard” science-backed diet because it’s full of nutrient-rich, satisfying foods that have been shown to promote better health, so it won’t hurt to ask your doctor about it if you want to give it a try.

Which psoriasis treatments help with flares?

Even if you may or may not be able to manage your psoriasis symptoms with what you eat, there are many other proven treatments that “work phenomenally well,” Dr. Feldman says. Psoriasis medications are determined by the severity of your symptoms, where they’re located on your body, and how much your condition affects your ability to do everyday tasks. 

There are some psoriasis treatments that may be worth asking your doctor about, according to the Mayo Clinic:

  • Topical corticosteroids are one of the most common and effective treatments for psoriasis. They penetrate into the skin and reduce inflammation to help reduce the appearance of plaques. You can use them as creams, foams, gels, medicated shampoos, or sprays.
  • Topical calcipotriene cream is a synthetic form of vitamin D that works to minimize redness and scaling of the skin.
  • Coal tar is found in medicated shampoos. It’s not usually a popular treatment because it smells pretty unpleasant and can make your hair dry.
  • Scale softeners are usually made with salicylic acid, a gentle exfoliator that helps soften psoriasis patches so other medicines can more easily sink in and work better.
  • Light therapy uses targeted UVB rays to shrink psoriasis lesions. How exactly this works is “still the basis of a lot of research that’s going on right now," Tina Bhutani, M.D., an associate professor of dermatology and the co-director of the Psoriasis and Skin Treatment Centre at the University of California, San Francisco, tells SELF.
  • Systemic therapies are commonly used to treat severe psoriasis. These include biologics, which help prevent your immune system from misfiring. These are available as injections or infusions, the latter of which may need to be given at your doctor’s office. Oral retinoids are another systemic therapy that can help by limiting your skin cell production and reducing inflammation.

Ultimately, working closely with a board-certified dermatologist will help you figure out the best course of action to manage your psoriasis symptoms. “You want to have a checklist when you go to the doctor, including all areas of the body affected by your psoriasis,” Dr. Feldman says.

Your treatment plan may include diet changes, but it’s important to remember that it’s just one (very small) piece of the puzzle. “We have to get to the underlying cause of the issue,” Dr. Feldman says—and that will likely require tackling the inflammation head-on with one of the medications above.

https://www.self.com/story/diet-for-psoriasis

Wednesday 1 December 2021

Treating Psoriasis: 5 Reasons to Consider Switching to a Biologic

From healthline.com

Psoriasis treatment isn’t a one-size-fits-all approach. If your goal is total clearance of your psoriasis, you’ll probably have to try out many different treatments before finding one that works best for you. One option: biologic drugs.

Biologics for psoriasis

Biologics are medications that target specific proteins within the immune system to slow down disease activity at the source. They’re administered in one of two ways: via intravenous infusion at a clinic or via an auto-injector you can use yourself at home.

There are currently 13 biologics on the market to treat psoriasis:

  • abatacept (Orencia)
  • adalimumab (Humira)
  • brodalumab (Siliq)
  • certolizumab pegol (Cimzia)
  • etanercept (Enbrel)
  • golimumab (Simponi and Simponi Aria)
  • guselkumab (Tremfya)
  • infliximab (Remicade)
  • ixekizumab (Taltz)
  • risankizumab (Skyrizi)
  • secukinumab (Cosentyx)
  • tildrakizumab (Ilumya)
  • ustekinumab (Stelara)

Your doctor can help you decide which may work best for your particular situation. It may take some trial and error to find the right biologic for you.

Here’s how to know whether switching to a biologic agent for psoriasis might be a good next step for you, along with some advice on how to overcome any hesitation you may have about making the switch.

Traditional treatment options for psoriasis include topical creams, corticosteroids, cyclosporine, retinoids, methotrexate, and phototherapy. People with mild to moderate psoriasis can usually manage their disease well with topical treatments.

However, these traditional treatment options may lose effectiveness over time, and they often don’t work well enough for those with moderate to severe cases.

The American Academy of Dermatology suggests taking a biologic agent if you have moderate to severe psoriasis that hasn’t improved using more traditional systemic agents or if you can’t tolerate those treatments because of side effects.

Biologics are typically reserved for those with moderate to severe psoriasis, but they could be an option if your psoriasis is greatly affecting your quality of life.

Even if your psoriasis is considered mild, you may have painful plaques on the soles of your feet, your palms, your face, or your genitals. The pain may prevent you from doing your usual activities. In these cases, a switch to a biologic may be justified.

Many psoriasis treatments have to be taken daily to be effective. It can be hard to remember to take your medication on time, especially if you’re busy or you travel often. Biologics, on the other hand, are usually taken less frequently.

Some biologics have to be injected once per week, but others, like ustekinumab (Stelara), need to be injected only once every 12 weeks after the first 2 doses.

You can also give yourself most biologics at home after being trained by a medical professional.

Psoriasis treatments like cyclosporine, corticosteroids, and methotrexate are known to cause side effects like mouth sores, nausea, upset stomach, and even skin cancer.

Biologics work in a more selective way than other psoriasis treatments. They target specific proteins in the immune system that have been proven to be associated with psoriasis. For this reason, they have fewer side effects than less-targeted treatments.

Biologics still come with side effects, but they tend to be less severe. The most common side effects are minor irritation, redness, pain, or a reaction at the injection site. There’s also a slightly higher risk of serious infections while taking a biologic drug.

You can also add a biologic to your existing psoriasis treatment plan. Combining treatments can improve the efficacy of your regimen, often at a lower dose. This helps decrease side effects.

Options including certolizumab pegol (Cimzia), etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade) have been shown to be safe and effective when taken with methotrexate.

Biologics are expensive. Most cost more than $20,000 per year. Not all insurance plans will cover enough of the costs.

If you’ve recently changed insurance, check how the new insurance company covers biologics. Your out-of-pocket expenses may have gone down considerably with the new insurance company, making it easier for you to afford biologic therapy. If so, work with your doctor to determine whether you should make the switch.

Biologics aren’t new. The first biologic for psoriasis was approved in 2003. Over the last couple decades, researchers have gathered quite a bit of evidence to support the safety and effectiveness of these medications.

You may be hesitant to talk with your doctor about biologics because you’ve heard they’re “stronger” drugs. Or perhaps you’re worried they’re too expensive.

It’s true that biologics are considered a more aggressive treatment option. They also have a high price point. But they’re more targeted drugs, which means they work very well. And they tend to have fewer side effects than other psoriasis treatments.

Still, you shouldn’t take a biologic if:

  • your immune system is significantly compromised
  • you have an active infection
  • you recently received a live vaccine such as shingles, MMR (measles, mumps, and rubella), or flu mist
  • you’re pregnant or nursing (though biologics can still be prescribed if there is a clear medical need)

If you’re afraid of needles, ask your doctor about a new treatment for psoriasis known as apremilast (Otezla). Otezla is taken as a pill twice per day. It isn’t considered a biologic. Rather, it’s in a new class of drugs known as PDE4 inhibitors. Otezla is FDA-approved to treat moderate to severe plaque psoriasis when phototherapy or systemic therapy is appropriate.

Biologics have been around for decades, and research continues to expand. It’s likely that even more treatment options will be available in the near future.

Switching psoriasis treatments is a common and accepted practice. Now could be a good time to start thinking about biologic therapy. Of course, the decision to start biologic treatment for psoriasis should be made alongside your doctor.

https://www.healthline.com/health/psoriasis/moderate-to-severe/5-reasons-to-switch-to-biologic-for-psoriasis?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2021-11-30&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e