What Foods Can Trigger a Psoriasis Flare-Up?

From healthline.com

When you have psoriasis, reducing triggers is an important part of managing your condition and avoiding flare-ups. Psoriasis flare-ups can be caused by a variety of triggers. These triggers may include bad weather, excess stress, and certain foods.

Let’s take a look at the foods that are most likely to trigger a psoriasis flare-up. There are some foods that are helpful to incorporate and certain diets to consider when creating a treatment plan for your psoriasis.

The foods listed below have been reported to trigger flare-ups, but they may not affect all those affected by psoriasis.

Foods to avoid if you have psoriasis

With psoriasis, it’s important to avoid foods that can trigger inflammation. Inflammation and the immune system response can lead to a flare-up.

Red meat and dairy

Red meat, dairy, and eggs contain a polyunsaturated fatty acid called arachidonic acid. Past researchTrusted Source has shown that by-products of arachidonic acid may play a role in creating psoriatic lesions.

Foods to avoid include:

• red meat, especially beef
• sausage, bacon, and other processed red meats
• eggs and egg dishes

Gluten

Celiac disease is a health condition characterized by an autoimmune response to the protein gluten. People with psoriasis have been found to have increased markersTrusted Source for gluten sensitivity. If you have psoriasis and a gluten sensitivity, it’s important to cut out gluten-containing foods.

Foods to avoid include:

• wheat and wheat derivatives
• rye, barley, and malt
• pasta, noodles, and baked goods containing wheat, rye, barley, and malt
• certain processed foods
• certain sauces and condiments
• beer and malt beverages

Processed foods

Eating too many processed, high-calorie foods can lead to obesity, metabolic syndrome, and a variety of chronic health conditions. Certain conditions such as these cause chronic inflammation in the body, which may be linkedTrusted Source to psoriasis flare-ups.

Foods to avoid include:

• processed meats
• pre-packaged food products
• canned fruits and vegetables
• any processed foods high in sugar, salt, and fat

Nightshades

One of the most commonly reported triggers for psoriasis flare-ups is the consumption of nightshades. Nightshade plants contain solanine, which has been known to affect digestion and may be a cause of inflammationTrusted Source.

Foods to avoid include:

• tomatoes
• potatoes
• eggplants
• peppers

Alcohol

Autoimmune flare-ups are linked to the health of the immune system. Alcohol is believed to be a psoriasis trigger due to its disruptive effects on the various pathways of the immune system. If you have psoriasis, it may be best to drink alcohol very sparingly.

Foods to eat if you have psoriasis

With psoriasis, a diet high in anti-inflammatory foods can help to reduce the severity of a flare-up.

Fruits and vegetables

Almost all anti-inflammatory diets include fruits and vegetables. Fruits and vegetables are high in antioxidants, which are compounds that decrease oxidative stress and inflammation. A diet high in fruits and vegetables is recommended for inflammatory conditions such as psoriasis.

Foods to eat include:

• broccoli, cauliflower, and Brussels sprouts
• leafy greens, such as kale, spinach, and arugula
• berries, including blueberries, strawberries, and raspberries
• cherries, grapes, and other dark fruits

Fatty fish

A diet high in fatty fish can provide the body with anti-inflammatory omega-3s. The intake of omega-3s has been linked to a decrease of inflammatory substances and overall inflammation.

Fish to eat include:

• salmon, fresh and canned
• sardines
• trout
• cod

It should be noted that there is still more researchTrusted Source that needs to be done on the link between omega-3s and psoriasis.

Heart-healthy oils

Like fatty fish, certain oils also contain anti-inflammatory fatty acids. It’s important to focus on oils that have a higher ratio of omega-3 to omega-6 fatty acids.

Oils to eat include:

• olive oil
• coconut oil
• flaxseed oil
• safflower oil

Nutritional supplements

A 2013 review of research literatureTrusted Source showed that nutritional supplements may help reduce inflammation in psoriasis. Fish oil, vitamin D, vitamin B-12, and selenium have all been researched for psoriasis.

Benefits of supplementation with these nutrients may include a decrease in the frequency and severity of flare-ups.

Diets to consider

Not all diets are good for psoriasis. Here are some options you may want to consider when choosing the best diet for your condition.

Dr. Pagano diet

Dr. John O. A. Pagano was well known within the health and wellness community for his approach to healing psoriasis through diet. In his book, Healing Psoriasis: The Natural Alternative, he describes how a healthy diet and lifestyle can improve psoriasis naturally.

Dr. Pagano’s dietary approach includes:

• consuming high amounts of fruits and vegetables
• limiting grains, meat, seafood, dairy, and eggs
• completely avoiding red meat, nightshades, citrus fruits, processed foods, and more

Trusted SourceA 2017 survey of more than 1,200 people with psoriasis indicated that the Dr. Pagano diet is one of the most successful diets for improving psoriasis outcomes.

Gluten-free

In people who have both psoriasis and gluten sensitivities, a gluten-free dietTrusted Source may provide some improvement. One small 2018 studyTrusted Source found that even people with mild gluten sensitivities can benefit from following a gluten-free diet.

Of the 13 participants who were placed on a gluten-free diet, all observed an improvement in their psoriatic lesions. The biggest benefit was observed for those participants with the strongest sensitivity.

Vegan

A vegan diet may also benefit people with psoriasis. This diet is naturally low in inflammatory foods such as red meat and dairy. It’s high in anti-inflammatory foods such as fruits, vegetables, and healthy oils.

Like the Dr. Pagano diet, the vegan diet also showed favourableTrusted Source results in study participants with psoriasis.

Speak with your doctor about following a vegan diet, as you need to be careful to get all the nutrients you need.

Mediterranean diet

The Mediterranean diet is well known for its numerous health benefits, including a reduced risk of certain chronic diseases. This diet focuses on foods that are high in antioxidants and healthy fats. It limits foods that are often considered to be pro-inflammatory.

In a 2015 studyTrusted Source, researchers found that people with psoriasis are less likely to be consuming a Mediterranean-type diet than their healthy counterparts. They also found that those who did adhere to elements of the Mediterranean diet had a lower disease severity.

Paleo

The paleo diet places an emphasis on eating whole foods and avoiding processed foods. Since many whole foods contain anti-inflammatory compounds, this diet may prove to be beneficial for people with psoriasis.

Unlike Dr. Pagano’s diet, it involves eating plenty of meat and fish. However, the 2017 researchTrusted Source suggests that the paleo diet is the third most effective diet in people with psoriasis.

Autoimmune protocol diet

The autoimmune protocol diet (AIP) focuses on eliminating foods that might cause inflammation. This diet is incredibly restrictive and primarily includes vegetables and meat, with certain oils and herbs mixed in.

It might not be appropriate for people with psoriasis, as too much meat is considered a trigger for flare-ups. In addition, it’s not intended to be a long-term dietary intervention.

Keto

This popular low carb diet has many touted health benefits, such as weight loss and improved nutrient markers. It’s true that reducing carbohydrates can help reduce processed food intake.

However, reducing carbohydrates also means reducing many anti-inflammatory fruits and vegetables. It also necessitates increasing protein from meat. Because certain keto foods can be triggers in people with psoriasis, this diet may not be recommended.

The takeaway

Many autoimmune conditions such as psoriasis can benefit from dietary changes. If you have psoriasis, you may find it beneficial to include plenty of anti-inflammatory foods, such as fruits, vegetables, and healthy oils.

You may also want to avoid pro-inflammatory foods, such as meat, dairy, and processed foods. These dietary changes may help to reduce the frequency and severity of your flare-ups.

It’s always best to reach out to a physician or registered dietitian nutritionist for more information on how your diet can help control your condition.

https://www.healthline.com/health/psoriasis/food-triggers-for-psoriasis?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2022-02-22&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e

Air pollution exposure may trigger psoriasis flares

From healio.com

Short-term air pollution exposure can increase the likelihood of psoriasis flares, according to a study

“Environmental air pollution is defined by the World Health Organization (WHO) as the contamination of the ambient air by any chemical, physical or biological agent that modifies the natural characteristic of the atmosphere,” Francesco Bellinato, MD, of the section of dermatology and venereology at the University of Verona in Verona, Italy, and colleagues wrote. “Psoriasis is a chronic inflammatory disease with a relapsing-remitting course and selected environmental factors such as infections and/or drugs may trigger disease flares. Whether air pollution could trigger psoriasis flares is not known.”

Short-term air pollution exposure can increase the likelihood of psoriasis flares.

Researchers conducted a case-crossover and cross-sectional, observational, retrospective study of 957 chronic plaque psoriasis patients.

Subjects had 4,398 follow-up visits and more than 15,000 air pollutant measurements.

Air pollutant concentrations were significantly higher in the 60 days before psoriasis flares for the 369 patients in the case-crossover analysis. This population included subjects with at least two consecutive visits, one psoriasis flare and a continuous systemic treatment for at least 6 months.

A median psoriasis area and severity index (PASI) score at the flare visit was 12 (interquartile range, 9-18), compared with PASI 1 at the control visit.

For the cross-sectional analysis, an air pollution or course particulate matter (PM) concentration were positively associated with an increase in PASI scores.

PASI scores of 5 or higher were more likely for those who had exposure to mean PM10 over 20 g/m3 (adjusted OR = 1.55; 95% CI, 1.21-1.99) and mean PM 2.5 over 15 g/m3 (aOR = 1.25; 95% CI, 1-1.57) in the 60 days before visits.

“Short-term air pollution exposure is associated with increased psoriasis activity and likelihood of having a psoriasis flare,” the authors wrote. “Further study is needed to examine whether these findings generalize to other populations and to better understand the mechanisms by which air pollution may affect psoriasis disease activity.” 

https://www.healio.com/news/dermatology/20220218/air-pollution-exposure-may-trigger-psoriasis-flares

Psoriasis: Myths vs Facts

From timesofindia.indiatimes.com

Often mistaken as just a skin condition, Psoriasis has been neglected and vastly misunderstood. Did you know that roughly 2.5 crore Indians suffer from this chronic progressive condition? Despite of these alarming numbers, most people are either ignorant of the condition, or falsely believe it to be a contagious disease. This leads Psoriasis patients to deal with not just physical suffering, but also mental instability social seclusion, and loss of confidence. 

Traditionally, lack of knowledge has barred patients from getting professional advice, leading to the patient suffering because of poor disease management. It also categorically led patients away from newer and better treatment options that could have offered them relief and peace of mind. Over a period, it has been proven that with the right choice of treatment combined with adherence to treatment can stop the pain, agony and help the patient lead a more confident and happy life. 

Using new therapies like biologics has proved life changing in some patients as they helped control their symptoms and worked better than many other treatments. But remember, effectiveness of any treatment primarily depends on the patient’s discipline and regularity in the treatment. As per the National Psoriasis Foundation, even if initial symptoms of psoriasis are not very severe, it is recommended that anyone living with psoriasis should consult a dermatologist regularly. It can help one gain control of their condition at the right time with the help of the right treatment plan customised as per the severity of the symptoms and the condition, overall health history and personalised responses to individual treatment options.

It is important for all of us to be aware of these facts as it will help psoriasis patients get the care, respect, and acceptance that they have missed in the past. Therefore, let’s dig deep into psoriasis and know the truth with Myths vs. Facts about Psoriasis: 

• Myth: Psoriasis is simply a skin condition and is caused by poor hygiene 

Fact: Psoriasis has nothing to do with hygiene. It is a genetically transferred disorder, i.e., it runs in the family. It is also not a simple skin condition that will heal by itself. You need to consult a dermatologist and follow recommended treatment plan to avoid flare ups.

• Myth: There is no treatment for psoriasis

Fact: In Psoriasis, adopting a holistic treatment plan depending on the severity of the condition is the key. Dermatologists can recommend medicines best suited depending on the patient’s condition considering the recent advancements in psoriasis treatment. Newer medicines like biologics are effective and safe and can make skin clearer. Relief from flares restores quality of life and self-confidence.  

• Myth: Psoriasis is contagious

Fact: The thick, red, scaly patches of skin and the cracks make psoriasis look like an infection or a contagious disease. This leads to the common reaction of distancing from the person with contempt affecting patient’s confidence and mental health with overall impact on quality of life.  However, the fact is that psoriasis is NOT contagious and does not spread by touch or proximity.

• Myth: Psoriasis is self-limiting & may not be treated

Fact: Visible discoloured skin patches & scales indicate psoriasis, but they also indicate inflammation inside the body. Effective treatment of psoriasis not only manages skin symptoms but may also help reduce inflammation inside the body that could lead to other diseases like psoriatic arthritis. That is why treating psoriasis is important. 

With Psoriasis myths busted, let us all offer care and respect to all psoriasis patients. Living with Psoriasis can be challenging, but with the right information, right support and right treatment can make it easier to cope with this condition and help psoriasis patients focus on those aspects of life that make them happier and confident. 

https://timesofindia.indiatimes.com/blogs/voices/psoriasis-myths-vs-facts-to-manage-your-psoriasis-better/ 

Is It Psoriasis or Ringworm?

From health.clevelandclinic.org

An expert explains the difference between the two skin conditions 

While there are a number of skin conditions that can cause inflamed, itchy and painful patches, two, in particular, stand out thanks to their similarities: ringworm and psoriasis. With overlapping symptoms, it can be hard to tell which is which.

But if you know what to look for, there are a few differences, including how each condition is treated. To get a better understanding of both psoriasis and ringworm, and how to tell them apart, we spoke to dermatologist Sean McGregor, DO. 

What’s the difference between psoriasis and ringworm?

The biggest difference between psoriasis and ringworm, says Dr. McGregor, is the origins of each. Psoriasis is an autoimmune condition, while ringworm is a fungal infection. “While a person’s autoimmune issues trigger psoriasis, you can acquire the ringworm fungus in a number of different ways,” he adds, “from soil, other humans or even pets.”

Additionally, psoriasis is a chronic condition, meaning it never goes away. Ringworm, conversely, will go away with treatment since it’s simply an infection.

How to tell the difference between psoriasis and ringworm

For treatment purposes, of course, it’s important to differentiate between the two conditions and know which one you have. No matter which you think you have, though, it’s always important to contact your healthcare provider so you can get proper treatment.

Shared symptoms

Ringworm and psoriasis have several overlapping symptoms, which is where confusion can sometimes set in, including:

• Inflammation.
• Itchy skin.
• Scaly, cracked skin.

But there are signs that can help you figure out which condition you may be dealing with.

Specific symptoms of ringworm

Dr. McGregor says there’s one symptom in particular that can help you figure it out. “Ringworm gets its name from a worm-like shape around the edges of the rashes,” he says.

One other thing to look for, he advises, is a bit of clearing in the middle of a rash. “Ringworm tends to have a little clearing in the center of the rash with more of the inflammation or irritation around that border.”

Specific symptoms of psoriasis

While psoriasis doesn’t have symptoms that are as clear cut as those of ringworm, there are a few other ways you might be able to tell that it’s psoriasis and not something else.

First, if the symptoms are recurring and lack that ring-like feature, it may be psoriasis. Since psoriasis is a chronic condition, it doesn’t really go away over a few days with treatment like ringworm will.

Second, about 30% of people with psoriasis develop psoriatic arthritis, a type of arthritis closely associated with psoriasis.

Treatment options

As mentioned, the big difference in treatment is that ringworm can be cured, while the chronic condition of psoriasis is managed. No matter which condition you may have, it’s best to start by talking to your healthcare provider.

Treatment for ringworm

For treating ringworm, Dr. McGregor says, “The antifungal cream terbinafine 1% is the best over-the-counter treatment available.” Lamisil™ is the most prominent version of this medicine. If you wind up with ringworm on your scalp, though, your doctor will prescribe you an oral version instead of the topical cream.

Treatment for psoriasis

There are many home remedies you can try for temporary relief for psoriasis, including:

• Moisturizing cleansers.
• Oatmeal bath.
• Epsom salt.
• Hydrocortisone.

When it comes to more long-term treatment, though, Dr. McGregor says your doctor will recommend topical steroids or Vitamin D ointment.

https://health.clevelandclinic.org/psoriasis-vs-ringworm/

Home Remedies for Psoriasis

From health.clevelandclinic.org

Psoriasis can present a number of different challenges for those who have the condition. From the itchiness of the dry, cracked and scaly patches of skin to the occasional pain, those with psoriasis can always use some relief.

Whether you experience psoriasis frequently or only occasionally, it’s always good to know the best ways to ease those symptoms. All the better if you can do it without having to schedule a doctor’s appointment.

To get a handle on the best home remedies for psoriasis, we spoke to dermatologist Sean McGregor, DO. 

What is psoriasis?

Psoriasis, Dr. McGregor says, is a chronic skin disorder that produces an inflammatory skin rash. The thick reddish patches of scaly skin can appear all over your body, but some of the more common places it occurs include:

• Knees.
• Elbows.
• Face or scalp.
• Around fingernails and toenails.
• Palms.
• Lower back.

Psoriasis is an auto-immune skin condition where your immune system attacks your skin, which in turn causes inflammation and leads to the creation of new skin cells. Because those new skin cells are created at a far faster rate than normal — every three or four days instead of every 30 or so days — the build-up of new cells creates the scaly skin.

While doctors don’t know exactly what triggers that immune system response, Dr. McGregor says, “We do know that there are genetic influences and, more recently, we’ve seen associations with metabolic syndrome, diabetes, high blood pressure and some cardiac issues.”

Natural and home remedies for psoriasis

When it comes to psoriasis, the first place to start is talking to your healthcare provider. Not every home remedy works the same for everyone, and your own doctor will be able to help you come up with a treatment plan that’s right for you and your specific condition.

Odds are some of the suggestions you receive may include one of these.

Moisturising cleanser

Over-the-counter moisturizing cleansers like Vanicream™, CeraVe® and Cetaphil® are options that target two psoriasis symptoms: dryness and itchiness. “These products help soften some of the scaly skin and provide hydration to the skin, potentially limiting some of the itching,” explains Dr. McGregor. These options also typically lack fragrances and other ingredients that can further irritate your skin.

Oatmeal baths

Dr. McGregor recommends oatmeal baths as a way of finding temporary relief from itching, dryness and flaking skin. Of course, we’re not talking about the food type of oatmeal but rather, what’s called colloidal oatmeal, a finely ground version that dissolves in your bath or that you find in lotions and soaps. It’s often used for other skin conditions like eczema. 

Epsom salt

Like oatmeal baths, a warm bath with Epsom salt can help relieve inflammation and remove those flaky scales from your skin. While there’s not a lot of scientific data on the topic, the common theory is that the magnesium in the salt aids that relief.

Coal tar

An older remedy, coal tar comes in multiple forms, including in shampoo, topical ointment and soap. “It calms down the inflammation caused by psoriasis which can help bring relief,” says Dr. McGregor.

Just be wary that it can be kind of greasy and can lead to staining of clothes or skin. As with all creams and topical ointments, you can prevent staining by wrapping the applied area in plastic wrap. “Talk to a dermatologist before your do,” advises Dr. McGregor. “It should be safe for adults, but I don’t recommend it for children.”

Salicylic acid cleansers

Like the topical cleansers listed earlier, salicylic acid cleansers, also often used to treat acne and blackheads, can provide anti-inflammation relief, as well as cleaning for scaly skin.

“One caveat with coal tar and salicylic acid cleansers is that they can also irritate skin for some people,” says Dr. McGregor. “We often recommend talking to your healthcare provider first and trying it on a small, specific area of skin rather than a large area to see what your reaction is.”

Cortisone and hydrocortisone

Again, notes Dr. McGregor, it’s all about soothing inflammation and cortisone and hydrocortisone creams do just that. “It can be beneficial to removing some of the redness and scaly skin we see with psoriasis,” he says.

Light therapy

Whether using a specific device or getting some sunlight, light therapy is a verified way to improve your psoriasis conditions. Light therapy isn’t used very much anymore not because it’s been disproven but, says Dr. McGregor, “We’ve seen so many advances in some of these other treatments that it’s fallen out of favour.”

Phototherapy for psoriasis isn’t the most convenient approach on your own, either, as the devices used for such treatment are essentially medical-grade tanning beds.

Getting regular sunlight can also help clear up psoriasis but it comes with a hitch. “Phototherapy is much different from just being in the sun,” says Dr. McGregor. A healthy amount of sunlight can help, but you never want to overdo it.

“We don’t want people spending so much time out in the sunshine just to clear up psoriasis that they put themselves at risk for sunburns or melanoma,” he says. “Especially since we have other effective ways to treat it that don’t include those risks.”

A better diet

As with so many other conditions, a healthy diet can go a long way to helping ease some of the symptoms of psoriasis. “There is that association between psoriasis and conditions like heart disease, high blood pressure and high cholesterol,” says Dr. McGregor, “so there’s a need to focus on diets that are generally healthy.

Some tips for a better diet include:

• Eat foods lower in carbohydrates.
• Avoid high glycaemic index foods.
• Eat healthy sources of protein.

“Having a healthier diet and exercise may not completely clear up your psoriasis, but it’s going to help keep it from getting worse,” he says.

https://health.clevelandclinic.org/home-remedies-for-psoriasis/

 

Hand Psoriasis: Everything You Need to Know About the Condition

From self.com

How to know if you’ve (literally) got a problem on your hands 

Imagine this scenario: Your future boss extends their hand for you to shake (you know, in a pre-pandemic world). But your hand psoriasis holds you back, and you’re worried your boss may not understand. 

This is just one small example of how psoriasis on hands, also known as palmar psoriasis, can get in the way of your daily life, and make you think twice about doing “normal things” that people without psoriasis likely don’t think about at all. (No, psoriasis is not contagious, by the way.)

That’s why psoriasis, particularly when it’s present on visible areas of the skin, like the hands, can significantly affect you physically and mentally. Below, SELF talked to experts about how to identify hand psoriasis and what you can do about it—so you can feel a bit more comfortable in your own skin.

What is psoriasis and how can it affect the hands?

Psoriasis is a chronic, autoimmune skin condition that causes an overgrowth of inflamed, scaly, and sometimes itchy patches on the skin. Your body basically produces way too many new skin cells due to an immune system malfunction, which most commonly results in plaques, per the American Academy of Dermatology (AAD). While psoriasis tends to occur in places like the knees, elbows, and scalp, it can also appear on the hands. And when it does affect the hands, it’s traditionally more difficult to treat. This type is actually called palmoplantar psoriasis, because it only affects the hands and feet.

Psoriasis is uncomfortable, but when it appears in a highly visible place (not to mention the one area of the body you tend to use the most), the condition becomes a whole new issue. But you don’t have to go to Elsa-level lengths to conceal your hands with gloves. There are many psoriasis treatments available to help you find relief.

What are the types of psoriasis?

Palmoplantar psoriasis isn’t a common psoriasis type, only about 3% to 4% of people with psoriasis have it. However, about 40% of people with plaque psoriasis have symptoms on their hands and feet in addition to other areas of the body, according to the National Psoriasis Foundation. The different types of psoriasis include:

• Plaque: Plaque psoriasis is the most common psoriasis type. These usually appear as inflamed, patchy areas with silver, white, or grey scales above the pink, red, or purple-hued lesions. Plaques usually look the same on both sides of the body and commonly appear on the elbows, torso, knees, and scalp.
• Guttate: Guttate psoriasis causes small, scaly spots that can appear anywhere from brown to purple or red in colour, depending on your skin tone. They usually appear on the arms, trunk, and legs.
• Inverse: This psoriasis type appears in areas where skin rubs against skin. Think the armpits, under your boobs, inner thighs, and the groin. The skin may appear bright red or purplish depending on your skin tone, smooth, and almost raw in appearance.
• Palmoplantar: As we mentioned, palmoplantar psoriasis occurs when psoriasis affects only the palms of the hands and soles of the feet. This psoriasis type can appear patchy and scaly and may or may not have colour changes, like reddening of the skin, due to inflammation.
• Pustular: Pustular psoriasis usually occurs when you have another psoriasis form, and you develop pus-filled bumps on the skin. These bumps usually are present on the hands, feet, or both. Those with palmoplantar psoriasis can develop pustular palmoplantar psoriasis.
• Erythrodermic: Severe plaque psoriasis sufferers can sometimes have their condition develop into erythrodermic psoriasis. The psoriasis type causes severe symptoms that require immediate medical attention, including inflammation over most of the body, fever, chills, and dehydration. It can occur if your psoriasis isn’t well managed, or after a triggering event, such as getting a severe sunburn or experiencing an allergic reaction. 

Can you have psoriasis on fingers or nails?

Psoriasis most commonly affects the palms of the hands. They may appear inflamed (pink, red, purple, or brown) with dry, thickened skin. The thick areas may have cracks or fissures. Sometimes, this appearance is similar to that of a fungal infection, like athlete’s foot, but on the hands.

About 60% of people who have psoriasis on their hands also experience changes to their fingernails. David Rosmarin, M.D., a dermatologist and assistant professor at the Tufts University School of Medicine, tells SELF changes from nail psoriasis may include:

• Lifting of the nail plate from the nail bed
• Oil spots (discoloration that looks like you spilled oil under your nail)
• Pitting
• White spots

While the psoriasis lesions may also appear on the knuckles and fingers, the palms are usually the originating area. When psoriasis extends to your fingers and knuckles, this can make it especially difficult to maintain the function in your hands, as it can be painful.

What are hand psoriasis symptoms?

Palmar psoriasis causes thick, scaly patches and often plaques on the palms and the soles of the feet. These scales may make the hands appear discoloured due to inflammation and swollen.

In addition to the changes in the appearance of your hands, palmoplantar psoriasis can be itchy. Some people also experience pain and develop deep cracks called fissures in the scaly patches of their hands.

Because palmoplantar psoriasis isn’t the only condition that can cause plaques and scales to the hands, it can be tricky for doctors to initially tell the difference between hand psoriasis and others, such as atopic dermatitis (also known as eczema,), Dr. Rosmarin explains.

You can even have both eczema and psoriasis on the hands, according to the National Psoriasis Foundation. In fact, about 63% of people with both psoriasis and eczema have hand involvement, according to a 2019 study published in the Journal of Dermatological Treatment. 

“Some of the keys that can be helpful for us is if there is nail involvement,” Dr. Rosmarin says. While both eczema and psoriasis can affect the nails with things like pitting, psoriasis is the skin disease that most frequently affects the nails, according to a 2017 study published in the journal Psoriasis.

If you have psoriasis that affects both the palms and soles of your feet, your doctor may also consider how your feet appear. With eczema, the arch of the foot (a non–weight bearing area) may have more lesions. This isn’t usually the case with psoriasis. “The pressure-bearing areas of the foot are usually worse in psoriasis,” Dr. Rosmarin says. This includes areas like the heel and the pad just below your toes.

What are the causes and triggers of hand psoriasis?

Doctors don’t know exactly what causes psoriasis on the hands. Instead of one specific cause, there’s likely a combination of genetic and environmental factors that play a role in its development. These include:

• Genetics, specifically variations on the human leukocyte antigen (HLA) Cw6, which is a gene partly responsible for immune system activity
• Friction to the palms, such as if you work with hand tools
• History of trauma or injury to the palms
• Irritants, such as exposure to chemicals
• Smoking

Those who work with their hands are most likely to have the condition, such as farmers, manual laborers, massage therapists, and environmental services professionals.

Why do flare-ups happen?

Many of the potential causes for hand psoriasis are also triggers for the condition, but there are a few other things that can cause a flare-up. Pay special attention to seasonal changes, household work, laundry detergent, and stress, as these can all make hand psoriasis worse. (Seriously, does stress make anything better?) Another thing to consider is whether your nightly glass of wine has anything to do with psoriasis flare-ups. According to one 2019 study published in the journal Psoriasis, drinking alcohol has been linked to flare-ups in general, not just on the hands.

On the physical stress side, some people experience psoriasis on their hands due to their occupation. Appropriately called occupational contact psoriasis, it causes flare-ups due to constant mechanical pressure on the skin from working with the hands as well as working with irritants. Drivers, cashiers, construction workers, dentists, and even pharmacists are at risk (due to frequent handling of bottle caps with a twisting motion), according to a 2020 study published in Occupational Dermatology. In this case, your job is causing the problem (but you probably knew that already).

It’s tough when your livelihood is causing your hand psoriasis symptoms. Talk to your doctor or workplace if there may be adjustments that could reduce your flare-ups. Examples include protective gloves, padding tools, or reassignment to a different job duty.

If you have both eczema and psoriasis on the hands, your doctor may recommend allergy testing to help identify what could worsen your symptoms. Avoiding these allergens may help to minimise psoriasis flare-ups. 

How is hand psoriasis diagnosed?

It would be really easy if doctors could take a skin sample and know without question what kind of skin issue you were dealing with. Of course, it’s unfortunately not that simple if you potentially have psoriasis on your hands.

“While biopsies can help confirm psoriasis on other parts of the body, it’s not a good test when we are trying to differentiate it on the hands and feet,” Dr. Rosmarin explains. It’s really important to look at the symptoms, he says.

That’s not to say that a doctor may not recommend taking a biopsy if they want to try another diagnostic option. There aren’t a lot of studies about the differences between eczema and palmar psoriasis under a microscope, but a smaller 2015 study published in The Journal of Dermatology found there were some key differences. These include white-to-grey scales for those with palmar psoriasis or brown-orange dots for those with hand eczema.

What are hand psoriasis treatments?

You probably already know that psoriasis on the hands can be challenging to treat. While that can feel a little disheartening, know that there are still lots of options to try.

“There are some treatments, such as certain topical creams or ointments, that can help with both psoriasis and eczema,” Dr. Rosmarin says. “The immune system is too active in the skin, so we have medicines that can tell the immune system to calm down.”

You’ll likely try topicals first.

Typically, the first-line treatment for psoriasis plaques on the hands is topical corticosteroids, which come in the form of anti-inflammatory creams, ointments, or gels. Sometimes, a doctor may recommend applying this with occlusion—this means wearing gloves or wrapping the hands, ideally to allow the medication to better penetrate. Other times, your dermatologist will recommend combining this medication with calcipotriene, an ointment that helps to slow skin cell growth.

Another topical application is acitretin. It’s a form of vitamin A (otherwise known as a retinoid) that can take three to six months of steady application to see results. (You shouldn’t use this treatment if you are thinking of getting pregnant or are pregnant, as oral retinoids have been linked to birth defects.)

Then, you might move on to light therapy or oral medications.

Unfortunately, psoriasis plaques can sometimes be so thick that it’s difficult for the topical medications to fully penetrate the skin. When this is the case, you may need to turn to the second-line treatments. These usually involve systemic treatments (pills you take orally) or light therapy.

Light therapy involves exposing your affected skin to UVA or UVB rays. While this sounds super weird given that you probably haven’t gone outside without your best SPF in years, the light slows the overgrowth of skin that leads to psoriasis symptoms.

This is not by any means an excuse to hit the beach, footloose and sunscreen-free. Instead, doctors prescribe UVA or UVB therapy at very specific time frames and with special devices.

If your doctor doesn’t recommend the light therapy route, there are systemic medications you can take to help calm down your psoriasis symptoms. These are usually methotrexate or cyclosporine, which are both immunosuppressants. However, you would most likely only take these medications if your hand psoriasis symptoms are severe and don’t respond to any of the other listed treatments.

Biologics are also an option.

Your doctor may recommend biologics if the others medications don’t work or you can’t take them for some reason. These medications target specific parts of the immune system, specifically the ones known to cause psoriasis, and are given by injection or I.V. Your doctor can discuss these with you, including considerations for side effects.

The road to recovery and condition management for those with palmoplantar psoriasis isn’t a short one. Unfortunately, trial-and-error and time are often required to see a resolution. That’s why it’s important to find a doctor that you can trust.

Can you prevent psoriasis on hands?

It’s not always possible to prevent psoriasis on your hands. If you happen to know what triggers your psoriasis or makes it worse, avoiding those can help. This includes things like:

• Refraining from smoking
• Trying to keep your stress levels down
• Wearing protective equipment (like gloves) to avoid injury to your hands
• Refraining from exposing your skin to household or other chemicals (again, protective gloves may help)

However, if you try these and you still get hand psoriasis, know that you aren’t alone. There is a genetic component to the condition and other underlying immune system responses that you can’t necessarily control. Fortunately, there are lots of treatments you can try for hand psoriasis. While they do require patience and carefully following the suggested treatment plan, working closely with your dermatologist can help you figure out what works best for you.

https://www.self.com/story/hand-psoriasis