From self.com
Hot showers, stress, and getting sick can all wreak havoc on your skin
Easing into winter is always a bit of a tricky transition. A lot of us are figuring out how to layer our clothes, taking our workouts indoors, and finding new routines to keep our skin happy in harsher conditions. When you have psoriasis, that last type of winter prep is even more challenging, since cold, dry weather can trigger flare-ups.
Psoriasis is a chronic, inflammatory skin condition that most commonly causes thick, inflamed, and scaly rashes or plaques that can be itchy and painful. Notably, the condition often goes through periods of flares and remission: Symptoms can worsen for weeks or even months before calming down again, per the Mayo Clinic.
Psoriasis flare-ups can come on seemingly out of nowhere, but there are a few common triggers. Some of them include stress; infections such as strep throat, cuts, and other skin injuries; and, yup, you guessed it, cold weather.
Why do psoriasis symptoms flare in the winter?
A lot of the evidence is anecdotal, but many dermatologists say their patients have flare-ups in the winter, according to the National Psoriasis Foundation. Scientists aren’t sure why cold weather can raise issues for some people with psoriasis—triggers vary from person to person, so some people with psoriasis have absolutely no problem with cold weather, while others dread winter’s impact on their skin.
Vitamin D deficiency—which is more common in the winter and can happen because of insufficient exposure to sunlight—may play a role. Some research shows a correlation between psoriasis and vitamin D deficiency, although more studies are needed to fully understand this connection. “Ultraviolet (UV) light has long been used as a treatment for psoriasis,” Katy Burris, MD, board-certified dermatologist at Columbia University Medical Center in New York City, tells SELF. “So [it makes sense that] during the winter months, when patients’ skin is covered with clothing and the days are shorter, [they] often report flares.”
Vitamin D supplements typically aren’t prescribed as a psoriasis treatment because there isn’t enough evidence to show that they would be effective, Laura Ferris, MD, professor of dermatology at the University of Pittsburgh, tells SELF. However, topical vitamin D products can be helpful for some people.
Another factor: Cold winter air—and indoor heating systems—are typically devoid of moisture. Low humidity levels tend to dry out the skin and can trigger psoriasis symptoms, according to the American Academy of Dermatology (AAD). “Basically, water moves from a gradient of high to low concentration,” Dr. Ferris says. “If the water concentration of the air is much lower than in the skin, you will lose more water from the skin than you would if the water concentration in the surrounding air [was] higher.”
Many people also experience heightened stress during the holidays—and stress can be a major psoriasis trigger for some people. Plus infections like strep throat tend to peak in the winter, and this and other illnesses can trigger flare-ups, per the AAD.
How to deal with psoriasis flare-ups during winter
Given all these potential triggers, you’re probably wondering if there’s anything you can do to keep your symptoms under control. There’s no way to avoid psoriasis flare-ups completely during any time of the year, but the following tips may help you get through the winter a bit more comfortably.
According to the National Psoriasis Foundation, everyone with psoriasis should see a board-certified dermatologist. This is even more important if your symptoms flare or become more severe over time. Additionally, you should see a dermatologist if psoriasis treatments recommended by your primary care doctor aren’t working or if you’re interested in trying a treatment that they don’t offer. “There are numerous medications we have available to help, including topicals, oral medications, and UV light treatments,” Dr. Burris says.
If your symptoms continue to flare even after you see a dermatologist, it’s important to keep using any treatments that your dermatologist has prescribed for you while you reach out to them about reassessing your regimen.
Light therapy is one of the most common, effective psoriasis treatments for people with mild to moderate psoriasis. There are many different types of light therapy available, like narrow-band UVB therapy, broad-band UVB therapy, and laser treatments. Depending on your symptoms and what type of psoriasis you have, your doctor may recommend you try just one type of light therapy or a combination of them.
The exact reason that light therapy effectively treats psoriasis is not very well understood, but researchers believe it suppresses cells in the skin related to the immune response, ultimately calming down inflammation. There are likely multiple intricate processes going on in the body that create this effect.
If your doctor recommends light therapy, you’ll likely need to visit their office about three times each week, for 10 to 15 minutes per session, Dr. Ferris says. Over time, you probably won’t need to go in for treatment as frequently. “I have some patients who come maybe once a week, and that really maintains them,” Dr. Ferris says, adding that other people do well coming in just once every two weeks.
“Managing stress as much as possible is always ideal,” Dr. Burris says. This is true for anyone, but especially for someone with psoriasis. “We don’t really know why stress causes [psoriasis and other] skin diseases to flare, but it really does,” Dr. Ferris says.
If you’re not sure how to relieve stress, consider yoga, meditation, journaling, exercise, sharing your feelings with a friend, or making an appointment with a therapist or other mental health professional. These stress-relieving activities and grounding exercises are a good place to start too.
A hot shower or bath in the winter might feel great at the time, but in the long run, it isn’t doing you any favors. In fact, hot water can seriously dry out your skin and strip it of nourishing oils. The AAD recommends keeping showers and baths to 10 minutes or less and showering or bathing in warm water rather than hot water.
Dry skin iis rampant in the winter, and all the more so if you have psoriasis. The Mayo Clinic recommends that people with psoriasis use a moisturizer every day—or even more than once a day if it helps your skin symptoms. Get in the habit of moisturizing right after you shower, and reapply lotion during the day if your skin feels dry and uncomfortable. The AAD also recommends sticking to fragrance-free creams and ointments to avoid irritating sensitive skin.
Dr. Ferris says that over-the-counter moisturizers containing salicylic acid can be helpful because they help get rid of dry skin and thin or soften psoriasis plaques, making it easier for topical medications to access the skin, which could make them more effective. Dr. Ferris notes that most over-the-counter moisturizers and shampoos with salicylic acid contain such low concentrations (2–6%) that it’s not typically irritating, especially when it’s in a cream or ointment.
A humidifier adds moisture back into the air, which can be helpful if your skin tends to be dry, cracked, or painful during the winter. Dr. Burris recommends using a humidifier at night during the cold, dry winter months to reduce dryness and the urge to scratch—which just makes things worse. “Dry skin is itchy skin, and the less one scratches, the less likely they will experience a flare in their underlying psoriasis or even eczema,” she says.
As we know, infections and illnesses can trigger psoriasis flares. That becomes a much bigger risk during cold and flu (and COVID and RSV) season, when viral illnesses are more common, Dr. Burris says.
According to the AAD, psoriasis symptoms can flare for somewhere between two and six weeks after bronchitis or other infections. If you get sick, seeking treatment as soon as possible can help minimize your chance of a skin flare-up.
Dr. Burris recommends washing your hands frequently to stay as healthy as possible this winter. The Centers for Disease Control and Prevention (CDC) also recommends protecting yourself from illness by avoiding close contact with people who are sick, keeping your hands away from your face, wearing a face mask when COVID or flu cases are high in your area, and practicing healthy habits like getting enough sleep and eating nutritious meals.
If you try some of these tips and are still feeling bogged down by psoriasis symptoms this winter, remember the very first one: See your dermatologist, and don’t hesitate to make another appointment if something isn’t working. They can help you learn to manage your condition better—and find a treatment that soothes you all year long.
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