Friday, 30 June 2023

5 Things to Stop Doing Right Now for Psoriasis

From healthcentral.com

Keep flares at bay by ditching these habits that can do a number on your skin

Apply your topical treatments. Avoid your triggers. Keep your skin moist. Stay in touch with your derm. Lower your stress. If you’ve lived with psoriasis for a while, this skin-care checklist will be second nature to you. But what about the things you shouldn’t be doing? It’s easy to overlook some less-obvious lifestyle tips, but they can have a big impact on your skin health.

Whether you’re still having regular psoriasis flare-ups you can’t link to any particular trigger, or you simply want to make sure you’re doing everything you can to keep your skin in the best possible condition, try adding—or subtracting!—these tips from your list.

1. Quit Smoking

We know you know, but it still needs to be said: Smoking is a major health hazard, proven to cause cancer, stroke, and heart disease, per the Centres for Disease Control and Prevention (CDC). Smoking increases inflammation in the body, says New York-based dermatologist Radha Mikkilineni, M.D., who is also clinical assistant professor at Cornell Medical School, Department of Dermatology-New York Presbyterian Hospital. The raised scaly skin patches from psoriasis result from systemic inflammation most-likely due to a misfire in the immune system. So Dr. Mikkilineni’s warning won’t come as a surprise: “Smoking reduces the effectiveness of treatment for psoriasis as it is pro-inflammatory and stimulates precisely what we are attempting to reduce in these patients.”

Smoking also impacts how certain drugs are metabolized by your body, which can make meds less effective, adds Karan Lal, D.O., director of paediatric dermatology and cosmetic surgery at Affiliated Dermatology in Scottsdale, AZ.

Research has shown that smoking increases the risk of developing psoriasis and having more severe flare ups of the disease. One study of nurses and other health professionals, published in the American Journal of Epidemiology, found that the risk of developing psoriasis is almost double in long-term smokers, compared with people who have never smoked. Another study of 276 psoriasis patients, published in Dermatologic Therapy, found that smokers may have an increased need for systemic treatment for psoriasis, such as biologics. 

If you have psoriasis and want to quit smoking, ask your dermatologist for the best next steps. Various quitting aids are available (like nicotine patches) but it’s important to check whether they could trigger your psoriasis, says the American Academy of Dermatology (AAD). The CDC offers free confidential coaching via the number (1-800-QUIT-NOW).

2. Stop Ignoring Antioxidants

According to a review article published in the British Journal of Dermatology, people with psoriasis often have decreased levels of antioxidant nutrients like beta-carotene, vitamin E, and selenium. Scientists believe this is due to a compromised gut barrier, which can impact nutrient synthesis and absorption, according to the International Journal of Molecular Sciences. Antioxidants are molecules that fight free radicals (compounds that can cause damage to the body if their levels aren’t kept in check) and reduce the risk of disease.

A simple way to strengthen your antioxidant defences is to drink green tea, which is packed with antioxidants, including polyphenols, which are also believed to reduce inflammation (always a good thing when you have psoriasis). Hit up our Anti-inflammatory Cooking Club for more good eats.

As well as being present in many types of food, antioxidants are available in supplement form. Dr. Mikkilineni recommends the oral antioxidant polypodium leucotomos (e.g. Heliocare) to protect the skin from inflammatory conditions as well as sun damage and rashes that develop from sun exposure. While we still lack strong research supporting anti-inflammatory diets or supplements for treating psoriasis, an article in the journal Antioxidants says these strategies have promising potential for psoriasis and can enhance disease management.

3. Stop Blaming Yourself

Psoriasis is a stressful condition in itself, but the pressure from social media and a beauty-focused society to have smooth, glowing, blemish-free skin can increase the stress potential enormously. “Making comparisons [between your skin and others’] can wreak havoc if you have obvious psoriasis,” Dr. Lal says. “It's very important to work in partnership with your dermatologist to understand the etiology (cause) of psoriasis—it is not your fault.”

It’s also important for doctors to weigh the pros and cons of the mental stress caused by psoriasis with the risks of medications, Dr. Mikkilineni adds. She says that sometimes she’ll go to systemic meds faster (rather than a more conservative approach with topicals, the usual first-line treatment) if a patient is under severe stress as a result of their condition. “It means they can get relief faster,” she explains. “I think patients often feel that systemic medications for their psoriasis are a huge step and are fearful of them. I try to explain that these medications work and in the right circumstances with the right patient can result in a huge quality of life improvement.”

Dr. Mikkilineni also advises patients to seek mental health support. “Some patients can benefit from cognitive behavioural therapy (CBT) and meditation,” she says.

4. Step Away From Stress

If cutting out stress was easy, the whole world would be floating on a sea of chill. But we all handle stress differently and have our own stressful experiences to deal with. “Having a chronic disease in itself is stressful and you have minimal control of it,” says Dr. Lal. “But psoriasis can be managed.”

Dr. Lal believes that manifestation is the key to a healthy life (while staying on top of your derm-approved treatment plan, of course). “If you keep your mind positive, you’re more likely to have a better outcome,” he says, adding that seeing a therapist is a great way to develop a positive framework on life. And remember, “psoriasis is a treatable condition and I have never not been able to clear a patient’s skin. Don’t give up—and find a dermatologist who fully supports your endeavour.”

Practical stress-relieving tips from the AAD include yoga, support groups, deep breathing exercises, and keeping daily gratitude lists.

5. Let Go of Harsh Bathing Routines

It’s a myth that you have to cut down on your bathing if you have psoriasis—there’s no benefit to this, as the skin barrier is not impaired in the same way as it is with atopic dermatitis (eczema), explains Dr. Mikkilineni—but there are modifications you can make to get the most out of bath time.

“It’s important not to use abrasive soaps and sponges on areas of psoriasis as this can worsen and even expand the psoriatic patches,” Dr. Mikkilineni says.

Dr. Lal recommends bathing daily with salicylic acid-based cleansers that can help soften and remove some of the scaling from plaques. Plus, keep baths to 15 minutes or less and showers to five minutes or less, use warm (not hot) water, and dry your skin—very gently—by patting it with a towel, before applying a fragrance-free moisturizer to all of your skin while it’s still slightly damp, per the AAD.

Finally—as always—don’t forget the basics! “Another aspect of skin health is overall health,” says Dr. Mikkilineni. “I cannot emphasize enough how proper nutrition and avoidance of sugary and highly processed foods can help maintain a healthy weight, reduce insulin resistance, and help with sleep and stress.” All of which can help you keep your psoriasis symptoms under control, and those flare ups to a minimum.

https://www.healthcentral.com/condition/psoriasis/5-things-to-stop-doing-right-now-for-psoriasis 

Wednesday, 28 June 2023

10 Tips for Managing a Psoriasis Flare

From healthline.com

Taking your medication as directed by your doctor is the first step in preventing psoriasis flare-ups.

You can also do other things to minimize symptoms and get relief quickly. Here are 10 to consider.

Keeping your skin lubricated can go a long way in preventing or worsening dry, itchy skin caused by a psoriasis flare-up. It can also help reduce redness and heal the skin, making your flare-up easier to manage.

The National Psoriasis Foundation recommends using heavy creams or ointments that lock in water. Look for moisturizers that are fragrance-free or alcohol-free. Fragrances and alcohol can actually dry out your skin.

If you’re looking for a natural or cost-effective solution, you can use cooking oils or shortening to keep your skin moisturized. When in doubt, ask your dermatologist for a recommendation.

Take shorter showers with lukewarm water to help protect your skin’s moisture. Be sure to use fragrance-free soaps. Always apply moisturizer after showering, washing your face, or washing your hands.

Add oil to bathwater if you prefer taking baths, or are looking to soothe dry, itchy skin. Soaking in Epsom or Dead Sea salts is recommended for itchy skin. Be sure to limit your bath time to 15 minutes and moisturize immediately afterward.

Try putting your creams or moisturizers in the refrigerator. This can help soothe the burning sensation that often accompanies the itching during a flare-up.

Try to resist the urge to scratch or rub your scalp during a flare-up. Doing so can cause bleeding, scabbing, and even hair loss.

Avoid using shampoos containing fragrance and alcohol. These products can dry out the scalp and worsen or even cause more flare-ups. When washing your hair, be gentle. Avoid scratching or scrubbing your scalp.

A scale softener that contains salicylic acid can help soften and loosen patches of psoriasis plaque during a flare-up.

Stress can cause flare-ups because your body copes with stress through inflammation. The immune systems of people with psoriasis release too many of the chemicals that are released during an infection or injury.

Speak to your doctor if your psoriasis is causing you stress and anxiety. They may be able to offer suggestions for coping with stress. They can also refer you to a mental health professional, such as a psychologist or social worker.

Practicing meditation or yoga, exercising, or spending time doing things you enjoy can also reduce your stress levels.

You may find it helpful to connect with others who have psoriasis. Check with your local hospital for a psoriasis support group, or search online for one in your area.

Researchers haven’t found a link confirming diet to psoriasis. However, evidence suggests that what you eat might increase your risk for psoriasis and could affect how well your psoriasis responds to treatment.

Eating a healthy diet could also help reduce the severity of flare-ups.

2013 studyTrusted Source found that people who had overweight or obesity and psoriasis experienced a reduction in the severity of their psoriasis with a healthier diet and more exercise.

Nutritional supplements or foods containing omega-3 fatty acids may also help with your psoriasis, according to the National Psoriasis Foundation. Omega-3 fatty acids have been linked to a decrease in inflammation.

Some sources of omega-3 include:

  • fish oil supplements
  • fatty fish, such as salmon and sardines
  • nuts and seeds
  • soy
  • vegetable oils

Speak with your doctor before increasing the amount of fish oil in your diet. High amounts may thin the blood and aren’t recommended for people taking blood thinners.

Joining a local support group can help you connect with others who understand some of the challenges involved with living with psoriasis.

Plus, a support group will help you realize you’re not alone. You’ll also have the opportunity to share ideas for managing psoriasis symptoms with others.

Coal tar solutions can ease psoriasis symptoms. They’re often found in local drugstores and include:

  • medicated shampoos
  • bath foams
  • soaps
  • ointments

Treatments you can buy without a doctor’s prescription often cost less. Your doctor may include coal tar as part of a treatment plan.

Treatments that contain coal tar relieve:

  • itch
  • plaque-type psoriasis
  • scalp psoriasis
  • psoriasis on the palms of hands and soles of feet (palmoplantar psoriasis)
  • scale

Avoid using coal tar if:

  • You’re pregnant or breastfeeding.
  • You’re sensitive to sunlight.
  • You’re taking medication that makes you more sensitive to ultraviolet (UV) light.

Quitting smoking can have the following benefits for people with psoriasis:

  • reduced risk of inflammation that affects the heart, liver, blood vessels, and gums
  • reduced chance of developing Crohn’s disease and other autoimmune conditions
  • fewer incidents of psoriasis flares
  • increased periods with little or no occurrence of flares
  • experience less palmoplantar psoriasis

If you decide to use a nicotine patch to help you quit smoking, ask your doctor first. Some nicotine patches can cause your psoriasis to flare.

Alcohol can interfere with the effectiveness of your prescribed treatment plan. Here’s how:

  • Your treatment may stop working or not work as effectively as it should.
  • You may experience fewer remissions (lengths of time without flares).

There are several benefits to limiting alcohol if you have psoriasis, including:

  • increased remissions
  • for women, reduced risk of developing psoriatic arthritis
  • reduced risk of developing fatty liver disease
  • lessened risk of liver damage due to psoriasis medications

A sunburn causes injury to the skin, which then may cause psoriasis to flare.

If you plan to spend time outdoors, apply sunscreen to all exposed skin before you go outside to prevent a flare. Water-resistant sunscreen with an SPF 30 or higher is best.

For some people, psoriasis flares increase in fall and winter.

Dry indoor heating can cause dry skin, which can worsen psoriasis. Moisturising dry skin can reduce flares that occur during the coldest months of the year.

Apply a quality moisturiser to your skin after your daily shower or anytime your skin feels dry. Use warm water when bathing or showering, not hot. Limit bath time to no more than 10 minutes.

Plug in a humidifier to add moisture to indoor air to relieve dry skin.

https://www.healthline.com/health/psoriasis/managing-severe-psoriasis-flare-ups?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2023-06-27&utm_term=s:hl_n:pso&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e 

Saturday, 24 June 2023

Eczema Diet Tips to Follow And Manage Flare-ups

From pinkvilla.com

There is no one-shot eczema diet that may work for everyone. It is a journey of discovering the foods that might trigger flare-ups for you and how to prevent them 

Eczema, a common chronic skin condition, causes discomfort and irritation and often impacts a person's quality of life. While there is no definitive cure for eczema, emerging evidence suggests that adopting an eczema-focused diet can play a pivotal role in managing symptoms and promoting skin health. Discover the transformative potential of an eczema diet as it nourishes the itchy skin and offers relief from symptoms. 

The connection between diet and eczema has gained significant attention in recent years as researchers uncover the profound influence of nutrition on various bodily processes, including immune function and inflammation. Over time, it has become evident that certain dietary choices can either aggravate or alleviate eczema symptoms, offering new directions to control atopic dermatitis apart from medical treatments.

In this article, we will explore the fundamental principles underlying an eczema-friendly diet, examine the scientific rationale behind its effectiveness, and provide practical dietary guidelines to empower individuals to make informed choices for healthier skin. 

As we navigate this informative journey, it is important to remember that dietary modifications should always be pursued with professional medical advice. Understanding the intricate relationship between what we eat and how it affects our skin can unlock a powerful tool for managing eczema and nurturing skin health from within. 

What Is Eczema?

Eczema, scientifically known as atopic dermatitis, is an inflammatory condition that is known to affect people of different ages. With its typical characteristic of causing itchy and inflamed skin patches, it also accompanies blisters, dryness, and scaling. It is most commonly found on the face, hands, elbows, and behind the knees. 

The causes of eczema are not yet fully understood, but genetics and environmental factors play a major role in the aggravation of the chronic disease.  People with eczema often have a compromised skin barrier, which allows irritants and allergens to penetrate the skin more easily. This triggers an immune response, leading to inflammation and the characteristic symptoms of eczema.

The condition is usually accompanied by severe itching, which causes people to scratch the affected areas. Scratching, on the other hand, aggravates the symptoms by making the skin more inflamed, thickened, and susceptible to infection. 

While there is no cure for eczema, various treatment approaches aim to manage the symptoms and improve skin health. These include moisturizing the skin, avoiding triggers such as certain fabrics or chemicals, and using topical corticosteroids or immunomodulators to reduce inflammation. In severe cases, medications may be prescribed.

In recent years, there have been several types of research looking into the role of diet in managing eczema. While specific dietary triggers may vary among individuals, certain foods have been linked to eczema flare-ups, such as dairy products, eggs, nuts, and gluten. Consequently, adopting an eczema diet that focuses on anti-inflammatory and nutrient-rich foods may help alleviate symptoms and support skin health.

What Are the Different Types of Eczema?

eczema diet

To ensure proper treatment, it is more important to classify the type of dermatitis. Here are the most common types of dermatitis found in people across the world. 

1. Atopic Dermatitis 

The most common type of eczema is atopic dermatitis. It is known to occur in individuals with a family history of asthma or a severe allergy to food. Healthcare professionals prefer it to be known as an atopic triad, meaning three. It accompanies hay fever and asthma in patients with atopic dermatitis. 

The red rashes may appear over the elbow and knee creases or may appear as small bumps filled with fluid. Dry skin, genetics, a weaker immune system, and a colder environment may trigger atopic dermatitis.  

2. Contact Dermatitis

Contact dermatitis has two types. Firstly, irritant contact dermatitis occurs when the skin comes into direct contact with an irritating agent such as detergents, particular fragrances, soaps, or chemicals. While allergic contact dermatitis, on the other hand, arises from an allergic reaction to specific substances such as certain metals, cosmetics, or plants like poison ivy, it shows typical symptoms of red, itchy, bumpy skin that may also look pink or magenta in colour, which over time gives a thick, scaly, or leathery look to the skin. 

3. Nummular Eczema

Coin-shaped or oval areas of inflamed skin that may be itchy and painful are the hallmarks of this kind of eczema. Although there is no recognized reason for nummular dermatitis, it is frequently brought on by dry skin, irritants, or skin trauma. It can be difficult to control and seems to happen more frequently in the winter.

4. Dyshidrotic Eczema 

Small, irritating blisters develop on the palms, sides of the fingers, and soles of the feet as a result of dyshidrotic eczema, which mostly affects the hands and feet. Dyshidrotic eczema is often linked to elements like stress, allergies, or exposure to certain metals. The blisters may hurt, and they can cause the skin to peel, split, and become dry.

5. Seborrheic Dermatitis

Seborrheic dermatitis primarily affects the scalp, causing dandruff-like flakes, redness, and itching. It can also occur in other oily areas of the body, such as the face, ears, chest, and groin. Seborrheic dermatitis is associated with an overgrowth of yeast on the skin and may be influenced by factors such as hormones, stress, or certain medical conditions.

6. Stasis Dermatitis

This type of eczema typically affects individuals with poor blood circulation, usually occurring in the lower legs. Stasis dermatitis results from fluid build-up (edema) in the legs, leading to swelling, redness, itching, and skin discoloration. It is also commonly seen in individuals with varicose veins or a history of leg vein problems.

How to Get Rid of Eczema?

eczema diet

Eczema is a chronic condition that currently has no known cure. However, with proper care and treatment, it is possible to control the symptoms, which may help you live a better quality of life. 

1. Topical Treatments

Moisturizers can be used to hydrate the skin and manage itching and inflammation. This includes emollients (moisturizers), corticosteroids, and topical calcineurin inhibitors (TCIs) that help manage inflammation. 

2. Antihistamines

Oral antihistamines can help alleviate itching and improve sleep quality, especially during flare-ups. They are particularly useful for individuals who experience severe itching at night.

3. Wet Wrap Therapy

This technique involves applying moisturizer or medication to the affected areas and then covering them with wet bandages or garments to enhance hydration, reduce inflammation, and provide relief.

4. Avoid Triggers

Identifying and avoiding triggers that exacerbate eczema symptoms is crucial. These triggers can include certain fabrics, harsh soaps or detergents, environmental allergens, stress, and certain foods. Keeping a journal and working with a healthcare professional can help identify individual triggers.

5. Systemic Medications

In severe cases, when other treatments have not been effective, systemic medications such as oral corticosteroids, immunosuppressants, or biologics may be prescribed. These medications may have potential side effects and are typically used for short periods under close medical supervision.

6. Lifestyle And Skincare Practices

This is one of the main factors to take care of while suffering from atopic eczema. Maintaining good skin care habits, avoiding scratching the infected area, and applying moisturizer generously are the keys to a healthy skin routine. 

Additionally, managing stress levels, practicing stress-reducing techniques, and wearing soft, breathable clothing can contribute to symptom improvement.

While eczema cannot be completely eradicated, people can achieve significant control over their symptoms and enjoy long periods of remission. Working closely with healthcare professionals like dermatologists and allergists to develop an individualized treatment plan that addresses specific triggers and needs is critical. 

Best Eczema Diet Tips And Plan to Try

Certainly! There are different types of diets that individuals with eczema may consider incorporating into their lifestyle. Just like not one size fits all, it is of no surety that this diet may help you control your symptoms. However, you may try and test first before going full-fledged. A diet for eczema includes plenty of fruits, vegetables, and probiotics. Keep reading to know more about ways to cure eczema with diet. 

1. Mediterranean Diet

eczema diet

The Mediterranean Diet is all about fruits, vegetables, whole grains, legumes, nuts, seeds, and healthy fats like olive oil. It also includes moderate consumption of fish, poultry, and dairy products while limiting the consumption of meat and processed foods. The purpose of this diet is to include omega-3 and quercetin in the diet; both are known to reduce inflammation and promote skin health. 

2. Gluten-free Diet

People allergic to gluten may find this type of diet beneficial. Gluten is a protein found in wheat, barley, rye, and many other grains. In some cases, eczema may be amplified by a gluten allergy. Eliminating gluten-containing foods can be an option to try when suffering from a severe gluten allergy and eczema as well. 

3. Elimination Diet

An elimination diet is an approach to identifying potential food triggers, gradually eliminating them from your diet, and reintroducing them one by one. This process helps pinpoint any specific food allergies or sensitivities that might be causing eczema flare-ups. According to a recent review of research, it was discovered that the diet could potentially result in a mild reduction in the severity of eczema in certain individuals. However, further studies are required to obtain more conclusive evidence.

4. Anti-Inflammatory Diet

eczema diet

The anti-inflammatory diet aims to minimize inflammation within the body, offering potential benefits for individuals seeking to manage eczema symptoms.  The dietary approach for this type of diet typically involves antioxidant-rich foods such as fruits, veggies, whole grains, fatty fish, and healthy fats such as olive oil. The purpose is to reduce the inflammation caused by eczema, which may help reduce the symptoms further.

Foods to Eat 

There are some foods that have been reported to help alleviate eczema symptoms. However, this may vary for different people, and hence, you should know what works best for you with the trial-and-error method. 

1. Omega-3 Fatty Acids

Omega-3 fatty acids have anti-inflammatory properties, which may help reduce the symptomatic inflammation caused by eczema outbreaks. 

Fatty fish such as salmon, mackerel, and sardines are great sources of omega-3 fatty acids. Furthermore, flaxseeds, chia seeds, and walnuts are some of the best vegan sources of omega-3. 

2. Probiotic-rich Foods

Bacteria present in probiotics are known to improve gut health and also influence body immunity. Probiotics found in foods like kefir, lime, sauerkraut, yogurt, and kimchi may help control eczema symptoms. 

3. Antioxidants

Antioxidants can help protect the body's cells from damage caused by free radicals. Including foods high in antioxidants may help relieve symptoms of eczema. According to research, drinking black, green, and oolong tea may help ease the symptoms. 

4. Foods Containing Quercetin

eczema diet

Quercetin is a flavonoid present in plants. It is responsible for the rich, deep colours of flowers, fruits, and vegetables. However, it is also known for its antioxidant and anti-inflammatory properties, which may help relieve symptomatic inflammation. 

Foods like apples, onions, berries, lime, oranges, and grapes contain quercetin and may be beneficial in managing eczema symptoms. 

What Are the Main Foods to Avoid with Eczema?

Eczema foods that trigger symptoms are best to be avoided. Keeping a food diary and monitoring symptom changes can also be helpful in pinpointing specific foods to avoid. Below is a potential list of foods to avoid with eczema:

1. Dairy Products

Milk, cheese, yogurt, and other dairy products include proteins that may cause allergic reactions or exacerbate eczema symptoms in some people.

2. Eggs

Eggs, especially egg whites, are well-known allergens and can aggravate eczema in those who are prone to it.

3. Wheat And Gluten

Some people with eczema may have issues with wheat and gluten-containing foods, especially if they have celiac disease or gluten sensitivity. These foods include wheat, barley, and rye.

4. Soy

Soy and soy-based products, such as tofu and soy milk, might exacerbate eczema symptoms in some people or cause allergic responses.

5. Nuts And Peanuts

eczema diet

Nuts rank among the top 10 most allergic foods in the US. Tree nuts, such as almonds, walnuts, and cashews, as well as peanuts, are popular allergies that aggravate an eczema condition.

6. Shellfish

All kinds of shellfish, including shrimp, crabs, clams, mussels, and lobsters, are susceptible to worsening an atopic dermatitis condition. While this also does not mean completely eliminating seafood from the diet, one can include it as early as the age of 4 years in very moderate amounts.  

7. Citrus Fruits

Citrus fruits like oranges, lemons, and grapefruits are acidic and can irritate the skin or worsen eczema symptoms in some individuals.

8. Spicy Foods

eczema diet

Spicy foods, such as hot peppers and spicy sauces, may trigger flushing or itching in certain individuals with eczema. 

9. Food Additives

Some additives, like preservatives, artificial flavours, and food colouring, may contribute to eczema flare-ups in susceptible individuals.

This is a form of elimination diet, and it may require medical supervision before shifting your routine diet. Hence, rather than eliminating all the triggers, a healthcare professional may help you with your customized “trigger foods” as per your condition and severity. Below is the list to guide you through the eczema diet plan. 

  • Monitoring is the key to helping you avoid allergic foods. Maintaining a journal to note down your daily intake of foods and drinks may help you narrow down your potential food triggers. 
  • Once you have completely eliminated all the trigger foods from your diet, start adding one at a time. It will help you understand which one is the root cause of the problem. 
  • Try to wait at least a day or two before adding another trigger food to your diet. Some allergens may take up to 48 hours to react. 

Conclusion 

Adopting a strategic approach to your eczema diet tips can be a valuable component in managing eczema symptoms. While there is no one-size-fits-all eczema diet, incorporating certain dietary practices can potentially help alleviate symptoms and promote overall skin health.

Focus on consuming foods rich in antioxidants, such as colourful fruits and vegetables, as they can protect against cell damage caused by free radicals. Additionally, including omega-3 fatty acids from sources like fatty fish, flaxseeds, and walnuts may have anti-inflammatory effects. 

Pay attention to potential trigger foods that are commonly associated with eczema flare-ups, such as dairy products, eggs, wheat, soy, nuts, and shellfish. Identifying and avoiding personal food triggers can be crucial. Lastly, maintaining a food diary and seeking guidance from healthcare professionals or registered dietitians can assist in tailoring an individualized approach to the eczema diet. By implementing these dietary tips, you may get the opportunity to better manage your eczema symptoms and improve your overall quality of life. 

https://www.pinkvilla.com/health/nutrition/eczema-diet-1226966

Wednesday, 21 June 2023

Q&A: Psoriatic arthritis and its impact on sleep

From healio.com

Key takeaways:

  • Rheumatologists and primary care physicians play a crucial role in addressing sleep problems among patients with psoriatic arthritis.
  • 73% of patients with psoriatic arthritis report poor sleep quality.

Healio spoke with Lourdes Perez-Chada, MD, MMSc, an instructor in dermatology and assistant director for Master of Medical Sciences in Clinical Investigation at Harvard Medical School, about how patients with psoriatic arthritis are impacted by sleep issues, and how rheumatologists and primary care physicians can address this issue.

Lourdes Perez Chada
Lourdes Perez-Chada

Healio: How common is it for patients with PsA to experience sleep problems? Examples of these problems?

Perez-Chada: Sleep problems in patients with PsA are very common. The most reported sleep problem is poor sleep quality. In a recent meta-analysis conducted by our study group, we found that 73% of patients with PsA report poor sleep quality as measured by a validated tool called the Pittsburgh Sleep Quality Index. Sleep quality is only one of the dimensions of “sleep health.” There are other dimensions of sleep health that could be affected in these patients including daytime alertness, sleep timing, duration, efficiency, and regularity. However, there is limited data about these other sleep health dimensions. With regards to discrete sleep disorders, a Danish cohort study showed that patients with PsA have a higher risk of developing obstructive sleep apnoea (OSA), and vice versa. However, data on the prevalence of OSA remains limited.

Healio: How many of those patients receive treatment for these sleep problems? Examples of treatment?

Perez-Chada: That is a great question, though further research is needed to answer it. The type of possible sleep therapies depends on the nature of the sleep problem. For example, if a patient suffers from chronic insomnia, cognitive behavioural therapy for insomnia (CBT-I) is considered the gold standard therapy. Instead, if a patient suffers from obstructive sleep apnoea, possible therapies might include Continuous Positive Airway Pressure (CPAP), oral appliances or even surgery.

Perez-Chada pull quote

Healio: Does the severity of the PsA symptoms have a direct impact on sleep? And vice versa, how can lack of sleep impact PsA symptoms?

Perez-Chada: In our qualitative study involving patients with PsA, we aimed to gain insight into their sleep experiences. Our findings revealed a possible bidirectional connection between PsA symptoms and sleep. Patients frequently expressed difficulties in either initiating or maintaining sleep due to musculoskeletal pain and itching associated with PsA. Additionally, they mentioned that their musculoskeletal pain hindered their ability to find a comfortable sleeping position. Interestingly, patients also reported that inadequate sleep exacerbated their musculoskeletal pain and itching sensations.

However, it is important to note that these observations were derived from qualitative data, and quantitative studies have yet to confirm these relationships. To address this gap, we have initiated a longitudinal study where we collect daily data on PsA symptoms and sleep patterns. This study is being funded by a pilot research grant received from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). By utilizing both subjective measures, such as sleep questionnaires and diaries, and objective measures, such as actigraphy, we aim to quantify these associations. This comprehensive approach will provide a more robust understanding of the interplay between PsA symptoms and sleep quality.

Healio: If patients with PsA don’t get treatment for their sleep issues, could it hurt their overall PsA disease activity? In what ways?

Perez-Chada: Cross-sectional studies have shown an association between poor sleep quality and disease activity. However, longitudinal studies testing the directionality of this association have not been conducted.

Considering that PsA is characterized by underlying systemic inflammation and that inadequate sleep is associated with inflammatory dysregulation, it is possible that poor sleep health among PsA patients may exacerbate the overall inflammatory burden, consequently leading to heightened disease activity. Our study group is currently conducting a prospective study to test this hypothesis.  By revealing the potential link between poor sleep health and disease activity in PsA, we hope to pave the way for improved treatment strategies that address not only the underlying inflammation but also the sleep-related factors that may contribute to disease severity.

Healio: How do you approach the discussion of sleep with your patients with PsA?

Perez-Chada: Rheumatologists and PCPs play a crucial role in addressing sleep problems among patients with PsA. To effectively initiate discussions about sleep problems, rheumatologists/PCPs can employ several approaches:

  1. Assessing sleep quality: Rheumatologists and PCPs should inquire about various aspects of sleep that could be affected, including sleep quality, difficulties with falling asleep or staying asleep, snoring, daytime sleepiness, and how sleep problems impact their patients' daily lives.
  2. Providing information: Rheumatologists and PCPs should educate their patients about the connection between PsA and sleep problems. It is important to explain how pain, itching, and inflammation associated with PsA can disrupt sleep patterns, and vice versa. Patients should be informed about the significance of addressing sleep problems to enhance their overall well-being.
  3. Screening for sleep disorders: Rheumatologists and PCPs can utilize validated screening tools to identify potential sleep disorders like insomnia, sleep apnoea, or restless legs syndrome. This screening process enables them to identify patients who may require further evaluation or referral to sleep specialists.
  4. Medication review: Rheumatologists and PCPs should carefully review the patient's current medication regimen to identify any medications that might contribute to sleep disturbances. If feasible, adjustments to medications can be made or alternative options explored to minimize their impact on sleep.
  5. Providing sleep advice: Rheumatologists and PCPs should offer guidance on maintaining a consistent sleep schedule, creating a comfortable sleep environment, practicing relaxation techniques, and avoiding factors that can disrupt sleep, such as caffeine or excessive screen time before bed. 
  6. By proactively addressing sleep problems, rheumatologists and PCPs can contribute to improved disease management, enhanced quality of life, and better overall health outcomes for their patients with PsA.

https://www.healio.com/news/rheumatology/20230613/qa-psoriatic-arthritis-and-its-impact-on-sleep