From everydayhealth.com
Psoriasis — along with some medications used to treat it — can wreak havoc on your immune system. Here’s how to stay healthy and improve your immunity while managing this chronic condition
Your immune system is made up of cells, tissues, and organs that help your body stay healthy and fight infections. But when you have psoriasis, your immune system doesn’t always work the way it should.
“Psoriasis revs up your immune system like there’s something that it’s trying to fight, but there’s actually nothing there,” says Anne Truitt, MD, a dermatologist at Skin Surgery Medical Group in San Diego. The resulting inflammation in your body leads to psoriasis symptoms such as skin plaques, according to the National Psoriasis Foundation (NPF).
Due to the nature of psoriasis, some of the medications used to treat it are also designed to affect the way your immune system works. “Because psoriasis is a condition where the immune system is ‘upregulated,’ when we use medicines to ‘downregulate’ the immune system, the medications that treat psoriasis can decrease your immunity,” says Marisa Garshick, MD, an assistant clinical professor of dermatology at NewYork-Presbyterian Weill Cornell Medical Centre and dermatologist at MDCS Dermatology in New York City.
This is especially true of systemic drugs, such as methotrexate. Those drugs tamp down the entire immune system to slow down psoriasis. Newer drugs such as biologics act on the immune system in a different way. Because they only target specific immune cells or proteins linked to psoriasis, they don’t affect the rest of the immune system the way systemic drugs do. That said, “Some biologics may carry an increased risk of certain types of infections, based on the particular cytokine or marker that they are decreasing,” Dr. Garshick says.
Treatment options such as topical medications don’t tend to affect the immune system as much, either, because they aren’t ingested or administered inside the body.
No matter which medication you take, it’s good to keep your immune system working as well as it can. Here’s how to do just that.
Strategies to Stay Healthy With Psoriasis
You may wonder if you need to do anything special to improve your immunity, especially in the colder months. “I think it’s important for everybody to boost their immune system during cold and flu season. But it’s also well documented in literature that psoriasis patients are at a higher risk of catching the flu than the average person,” says Dr. Truitt. This is especially true for those who take systemic medication.
The good news? Taking measures to prevent infections can not only help you stay healthy but also lower the frequency and severity of psoriasis flares. Start with these strategies.
1. Wash Your Hands Often
Even though COVID-19 has died down, washing hands is still key to cutting down the risk of any infection. And for people with compromised immunity, proper handwashing can reduce the incidence of colds by up to 21 percent, according to research published in the Annals of Translational Medicine.
Wash your hands before and after eating or preparing food, after coughing or blowing your nose, after using the toilet, and when you arrive somewhere new.
Because psoriasis patches tend to be dry, opt for handwashing instead of hand sanitizers whenever possible. “Stay away from sanitizers that have a lot of alcohol or drying components to it,” Truitt advises. “And then make sure that you’re moisturizing with a bland moisturizer after drying your hands.”
2. Get All of Your Recommended Vaccines
Just 31 percent of people with psoriasis got the flu vaccine during the 2018–2019 season, even though it was recommended to almost all of them, according to one study. This may be in part because people worry that the vaccine will trigger their immune system and lead to a psoriasis flare. But the opposite may be true, according to another study. Researchers found that people with moderate-to-severe psoriasis benefit from influenza, pneumococcal, and shingles vaccines.
Talk to your doctor about which vaccines are recommended for you, based on your age and vaccine history.
3. Exercise Regularly
There are countless benefits to exercise, including better immunity. Research has found that regular physical activity can prepare and strengthen the immune system against communicable diseases such as COVID-19.
“There’s also definitely a strong correlation between regular exercising and reducing your psoriasis flares,” says Truitt. “Exercise also helps reduce the comorbidities associated with psoriasis like obesity, diabetes, and cardiovascular issues.”
Exercising regularly can also help with losing weight or maintaining a healthy weight. Doing so helps reduce inflammation in the body, which can improve psoriasis and reduce the risk of these comorbidities.
4. Eat an Anti-Inflammatory Diet
To both strengthen your immune system and reduce inflammation in your body, stick to an anti-inflammatory diet, suggests the University of Pittsburgh Medical Center. This includes plenty of:
- Plant-based foods: fruits, vegetables, whole grains, beans
- Oily fish: salmon, sardines, mackerel
- Healthy fats: olive oil, nuts, avocados
You should also limit your intake of processed, packaged, and sugary foods, such as fried foods, processed meats, chips, and cookies.
5. Prioritise Sleep
Almost 90 percent of people with psoriasis have trouble sleeping, according to researchers at the University of California in San Francisco. When you’re flaring and itchy, it can be hard to sleep. Unfortunately, lack of sleep is tied to poorer immunity.
To get the best rest possible, practice good sleep hygiene by sticking to a regular sleep-wake schedule and keeping your bedroom cool, quiet, and free of electronics. Talk to your doctor about other strategies that might help, based on your individual circumstances.
6. Get Enough Vitamin D
Research suggests people with psoriasis may have low vitamin D levels. It’s not only linked to immunity. “Vitamin D is essential for healthy skin. It calms inflammation and helps normalize skin turnover,” says Truitt.
To get more vitamin D, eat dairy, fish, and soy alternatives fortified with the vitamin, or talk to your doctor about supplements. Spending time outdoors can help you absorb some vitamin D from the sun, too, which may also improve the appearance of psoriasis skin. Just be sure to limit your time in the sunshine and wear sunscreen.
Speak With Your Doctor
A healthy lifestyle can go a long way toward helping your immunity and your psoriasis. “If you have any concerns about infections, it’s always best to speak with your doctor to determine the specific risks related to your particular [psoriasis] medication,” says Garshick.
Your doctor may be able to switch you to another medication that will manage flares without affecting immunity.
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