Sunday, 1 June 2025

Living Better with Psoriatic Arthritis: How Lifestyle Changes Can Make a Difference

From medscape.com

Psoriatic arthritis (PsA), a chronic inflammatory condition characterized by dactylitis, enthesitis, peripheral arthritis, skin and nail psoriasis, and spondylitis, occurs in around 10%-30% of people with psoriasis. While several pharmacological treatment strategies exist, PsA continues to significantly impact patients' pain levels, functional capacity, and mental well-being. 

Along with joint and skin manifestations, PsA is associated with several comorbidities, including cardiovascular disease (CVD), central sensitization syndrome, diabetes mellitus, dyslipidemia, fatty liver disease, gout, infections, inflammatory bowel disease, kidney disease, metabolic syndromeobesity, osteoporosis, and uveitis, all of which negatively impact quality of life (QOL). Patients with PsA are also more likely to experience psychological issues, such as anxiety and depression. Given these challenges, nonpharmacological interventions play a key role in disease management. Healthy lifestyle changes, including dietary modifications, regular exercise, and quitting smoking — along with psychological interventions — are essential to improve PsA and QOL. Here are common nonpharmacological interventions that can improve symptoms and QOL of patients with PsA.

In their treatment guideline, the American College of Rheumatology and National Psoriasis Foundation (ACR/NPF) recommend nonpharmacological interventions for PsA, including acupuncture, low-impact exercise, massage, occupational therapy, physical therapy, smoking cessation, and weight loss despite weak evidence for all except smoking cessation.

The Importance of Physical Activity in Reducing Inflammation

Physical activity and targeted exercises play an important role in reducing inflammation, disease severity, and outcomes in patients with PsA. Studies have found that exercise, particularly when combined with dietary modifications, can improve PsA symptoms. The ACR/NPF recommend low-impact exercise over high-impact exercise for managing PsA. In their guideline, the European Alliance of Associations for Rheumatology notes regular physical activity as an integral part of care for patients with PsA.

Regular exercise, including resistance training, aerobic, and flexibility exercises may improve and preserve joint function, reduce inflammation, and enhance QOL in patients with PsA. A 12-week single-blind parallel randomized controlled trial by Silva et al found functional training and resistance training similarly improved disease activity, functional capacity, functional status, general QOL, and muscle strength in patients with PsA. 

The Link Between Diet and Inflammation in PsA

Dietary interventions focused on weight loss alleviate mechanical strain on the joints and reduce the risk of CVD in patients with PsA. Weight loss has also been shown to improve disease activity. Moreover, research suggests some dietary modifications, along with exercise, can improve PsA disease outcomes independent of weight loss. Diets rich in saturated fats or certain omega-6 fatty acids while anti-inflammatory diets can improve PsA symptoms and disease activity. Among various anti-inflammatory diets, the Mediterranean diet has gained the most popularity as studies have found it to be associated with lower disease activity in patients with PsA. 

According to the Medical Board of the National Psoriasis Foundation, patients with PsA may consider the Mediterranean diet on a trial basis in conjunction with pharmacotherapy. The NPF medical board also emphasizes increased intake of fiber, complex carbohydrates, monosaturated fatty acids, and omega-3 fatty acids. Although other dietary interventions for improving PsA are less studied, a case report by Lewandowska et al found a whole-food vegan diet improved PsA symptoms a 40-year-old woman. Further research, however, is needed to confirm the role of vegetarian or vegan diets in modulating PsA disease activity.

Smoking: What Role Does It Play?

The association between smoking and the development of PsA remains inconclusive, with studies yielding mixed results. At the population level, smoking is positively associated with PsA. However, some studies suggest smoking increases the risk of developing PsA, while others indicate no significant association between cigarette smoking and the progression of joint damage. Beyond disease onset, smoking has been linked to poorer treatment outcomes in PsA. An observational cohort study by Højgaard et al found that patients with PsA who smoke had poor responses to treatment with tumour necrosis factor-α inhibitors and were also less likely to adhere to their treatment plan. Additionally, smoking is a risk factor for CVD and other comorbidities common in PsA. Therefore, smoking cessation is an important lifestyle intervention for patients with PsA — not only to improve treatment efficacy but also to reduce the risk of other comorbidities, thereby improving the QOL.

Integrating Weight Management in PsA Care

The relationship between PsA and obesity appears to be bidirectional: Research has shown obesity is a common risk factor for developing PsA and that joint dysfunction and reduced physical activity due to PsA itself may result in weight gain. Patients with PsA and obesity often exhibit higher disease activity and poor response to treatment. An interventional study by Klingberg et al showed weight loss treatment with a very low energy diet improved disease activity, pain, fatigue, and C-reactive protein in patients with PsA and obesity. Similarly, another study by Klingberg et al also reported improvement in PsA disease activity after 12 months of weight loss treatment.

In addition to diet and exercise, GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists and incretins associated with weight loss may benefit patients with PsA and obesity. However, research on the effect of such drugs on PsA is quite limited still and requires further investigation. 

The Bidirectional Link Between Sleep and Inflammation

In addition to obesity, there also appears to be a bidirectional relationship between PsA and sleep disorders. Persistent sleep disorders in PsA may be interconnected with inflammatory disease activity, chronic pain, fatigue, and psychological distress, creating a vicious cycle where each factor intensifies the others. Prolonged and significant decline in sleep quality reduces overall QOL and increases a patient’s risk of developing CVD, hypertension, and metabolic disorders, comorbid conditions associated with PsA. Prolonged deterioration of sleep quality can negatively impact the QOL of PsA patients and increase the risk of developing hypertension, CVD, and metabolic disorders. 

Several lifestyle changes can help to improve sleep quality in patients with PsA. These include maintaining regular sleep-wake cycles, limiting alcohol and caffeine intake, and improving the patient's sleeping environment. Additionally, medications used to treat PsA — such as guselkumab, tumor necrosis factor inhibitors (adalimumabcertolizumab pegoletanerceptgolimumabinfliximab), and the Janus kinase inhibitor filgotinib — have shown potential in improving sleep outcomes in patients with PsA.

The Psychological Burden of PsA

Pain, fatigue, anxiety, and depression are common psychological comorbidities of PsA that have a negative impact on QOL. The odds of being diagnosed with behavioural and mental health disorders are higher in patients with PsA compared to the general population. Even with treatment, studies have shown that PsA affects patients emotionally, socially, and occupationally, underscoring the importance of comprehensive management since targeting the inflammatory activity of PsA alone may not improve the QOL. 

Cognitive behavioural therapy is a well-established psychological intervention that can improve symptoms of depression, anxiety, and sleep disturbances in patients with PsA. It can also improve sleep quality in PsA patients. Although research is limited, the effectiveness of cognitive behavioural therapy (CBT) to improve psychological distress may in turn improve overall QOL in patients with PsA. Although research on this is limited, CBT can prove to be beneficial in improving mood disorders and the overall QOL of PsA patients.

https://www.medscape.com/viewarticle/living-better-psoriatic-arthritis-how-lifestyle-changes-can-2025a1000cvn?src= 

Thursday, 29 May 2025

Psoriasis, Sleep, and Mental Health: What’s the Connection?

From healthcentral.com

A new study has uncovered a strong link between psoriasis, REM disturbances, and depression—suggesting the condition is anything but skin deep 

If you have psoriasis and struggle to sleep at night, your issue might be more than skin deep. New research reveals a strong connection between psoriasis, sleep problems, and mental health—with each condition potentially worsening the others. Psoriasis itself causes an overactive immune system to produce inflammation and rapid skin cell build-up, leading to itchy, uncomfortable patches that can disrupt sleep. “Stress, injury to the skin, allergens, certain medications, even infections, can all trigger a psoriasis flare,” explains Veena Vanchinathan, M.D., a board-certified dermatologist at Kaiser Permanente in San Jose, CA who is not associated with the study. These same triggers often disturb sleep patterns as well, making sleep management just as important as traditional treatments for managing psoriasis effectively.

People With Psoriasis Sleep Poorly—and Feel Worse

In the recent study, presented at the American Academy of Dermatology Spring 2025 conference, Tina Bhutani, M.D., a board-certified dermatologist in private practice and volunteer faculty member at University of California, San Francisco, found that poor sleep doesn’t just cause daytime fatigue—it can amplify mental health issues and create a cycle of worsening psoriasis flares and increasing sleep disruption.

Dr. Bhutani and fellow UCSF researchers surveyed 487 people with psoriasis and 69 individuals without the condition, using validated questionnaires to assess sleep quality, depression, and anxiety. Psoriasis patients scored significantly worse across all measures—they had more trouble falling asleep, woke more frequently, experienced more insomnia symptoms, and showed higher depression and anxiety levels.

When examining the relationship between sleep and mental health specifically within the psoriasis group, the researchers found that even after adjusting for factors like disease severity or treatment, greater sleep impairment was significantly associated with anxiety and depression.

“Our results confirm the association between sleep quality and mental health in these patients,” says Dr. Bhutani. “But it’s not just that psoriasis patients tend to have sleep issues and mental health issues separately. The data shows the worse your sleep is, the more likely you are to also be experiencing anxiety and depression.”

Why Psoriasis Might Ruin Your Sleep


It makes sense that the itching and pain from psoriasis patches significantly impact sleep quality. Past research has shown that people with psoriasis are twice as likely to have sleep issues than the general population, with more than 85% of psoriasis patients reporting sleep difficulties. But physical discomfort isn’t the only culprit.

“There’s also research that suggests the heightened inflammatory process—the very thing driving the psoriasis—might interfere with the body’s sleep regulation system,” explains Dr. Bhutani.

Dr. Bhutani first became interested in this connection when one of her patient’s psoriasis dramatically improved after his sleep quality increased. “He had really tough to treat psoriasis and we had basically tried everything,” says Dr. Bhutani. “He came in one day and his skin was practically clear.” The patient’s wife had been treated for sleep apnoea, which had been disturbing both their sleep. Once she received treatment, both got better rest—and his psoriasis nearly disappeared. This case inspired Dr. Bhutani to investigate the sleep-psoriasis relationship further.

A Holistic Approach to Managing Skin Flares

The strong interconnection between psoriasis, sleep problems, and mental health suggests these aren’t simply co-occurring conditions—they’re actively influencing each other. Psoriasis symptoms directly interfere with sleep, and that lack of restorative rest takes a toll on mental health, creating what Dr. Bhutani calls “a potentially vicious cycle” of worsening skin, poorer sleep, and increasing depression and anxiety.

While more research is forthcoming, this study demonstrates why a holistic approach to psoriasis treatment is essential. “As dermatologists, we’re trained to treat skin diseases, but we also need to encourage our patients to seek help for sleep disorders, anxiety and depression, and other associated conditions, like cardiovascular disease and diabetes,” emphasises Dr. Bhutani.

Beyond medication, making lifestyle changes that improve overall health can have a big impact on your psoriasis. Eating better, exercising more, managing stress, and, yes, improving sleep quality can all lead to fewer flare ups, clearer skin, and a happier outlook on life.

If your psoriasis symptoms are keeping you awake, talk to your doctor about topical treatments that can help soothe the itch and inflammation. After that, make sleep a priority by keeping your bedroom cool and dark to encourage your body to fall asleep and sticking to a regular schedule. “A consistent sleep schedule, same bedtime, same wake up time—even on weekends, can help you get higher quality sleep,” says Dr. Bhutani.

https://www.healthcentral.com/news/psoriasis/psoriasis-sleep-and-mental-health-connection

Tuesday, 27 May 2025

Belly fat compared to overall body fat is more strongly linked to psoriasis risk

From medicalxpress.com/news

Researchers have found that central body fat, especially around the abdomen, is more strongly linked to psoriasis risk than total body fat, particularly in women. This link between central fat and psoriasis remained consistent regardless of genetic predisposition, indicating that abdominal fat is an independent risk factor.

The study in the Journal of Investigative Dermatology, provides insights that could help improve early risk prediction and guide personalized prevention strategies.

Psoriasis is a chronic inflammatory skin condition that can have a significant impact on quality of life. Many individuals with psoriasis also have elevated levels of body fat. While it is well established that increasing levels of body fat raise the risk of developing psoriasis, the impact of specific fat distribution and genetics remains unclear.

Researchers of the current study analysed data from over 330,000 participants with white British ancestry in the UK Biobank, including more than 9,000 people with psoriasis. They examined 25 different measures of body fat using both traditional methods and advanced imaging techniques, assessing how each was associated with psoriasis.


Lead investigator Ravi Ramessur, MD, St John's Institute of Dermatology, King's College London, explains, "Our research shows that where fat is stored in the body matters when it comes to psoriasis risk. Central fat—especially around the waist—seems to play a key role. This has important implications for how we identify individuals who may be more likely to develop psoriasis or experience more severe disease, and how we approach prevention and treatment strategies."

Catherine H. Smith, MD, also at St John's Institute of Dermatology, King's College London, and senior author, adds, "As rates of obesity continue to rise globally, understanding how different patterns of body fat influence chronic inflammatory conditions such as psoriasis is important.

"Our findings suggest that central body fat contributes to psoriasis risk irrespective of  and reinforces the importance of measuring waist circumference and pro-active healthy weight strategies in psoriasis care."

Because this study only included individuals of white British ancestry from the UK Biobank, the generalizability of these findings to more diverse populations may be limited. Future studies incorporating datasets with dermatologist-confirmed diagnoses and broader ethnic representation will be important to further validate these associations and refine risk stratification approaches.

Dr. Ramessur notes, "We were surprised by how consistently strong the association was across different central fat measures and how much stronger the effect was in women. The observed links between central body fat and psoriasis suggest that there may be underlying biological mechanisms contributing to the disease that are not yet fully understood and which warrant further investigation."

In an accompanying editorial, Joel M. Gelfand, MD, MSCE, FAAD, Department of Dermatology and Center for Clinical Sciences in Dermatology, University of Pennsylvania Perelman School of Medicine, points to the potential of incretin therapy for psoriatic disease. Incretins are gut-derived hormones, principally glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), that regulate glucose, digestion, and appetite, and are approved for the treatment of diabetes, obesity, and obesity-associated obstructive sleep apnoea.

Dr. Gelfand comments, "The strong relationship between psoriasis and obesity and the emerging promise of glucagon-like peptide-1 receptor agonists (GLP1RA) for reducing psoriasis morbidity is a call to action for large-scale clinical trials of GLP1RA monotherapy for treatment of psoriasis.

"Our current paradigm of just focusing on the skin and joint manifestations when treating psoriasis is outdated in the context of our evolving understanding of the tight relationship of , obesity, and cardiometabolic disease."

https://medicalxpress.com/news/2025-05-belly-fat-body-strongly-linked.html 

Saturday, 24 May 2025

Your Essential Care Guide for Scalp Psoriasis

From healthcentral.com

Check out these dermatologist-approved techniques to manage scalp psoriasis flakes and find lasting relief for your hair type 

Have you ever run your fingers through your hair and wondered, How can I get rid of these flakes? If you’re one of the estimated 3.5 million people in the US who have scalp psoriasis (per the Cleveland Clinic), it’s a common question.

Scalp psoriasis is a type of psoriasis, a chronic autoimmune disorder that causes the body to attack its own skin. It can look like fine scaly areas along the hairline or thick, crusted patches all over the scalp, and it’s caused by a mix of factors.

“Most cases develop due to a combination of genetic susceptibility along with an environmental trigger,” says Veena Vanchinathan, M.D., a board-certified dermatologist who practices at Kaiser Permanente in California’s San Francisco Bay area. That means if you have a family history of psoriasis, you might be prone to it, and it can then be kick-started by something like stress, an injury to the skin, a chemical irritant, or an allergen. Once triggered, your immune system mistakenly identifies your skin as a threat, leading to inflammation and increased skin cell production. All those extra skin cells pile up into thick, sometimes itchy patches on your scalp that become dry, scaly, and flaky.

Those persistent flakes aren’t just annoying—they can be uncomfortable and embarrassing. But should you try to remove psoriasis scales yourself, or could that make things worse? We asked top dermatologists for their very best DIY strategies to safely manage your scalp psoriasis at home—plus, when it’s time to put down the coal tar and seek professional help.


Treating Psoriasis Scales on Your Scalp


Psoriasis scales are very different from other scalp flakes, like dandruff. “Psoriasis typically involves much thicker, white or yellow, and more adherent scaling than dandruff, which tends to have fine, white flaking,” says Dr. Vanchinathan. Unlike dandruff, which is typically caused by seborrheic dermatitis or scalp eczema, psoriasis scales are not easily removed by brushing or combing.

“If you have scalp psoriasis, it’s never a good idea to physically scrape or comb out the flakes,” says Alison Ehrlich, M.D., a board-certified dermatologist in Chevy Chase, MD, and the former founding chair and director of clinical research in the department of dermatology at The George Washington University in Washington, D.C. “Picking at scales on the scalp can lead to irritation and bleeding,” she says.

Dr. Vanchinathan doesn’t recommend manual removal or exfoliation either. “Removing those scales can be very uncomfortable, even painful, and it’s not a long-term fix,” she says. “It increases the risk of skin infection and can lead to permanent hair loss.” If you do try to peel off a patch of psoriasis scales, you might see dots of blood underneath. “That’s called the Auspitz sign,” says Dr. Vanchinathan. It’s confirmation that the inflammation and the blood vessels are much closer to the surface in those psoriasis patches and underscores why being super gentle is important, she says.

Still, there are safe, effective ways to manage scalp psoriasis and reduce flaking and scaling with targeted, dermatologist-approved treatments.

Exploring the Effectiveness of Scalp Psoriasis Treatments

There are a number of over-the-counter and prescription psoriasis scalp treatments that can moisturize and soften scales and gently exfoliate dead skin cells, without the risk of irritation.

Medicated Shampoo

“I am a huge fan of over-the-counter shampoos,” says Dr. Vanchinathan. “Shampoos with ingredients such as ketoconazole and zinc pyrithione, which reduce inflammation and fight fungal overgrowth on the scalp, can be incredibly helpful for long-term scale reduction,” she says. These types of shampoos can also ease itching. If over-the-counter products aren’t giving you the results you want, your doctor can prescribe a stronger formula.

Salicylic Acid

Commonly found in topical solutions and shampoos, salicylic acid is an excellent ingredient for treating the scaly patches of psoriasis. Studies show salicylic acid can soften and loosen the outer layer of skin, helping to remove dead skin cells that build up at the surface. That said, “salicylic acid can be too drying for people with curly or textured hair,” says Dr. Ehrlich, who recommends using a moisturizing conditioner after shampooing.

Coal Tar

Coal tar has been used for over a century to treat psoriasis by slowing down cell turnover, according to the American Academy of Dermatology (AAD). “It soothes scaling and itching,” says Dr. Ehrlich. Coal tar shampoos are thick, so be gentle when working it into your scalp. And wear a hat when you head outdoors—the AAD notes coal tar can make your skin more sensitive to the sun.

Lactic Acid and Urea

Lactic acid promotes exfoliation and urea helps to break down the thick scales of psoriasis. “Together these ingredients can be helpful for softening scales and reducing flakes,” says Dr. Ehrlich. Research shows creams containing the combo can reduce skin thickening and improve the appearance of psoriasis patches. But be careful if you have broken or irritated skin. “These ingredients can cause burning or stinging,” says Dr. Vanchinathan.

Moisturising the Scalp

“Keeping the scalp moisturized can help prevent scales from becoming dry, flaky, and itchy,” says Dr. Vanchinathan. Look for scalp oils or moisturizers with the National Psoriasis Foundation (NPF) Seal of Recognition—they’re vetted to be free of common irritants. Try applying one and letting it sit on your scalp for 10 to 15 minutes before rinsing with warm (not hot) water. Just note: “Moisturizing feels good, but it doesn’t treat the underlying psoriasis,” says Dr. Ehrlich.

Should You Use a Soft Brush?

Experts advise against brushing your hair—even softly—due to the risk of scalp wounds, infection, and permanent hair loss. If you do try to manually loosen scales with a brush, be as gentle as possible. Use a soft-bristle brush, go slowly to minimize irritation and injury to the skin, and stop immediately if you feel pain or see blood (the Auspitz sign).

Light Therapy

Professional light therapy, or phototherapy, relies on shining a narrow band of UV-B light directly on affected areas of the scalp to ease inflammation and reduce the scaling, redness, and itch of psoriasis. “It’s one of the most helpful treatments I have for patients who don’t respond to topicals,” says Dr. Vanchinathan. Phototherapy is usually done in a clinic or doctor’s office and involves a series of treatments, two or three times a week for a few months. Hair on the scalp can make it tricky to get good results, says Dr. Ehrlich, so your dermatologist may combine it with other treatments.

A Healthy Scalp-Care Routine for Psoriasis

Want to keep your scalp flake-free? “The best way to minimize scaling is to treat the underlying psoriasis that’s causing it,” says Dr. Ehrlich. Talk to your doctor to create a treatment plan that makes sense for the severity of your scalp psoriasis, which might involve over-the-counter psoriasis scalp treatments, prescription topicals, or systemic medications. After that, how you wash your hair matters, too.

The AAD recommends using a medicated shampoo every two to three days, and washing gently—no aggressive rubbing or scrubbing, which can make psoriasis flare. “Shampooing with powerhouse skincare ingredients can reduce scaling and is a successful long-term strategy,” says Dr. Vanchinathan.

Medicated shampoos can dry out your hair, so be sure to follow up a suds session with a conditioner. If you have curly or textured hair, you might prefer to wash once a week and use a prescription treatment in between, says Dr. Ehrlich. And if you have especially thick patches of scalp psoriasis, consider adding a salicylic acid-based scale softener to your routine.

Be cautious about social media advice. “It’s never a good idea to put undiluted essential oils on your scalp, or to ‘correct the pH’ of your skin with lemon juice or vinegar,” warns Dr. Vanchinathan. “And never use unsafe tools like knives to remove psoriasis scales.”

Always consult your dermatologist before trying trending online remedies.

If you don’t see improvement after three to four weeks of using an over-the-counter shampoo or psoriasis scalp treatment, check in with your dermatologist. “There are effective prescription treatment options, including newer oral and injectable medications,” says Dr. Ehrlich. “If one doesn’t work, another might.”

Diet and Lifestyle Adjustment to Ease Scalp Psoriasis

In a survey published in Dermatology and Therapy, psoriasis patients reported skin improvements when they cut back on alcohol, gluten, and night shades, and also when they ate more fish and vegetables and took a vitamin D supplement.

Certain diets, like the Mediterranean, Pagano, vegan, and Paleo, have also been linked to clearer skin. The Mediterranean diet in particular, which is based on eating fresh fruits and vegetables that have anti-inflammatory properties, has positive effects on both skin and heart health, which is important since psoriasis is linked to an increased risk of cardiovascular disease.

Moving more can help your scalp psoriasis, too. In a study published in Skin Health and Disease, psoriasis patients who walked regularly for 20 weeks saw major improvements (half experienced 50% clearer skin), likely because increased blood circulation helps deliver anti-inflammatory compounds to affected skin while supporting the removal of dead skin cells and toxins. Exercise also improved their blood pressure and mental health.

Bottom Line

“Picking at scalp scales can result in hair loss,” says Dr. Ehrlich, so it’s not a good idea to remove psoriasis scales on your own. Instead, focus on managing and reducing scales with scalp psoriasis treatments made with ingredients that soften skin and encourage cell turnover, likeketoconazole, zinc pyrithione, salicylic acid, coal tar, lactic acid, and urea, and be gentle when applying them.

Your scalp psoriasis may also improve if you make healthy food choices, avoid smoking and drinking alcohol, and get more exercise. And if over-the-counter shampoos and treatments aren’t keeping your scalp psoriasis scales in check, it’s time to explore prescriptions and other treatments with your dermatologist.

https://www.healthcentral.com/condition/psoriasis/your-essential-care-guide-for-scalp-psoriasis

Tuesday, 20 May 2025

New Study Links High Blood Sugar to Psoriasis Flares

From healthcentral.com 

Scientists took a close look at the connection between psoriasis and diabetes. The findings could change the way some healthcare is practised

High blood sugar may do more than coexist with psoriasis (PsO)—it might actually trigger flare-ups. That’s the key takeaway from a new study published in Clinical, Cosmetic and Investigational Dermatology, which found that hyperglycaemia (elevated blood sugar levels) is associated with worsening psoriasis symptoms, especially in people with severe disease.

“This is significant because it reinforces the idea that psoriasis is not just a skin-deep issue,” says Hannah Kopelman, D.O., a board-certified dermatologist and skincare podcast host in Boston who was not involved in the research. “It’s a systemic inflammatory disease that interacts with other metabolic conditions in complex ways.”

For years, researchers have known that people with psoriasis (PsO) tend to have elevated levels of inflammatory substances in their blood—raising their risk for metabolic syndrome, cardiac events, and diabetes. But this new research suggests a more active role for blood sugar: it may not only reflect disease severity but actually drive it. The bidirectional relationship could have profound implications for how we approach treatment strategies for the estimated 7.5 million Americans living with this chronic skin condition.

Blood Sugar’s Role in Predicting Psoriasis Flares

                                                                              GettyImages/Halfpoint Images

So, what did the research show? In a retrospective cohort study, scientists reviewed 15 years of medical data from 201 patients with plaque psoriasis treated at Ramathibodi Hospital in Bangkok, Thailand. Of those, 95 had severe psoriasis and 106 had mild disease. All participants also had either type 2 diabetes or prediabetes.

To examine the possible connection between long-term blood sugar levels and psoriasis flare-ups, the researchers analysed data from more than 1,700 follow-up visits between 2008 and 2022. Specifically, they looked at HbA1c levels—a measure of blood sugar control over time.

The findings revealed that patients with severe psoriasis who had an HbA1c of 7% or higher (indicating poorly controlled diabetes or prediabetes) were significantly more likely to experience flares. The study also identified alcohol consumption as a separate risk factor for flare-ups.

“In our study, we found that hyperglycemia (HbA1c ≥ 7%) and alcohol drinking status were independent prognostic factors for exacerbation in severe psoriasis patients with diabetes or prediabetes,” the researchers wrote. “We believe that diabetes surveillance may be necessary for all psoriasis patients, and strict glycaemic control may aid in managing severe psoriasis.”

A Call for Cross-Specialty Collaboration

The findings also underscore that rarely does a chronic disease—or its treatment—exist in isolation—the study links dermatology, endocrinology, and primary care as essential components in managing psoriasis.

“This research reminds us that everything is interconnected,” says Dr. Kopelman. “In the clinic, we may start emphasizing not just topical or biologic treatments but also the importance of metabolic health as part of the treatment plan for psoriasis.”

For patients struggling with both conditions, this study offers hope that better control of one condition may positively impact the other. This research gives us another tool in our toolkit, explains Dr. Kopelman. We now have stronger evidence to motivate patients to work on their blood sugar control as part of their comprehensive psoriasis management strategy.

While more research is needed to fully understand how high blood sugar influences psoriasis flares and treatment outcomes, the takeaway is clear: for people with severe psoriasis, managing blood sugar may be a meaningful part of reducing flare risk—and a reminder that whole-body health matters in skin disease management.

https://www.healthcentral.com/news/psoriasis/new-study-links-high-blood-sugar-to-psoriasis-flares?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGajPuEoJA8iWy1Iex1N-bygus2vIIdzmPYIfzvqoaZBIMzQ5QiwZYXDGepKzzFs9F1Ku6WdnO3HZVG1CGYyyFtr_OqJe65UNQBcnkj5uDZbxZwhjM

Sunday, 18 May 2025

The Best Products For Treating Psoriasis, According To Dermatologists

From yahoo.com

Whether you suffer from psoriasis yourself or have heard about it from a famous Kardashian who has been very transparent about her symptoms, you know that the skin condition is far from glamorous and often results in red scaly plaques that can occur anywhere on the body.

Dr. Carolyn Stull, board-certified dermatologist of MDCS Dermatology in New York City, described psoriasis as a chronic inflammatory condition that affects about 2% of the world’s population.

“[It] commonly arises on the scalp, ears, elbows, knees and nails,” she said. “In addition to the skin, psoriasis can also affect joints resulting in psoriatic arthritis.”

Stull said that a number of prescription treatments exist for topical psoriasis, such as steroids and injectable therapies, but there are also over-the-counter products that can help manage flare-ups in addition to lifestyle changes, like not smoking tobacco.

Before your next plaque surfaces and that unbearable tingle of an itch arises, you may find relief in the upcoming list of products and ingredients recommended by dermatologists like Stull and Dr. Brendan Camp.

A ceramide-filled CeraVe cream just for psoriasis                                                                                                            A ceramide-filled CeraVe cream just for psoriasis

A ceramide-filled CeraVe cream just for psoriasis

Board-certified dermatologist with New York City-based MDCS Dermatology Dr. Brendan Camp suggested this moisturizing cream from CeraVe, a brand with a long like skin care expert endorsements and adored by many here at HuffPost

"The salicylic acid in this thick moisturizer helps to remove excess skin flakes, leaving skin softer, smoother, and less scaly," Camp said. Other exfoliants include lactic acid, a milder acid that might be better tolerated by sensitive skin. 

And like all of CeraVe's unscented and nourishing skin products, this thick cream is formulated with three essential ceramides that are fundamental for not just hydration but for helping to maintain a healthy skin barrier.

$21.82 at Amazon

$21.99 at Target

$21.82 at Walmart

A highly rated salicylic acid-containing cream                                                                               A highly rated salicylic acid-containing cream


A highly rated salicylic acid-containing cream

Board-certified dermatologist at MDCS Dermatology Dr. Carolyn Stull explained that salicylic acid is a beta hydroxy acid commonly found in topical psoriasis treatments and can be helpful for exfoliating thick scaly areas on the skin.

Based on this information, in addition to its many positive reviews, we found 3% salicylic acid formula cream that claims to loosen scales and prevent flare-up reoccurrence. The medicated treatment is packed with hydrators like shea butter and avocado oil, as well as a bevy of soothers like aloe, allantoin and bisabolol, an anti-inflammatory ingredient. Plus, there's also the inclusion of panthenol, a humectant that can draw moisture into the skin and promote wound healing.

$9.49 at Amazon

$11.39 at Target

$9.99 at Walmart

A medicated shampoo and conditioner for scalp psoriasis                                                                A medicated shampoo and conditioner for scalp psoriasis


A medicated shampoo and conditioner for scalp psoriasis

We've had dermatologists previously refer to Nizoral as the "gold-standard" of dandruff shampoos and their new formula created specifically for scalp psoriasis comes at the recommendation of Camp. 

"This shampoo contains 3% salicylic acid, which helps gently exfoliate dead skin cells and reduce flakes in the hair and on your clothing," he said. 

The two-in-one shampoo and conditioner also contains tea tree oil, which can help relieve itch, along with several antioxidant ingredients that can potentially reduce inflammation. And unlike many other medicated shampoos, Nizoral remains gentle even on grey, colour-treated or chemically processed hair and reviewers agree it's left their tresses feeling soft.

$15.50 at Amazon

$22.49 at Target

$27.95 at Walmart

A multi-symptom relief cream                                                                               A multi-symptom relief cream


A multi-symptom relief cream

Camp suggested this psoriasis-targeted Gold Bond cream that aims to treat multiple psoriasis symptoms like irritation, skin flaking and scaling. The steroid-free formula is powered by salicylic acid, an useful ingredient according to both Camp and Stull, along with ceramides and seven different intensive moisturizers to condition and soften psoriasis-affected skin.

$9.47 at Amazon

$12.69 at Target

A water-resistant anti-itch cream                                                                                          A water-resistant anti-itch cream


A water-resistant anti-itch cream

For targeted itch relief, Camp recommends this maximum strength hydrocortisone cream in a water-resistant formula that contains petroleum for creating a moisture-locking barrier on the skin. 

"In a thick, ointment-based formula, this hydrocortisone-containing anti-inflammatory product helps reduce itch and other symptoms associated with psoriasis," Camp said.

$7.98 at Amazon

$7.98 at Walmart

A prebiotic repairing cream                                                                                               A prebiotic repairing cream


A prebiotic repairing cream

"[This] is a thick, rich moisturizer with shea butter, ceramides, and prebiotic thermal water, this product is clinically shown to reduce dry, rough skin and provide long-lasting hydration," Camp said of this whole-body Triple Repair moisturizing cream from La Roche-Posay.

The brand explains that prebiotic thermal water is a unique ingredient that's rich in a natural antioxidant while the three essential ceramides can help restore the skin barrier, something that is compromised in skin conditions like psoriasis, eczema and severe dryness. 

$19.99 at Amazon

$19.99 at Dermstore

$19.99 at Ulta

A coal tar treatment                                                                                                        A coal tar treatment

A coal tar treatment

According to Stull, vitamin D-based topicals are an available treatment for managing psoriasis. Although she didn't mention a product in particular, we found this vitamin D ointment made to help slow cell overgrowth and prevent reoccurrence. 

As someone who personally struggles with eczema — a different skin condition that's often managed similarly to psoriasis —I have firsthand experience using the MG217 medicated ointment. This extra-strength formulation features 2% coal tar, one of the oldest remedies for treating inflammatory skin conditions due to its ability to reduce scaling, flaking, redness and irritation of the skin, while also imparting some antibacterial benefits.

After applying a liberal layer at night before bed, I suggest popping on a pair of reusable cotton gloves since this product does stain sheets and clothing.

$9.56 at Amazon

$13.97 at Walmart

https://www.yahoo.com/lifestyle/best-products-treating-psoriasis-according-110026688.html