From healthcentral.com
Right this way for fast relief of your itchy, painful skin
Flares are a fact of life with psoriasis, the skin condition that appears as scaly plaques on areas of the body like the scalp, elbows, and knees. Not only can psoriasis flares make people feel self-conscious, “they can be very itchy and uncomfortable for patients to deal with,” says Lauren Penzi, M.D., a board-certified dermatologist in New York City.
Psoriasis flares can describe any time that you’re not in remission, and they can reduce your quality of life, impair your activity, and increase your anxiety, according to a study in the Journal of Psoriasis and Psoriatic Arthritis. And they tend to be a long-term game: If psoriasis plaques are there on Monday, “they’re probably still going to be there on Friday—but maybe they're not as itchy, as white, as flaky, or as bothersome,” says Elizabeth Kiracofe, M.D., a board-certified dermatologist in Chicago. “But they’re still going to be there because psoriasis doesn’t come and go that quickly.”
That’s because psoriasis is a chronic disease that stems from a disruption in the immune system which affects skin cells. This “increases the inflammation that goes on in the body that then signals the skin to make the psoriasis lesions that we see with our eyes,” says Dr. Kiracofe.
The good news? The sooner you can treat a psoriasis flare-up, the faster you’ll get relief—and this is the month to start. Depending on the severity of your psoriasis, you may need to explore long-term options like biologics, a type of medication that works from within the body to control and clear plaques. “A biologic can be part of the marathon plan,” she says.
However, there are steps you can take at home to get relief in the meantime. Here’s what the experts recommend for getting your symptoms under control ASAP.
Slather Moisturizer Everywhere
Moisturizing is a must for anyone with psoriasis, since it can be associated with a compromised skin barrier—but especially if you’re dealing with a flare. Pro tip: Moisturize your skin from head to toe, not just where you notice an initial plaque. “A common misconception with psoriasis is that you only need to treat the lesions, but in patients who have psoriasis, all of their skin is compromised, and so their barrier is disrupted everywhere,” says Dr. Kiracofe.
She recommends any moisturizer that you can scoop from a tub or squeeze out of a tube, “because that implies it’s a little heavier,” she says. Look for skin-soothing formulas with occlusive ingredients—like oils and butters—as well as ceramides, since these types of lipids can be missing from the skin barrier when it’s compromised.
At night, you can take your skin hydrating game up a notch by topping off areas where plaques appear with wet dressings that can lock in ointments—follow this how-to in order to do it properly.
Target Plaques With Topical Steroids
With moderate to severe psoriasis, systemic meds may be needed to treat the underlying disease. But for immediate plaque-itch relief, topical steroids are your best friend. “Use it twice a day until the plaque is gone, plus two extra days,” says Dr. Kiracofe. “Then we know it’s going to stay gone—versus if you just use it once a day for a few days a week.”
Apply your medication first, and then top it with moisturizer. Most of the prescription topicals prescribed for psoriasis “are stripping of the skin barrier, so they’re dehydrating to the skin,” says Dr. Kiracofe. And when skin is dehydrated, the moisture barrier is more fragile—so using medication alone is “kind of like three steps forward, two steps back,” she says.
Both Dr. Penzi and Dr. Kiracofe agree that if you don’t have prescription-strength topicals on hand, go ahead and use a 1% hydrocortisone cream. It’s not a long-term solution, but it can help you manage your flare until you see a doctor.
And, if you can’t get in with your dermatologist right away, consider seeing your primary care doctor, who can start you off with a prescription for a more powerful topical steroid. And, of course, “we want to make sure that—in addition to whatever active ingredient—we’re still moisturizing the skin as well,” says Dr. Kiracofe.
Apply a Cool Compress
Psoriasis flares can come with intense itchiness and you want to do all you can to prevent yourself from scratching your plaques, since it further traumatizes an already compromised skin barrier.
As you wait for topical formulas to bring healing, apply cool compresses to temporarily calm inflammation and itching, says Dr. Penzi. (If you’re able to make it to the drugstore, she also points to pramoxine as a good, over-the-counter topical anaesthetic that helps numb the skin to control itchiness.) Cooling the skin can actually have a big impact on the intensity of itch; one study found that it acts directly on sensory receptors that oversee itchiness in skin.
Download a Mindfulness App
According to the American Academy of Dermatology Association (AAD), many things can trigger a psoriasis flare, from summertime exposures—such as a sunburn or even sitting in air conditioning—to chronic issues like increased stress. Stress and psoriasis are closely linked; even changing jobs or a breakup out of nowhere can trigger some psoriasis flares, as stress releases hormones like cortisol, which can exacerbate inflammation. For that reason, the skin is often the first place you’ll see signs of stress, says Dr. Kiracofe.
On the bright side: “Anything that can bring down the production of that stress hormone is beneficial,” says Dr. Kiracofe. In fact, she recommends mindfulness apps to her psoriasis patients, asking them to meditate two to three minutes a day. It may also help you fight the urge to scratch, she says. A systematic review of the relationship between mindfulness and psoriasis found that it can in fact be a short-term tool for improving both the severity of psoriasis as well as quality of life (meaning people with psoriasis experience less worry, anxiety, and depression stemming from the condition).
Layer on Extra Protection
Depending on the weather, this might be a good time to spring for long sleeves and pants to protect your skin, since any scratches or even tiny wounds can trigger the development of a new plaque. It’s called the Koebner Phenomenon, where “new psoriasis lesions form on previously unaffected skin due to trauma,” says Dr. Penzi.
So, it’s critical to protect your body from any incidental trauma, according to Dr. Kiracofe. That’s also part of the reason moisturizing is so important: It acts as an extra shield. “If your skin is healthy and moisturized and prepared, that trauma is less likely to have an impact,” she says.
Your Flare Game Plan
Unlike some skin conditions, psoriasis is an autoimmune disease. And, as an immune-mediated problem stemming from within your body, “it generally needs prescription medicines to help solve it” from the inside, says Dr. Kiracofe. Since there is no cure for it (yet), the objective is for psoriasis that’s “well controlled,” as she puts it: “My goal as your doctor is to make sure that psoriasis is no longer the first thing you think about when you get up in the morning.”
So, while these tips can offer quick relief and quell inflammation from the outside, they can’t address the autoimmune disease that’s triggering the plaque-causing inflammation in the first place—which is why it’s worth getting in touch with your doctor if your current treatment plan isn’t cutting it. “There are so many new things that we have to offer in the world of psoriasis—because, frankly, over-the-counter stuff just can't solve the problem,” Dr. Kiracofe says.
https://www.healthcentral.com/condition/psoriasis/science-backed-tips-for-easing-a-psoriasis-flare
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