Ask the Expert: A Dermatologist's Approach to Managing Psoriatic Arthritis

From verywellhealth.com

By Brendan Camp MD

Psoriasis and psoriatic arthritis (PsA) are both autoimmune conditions.

Psoriasis occurs when skin cells turn over quickly—taking days to grow and fall off rather than the typical month-long cycle. As a result, skin cells build up, creating plaques that appear dry, inflamed, and flaky.

Psoriatic arthritis occurs when the immune system attacks your cells, leading to symptoms like joint stiffness, pain, and swelling.

Not everyone with psoriasis will develop PsA, and not everyone with PsA will have skin symptoms.

The Skin–Joint Connection: Can Treating One Help the Other?

Many traditional therapies for PsA broadly affect the immune system, impacting many body systems, but biologics, a newer class of drugs, offer more targeted treatment.

Biologics "turn down" the activity of various immune cells and are particularly effective in helping manage PsA and psoriasis symptoms.

As a dermatologist (a doctor specializing in treating skin, hair, and nail conditions), I usually see PsA patients with skin and joint symptoms. For many people, stress, illness, or even an injury can trigger an autoimmune response and result in psoriasis or PsA flare-ups.

Before prescribing a biologic, I typically ask my patients with PsA if they are experiencing symptoms of joint pain to ensure that the treatment covers both skin and joint inflammation.

Often, I coordinate with rheumatologists (doctors who specialize in autoimmune disease and other conditions affecting the musculoskeletal system) to ensure our patients receive comprehensive PsA care.

I usually recommend phototherapy or topical medications for those with psoriasis symptoms. While these treatments can effectively manage skin symptoms, they will not help joint pain.

Skincare Tips for PsA Skin Symptoms

There are many treatment options for people with psoriasis. Your dermatologist can help you find the best option for your needs. A good place to start, though, is to establish a skincare routine that focuses on the following:

• Reducing irritants: Opt for skincare products that contain the National Psoriasis Foundation Seal of Recognition.
• Exfoliating: Exfoliate dead skin with products containing chemical exfoliants like urea or salicylic acid.
• Showering smart: Take short showers with tepid water to avoid removing too much oil from your skin.
• Moisturizing: Apply moisturizer immediately after showering to provide a barrier layer to protect your skin.
  

These habits will help improve your skin's strength and overall health.

Lifestyle Factors That Influence PsA Skin Symptoms

Medications and skincare are critical to managing PsA. However, healthy lifestyle habits can help reduce symptoms and manage the condition long-term.

• Exercise can help keep joints loose, reducing pain and inflammation. To reduce joint strain, opt for low-impact exercises such as swimming, cycling, or yoga.
• Diet and lifestyle choices are essential to managing PsA. Emphasize whole foods. Limit foods, drinks, and substances that increase inflammation, such as processed foods, tobacco, and alcohol.
• Stress can be difficult to manage when you're dealing with the physical and emotional toll of PsA. Many of my patients rely on complementary treatments like acupuncture, massage therapy, and prioritizing sleep to improve their stress levels.
  

Living Well With PsA

The primary symptoms of PsA are physical: joint pain and stiffness. However, PsA can profoundly affect your psychosocial well-being. Early diagnosis and treatment are essential to mitigate the physical, mental, and social effects of PsA on your life.

One of the biggest challenges many people with PsA face is accepting that PsA medications are long-term treatments. Psoriatic arthritis is a chronic condition for which there is currently no cure. Joint damage from PsA can continue to worsen without treatment, necessitating the long-term use of medications.

It is important to remember that, while it sometimes may feel like it, you are not the only person living with PsA. There is a community of people experiencing similar physical, mental, and social challenges. Talking with others, including your healthcare provider, physical therapist, and members of support groups like the National Psoriasis Foundation and the Arthritis Foundation, can be a valuable source of information, education, and empowerment.

https://www.verywellhealth.com/ask-the-dermatologist-psoriatic-arthritis-11792302