What to Avoid Putting on Psoriasis Skin: Hot Water and More

From healthline.com

Many common skin care products can help you manage psoriasis, but others can cause irritation and flare-ups of symptoms. This includes products containing alcohol, sulphates, and essential oils.

Psoriasis is an autoimmune condition that shows up on the skin. It can lead to painful patches of raised, shiny, and thickened skin.

The patches often appear red or pink with white or silver scales on light skin tones. On darker skin tones, they may be salmon-coloured, violet, or sometimes difficult to see, according to experts.

Here are seven things to consider not putting on your skin if you have psoriasis.

1. Lotions with alcohol

It’s important to keep your skin moist by applying creams and lotions. Dry skin often makes psoriasis symptoms worse.

But you may want to choose your lotion carefully. Many contain ingredients that can dry out your skin even more. One of the biggest ingredients that can cause dry skin is alcohol.

Companies often use alcohols like ethanol, isopropyl alcohol, and methanol to make a lotion feel lighter or to act as a preservative. These alcohols can dry out your skin’s protective barrier and make it difficult to lock in moisture.

When it comes to lotions for psoriasis, your best bet is one that’s thick and oily, like petroleum jelly or shea butter. These help trap moisture.

Unscented lotions that include ceramides are also better for people with psoriasis. Ceramides are the same type of lipids that we have in the outer layer of our skin.

Apply your moisturizer within a few minutes of bathing, showering, and washing your hands. You may also want to apply it right before you go to bed.

2. Fragrance

Fragrances are added to products to make them smell good. For some people, though, they can cause skin irritation.

To avoid making psoriasis worse, aim for a fragrance-free product when choosing a skin care or hair care product, the National Psoriasis Foundation (NPF) suggests. Try to avoid spraying perfumes directly on your skin as well.

3. Sulphates

Sulphates are ingredients often used in shampoo, toothpaste, and soap to help the product foam up. However, some types of sulphates can cause skin irritation, especially in people with sensitive skin and conditions like psoriasis.

Because of this, you may want to avoid products containing sodium lauryl sulphate or sodium laureth sulphate. If you’re unsure, look for product packaging that specifically says “sulphate-free.”

4. Wool or other heavy fabrics

You may want to consider wearing light fabrics that won’t irritate your skin. Heavy fabrics like wool can irritate your already sensitive skin and even make you itchy.

Instead, choose gentler fabrics that allow your skin to breathe, such as cotton, silk blends, or cashmere, the NPF advises. Or, if you want to wear wool for warmth, layer it over a less irritating fabric.

5. Tattoos

Getting a tattoo requires making tiny cuts in the skin. This repetitive injury can trigger a psoriasis flare.

In one case, it even resulted in skin lesions all over the body, not just where the tattoo was applied, the NPF reports. This is known as the Koebner phenomenon. It can result from any traumatic injury to the skin.

Some tattoo artists may not agree to tattoo a person with psoriasis, even when someone doesn’t have active plaques. Some states even prohibit tattoo artists from tattooing a person with active psoriasis or eczema.

Despite the risks, some people with psoriasis still get tattoos. If you’re considering a tattoo, always talk with your dermatologist before making the decision.

6. Too much sunlight

You may have heard that vitamin D from the sun can benefit your skin. The ultraviolet (UV) rays in sunlight slow the growth of skin cells, which is good for psoriasis.

Phototherapy is a treatment for psoriasis that involves carefully exposing your skin to UV light. Phototherapy is approved by the Food and Drug Administration (FDA) and uses UVA and UVB light. This process is also done with the assistance of a dermatologist.

However, moderation is key. If you want to naturally expose your skin to the sun, it’s essential that you don’t go overboard.

Aim for about 15–30 minutesTrusted Source at a time, which is the amount of time a doctor would typically perform phototherapy. Also, remember to use sunscreen. Sunburn may trigger psoriasis symptoms and can increase your risk of skin cancer.

While tanning beds may seem similar to phototherapy, you should avoid using them. Tanning beds use only UVA light, which isn’t effective for psoriasis. They also greatly increase your risk of skin cancer.

The NPF doesn’t support the use of indoor tanning beds in place of phototherapy.

7. Hot water

Use warm water instead of hot water every time you bathe or shower. Hot water can be incredibly drying and irritating to your skin.

The American Academy of Dermatology recommends taking just one daily shower or bath. They also recommend keeping your showers under 5 minutes long and baths under 15 minutes long.

The takeaway

Injuries, dry skin, and sunburns can all trigger psoriasis flare-ups, so it’s important that you take excellent care of your skin.

When considering a new skin care treatment, try to find out whether it’s been endorsed by dermatologists and check the ingredient list of any products you’re considering. Be wary of any product claiming it can “cure” psoriasis.

If you’re unsure about a particular household or skin care product, check to see if it has earned the NPF’s Seal of Recognition.

Frequently asked questions

Here you’ll find answers to additional questions about safe things to put on your skin if you have psoriasis.

Is Vaseline good for psoriasis?

Thick and oily emollients like Vaseline are good for skin with psoriasis.

In fact, research from 2021Trusted Source shows that they can help protect the skin’s barrier function. “Barrier function” refers to the skin’s ability to protect your body from the external environment while also keeping in moisture.

What makes skin psoriasis worse?

Any scented skin care products or those containing alcohol or sulphates may trigger psoriasis.

What is good to rub on psoriasis?

The NPF recommends a number of moisturizing and emollient lotions for skin with psoriasis. For over-the-counter products, consider choosing something with ceramides or salicylic acid.

Takeaway

Psoriasis is an autoimmune condition that affects the skin. Certain skin care products can worsen the symptoms or trigger flares.

Always check the label of any product to make sure it does not contain a harsh ingredient. Knowing how to take care of your skin will help you keep psoriasis symptoms at bay.

https://www.healthline.com/health/psoriasis/what-not-to-put-on-your-skin-with-psoriasis

Could Your Joint Pain Actually Be Psoriatic Arthritis?

From gq.com

By Caitlin Carlson

Experts share how to identify psoriatic arthritis, and how to stay active if you’re dealing with the condition 

It's easy to chalk up stiff fingers, sore knees, or an achy heel to aging (the joys!) or tough workouts. But for some active men with psoriasis, those symptoms may point to something else: psoriatic arthritis, a form of joint pain and stiffness that affects those with the skin condition psoriasis.

You might have psoriasis for a couple of years without joint involvement, but that doesn't mean you’re out of the woods, says Khattri Saakshi, MD, a board certified dermatologist, at Mount Sinai and one of only a handful of triple-board certified physicians across the United States. In fact, the typical delay between a psoriasis and psoriatic arthritis diagnosis is seven to 12 years, according to research published in the Journal of Clinical Medicine. If you don’t have diagnosed psoriasis or any of the accompanying skin symptoms, 10 to 15% of psoriatic arthritis patients develop joint symptoms before any skin issues from a psoriasis perspective show up, Dr. Saakshi says.

There is good news in all of this: Experts say there are now safe and effective medications to manage the condition, and people with psoriatic arthritis can—and should—keep exercising, which may even help alleviate symptoms.

While it’s always wise to see a doctor about your particular symptoms, here are some things to keep in mind if you’re wondering if your joint pain may actually be psoriatic arthritis—and how to keep moving if you do get a diagnosis.

Collage: Eva Baron; Getty Images

What is psoriatic arthritis?

Psoriatic arthritis is an inflammatory condition of the joints that can also impact where tendons and ligaments attach to bones.

Because early detection is key, Dr. Saakshi recommends discussing joint symptoms or morning stiffness with your dermatologist, who can refer you to a rheumatologist, (a doctor that specializes in conditions of the immune system), at every follow-up appointment. “Early diagnosis and treatment is super, super, super important because data says that even a six-month delay in diagnosis has irreversible changes,” Dr. Saakshi says. “We don't have any medications that reverse damage that has happened, it only prevents the progression of damage.”

It’s also important to point out that while many autoimmune conditions are more common in women, psoriatic arthritis is one of the exceptions, says Mayo Clinic Rheumatologist Nolan K. McBride, MD. “Men and women are equally likely to be affected overall,” he says, although women may have more severe symptoms compared to men.

How do I know if I have psoriatic arthritis?

When Dr. Saakshi sees patients, one of the first questions she asks is whether they have stiffness or joint pain that wakes them up at night, or first thing in the morning. Melanie H. Smith, MD, PhD, rheumatologist at Hospital for Special Surgery, agrees this is a “classic” differentiator between sports soreness/injuries and psoriatic arthritis: “With psoriatic arthritis, patients often tell me it feels like I'm moving through molasses,” when they first wake up, she says. “You can definitely feel sore in the morning after a hard workout, but usually you can still move pretty normally after two to 10 minutes as opposed to an hour,” Smith says. “When someone's telling me ‘I'm stiff in the morning’ or ‘I feel worse in the morning than I do in the afternoon,’ to me that is a flag that this is not mechanical issues or a gym injury,” she says. Men in particular have more spine involvement, called axial disease, than women, Smith says, which may cause low back pain that's worse in the morning.

Another “tell” of psoriatic arthritis, Saakshi says, is resting pain or stiffness that comes on after sitting much of the day as well as decreased range of motion.

Smith adds joint swelling to the list, which can be one of the first symptoms of the condition and doesn’t tend to accompany typical post-workout soreness. “In the hands, if there are defined joints, let's say one knuckle is painful, swollen, but the other ones aren't, that can also be a sign that something's up.” The technical term for this is dactylitis, but it’s sometimes referred to as “sausage digits,” Saakshi says. McBride agrees, adding “I always ask patients for changes they can see. Obvious swelling and discoloration of a joint or tendon warrants investigation.” With psoriatic arthritis, “some people also describe feeling flu-ish,” or achy all over, Smith says.

Perhaps the biggest difference between diagnosable psoriatic arthritis and soreness, McBride says, is how long the symptoms last. “Even some of the worst cases of post-workout soreness should start to improve after 48 hours,” he says. Joint pain, excessive stiffness, significant tenderness, or worsening of pain with touching or pushing on the area, especially lasting for days to weeks, should be discussed with your doctor, he adds.

For those with skin psoriasis and no joint concerns now, it’s important to recognize features that may suggest an increased risk for arthritis, McBride says, which may include scalp psoriasis, psoriasis affecting a large portion of the body, and changes to the nails called pits.

Smith points out that family history is a big part of this, too, so find out if anyone in your family has the condition. In patients that have psoriasis, another risk factor for developing psoriatic arthritis is obesity, Smith says. “I spend a lot of time talking to my patients about trying to get to a healthy weight or maintain a healthy weight, eat healthy, control your cholesterol, get exercise daily. All of those things are really important.”

How to exercise when dealing with a flare up

Saakshi says that the question of when and how to exercise comes up with many of her patients. “In the midst of a flare of your joints, it might be a little harder to exercise just because of the component of pain,” she says, but gentle low-impact movement could actually help. And while she can’t point to any hard data on whether exercise can prevent flares, “muscle strengthening around the joints is super beneficial,” she says. Smith agrees: “If you have a gym injury, oftentimes part of the answer is to rest,” Smith says. “With psoriatic arthritis, rest isn't necessarily going to make it better.”

Still, Saakshi cautions against pushing past pain and the range of motion your joints allow at any point in time. “The saying ‘no pain, no gain’ does not apply when you have an inflammatory condition like psoriatic arthritis,” she says.

She encourages patients to try lower-impact activities like swimming, cycling, walking, yoga, or Pilates, if higher-impact activities like running exacerbate symptoms. “It really comes down to how significant the flare is.” McBride adds that enthesitis, inflammation where the tendon attaches to bone, can up your risk for injury, so if this is the case, avoid explosive movements (think: box jumps) and use lighter weights for moves that impact affected areas. “Isometric exercises have been shown to be helpful for those with joint inflammation that is otherwise preventing full range of motion,” McBride says. “Stretching should be an integral part of every day, especially for those with inflammation in the back, to maintain mobility and function.” Smith says that working with a trainer or a physical therapist can also be helpful in these cases.

Once you get a diagnosis and start treatment, you may have more exercise options. “The goal is to have patients have no joint swelling or pain and to be able to do the activities they want to do,” Smith says.“ If that includes running marathons, that is definitely reasonable.”

When to see a rheumatologist

Unchecked or chronic joint inflammation can lead to permanent damage to the bones, Smith says. “Something we worry about, especially in patients who have long-standing, not completely treated disease, is cardiovascular risk, like risk of heart attack,” Dr. Smith says.

The experts agree that there should be a low bar as for when to see a rheumatologist about any of the aforementioned symptoms. At the end of the day, intervening sooner rather than later is the best choice for your health, McBride underscores. “I want to keep my patients healthy and moving for as long as possible, so they can enjoy doing the activities they love. We are lucky to have so many options now to help people meet that goal.”

https://www.gq.com/story/psoriatic-arthritis-joint-pain 

Wondering Why Your Eczema Won’t Clear? Dermatologists Say It Might Not Be Eczema

From newbeauty.com

New AAD guidelines on treatment-resistant eczema are telling doctors to look for impostors before reaching for a stronger prescription 

Eczema that refuses to clear despite doing everything a dermatologist recommends is more common than most patients realize, and dermatology’s governing body just weighed in on why. The American Academy of Dermatology (AAD) has released its first-ever guidelines specifically for adults whose atopic dermatitis (AD) isn’t responding to treatment.

The guidance opens with an idea that runs against instinct: the fix might not be a stronger drug. It might be a different diagnosis. The misdiagnosis problem with eczema is something dermatologists have been raising for a while, and this is the first time the AAD has given doctors a formal playbook for it.

Ahead, what the new guidelines say about misdiagnosis, the conditions that can masquerade as eczema and when it's time to ask your dermatologist for a second look.

Unsplash/Ashley Nicole

Why Adult Eczema Is So Easy to Get Wrong

The guidelines, published August 31 in the Journal of the American Academy of Dermatology, zero in on a detail that trips up a lot of care: about 1 in 4 adult AD cases actually start in adulthood, a pattern that’s historically harder to diagnose than the childhood version most people associate with eczema. Roughly 2 percent of adults worldwide have AD, and until now there’s been no dedicated guidance on what to do when a presumed case just won’t respond. Rochester, MN dermatologist Dawn Davis, MD, senior author of the guidelines, told Medscape that persistent, treatment-resistant symptoms are a signal to reconsider the diagnosis altogether rather than assume the case is simply harder to treat.

The Conditions That Can Hide Behind an Eczema Diagnosis

The guidelines list out a handful of look-alikes and co-travellers that can explain a stalled treatment plan: allergic or irritant contact dermatitis, food allergies, asthma, allergic rhinitis, psoriasis, hives and in rare cases, a form of skin lymphoma. Davis described watching this play out in her own patients, whose eczema flares don’t always trace back to eczema itself. It’s the same overlap dermatologists have pointed to elsewhere, where a reaction to something in a skin care ingredient turns out to be driving symptoms that get chalked up to eczema.

What the Guidelines Actually Tell Dermatologists to Do

Instead of a one-size-fits-all test, the guidelines give doctors a decision tree based on what a case looks like. Patch testing is highlighted for adult-onset eczema, rashes in unusual places like the hands or eyelids, or dermatitis that isn’t budging under standard treatment. Biopsies come into play when something about the case looks more like a different condition entirely. Skin scraping and cultures help rule out infections or infestations that can mimic eczema. And when none of that clears things up, the guidelines say the next step is a referral to a specialist, not another treatment escalation.

The Takeaway for Anyone Whose Eczema Isn’t Improving

Chicago dermatologist Peter Lio, MD, a clinical assistant professor at Northwestern University Feinberg School of Medicine who wasn’t involved in writing the guidelines, called the message underneath all of this “deceptively simple”: don’t assume a stalled treatment means the disease is just stubborn. For patients, that reframe is good news. If your eczema treatment has stopped working the way it should, this is a reason to bring it up with your dermatologist as a diagnosis question, not just a dosage one. It’s a similar shift in thinking to the one behind recent dosing updates for eczema biologics, where the goal is matching treatment to the individual patient rather than a single fixed protocol.

https://www.newbeauty.com/view/eczema-not-clearing-up-aad-guidelines

Common psoriasis triggers that can cause psoriasis flare-ups

From aad.org

If your psoriasis seems to flare for no reason, one or more triggers could be to blame. Everyday things like stress, a bug bite, and cold temperatures can trigger psoriasis.

Triggers vary from person to person. By finding your triggers and learning how to manage them, you can gain better control of your psoriasis and have fewer flares.

To find yours, you’ll have to do a bit of detective work. A good place to start is by looking at this chart of the common triggers, which also gives you signs that that it could be a trigger for you.

Stress

Do you get flare-ups when you're feeling overwhelmed or stressed? Stress is a common trigger.

Reduce risk of flare-ups from stress

• Find a way to manage your stress and practice it — even when you’re feeling okay. Common stress busters include yoga, meditation, and support groups.

• Before going to sleep, write down 3 things that you’re grateful for. Do this daily.

• When you start to feel stressed, take a deep breath, hold it, and exhale slowly.

Skin injury

If this triggers your psoriasis, you’ll get a flare-up near (or in the same spot as) the injury or bite. This happens about 10 to 14 days after you injure your skin.

Flare-ups happen after getting a cut, scrape, sunburn, scratch, outbreak of poison ivy, bruise, or bug bite.

Reduce the risk of flare-ups from a skin injury

• If you injure your skin, treat it quickly.

• If your skin itches, calm the itch.

• Avoid scratching, which can trigger a flare.

• Try to avoid getting bug bites by using insect repellent and staying indoors when bugs are most active. Bugs are most active at dusk and dawn.

Drinking frequently or in excess

If you drink daily or have more than 2 drinks in a day frequently, your treatment for psoriasis may have little or no effect. Even treatment that could be effective for you may not work and you’ll continue to have flare-ups.

Reduce the risk of flare-ups from drinking

• Quit drinking.

• If you continue to drink, limit how much you drink in a day. Women should stop after 1 drink. Men should limit themselves to 2 drinks per day.

• Be sure to tell your dermatologist if you drink alcohol. Drinking can make it risky to take some psoriasis medications like methotrexate.

Smoking

Does your psoriasis flare unexpectedly? If you smoke or spend time with people who smoke, this could be the cause.

Reduce the risk of flare-ups from drinking

• Stop smoking. Because this can be difficult, ask your dermatologist or primary care doctor for help.

• Before trying a nicotine patch, ask your dermatologist whether using it could trigger your psoriasis.

• Avoid being around people who are smoking.

Dry, cold weather

If your psoriasis worsens when the humidity or temperature drops, such as in the winter or fall, this is likely a trigger for you.

Reduce the risk of flare-ups from dry, cold weather

• Treat your psoriasis.

• Limit showers and baths to 10 minutes and use warm rather than hot water.

• Immediately after bathing, slather on moisturizer, using a fragrance-free ointment or cream rather than a lotion.

• Use a gentle, moisturizing cleanser instead of soap.

• Apply moisturizer throughout the day when your skin feels dry.

• Plug in a humidifier when the air in your home feels dry.

• Stay warm and protect your skin from extreme weather when outside by wearing a hat, gloves, waterproof boots, and a winter jacket.

• Sit far enough away from a fireplace, radiator, or other heat source so that you cannot feel the heat on your skin.

• Remove wet clothes and footwear when you come in from the cold.

• If your psoriasis continues to flare, see your dermatologist. Ask if phototherapy may be a treatment option for you in the winter.

Sunshine, warm weather

During warm weather, psoriasis can flare if you:

• Sunburn

• Spend time in air conditioning

Reduce the risk of flare-ups during warm weather

• If you spend time in air conditioning, apply moisturizer immediately after showering or getting out of a bath.

• If your skin still feels dry from spending time in air conditioning, apply moisturizer throughout the day.

• Avoid sunburn by wearing sunscreen. You want to apply sunscreen to skin that clothing doesn’t cover and is free of psoriasis. To get the protection you need, use sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.

Infection

Psoriasis can flare 2 to 6 weeks after strep throat, an earache, bronchitis, or another infection. This is especially common in kids.

Reduce the risk of flare-ups due to infection

• Treat the infection. This can lessen or clear the psoriasis.

• Tell your dermatologist if you have an HIV (human immunodeficiency virus) infection, which can make some psoriasis treatments risky.

Medication

Some medications can cause a flare-up. If a medication is a trigger for you, you’ll flare 2 to 3 weeks after beginning a medication.

Reduce the risk of flare-ups from medication

• If you think a medication is causing your psoriasis to flare, DON’T stop taking it. Ask the doctor who prescribed it whether the medicine could be causing your psoriasis to flare. If it could, ask if you could take another medication.

• Before taking a medicine for the first time, ask the doctor prescribing it if the medicine could cause psoriasis to flare. Medicines that commonly trigger psoriasis include lithium, drugs taken to prevent malaria, strong corticosteroids like prednisone (if you quit taking it rapidly instead of stepping down), medicine that treats high blood pressure and problems with your heartbeat, some arthritis medications.

Tattoos and piercings

When you get a tattoo or piercing, you injure your skin. Any time you injure your skin, psoriasis can flare.

Reduce the risk of flare-ups from tattoos and piercings

• Avoid tattoos and other types of body art if you have psoriasis.

• If you want to get any type of body art, talk with your dermatologist first. Your dermatologist may be able to offer some tips that can reduce flare-ups.

Shaving

If you cut yourself while shaving, you may notice new psoriasis about 10 to 14 days later where you cut yourself.

Reduce your risk of flare-ups from shaving

• Take care to avoid cutting yourself while shaving.

• Dermatologists’ tip: To reduce cuts and nicks, try applying moisturizer and then shaving gel before you shave.

Images
Getty Images

https://www.aad.org/public/diseases/psoriasis/triggers/flares