9 Psoriasis ‘Mistakes’ and How to Avoid Them

From everydayhealth.com

Psoriasis is an inflammatory condition that speeds up the life cycle of skin cells, causing red, scaly patches that can be itchy, painful, or cracked. 

Managing psoriasis can be tricky: There are oral, topical, and injectable therapies to try, a daily skin-care routine to maintain, and lifestyle habits to keep front of mind. And even with the best intentions, flare-ups can still occur. 

To keep psoriasis in check and improve your overall health, experts recommend avoiding the following common mistakes.

1. You Delay Seeking Help During a Flare or When Symptoms Worsen

Whether it’s a busy schedule, procrastination, or the hope that psoriasis symptoms will simply go away on their own, it’s common for people to put off seeing a dermatologist when new spots appear, says Lawrence Green, MD, a clinical professor of dermatology at the George Washington University School of Medicine in Washington, DC.

But delaying care often means inflammation has more time to escalate, which can make symptoms harder to control. “The earlier you can treat it, the easier it is to treat — and the less stress it’ll be on your body,” Dr. Green says.

Schedule an appointment with your dermatologist if you see changes in your skin, such as a rash that’s not going away, a rash that’s worsening, or flare-ups that are becoming more frequent, severe, or widespread.

Even if plaques aren’t itchy or bothersome, getting them checked early puts you on the front foot before they get more difficult to manage, Green says. 

It also gives your doctor a chance to reassess whether your current treatment plan is still appropriate or needs adjusting.

2. You Don’t Give a New Medication Enough of a Chance — or You're Reluctant to Try New Therapies

Finding the right psoriasis treatment takes patience — and some trial and error.

While it’s tempting to stop a new medication if you don’t see immediate results, it’s worth the wait to find the right combination of therapies for you, according to Steven Daveluy, MD, a professor and the program director at Wayne State University’s School of Medicine in Detroit, where he specializes in treating patients with skin diseases such as psoriasis and eczema.

That’s because — with the right combination of therapies — psoriasis should be contained to 1 percent of your skin or less. “That’s the size of the palm of your hand, including fingers and thumb. If you have more than that, it’s time to do something to reach that goal,” Dr. Daveluy says.

Different treatments work at different speeds, taking between weeks or even months to show their full effect. But by the three-month mark, the target for a new treatment is a 75 percent improvement or for psoriasis to cover 3 percent or less of your body. By six months, you should hit the 1 percent threshold.

Stick with a treatment for this recommended period — often three months — before making changes, Daveluy says.

3. You Neglect Daily Skin Care

Daily skin care is crucial for managing psoriasis, but it takes time and commitment. And it’s easy to overlook when you’re not battling flare-ups.

But your skin-care routine helps to keep plaques at bay, Green says. “If you’re not moisturizing on a regular basis, especially on dry skin areas like the arms and legs, you’re more likely to get psoriasis there,” he says.

Take a bath or shower for about 5 to 15 minutes a day using warm — not hot — water, then follow up with a fragrance-free moisturizer.

For the winter months, Green recommends using thick, heavy creams or ointments over lighter pump lotions, which can be saved for warmer temperatures. 

This applies to your topical prescription medications, too. “Some patients use their topical medications sporadically and wonder why they don’t work. You have to use the medicine as directed in order for it to work,” he says.

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4. You Forget to Apply Sunscreen

Psoriasis can flare up if you get a sunburn. This is why protecting your skin from the sun is important, says Marisa Garshick, MD, a dermatologist in New York and New Jersey, and a clinical assistant professor of dermatology at NewYork-Presbyterian Weill Cornell Medicine.

Severe sunburn can lead to skin injury, which may create new plaques or worsen existing ones. But while sun exposure can trigger short-term problems, it can also lead to long-term skin damage and risk of skin cancer. 

Medications commonly prescribed to treat psoriasis — like acitretin or methotrexate — can increase sun sensitivity, making the skin more vulnerable to burning and damage. People who have undergone extensive UVB phototherapy may also face a higher risk of skin cancer, making daily sun protection even more important.

When choosing a sunscreen, look for a broad-spectrum formula with SPF 30 or higher, ideally containing zinc oxide or titanium dioxide, which help block harmful UV rays. Sunscreen should not be applied to open wounds or actively inflamed, cracked plaques, as this can cause irritation or stinging.

“It’s always a good habit to get into to maintain the healthiest skin you can,” Dr. Garshick says.

5. You Don’t Take Your Mental Health Seriously

Psoriasis affects more than just the skin. Research shows that anxiety and depression are more common in people with psoriasis than in the general population, and the emotional burden can be just as challenging as the physical symptoms.

Mental health is an important part of psoriasis treatment, and it’s worth discussing with your doctors, including your dermatologist and primary care provider, if symptoms are affecting your daily life, Daveluy says. While it can feel awkward to bring up, addressing mental health early can lead to better overall care and support.

Daveluy checks in on his patients but suggests patients be proactive. Patients can initiate the conversation by asking, “I heard that psoriasis and mental health can be related. Would it be all right if we discuss my mental health?”

Support extends beyond the doctor’s office, too. There are resources like patient support groups, such as those offered by the National Psoriasis Foundation, Daveluy says. “Talking to someone who truly understands the lived experience of psoriasis is so valuable,” he says.

6. You Rely on Unproven Treatments or Home Remedies Rather Than Medical Treatments

Home remedies and internet “hacks” can be tempting when psoriasis is frustrating or slow to improve, but many of these approaches are unproven and may do more harm than good.

Psoriasis can worsen with skin injury, a process known as the Koebner phenomenon, where skin trauma — like scratches — can cause plaques to spread to unaffected areas. “If you irritate the skin by applying some kind of at-home remedy or concoction, it actually can make the psoriasis worse,” Garshick says.

Green has also dissuaded his patients from trying things like applying apple cider vinegar to plaques. “As a physician, we give things that we know work,” he says. “We want things that the [U.S. Food and Drug Administration] FDA approves or we know there's scientifically sound evidence that it works.”

7. You Focus Only on Psoriasis Control and Neglect Overall Health

It’s easy to focus all your attention on managing psoriasis itself, especially if you’re seeing a dermatologist frequently. But this can sometimes lead people to overlook other important aspects of their health, such as regular primary care visits or recommended screenings.

Research shows that psoriasis is linked to a higher risk of several other conditions, including high blood pressure, heart disease, diabetes, and psoriatic arthritis.

“It’s very important that everyone with psoriasis has a primary care provider to help detect and manage any of these other problems,” Daveluy says. If you’re at an increased risk of skin cancer because of medications or phototherapy, make sure you’re getting your skin and moles checked regularly, too, Garshick says.

Don’t look at psoriasis in a silo, and take account of your overall physical and mental health, Daveluy says. “Diet, exercise, mental health, and psoriasis are all connected, so it's really important that patients are addressing their whole health. It can be intimidating, but you don't need to change everything at once,” he says.

8. You Don’t Follow a Healthy Diet

If you’re not paying attention to what’s on your dinner plate, you may be making psoriasis harder to manage. 

Nutrition plays a real role in inflammation, weight, and overall health — all of which can influence symptom severity and how well treatments work, according to Caylee Clay, RDN, a registered dietitian-nutritionist in Brooklyn, New York, who has psoriasis and specializes in helping clients manage autoimmune diseases.

Diet also affects psoriasis patients’ risk of developing comorbidities like heart disease and diabetes, Clay says. 

Despite this, researchers say that many people with psoriasis have “imbalanced” diets, leaning toward carbohydrates, sugar, and fried foods, that can fuel inflammation.

An anti-inflammatory eating pattern, such as the Mediterranean diet, is a strong place to start when making changes to your eating habits. Clay suggests taking elements from the diet that work for you, such as a focus on fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil, while limiting ultra-processed foods, excess sugar, and alcohol.

9. You’re Still Smoking and Drinking Alcohol

Smoking or having a glass of wine may feel like a way to de-stress during a flare, but these habits can make psoriasis worse.

“Unfortunately, smoking and alcohol are linked to more severe psoriasis, poorer treatment response, and higher risk of comorbidities like heart disease. Both smoking and alcohol increase inflammation plus add toxins to our system that strain our organs and immune system,” Clay warns.

Cutting back or quitting isn’t easy — Clay suggests turning to healthier ways to unwind, such as journaling, going on walks, seeing a therapist, or exploring your religion or faith.

The Takeaway

• Effective psoriasis management involves regular consultation with your healthcare providers, especially during flare-ups, to adjust any treatment plans as necessary. 
• Commit to daily skin care and consistently use prescribed topical treatments to keep psoriasis under control, even if symptoms aren’t currently present. While treatment for psoriasis may involve some trial and error, it’s important to give medical therapies time to work. 
• If psoriasis is taking a toll on your emotional health, don’t hesitate to tell your doctor and seek help from mental health professionals or peer support groups.

https://www.everydayhealth.com/skin-condition/psoriasis-mistakes-and-how-to-avoid-them/ 

Dietitians Flag the Worst Foods and Drinks for Psoriasis

From eatingwell.com

Limiting these foods can help relieve symptoms and pain 

• Psoriasis is an autoimmune condition that results in red, scaly skin patches.
• Food choices cannot cure psoriasis, but fried foods, processed meats and sugary beverages may make the symptoms worse.
• Dietitians say eating foods rich in anti-inflammatory omega-3s and fibre can help.

Inflammation is your body’s way of protecting itself when there’s an infection or tissue damage. There are two types: chronic and acute. Acute inflammation is temporary—think of a time you got a cut on your finger and your skin became red and tender but resolved with time. On the other hand, chronic inflammation is ongoing and often associated with certain health conditions like joint pain, type 2 diabetes and ulcerative colitis.

While some chronic inflammatory conditions can go unseen, symptoms of psoriasis can be harder to hide. Psoriasis is a skin condition where the immune system goes into overdrive and cause skin cells to grow and shed too quickly, leaving a person with splotchy red spots. These spots can be itchy or cracked and even cause some serious joint pain. While it is important to work with a doctor for this condition, it is also important to think about what lifestyle habits can make a difference, including what we eat. 

“Psoriasis is an inflammatory condition driven by immune dysregulation, with excess pro-inflammatory cytokines (chemical messengers that coordinate immune responses). Certain foods either exacerbate or calm these processes,” says Jennifer Pallian, RD. Here, Pallian and three other registered dietitians share why deep-fried foods, processed meats, alcohol and sugary beverages are the worst foods for psoriasis, plus offer healthy eating tips to help decrease symptoms.

                                                                                     Credit: Getty Images. EatingWell design

1. Deep-Fried Foods

Deep-fried foods, which are often high in saturated and trans fats, can cause flare-ups for those with psoriasis. “These fats increase the LDL (bad) cholesterol in the blood, and studies show there may be a link between excess fat in the body and psoriasis symptoms,” says Maggie Michalczyk, RDN.

Plus, fried foods may have other risks. “When some foods are fried, they also produce compounds called advanced glycation end products (AGEs) during high-heat cooking, which may trigger psoriasis flare-ups,” says Lauren Manaker, M.S., RDN, LD, CLEC. AGEs can damage cells and tissues by promoting inflammation.

2. Processed Meats

According to Manaker, processed meats like hot dogs, pepperoni and chicken nuggets are packed with ingredients that may fuel inflammation. “Deli meat or any processed meat can have more saturated fats and trans fats,” says Yvette Hill, RDN, IBCLC. “Breakfast meats such as sausage and bacon would also be on this list. Also, popular snacks like beef jerky would be a food to be cautious of.” The saturated fat in these foods may contribute to keratinocyte overgrowth, says Pallian. Keratinocytes are found in the outer layer of skin, and overgrowth can result in rough and scaly red patches.

3. Alcohol

“Alcohol has been shown to trigger and worsen inflammation, affecting the lipid composition of the skin barrier,” says Hill. “Research also points to alcohol’s metabolite, acetone, which may promote keratinocyte proliferation (skin thickening).” Some research also shows that for those with psoriasis, drinking alcohol can double one’s chances of developing non-alcoholic fatty liver disease.

4. Sugary Beverages and Foods

Manaker explains that drinks like sodas and sweet teas “may impact blood sugars negatively, which can lead to the release of pro-inflammatory cytokines. Over time, this may exacerbate psoriasis symptoms and make it harder to manage flare-ups.” “Excessive sugar consumption may also reduce the health-promoting effects of omega-3 fatty acids, which otherwise help reduce inflammation and support skin health,” adds Pallian.

Tips to Manage Psoriasis

We asked the dietitians their best healthy eating tips for managing psoriasis. Here’s what they said.

• Focus on omega-3 fatty acids. A diet rich in omega-3 fatty acids, as well as other anti-inflammatory foods, can help to reduce psoriasis symptoms. “Fatty fish like salmon, mackerel and sardines are anti-inflammatory all-stars,” says Manaker. “If you’re following a plant-based diet, try chia seeds, flaxseeds or walnuts [which all have] omega-3 fatty acids. Walnuts are the only tree nut that is an excellent source of ALA omega-3 fatty acids.”
• Incorporate more fibre. “Fibre from whole grains, fruits and vegetables should be emphasized, not only to improve gut microbiota composition but also to lower energy intake and help with weight control, which is important because obesity and metabolic syndrome frequently coexist with psoriasis,” says Pallian. She recommends following a Mediterranean diet, which is naturally rich in vegetables, fruits, legumes, fish and olive oil.
• Add in fermented foods. “Foods like kimchi, sauerkraut and miso are great for gut health,” says Manaker. “A healthy gut microbiome may help regulate inflammation and support your immune system.”
• Make recipes with anti-inflammatory turmeric and ginger. “Turmeric (with black pepper for better absorption) and ginger are natural inflammation fighters. Add them to teas, soups or roasted veggies for a flavourful, skin-friendly boost,” says Manaker. Some of our favourite recipes with these anti-inflammatory ingredients include these Turmeric Chicken & Avocado Wraps and these Sesame-Ginger Watermelon-Avocado Rice Bowls.
• Consider a vitamin D supplement. “Taking a vitamin D supplement can be helpful, especially for those who might be deficient, because lower vitamin D levels have been linked to worse psoriasis symptoms,” says Michalczyk. Always check with your health care provider before starting a new supplement.
• Keep a temporary food journal. “Everyone’s psoriasis triggers are different,” says Manaker. “Tracking what you eat and how your skin reacts can help you identify patterns and avoid flare-up foods.”

• Our Expert Take

  Psoriasis is a chronic autoimmune condition that causes skin cells to grow and shed too quickly, resulting in red, scaly skin patches. Psoriasis is not caused by one single factor—it is often the combination of genetic, lifestyle and environmental factors. While your food choices cannot cure or cause psoriasis, dietitians say deep-fried foods, processed meats, alcohol and sugary beverages can make the symptoms worse. Instead, eating foods rich in anti-inflammatory omega-3s and fibre can help you manage symptoms.

• https://www.eatingwell.com/worst-foods-for-psoriasis-11838925

What Do You Wish More People Knew About Living With PsA in Your 30s?

From healthcentral.com

By Meaghan Quirin

Your 30s are supposed to be this big decade. Where you make career moves, settle into adult relationships, maybe build a family or buy a home, whatever version of that typical life arc applies. But when you’re living with a chronic illness like psoriatic arthritis (PsA), it often doesn’t unfold that way. Instead of building momentum, you’re just trying to keep your head above water. Or backtrack and rebuild. Or grieve the version of your life you thought you’d be living by now.

I’ve spent a lot of my 30s figuring out how to manage this disease and all the ripple effects that come with it, physically, emotionally, and logistically. That includes trying medications that don’t work, recovering from flare-ups that knock me down for weeks, advocating for myself in medical spaces, and reimagining what I can handle professionally, socially, and personally. These aren’t things most people see from the outside.

That’s the hard part, PsA is mostly invisible. So when you aren’t hitting those expected milestones or moving through life at the same pace as your peers, people don’t always know why. There’s this silent pressure: Do they think I’m lazy? Unmotivated? Just not trying hard enough? It can feel incredibly isolating. Especially when you’re comparing yourself to others who seem to be charging ahead while you’re sidelined by symptoms you didn’t ask for and can’t always control.

There’s also the added emotional weight of knowing how many decisions get shaped, or delayed, by this illness. People don’t realize family planning might be on hold, not because of lack of desire, but because your disease isn’t stable enough or your medications aren’t pregnancy-safe. Career changes might not be bold leaps, but necessary pivots to survive the demands of full-time work with chronic fatigue and joint pain. Even social stuff becomes complicated like attending weddings, traveling, showing up for friends, sometimes it’s just too much, and you have to constantly navigate your limits.

What I wish more people understood is that living with PsA in your 30s doesn’t mean you have to you stop trying, or that you have to give up on the life you want. It might mean your timeline looks different. Your priorities shift. And so much of your energy goes toward things other people never have to think about, like what combination of meds will allow you to function without making you feel worse, or how to schedule rest before and after basic life events. It’s not just physically exhausting, it’s emotionally exhausting, too. And yet, you keep going. You keep finding ways to adapt, to create space for yourself, to build a life that honours both your goals and your reality. It might not look like what you imagined, and it’s OK to feel however you need to about that.

https://www.healthcentral.com/condition/psoriatic-arthritis/whats-something-you-wish-more-people-knew-about-living-with-psa-in-your-30s 

Finding Community—and Herself—Through a Psoriasis Diagnosis

From healthcentral.com

Student and advocate Alina Vue shares the challenges and triumphs of living with generalised pustular psoriasis and psoriatic arthritis 

Between early morning classes and late night study sessions, no one ever said college was easy. But for Alina Vue, a 25-year-old student based in Westminster, CO, it’s been especially tough juggling classes and not one, but two forms of psoriasis. “This is my second attempt at college; I was in my second year before I took my hiatus,” shares Vue, who is currently studying communications at Front Range Community College.

Vue was just two years old when her mother first noticed splotchy rashes on her skin. “At first, they thought it was just baby eczema. That’s pretty common with the kids in my family,” says Vue, who is Hmong American. So her parents did as most would: moisturized her skin well and sought to reduce irritation via home remedies.

“But it kept getting worse,” Vue explains. One day, her skin not only turned really red, but felt very hot to the touch. Worried this was far beyond eczema, her mother rushed Vue to the local emergency room in Green Bay, WI. There, a doctor quickly recognized the symptoms of generalized pustular psoriasis (GPP), which include inflamed skin, fever, fatigue, nausea, weight loss, itching, muscle weakness, headaches, and the tell-tale painful pus-filled white and yellow bumps.

“I vividly remember being very itchy,” Vue says. “I’m glad that I was diagnosed, because it is a pretty severe experience. My mom was my champion. She was clear that something was wrong.”

While the National Psoriasis Foundation estimates that 2% to 3% of the population has one of the five types of psoriasis, only about 1%of those cases are GPP. The low prevalence is one of the reasons Vue likes to share her story. “People tend to think psoriasis is just a skin thing, and it definitely relates to the skin, but it’s an autoimmune disease, so it’s definitely more than what they think it is. It’s inflammatory, so it can lead to organ issues, I’ve had swollen feet, I’ve lost a lot of weight unexpectedly. It’s an all-around intense health issue separate from the skin itself,” Vue says.

Finding the Pattern

By the time Vue was old enough to start kindergarten, her health was locked into a pattern: a massive flare each winter, followed by recovery each summer. “I would have this dual experience throughout the year of like, ‘Ah, everything’s fine!’ and then come my birthday in September, things would start getting worse again. I have a lot of memories of not being able to do recess because I lived in a very cold climate. I did a lot of activities in bed because it was very hard to move around,” Vue says.

By the time Vue reached third grade, her condition had gotten more severe, leading her mother to homeschool her for a year. “That was one of the worst bouts of my psoriasis because it was just so hyper-aggressive. It was a tumultuous time and I was very sedentary,” remembers Vue.

She filled her days drawing and writing poetry with a cousin. She credits her father with the inspiration to put pen to paper. “My father is a pastor, and he used to write sermons all the time, so words were a big part of my childhood. But I also didn’t know how to tell people things, and writing was a more accessible tool for me to express myself,” says Vue.

These days, she’s tapping that tool for school. The severity of her conditions has meant that she hasn’t yet been able to work a job, but she’s excited to put her talent to good use after graduation. “I love film and design, and I would love to be in the film industry as a graphic designer or social media marketer, or even in spaces where I can talk about movies and fashion and art,” she says.

Adding a Diagnosis

Vue returned to school for fourth grade, but not before being thrown for another loop. In late 2009, when she was nine, she noticed a new pain. “I was struggling with swollen ankles,” she says. But her inflamed joints didn’t seem like a big deal until she was hospitalized for two weeks for her pustular psoriasis. “I was very sick. I remember being in the hospital and in the midst of it all, doctors recognized that I also had the presentation of psoriatic arthritis,” she says.

Psoriatic arthritis is an autoimmune condition in which the immune system doesn’t just attack the skin, but it goes after the joints, tendons, and ligaments, leaving pain, swelling, and stiffness in its wake. About one in every three people with psoriasis will develop this painful condition (2.4 million people in the United States alone), though it is usually diagnosed between the ages of 35 and 55. Studies estimate that about 15% people with this condition have not yet been diagnosed.

If left untreated, psoriatic arthritis can cause permanent joint damage. That’s definitely a concern for Vue, who says the condition has always felt undertreated, with doctors mostly relying on the medications for her GPP to treat both. “I'm trying to see a rheumatologist right now,” she shares.

Experimenting With Treatments

Middle school is tough for everyone, but it hit Vue especially hard. At the start of sixth grade, she experienced a flare so bad it put her back in homeschool.

Courtesy of Alina Vue

“I had a very hard time walking because the pain was aggressive. So I was sitting all the time, mostly at a table doing my homework. But after a month or so, the skin behind my knees started closing up, and then my legs started atrophying,” Vue shares. Unable to straighten her legs or walk on them, she was hospitalized again, and it took two months of physical therapy to get her back on her feet. “It was a very trying time.”

It was also a time of experimentation. Like most chronic illnesses, psoriasis can be treated with many types of medications. And like most chronic illnesses, it can be tough to land on the right, unique combination that will facilitate a person’s best life.

Vue is no exception. She’s been on several topical medications, most notably triamcinolone, a corticosteroid that she used for four years and discontinued because it thinned her skin and sensitized it. She’s taken oral systemic medications, including immunosuppressants cyclosporine (“tasted horrible and didn’t change anything”) and methotrexate (“actually made me more itchy”), with little success. She also tried UV light therapy, but that just “made me feel like a cupcake in a display case.”

It wasn’t until 2010 that Vue’s doctors introduced biologics, which are injected or IV-infused medications that target relevant portions of the immune system, rather than smothering the entire thing. She started with Humira (adalimumab), an injectable that worked for a year before abruptly stopping. Then she moved to IV infusion Remicade (infliximab)for a year until it triggered anaphylaxis, her body developing antibodies against the medication and her throat closing up.

Seeing her child gasp for air brought Vue’s mom to a breaking point. Vue moved to virtual school (where she stayed through graduation), and they took two years off medications, trying ultimately unsuccessful home remedies, including some from their Hmong culture like eating eucalyptus leaves for their anti-inflammatory properties.

Testing Genetics

By age 16, Vue was ready to try medications again, starting with injections of Stelara (ustekinumab), which blocks the IL-12 and IL-23 proteins in the immune system. Again, it worked for a year before failing, throwing 17-year-old Vue into yet another flare.

Lucky for Vue, her doctor had a new plan. “She asked if we’d be okay with doing genetic testing to see if there’s a specific mutation causing my psoriasis, because there are certain medications that specifically target that, which would make it easier for recovery,” Vue says. “I said, ‘Yes!’ and they found my specific mutation and the right medication for me.”

It turned out, Vue has a mutation of the IL36RN gene, which makes a protein called interleukin 36 receptor antagonist (IL-36Ra). Researchers have linked this mutation (along with more than a dozen others) to GPP, as it reduces the amount of the protein in the skin of people like Vue, clearing the way for uncontrolled inflammation.

That led them to try Taltz (ixekizumab), a biologic that works by blocking interleukin-17A (IL-17A), another inflammation-causing protein linked to GPP. While Taltz is marketed as a medication for psoriatic arthritis and the more common plaque psoriasis, researchers have found that it can successfully treat GPP, too.

More than that, the autoinjector works for Vue, effectively putting her GPP into remission for seven years. “It really worked well, but my mom and I were wary, because so many things stopped working at the one-year mark,” she says. “But then it kept going, and I haven’t experienced a lot of major side effects. It’s the longest I’ve ever gone without a flare. Sometimes I’m still surprised, but I’m so glad.”

Still, Taltz, plus a skincare regimen of vitamin D topical cream and CeraVe, is not perfect. It hasn’t helped with her psoriatic arthritis as hoped, and as an immunosuppressant, it can open users up to infection. Vue got a taste of that in 2024, when a combination of summer heat and an infection she caught during an unmasked Mother’s Day photo shoot triggered her first GPP flare since starting Taltz. That touched off a new pattern; it flared again summer of 2025.

Sharing Her World

Courtesy of Alina Vue

While she’s in a good place now, Vue doesn’t shy away from sharing the highs and the lows of living with psoriasis. She was diagnosed with major depressive disorder in 2024, but notes that the online psoriasis community has been pivotal to finding her footing.

“Psoriasis has significantly affected my mental health. Even though I grew up with very supportive people, it still felt like I was always in a bubble and separate from everyone,” she shares. “But seeing other people in the community talking about it and knowing that I wasn’t the only one with these intense feelings made me feel like I could carry less weight. Hearing them say, ‘This is who I am, and it’s okay,’ made me feel more confident and safer in the world.”

Ultimately, her experience with psoriasis has taught her some important lessons beyond what she could pick up in a classroom. “It’s difficult, but it’s also a beautiful opportunity to understand ourselves and each other,” she shares. “I have learned so much about my own humanity. There is so much beauty to be had from just witnessing other people’s journeys and being witnessed back.”

https://www.healthcentral.com/condition/psoriasis/finding-community-and-herself-through-psoriasis-diagnosis

Psoriatic Arthritis FAQs: Questions to Ask Your Rheumatologist

From healthcentral.com

Newly diagnosed? Brief yourself on these PsA must-knows, and then bring this list of questions to your doctor 

A diagnosis of chronic illness can leave you with more questions than answers and a complex disease like psoriatic arthritis (PsA) can be especially confusing. Psoriatic arthritis isn’t a condition people know much about, unless they have it or someone close to them does. If psoriatic arthritis has made an appearance in your life, you’re going to want to know what to ask your doctor. Read on to get a briefing on the major FAQs for this condition, and then bring this list, plus any other questions that pop up, to your rheumatologist appointment so that you can get answers.

                                                                                GettyImages/AndreyPopov

What Caused My Psoriatic Arthritis?

Psoriatic arthritis is an autoimmune condition that causes the body to attack healthy cells in the joints, as if they were a bacteria or virus that needs to be fought. The exact cause of psoriatic arthritis is unknown, but experts think a combination of genetics (a family history and specific inherited genes) and environmental factors (stresses to the body like infection, injury, psychological stress, and obesity) ultimately come together to trigger the condition, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

“Autoimmune conditions tend to be more common in females, but PsA affects females and males equally in adults,” says Dori Abel, M.D., a paediatric rheumatologist in Philadelphia.

How Will You Diagnose My Condition?

Since no single test can diagnose the condition, your doctor will take several steps to determine if psoriatic arthritis is causing your symptoms. These steps can include:

Taking a Full Family History

You are more likely to have psoriatic arthritis if a family member has psoriasis or psoriatic arthritis.

Performing a Physical Exam

“The most important test is a clinical exam, as there are certain signs and symptoms which are very typical for psoriatic arthritis,” says Lisa Mandl, M.D., a rheumatologist at Hospital for Special Surgery in New York City. During this exam, your doctor will ask about what symptoms you’ve been experiencing and examine your joints (looking for swelling and tenderness), skin, and nails to look for changes consistent with PsA and psoriasis.

Doing Lab Work

You may also have blood drawn and tested. Some biomarkers found in the blood, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) signify inflammation, and that can tell your doctor that you likely have an autoimmune condition, per the Arthritis Foundation. However, they don’t automatically mean you have psoriatic arthritis. Other substances in the blood, like rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, can rule out rheumatoid arthritis. Even if blood tests are negative, they can help determine what conditions you don’t have, Dr. Mandl notes.

Ordering Imaging Tests

X-rays, MRIs, and ultrasounds can find changes in the joints and surrounding tissues that signify psoriatic arthritis inflammation and damage.

Taking a Sample of Synovial Fluid

Synovial fluid is a lubricating liquid found in the joints that keeps bones from rubbing against each other and allows the joints to function smoothly. A synovial fluid analysis, which involves removing some of this fluid from a swollen joint and sending it to a lab to test for signs of inflammation, can also help rule out other conditions such as gout or an infection, says Dr. Mandl.

What Are the Most Common Symptoms of Psoriatic Arthritis?

Psoriatic arthritis symptoms and the order in which they show up, can vary from person to person. Most people with psoriatic arthritis have psoriasis first, but it’s also possible to have joint pain before experiencing any skin symptoms, per NIAMS. (It’s also possible to have PsA without psoriasis, Dr. Abel notes.) The most common symptoms of psoriatic arthritis include:

Joint Issues

Joint-related symptoms may include:

• Stiffness, pain, and swelling of one or more joints that’s often worse in the morning or after periods of inactivity

• Painful, sausage-like swelling of an entire finger or toe (dactylitis)

• Tenderness in the areas where tendons or ligaments attach to bones, like the back of the heel and sole of the foot

The joints of the fingers—and specifically, the distal interphalangeal joints (DIPs), which are the last knuckles before your nail beds – are most often affected by psoriatic arthritis, says Dr. Abel. However, she adds, it can also affect other joints, including the knees, ankles, elbows, wrists, spine, neck, and hips. Psoriatic arthritis is often asymmetric (meaning it doesn’t necessarily impact matching joints on both sides of the body), but when it affects many joints (more than five), it is likely to become more symmetric, Dr. Abel says.

Other Symptoms

Non-joint-related symptoms of psoriatic arthritis can include:

• Fatigue

• Scaly, inflamed patches of skin, commonly on the scalp, elbows or knees

• Nail changes, such as pitting (tiny dents), crumbling, or separation from the nail bed

• Eye inflammation that causes pain, redness, and blurry vision

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• How Will You Treat My Condition?

• "There are two types of initial treatment for psoriatic arthritis: treatment to improve your symptoms quickly so that you feel better, and treatments to stop psoriatic arthritis from getting worse over time and damaging your joints,” says Dr. Mandl. Factors like which body parts are affected, the severity of your symptoms, which ones bother you the most, other health problems you have, and your health insurance will all influence what treatment your doctor starts you on, per the Arthritis Foundation.

For example, “If someone only has a joint or two involved, we may just inject that joint with steroids,” Dr. Abel says. But when it’s more than a couple of joints, or if the arthritis keeps coming back in the same joint and you need repeat injections, “you want to be considering systemic therapy,” she says. Many people with psoriatic arthritis should expect to be on long-term therapy that keeps their disease under control and prevents progression and joint damage.

Treatments for psoriatic arthritis include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs like ibuprofen, naproxen, aspirin, and nabumetone treat mild psoriatic arthritis by reducing inflammation and improving joint pain.

Corticosteroids

Steroids—most commonly prednisone—are used to quickly reduce inflammation and get symptoms under control. They can be helpful during a flare or as a bridge until a new treatment starts to work, which can take a few months, Dr. Abel says. Steroids can be taken orally or via injection.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

These drugs lower inflammation, reduce symptoms, and prevent joint damage by suppressing the body’s overactive immune system. Examples include:

• Arava (leflunomide)

• Azulfidine (sulfasalazine)

• Rheumatrex (methotrexate)

Biologics

A biologic is a type of DMARD made from a living microorganism or cell. These medications target specific proteins in the immune system to control psoriatic arthritis; most are taken by injection or IV. They’re classified according to what part of the immune system they zero in on. A few examples:

• Tumour necrosis factor (TNF) inhibitors. Remicade (infliximab), Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab), Simponi (golimumab)

• Interleukin-17 (IL-17) or interleukin 12 and 23 (IL-12/23) inhibitors. Cosentyx (secukinumab), Tremfya (guselkumab), Siliq (brodalumab), Stelara (ustekinumab)

• T-cell inhibitors. Orencia (abatacept)

Are There Side Effects to Treatments?

All medications come with potential side effects and psoriatic arthritis drugs are no exception. The side effects that you might experience depend on the type of medication you’re taking.

• NSAIDs: Using NSAIDs long-term can cause stomach irritation and ulcers, internal bleeding, kidney problems, and heart problems.

• Corticosteroids: Steroids are meant to be used only short term because they can cause some pretty rough side effects with long-term use, including osteoporosis, high blood pressure, adrenal insufficiency, diabetes, mood problems, and glaucoma.

• DMARDS and biologics: DMARDs and biologics are the strongest and most effective medications for PsA. “They work to quiet the inflammation in joints and skin by lowering the immune system, which also puts you at a slightly increased risk of infection,” says Dr. Abel. Depending on the medication, side effects can include fever, mouth sores, hair loss, stomach upset, fatigue, and liver and kidney damage. When taking one of these medications, your doctor will send you for regular bloodwork to make sure you’re tolerating it well and that they catch any changes in the liver and kidneys early, Dr. Abel says.

If you’ve started a new medication recently, it’s important to let your doctor know if you’re experiencing any new symptoms, even if they seem unrelated, especially fever or any other significant illness, notes Dr. Abel.

What Lifestyle Changes Do You Recommend?

A few lifestyle shifts can help improve psoriatic arthritis symptoms and overall health.

Exercise

“It is important to be active, especially if you have not been because your joints have been hurting,” Dr. Mandl says. Exercise has been shown to reduce pain and improve physical function in people with PsA, according to research on optimal lifestyle management of PsA in Rheumatic & Musculoskeletal Diseases Open. The reason is unclear, but it could be because exercise has anti-inflammatory effects, helps with weight management, and improves mobility and strength in the muscles and tissues that support the joints. Increased physical activity also helps prevent associated conditions such as heart attack, stroke, and diabetes, Dr. Mandl notes.

Weight Management

Maintaining a healthy weight is an important part of living better with psoriatic arthritis. “People with psoriatic arthritis can be at increased risk of weight gain as they get older,” Dr. Mandl notes. Excess weight not only increases the risk of comorbidities like heart disease, stroke, metabolic disease, and diabetes, but fat tissue also contains inflammatory cells, so reducing it can be beneficial, per the RMD Open research. People who are overweight may also not respond as well to psoriatic arthritis medications, per research on obesity and PsA in Rheumatology and Therapy.

“Eating a healthy diet, such as a Mediterranean diet high in omega fatty acids, is also a good idea,” says Dr. Mandl. There’s not one best diet for PsA, but focusing on good nutrition and a healthy diet can help with weight maintenance and reduce the risk of cardiovascular disease and metabolic disease—both of which people with psoriatic arthritis have a higher risk of developing, per the RMD Open review. Some research also suggests that eating more anti-inflammatory foods can help promote lower levels of inflammation in the body, though there’s not a lot of strong evidence, the review notes. “The best evidence is for the Mediterranean diet,” says Dr. Abel. “That means focusing on whole grains, legumes, fruits, vegetables, lean meats, and proteins.”

Sleep

Getting good quality sleep may also help with disease management. For one, sleep deprivation affects the hormones that control hunger and satiety, and makes you more likely to overeat and choose unhealthy foods, per the RMD Open review. It also increases cortisol and promotes inflammation.

Do I Still Need to See My Other Doctors?

Short answer: Yes! Your rheumatologist will be your point person for all things psoriatic arthritis, but your other doctors still play an important role in your overall healthcare. For example, you’ll want to see your usual providers for age-appropriate cancer checks, like a pap smear, mammogram, and colonoscopy, Dr. Mandl says.

“You should also see a dermatologist yearly for a skin check, as many of the medications used for psoriatic arthritis increase your risk of non-melanoma skin cancers, including basal cell and squamous cell carcinoma,” Dr. Mandl notes.

Is It Normal to Feel Tired?

Unfortunately, yes. Fatigue is common among people with psoriatic arthritis. One study on fatigue in psoriatic arthritis in the Annals of Rheumatic Diseases found that almost half of all study participants experienced at least moderate fatigue, with over 27% experiencing severe fatigue. Another study on fatigue in psoriasis and PsA in Advances in Dermatology and Allergology also found that 28% of participants with PsA reported severe fatigue compared to 17% of those with psoriasis and 1.6% of the control group with neither condition.

Psoriatic arthritis may cause fatigue directly—constantly fighting inflammation drains your body’s resources—and indirectly, as a result of medication side effects, inactivity, anaemia, depression, and lack of sleep (due to pain). Since fatigue seems to be partially caused by inflammation and pain, getting the disease under control with the proper treatment can help improve your energy levels.

Exercise is also beneficial for combatting fatigue, Dr. Mandl says. “You have to wait until your inflammation is under control, and there is often a lag time between getting the inflammation under control and fatigue getting better,” she notes. “Once you start exercising, ramp up slowly, and don’t be discouraged if you are more tired initially.” Once you adjust to the activity and make it a regular part of your routine, it can be energizing.

“Taking care of one’s mental health is also really important,” says Dr. Abel. “There’s a lot of work being done in rheumatology in general and in psoriatic arthritis specifically about mental health because there’s a lot of overlap between depressive symptoms, fatigue, and psoriatic arthritis,” she explains. “If you’re depressed and don't want to move, that’s going to stiffen the joints. You also get endorphins from exercising, so if you don't do it, you can get depressed, and it’s this vicious cycle.” Seeing a therapist and being treated—either with therapy, medication, or both—for depression symptoms can help with overall psoriatic arthritis symptoms, especially fatigue, Dr. Abel says.

Remember, psoriatic arthritis is a systemic disease, so shoring up your overall health, both physically and mentally, is a great way to improve the condition and help you feel better day-to-day.

https://www.healthcentral.com/condition/psoriatic-arthritis/questions-to-ask-your-doctor