Do Supplements Help Psoriasis? What the Research Shows

From healthcentral.com

Vitamin D and curcumin show some promise—but the evidence is mixed. Here’s what to know before adding supplements to your psoriasis treatment plan 

Psoriasis is an immune-related condition that causes inflammation in the body. Because of that, many people wonder if changing what they eat—or taking certain supplements—might help. Some nutrients are known to fight inflammation, and a few have been studied in people with psoriasis. So it seems logical: If you can’t perfectly follow a Mediterranean or DASH diet, could a daily supplement help calm inflammation instead?

It’s not that simple. Supplements can be expensive, and so far, research on whether they improve psoriasis symptoms has been limited and mixed. To get clearer answers, researchers recently reviewed more than 20 clinical trials, published in Frontiers in Nutrition, that looked at popular supplements for psoriasis. Two showed the most promise—but results varied, and none worked for everyone. Here’s what to know before adding anything new to your routine.

Weighing the Evidence

The review examined seven commonly discussed supplements:

• Curcumin

• Fish oil

• Multivitamins

• Probiotics

• Selenium

• Vitamin D

• XP-828L (whey protein extract)

Each of these has anti-inflammatory properties that could, in theory, help psoriasis.

“Omega-3 fatty acids [in fish oil] have the most acceptable data to support use in psoriasis, and oral supplements containing antioxidants such as vitamins A, C, E, and selenium may help promote anti-inflammatory pathways that counter the pro-inflammatory ones in psoriasis,” says Rosanne Paul, D.O., an assistant professor of dermatology at Case Western Reserve University in Cleveland, OH who was not one of the study’s authors.

Still, the overall evidence wasn’t strong enough to clearly recommend most of them. Multivitamins appeared to show the biggest improvement, but results differed greatly between studies, making it hard to trust the finding. XP-828L, a whey protein extract, showed some possible benefit, but it isn’t available in the U.S.

                                                                                    GettyImages/smirart

That left two supplements that stood out: vitamin D and curcumin.

Vitamin D

Vitamin D is often called the “sunshine vitamin.” It plays a role in skin cell growth, helps regulate immune cells in the skin, and reduces inflammation. It’s also used in some prescription topical psoriasis treatments. People with psoriasis are more likely to have low vitamin D levels, and sunlight exposure often improves symptoms.

When it comes to taking it in oral form, the review found that vitamin D supplements led to mild to moderate improvement in psoriasis symptoms overall. However, study results were inconsistent. “There is a small improvement in PASI [Psoriasis Area and Severity Index] scores, but because the studies are all over the place, it’s not clear if this is actually clinically significant,” says Jessica Kaffenberger, M.D., a board-certified dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center in Columbus, OH who did not author the study. “It’s reasonable for patients to make sure they’re getting the recommended amount of vitamin D, but I wouldn’t recommend high doses.”

Adults under 50 should aim for 600 IU of vitamin D daily. Those 50 and older should aim for 800 to 1,000 IU daily. The safe upper limit is 4,000 IU per day.

Curcumin

Curcumin is the main active compound in turmeric. It gives the spice its bright yellow colour and is known for its anti-inflammatory effects. “Curcumin has been shown as a potentially effective adjunctive treatment for psoriasis in both topical and oral formulations,” says Dr. Paul.

In the review, people who took curcumin along with their usual psoriasis treatment had lower levels of interleukin-22 (IL-22), a protein that drives inflammation in psoriasis. They also showed some symptom improvement. It’s thought that it may calm the immune signals that tell your body to make the pro-inflammatory proteins in the first place.

Curcumin in food and most supplements is generally safe (up to 4 grams of concentrated curcumin supplements per day). However, some highly concentrated forms may carry a risk of liver injury. Always talk with your doctor before starting a new supplement.

The Bottom Line

Research on supplements for psoriasis is still evolving. Of those studied, vitamin D and curcumin show the most potential—but neither replaces standard treatment. If you’re thinking about adding a supplement, talk with your dermatologist first. Together, you can decide what fits safely into your overall care plan.

https://www.healthcentral.com/news/psoriasis/do-supplements-help-psoriasis-research?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGgUy_I1XOw_oTHunbiI9SEpTHxKxIz3oPjWyrOzd7X1UCqn4qP72YGnGkjdpRrMHbA6ibVdLeDKHYgjUjF0-UWL3TRci7NwD2_Fz5oxUnLW8v2dYk

Advances in Psoriasis Treatment: What’s New For Mild, Moderate and Severe Disease

From jewishlink.news

By Dr. Alex Doctoroff

Psoriasis is a chronic autoimmune skin condition that affects millions of people worldwide. It causes red, scaly and often itchy patches on the skin. Psoriasis is not contagious. Psoriasis can have a profound impact on a person’s physical comfort, self-esteem and overall quality of life. Though there is currently no cure for psoriasis, treatment options have expanded significantly in recent years, giving patients a wider range of choices that are safer, more effective and easier to use than ever before.

Depending on the extent of skin involvement and how much it interferes with daily life, psoriasis is generally classified as mild, moderate or severe. Mild psoriasis typically affects less than three percent of the body and tends to be more localized, such as patches on the elbows or scalp. Moderate psoriasis may cover more skin or affect areas that interfere with everyday activities or cause significant emotional distress. Severe cases involve more widespread skin involvement, or the presence of psoriatic arthritis, which causes joint pain and stiffness. Each level of severity requires a different approach to treatment, and recent advancements are helping to tailor these options more precisely to individual needs.

For those with mild psoriasis, topical treatments are usually the first line of defence. For decades, corticosteroid creams and ointments have served as the primary therapy. These drugs help reduce inflammation and calm overactive immune responses but can cause side effects like skin thinning when used long term. Additional topicals like vitamin D analogues and calcineurin inhibitors have offered steroid-free alternatives for sensitive areas. In recent years, however, there has been a push to develop even safer, more sustainable options for topical therapy.

Two major breakthroughs in this area include tapinarof and roflumilast. Tapinarof is a non-steroidal cream approved in 2022 that targets the skin’s immune signalling through a pathway called the aryl hydrocarbon receptor. It offers strong results with a low risk of side effects. Roflumilast, another newer agent, inhibits an enzyme involved in inflammation and is particularly useful for sensitive areas such as the scalp or body folds. Both of these treatments represent a new era of steroid-free topical management, giving patients options that are effective and safe for continuous use.

In addition to topical treatments, Xtrac laser is a valuable treatment option, which we routinely use. The benefit of Xtrac is that after the treatment is completed, a long-term remission (seven to 12 months) is usually possible. For those patients who have widespread involvement with psoriasis, but are unwilling or unable to use biologic treatments (more on biologics later), narrowband ultraviolet B (UVB) phototherapy is one of the most effective methods.

As psoriasis becomes more widespread or difficult to manage with topicals alone, treatment often escalates to systemic options—medications that work throughout the body. Traditionally, oral medications like methotrexate and cyclosporine were used to manage moderate to severe psoriasis. While effective for some, these drugs carry serious side effects risks, such as liver or kidney toxicity, and require frequent blood tests to monitor for complications.

In recent years, however, newer oral treatments have emerged that offer similar or better results with fewer risks. One of the most exciting developments is the introduction of deucravacitinib, a once-daily pill that works by selectively inhibiting a molecule involved in the immune response known as TYK2. Unlike older systemic drugs, deucravacitinib has a more targeted mechanism and a favorable safety profile, making it an attractive option for patients who prefer pills over injections. This reflects a broader trend in psoriasis care toward personalized treatment—choosing the right therapy for the right patient at the right time.

For people with severe psoriasis, particularly those with joint involvement or very widespread skin symptoms, biologic therapies have become the gold standard. Biologics are advanced medications that work by blocking specific parts of the immune system that are overactive in psoriasis. Instead of suppressing the entire immune response like older drugs, biologics act on precise targets, such as certain interleukins or inflammatory proteins, allowing for more effective treatment with fewer side effects.

The most common misconception I have to address with patients is the notion that biologics are toxic or immunosuppressive. This notion is not correct. Biologics do not generate toxicity for internal organs, such as liver or kidneys, like older oral medications did. And they certainly are not immunosuppressive, like older medications were. I think of biologics more like immunomodulators: they decrease body
mediators, which are elevated, without lowering one’s immune system as a whole.

There are several classes of biologics, each targeting a different pathway in the immune system. Earlier biologics focused on tumour necrosis factor-alpha, a general inflammatory protein, while newer agents have shifted toward more specific targets like interleukin-17 and interleukin-23. These newer biologics, such as risankizumab, guselkumab and ixekizumab, have shown remarkable success in clinical trials, with many patients achieving clear or nearly clear skin. Injections are typically spaced out every few weeks to months, and many patients report significant improvements in both symptoms and quality of life.

One of the most exciting trends in the biologic space is the rise of IL-23 inhibitors. These medications have become particularly popular due to their long-lasting effects, high success rates and relatively low risk of side effects. Patients on IL-23 blockers often need only four to six injections per year after an initial loading period, making them convenient and less disruptive to daily life. These therapies are now often considered as first-line options for patients beginning biologic treatment.

Cost and accessibility remain a concern, but the introduction of biosimilars—less expensive versions of brand-name biologics—has begun to lower barriers. Biosimilars are now available for some of the most widely used biologics, offering similar efficacy at a reduced price, and their presence is expected to grow in the coming years. This is a significant step forward in making advanced treatment more widely available to people with severe disease.

The overall message is one of hope. Psoriasis may still be a lifelong condition, but managing it has never been more achievable. Today, patients have access to a wide spectrum of therapies—from innovative topicals and smart light treatments to powerful biologics and targeted oral medications. With regular follow-up, an individualized care plan and open communication with a dermatologist, many people can now live free from the discomfort and stigma of uncontrolled psoriasis. Whether your disease is mild and manageable or severe and persistent, the options available today offer real possibilities for relief, recovery and long-term remission.

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Dr. Alex Doctoroff is dual board certified in dermatology and Mohs Surgery. He is the past president of the New Jersey Dermatological Society and a clinical assistant professor of dermatology at Columbia University Medical Center and New York Presbyterian Hospital. 

https://jewishlink.news/advances-in-psoriasis-treatment-whats-new-for-mild-moderate-and-severe-disease/ 

How Does Psoriasis Affect the Hands?

From healthcentral.com

Learn the ways this chronic skin condition can cause rashes and lesions on your skin, plus the best ways to treat it 

Most people think nothing of giving a high-five, but if you have psoriasis on your hands, you likely cringe just thinking about it. This type of contact with another person can be painful and sometimes embarrassing.

“Patches of psoriasis affecting the thick skin of the palms tends to crack, bleed, and cause painful fissures,” says Joel Gelfand, M.D., a professor of dermatology and epidemiology at the University of Pennsylvania in Philadelphia.

Let’s take a closer look at exactly how your hands can be affected by psoriasis, where on the hands psoriasis generally appears, and what you can do to treat it.

                                                                            Getty Images/Jatuphol Aroonsawasd

Where on the Hand Psoriasis Can Occur

According to the Cleveland Clinic, psoriasis on your hands can target your:

• Fingernails

• Fingers

• Nails

• Palms

• Skin on top of the hand

• Webbing between fingers

• Wrists

Appearance of Hand Psoriasis

Psoriasis can occur from your wrist to your fingernails. Psoriasis on the hands often varies from predominantly pustular lesions to thick hyperkeratotic plaques, according to the journal Dermatologic Therapy. Like elsewhere on the body, psoriasis on the hands can appear as itchy, scaling, and reddened skin plaques.

Psoriasis on the nails can cause multiple irregularities of the nails including pitting, crumbling, thickening, discoloration, white or reddish spots, and separation of the nail from the nail bed. Though sometimes mistaken for nail fungus, nail psoriasis looks a little different.

Lesions and plaques caused by psoriasis can be so disabling that doing anything with your hands during a flare can feel impossible. Plus, it’s awkward to explain to a curious outsider what’s going on with your skin. If you have hand psoriasis (or think you might), here’s what’s going on and how you can keep it from disrupting your life.

                                                                    Psoriasis on hands. Cureus/© 2021, P et al.

Symptoms of Hand Psoriasis

While symptoms can vary from one person to the next, these are some of the tell-tale signs of psoriasis, based on which part of your hand it occurs on.

Palms and Fingers

According to the National Psoriasis Foundation, when you have psoriasis on your palms and fingers you may experience red/discoloured, dry, and thickened skin, as well as deep cracks on the skin. You may also have limited movement with your hands including grip strength or be limited in your ability to shake hands. That’s why when psoriasis strikes the hands, it is known to have an outsize effect.

Nails

According to a study published in the Journal of the American Academy of Dermatology, the most common features of nail psoriasis is onycholysis (nail plate separating from the nailbed) and nail plate pitting. You may also notice nail discoloration, especially if the nail has lifted from the nailbed. If the psoriasis that is attacking your nails goes untreated, it can result in a loss of the affected nails.

Prevalence of Hand Psoriasis

The prevalence of psoriasis varies around the world with about 3% of the U.S. population living with the condition. Out of those with psoriasis anywhere on their body, about 1 in 5 have psoriasis on the hands (and interestingly, about the same percentage have psoriasis on their feet).

Nail psoriasis is much more common with about half of the people with psoriasis having it on their nails. Across a lifetime, almost everyone (90%) of those with psoriasis will experience nail psoriasis, according to the National Psoriasis Foundation.

Causes of Hand Psoriasis

Psoriasis can show up anywhere on the body. Whether it is on your hands, feet, or scalp, the root cause of psoriasis is an overactive immune system. That overactive immune system may trigger a psoriasis flare due to one of these factors:

• Environment

• Genetics

• Lifestyle (such as smoking)

• Stress

• Skin injury

• Illness such as strep throat

• Cold weather/decreased sunlight

Types of Hand Psoriasis

While colloquially people describe skin plaques and pain in this area as hand psoriasis, technically there are several subtypes of the chronic skin disease, depending specific symptoms and where exactly on your hands it appears. Types of hand psoriasis include:

Palmoplantar Psoriasis

This form of psoriasis appears only on the palms and/or the bottoms of the feet, and accounts for less than 5% of psoriasis cases, according to the Journal of the American Academy of Dermatology. Palmoplantar psoriasis can be extremely pain, making those high-fives and handshakes really uncomfortable. In some cases, symptoms can seriously disrupt your life. In at least one study, people with palmoplantar psoriasis were significantly more likely to have problems with mobility, self-care, and other everyday activities.

Treatment for palmoplantar psoriasis can be tricky. The condition is likely to lead to secondary fungal infections and people sometimes have allergic reactions to the topical medications they’re using for treatment. Those with palmoplantar psoriasis also tend to be hypersensitive to touch.

“Making matters even more difficult is that palmoplantar psoriasis is often resistant to treatment,” Dr. Gelfand says. “Current treatments, even our newest biologics, often have limited benefit for psoriasis of the palms.”

Dactylitis

Dactylitis is sometimes referred to as “sausage” fingers. Dactylitis is linked to psoriatic arthritis and most frequently appears in those whose psoriasis is advancing into psoriatic arthritis.

Dactylitis often involves painful swelling along your entire finger or toe, not just around one of the joints. It can be one of the first signs of psoriatic arthritis—even if you do not have psoriasis on your hands. Anti-inflammatory drugs, either over-the-counter or prescription, such as non-steroidal anti-inflammatory drugs (NSAIDs), may provide some relief. If your fingers start to swell, let your doctor know as soon as possible because early treatment can improve later outcomes.

Enthesitis

Enthesitis typically occurs in people whose psoriasis has evolved into psoriatic arthritis. Enthesitis the swelling of the entheses, or the connective tissue that joins ligaments and tendons to the bones in your hands. Your fingers may feel stiff and painful, but unlike dactylitis, you may not have visible swelling. Your dermatologist may suggest an oral or injectable anti-inflammatory to relieve the ache.

Nail Disease

Psoriasis causes your skin cells to reproduce much more quickly than they should thanks to an overactive immune system. Since your nails are part of the skin, psoriasis can develop under the cuticle and wreak havoc on the growth and health of your nails. As a result, you may see pitting, vertical ridges, discoloration, and separation from the nail bed. Estimates of nail psoriasis range from about 50% to as high as 80% in those with psoriasis.

Treatment of Hand Psoriasis

The treatments used for hand psoriasis are the same used for other forms of plaque psoriasis. There is no single best approach: Which treatment your doctor recommends will depend on a variety of factors such as how severe your psoriasis on your hands is, how long you have had psoriatic disease, and what other treatments you have already tried. Some of the more common treatments include:

Topicals

Topical medications are applied directly to the skin. They come in different forms such as lotions, tars, and bath solutions. There are helpful topical medications available over-the-counter without a doctor’s prescription. Some of the topicals that are now available are natural products made for sensitive skin.

The National Psoriasis Foundation keeps a list of products that are intended to be non-irritating for people with psoriasis. Your doctor may also prescribe a stronger topical to help bring your symptoms under control.

Phototherapy

Phototherapy, or light therapy for psoriasis, involves holding your hands under an ultraviolet light source on a regular basis. Ultraviolet light from the sun or an artificial light has a profound immunosuppressive effect. There are few side effects of phototherapy which is one explanation of why it has been around so long. Your dermatologist will have a medical UV light designed with a wavelength to best treat psoriasis.

Oral Treatments

For more advanced cases of psoriasis, your doctor may prescribe a systemic medication to be taken as a pill. Instead of acting locally on just your hands, some of the newer oral treatments can selectively target molecules inside of your immune cells to help reduce inflammation at the source—think of it as treating your psoriasis more upstream. If you are also living with psoriatic arthritis (PsA), an oral treatment may be prescribed that can treat your psoriasis and PsA simultaneously.

Biologics

Biologics are delivered by injection or infusion and target a specific part of your immune system, depending on which biologic you are prescribed. Studies have indicated that biologics can successfully manage previously difficult to treat psoriasis, such as on the hands and nails, according to the Journal of Clinical Medicine. The cost of biologic treatment can be challenging, even with health insurance. If you are unable to afford the medicine you are prescribed, talk to your doctor. There are a variety of programs designed to help meet the financial needs associated with biologic treatment.

How to Manage Hand Psoriasis

While there’s no cure for psoriasis, there are some things that you can do to ease symptoms that affect your hands.

See Your Dermatologist

Even if you have psoriasis on other parts of your body, you want to make sure that your new hand outbreak is indeed psoriasis and not another condition. According to the American Academy of Dermatology, dry and itchy skin can be caused by a number of conditions, including eczema. It’s not only difficult to tell the difference between the two (especially in kids), but you can have both at the same time. Similarly, if your finger joints are suddenly sore, you will need to rule out overuse, psoriatic arthritis, rheumatoid arthritis, osteoarthritis, or a virus such as Lyme disease.

Work With an Occupational Therapist

If you are dealing with psoriatic arthritis along with psoriasis, stiffness and swelling can be significant issues and you may benefit from working with an occupational therapist. “Many occupational therapists specialize in hand therapy and provide a variety of treatment options to assist with hand discomfort,” says Aleksandra Radjen, Ph.D., a physical therapist at the Cleveland Clinic in Ohio. What’s more, they help you improve the use of your hands and maintain the skills you need to live your everyday life.

Stay on Top of Your Overall Treatment Plan

By treating your psoriasis aggressively, you can help lessen its impact on your body overall. So take your meds regularly and on time, keep your body moving, and try to stick to a plant-based diet.

Protect Your Hands

Preventing hand injuries is extra important if you have psoriasis. Wear gloves or other protective gear whenever possible, including when you’re doing everyday chores like washing dishes or weeding the garden. New lesions can develop from a cut, bruise, or burn, a tendency known as the Koebner phenomenon (named after the dermatologist who discovered it, Heinrich Koebner).

Practice Good Nail Care

They need to be protected just as much as your skin: Use tools instead of your fingernails to open packaging; keep them short to prevent ripping; and avoid the harsh chemicals that can be found in some nail polishes and polish removers, which can weaken your nails even further. And don’t forget the moisturizer.

“Moisturize them every day with an emollient cream or ointment,” says Tamy Buckel, M.D., a dermatologist in Chestertown, MD.

Talk to a Mental Health Pro

If you feel self-conscious, embarrassed, or if your hand psoriasis is preventing you from doing the things you enjoy, it may be time to talk to someone about it. A counsellor, therapist, or even a psychodermatologist can be a great addition to your care team.

Never heard of a psychodermatologist? That’s probably because it’s a new subspecialty of dermatology and psychiatry, and it was created because healthcare professionals who recognized that having a skin condition can cause stress and anxiety.

Bottom line? Dealing with daily pain—whether it’s your hands, feet, or anywhere else on your body—is exhausting. If you have hand psoriasis, you do not need to go at this alone. Seek out the advice of dermatologist, who can guide you toward treatments and lifestyle changes to make your world a little easier.

https://www.healthcentral.com/condition/psoriasis/psoriasis-on-hands

Can You Get Psoriasis On Your Lips?

From healthcentral.com 

Lip psoriasis is extremely rare, but it’s not out of the realm of possibility. Here’s what experts say to look for and what to do if you are diagnosed with the chronic skin condition

While the chronic skin condition psoriasis (PsO) is most commonly seen on the knees, elbows, and scalp, if you’re living with psoriasis, you know first-hand that it can occur just about anywhere on the body, including the lips. While extremely rare (only around 120 cases have been reported in the scientific literature, noted one Cureus case report on oral psoriasis), the condition can affect your mouth area, resulting in painful mouth sores and cracked lips.

If you have psoriasis and you’ve been experiencing mouth pain, it’s logical to wonder if the skin disease is to blame. We went to two board-certified dermatologists to find out more about psoriasis on the lips—including what the symptoms look and feel like, what causes it, and how to treat it.

Lip Psoriasis: What Is It?

While psoriasis can occur on the lips—as well as on the tongue and inside the mouth—it’s very rare, according to Marisa Garshic, M.D., a board-certified dermatologist in private practice and assistant professor of dermatology at Weill Cornell Medicine in New York City.

“Psoriasis involvement of the lips in isolation has been very rarely reported in the medical literature but may also precede development of psoriasis lesions elsewhere on the body,” adds Pooja Rambhia, M.D. a board-certified dermatologist at UnionDerm in New York City. She notes that if you don’t already have psoriasis elsewhere on the body, it can be incredibly difficult for physicians to diagnosis since there are so many different conditions that affect the lips—and because psoriasis doesn’t always appear the same ways on the lips as it does on other areas of the skin.

“More commonly, you can have what’s called ‘geographic tongue’ where you have generally asymptomatic white migrating lesions on the tongue,” says Dr. Rambhia. “Approximately 10% of patients with psoriasis present with findings of a geographic tongue.” These white lesions can also spread to the lips or inner cheeks, she adds.

                                                                                  GettyImages/Tero Vesalainen

What are the Symptoms of Psoriasis on the Lips?

The reality is that symptoms of psoriasis on the lips can look and feel like a variety of other afflictions, including eczema and cheilitis (a broad term for inflammation of the lips). According to Dr. Garshick, lip psoriasis may also be asymptomatic. But when symptoms of psoriasis on the lips do happen, the most common symptoms, our experts say, include:

• Burning sensation of the lips

• Fissuring or cracking of the lips

• Red patches associated with small pustules

• Soreness and general pain

• White scaling

How Can You Tell the Difference between Psoriasis and Cheilitis?

Cheilitis is an umbrella term that refers to inflammation of the lips and the surrounding skin, and according to Dr. Rambhia, lip psoriasis can be considered a type of cheilitis, though a very rare one. “There are many different causes and subsequent diagnosis of cheilitis,” she says. “Some examples include actinic cheilitis, angular cheilitis, eczematous cheilitis, and contact dermatitis.”

Dr. Garshick adds that while it can be quite cumbersome to differentiate between lip psoriasis and other inflammatory lip conditions, there are some ways to tell them apart. These are some of the most common ailments that affect the lips, and how they differ from psoriasis:

Chapped Lips

Chapping may appear as flaking on the lips and the surrounding skin, and typically can be cleared up with hydrating lip balms and occlusive ointments, whereas lip psoriasis may not respond to these over-the-counter treatments and typically will involve redness as well.

Contact Dermatitis

“While contact dermatitis can also appear as red, flaky patches [like psoriasis], it is often in an area that has been exposed to an allergen or an irritant,” says Dr. Garshick. “For this reason, it may worsen with certain triggers or be present in other areas.”

Perioral Dermatitis

Perioral dermatitis is a common inflammatory skin condition that primarily affects the area around the mouth (peri-oral) but can also extend to the nose and eyes. Rather than the white-coloured rash of lip psoriasis, perioral dermatitis typically appears as a red or pink rash with small, raised bumps or pustules. The rash may be itchy or uncomfortable and can sometimes cause a burning sensation.

Cold Sores

Also known as fever blisters, cold sores are small, fluid-filled lesions or blisters that typically appear on or around the lips, mouth, or nose. They are caused by the herpes simplex virus (HSV), primarily HSV-1.

What Triggers Lip Psoriasis?

As Dr. Rambhia explains, there are no specific triggers isolated to lip psoriasis. However, some triggers for psoriasis in general include:

• Hormonal fluctuations: Psoriasis has been shown to be influenced by various hormonal fluctuations, including those seen during puberty, postpartum, and menopause.

• Infections: Streptococcal infections have been shown to trigger a specific subtype of psoriasis, called guttate psoriasis.

• Injury or trauma: Psoriasis can frequently “Koebnerize”. The Koebner phenomenon refers to the development of fresh psoriatic lesions in areas of previously unaffected skin following injury or trauma in individuals with psoriasis.

• Medications: Various medications, including but not limited to lithium and beta-blockers, have been associated with psoriasis flares.

• Smoking: A twin study published in the International Journal of Dermatology revealed that individuals who smoke heavily are over twice as likely to develop psoriasis.

• Stress: Stress can trigger changes in the immune system, leading to inflammation and immune system dysregulation. In psoriasis, the immune system mistakenly attacks healthy skin cells, causing the rapid turnover of skin cells and the formation of psoriatic plaques.

How Is Psoriasis on the Lips Diagnosed?

To get psoriasis on the lips diagnosed, you’ll need to be examined by a board-certified dermatologist. “It’s important to share your history of persistent rashes on the skin, as well as any family history of psoriasis or evidence of psoriasis elsewhere on the body,” says Dr. Rambhia. “In some cases, a biopsy of the lip [tissue] is done to confirm a diagnosis.” Dr. Garshick adds that a biopsy is often recommended as it’s one of the only ways to accurately confirm whether it’s psoriasis, or another inflammatory condition.

How Do You Treat Lip Psoriasis?

Like anywhere else on the body, psoriasis on the lips can be treated with at-home remedies or medication—it all depends on the severity of your case and what your doctor recommends. “Treatment of psoriasis on the lips includes prevention of flare ups, for which regular use of Vaseline or Aquaphor can help to keep the lips soft and smooth,” says Dr. Garshick. She also notes that avoiding triggers, such as smoking, stress, and infections, can be beneficial. “Additionally, some options to treat psoriasis include topical steroid creams, topical non-steroidal creams, as well as systemic treatments such as biologics.”

At-Home Treatments

To help prevent and treat psoriasis flare ups on the lips, there are a few different measures you can take, including:

• Keep lips moisturized and protected with an ointment like Vaseline or Aquaphor.

• Avoid triggers such as smoking, stress, and spicy foods.

• Use soothing lip balms with anti-inflammatory ingredients like aloe vera and turmeric.

• Apply over-the-counter hydrocortisone cream to the area.

Prescription Treatments

If you’re unable to tackle psoriasis on your lips with at-home remedies, your doctor may prescribe you medication to help get it under control—this can include both topical and systemic treatments, such as:

• Topical steroid creams: These creams, which contain corticosteroids, work by reducing inflammation, itching, and redness associated with psoriasis flare-ups. However, when using these creams on the lips, caution must be exercised due to the thin and sensitive skin in this area. Strong steroid creams may cause side effects such as thinning of the skin, discoloration, or even exacerbate symptoms if used for prolonged periods or inappropriately.

• Biologics: These drugs are typically reserved for moderate to severe psoriasis that hasn't responded well to other treatments. Biologics work by targeting specific parts of the immune system involved in psoriasis inflammation, thereby reducing symptoms such as redness, scaling, and discomfort.

Takeaways

Psoriasis on the lips and perioral area is extremely rare, but there have been reports of it occurring in medical literature. Moreover, psoriasis of the lip typically only presents when you’ve already experienced psoriasis on other areas of the body. Though diagnosis of lip psoriasis can be very challenging as it often looks identical to other types of inflammatory rashes of the lips, it’s critical to see a board-certified dermatologist to get accurately diagnosed and treated.

https://www.healthcentral.com/condition/psoriasis/psoriasis-on-lips