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/ 

Best and Worst Advice on Managing Psoriasis

From healthcentral.com 

Hear what works (and what doesn’t) from your PsO peers

More than 7.5 million people in the United States have psoriasis, an autoimmune skin disease. If you’re one of them, you know its impact can go deeper than skin; approximately a third of people with psoriasis also develop psoriatic arthritis, a condition that impacts joints and surrounding tissues. There is no cure for psoriasis, but there have been enormous leaps forward in the treatment landscape. As research reveals more about the mechanisms that cause psoriatic inflammation, treatment has become more targeted and effective. Today, there are multiple FDA-approved biologic options for psoriasis treatment.

                                                                                            GettyImages/pocketlight

Misinformation Abounds

Despite scientific breakthroughs in psoriasis, misinformation remains common. Maybe you’ve heard people say that psoriasis can be cured or that it can be transmitted sexually to another person—neither is true. Fortunately, there are reliable resources such as the National Psoriasis Foundation that can provide science-backed info on managing the condition. Another great resource? People living with psoriasis themselves, who have heard every myth under the sky about their condition—and have something to say about the best (and worst) advice they’ve been given.

Worst Advice: Lube Up With Oil

                                                         GettyImages/Andrii Medvediuk

Emily Hertzberg, 41, an art teacher who lives in East Meadow, New York has had no shortage of bad advice about her psoriasis. “Someone once told me to put olive oil on my psoriasis patches, which of course didn’t work,” says Hertzberg. “It just made my skin extra greasy which is gross,” she explains. While olive oil has shown potential for a variety of skin conditions, investigators of a 2025 study admit that more quality evidence is needed to recommend olive oil for all skin conditions. Hertzberg has decided, “I’ll stick to olive oil for cooking!”

Best Advice: Try Light Therapy

                                                            GettyImages/Kalinovskiy

“Years ago, someone mentioned light therapy to me for psoriasis and I have been utilizing its incredible benefits ever since,” reports Hertzberg. “It is such a game changer for me, it shrinks my patches and helps combat flares.” Also known as phototherapy, light therapy is usually administered at a dermatology clinic, hospital, or in a doctor’s office. It can be used alone or in addition to another psoriasis treatment. According to a 2023 article, clinical response to light therapy is relatively quick, often within one to two weeks.

Worst Advice: Bathe in Bleach

                                              GettyImages/Richard Villalonundefined undefined

Bree Pease, 22, originally from Australia and now living in Saskatchewan, Canada, has learned to spot potentially harmful tips when she receives them. “I’ve heard a lot of bad advice, but the worst was probably from a random person online who told me to ‘just take a bleach bath,’” she says, “As if burning my skin off would somehow make it better!” While some skin conditions may benefit from a tiny dose of bleach added to bathwater, psoriasis (which is caused by immune system dysfunction) isn’t one of them.

Best Advice: You’re More Than Your Skin

                                                              GettyImages/fotostorm

Ever feel like you spend more time fighting the negative psychological impact of psoriasis than the physical symptoms? People with psoriasis are more likely to live with depression and anxiety, according to the National Psoriasis Foundation. The battle to conquer mental health demons is real, says Pease. “The best advice I ever got was from someone in the psoriasis community who told me, ‘Your skin doesn’t define your worth.’ It sounds simple, but at a time when I was struggling with confidence it changed everything for me.”

Worst Advice: Just Moisturize

                                                         GettyImages/Bogdan Malizkiy

“The worst advice I have received—from more people that I’d like to count—is: ‘That scab looks dry, have you tried putting some moisturizer on it?’” says Lianne Hunter, 38, a public relations director from Manchester, United Kingdom. Though it’s coming from a place of kindness, Hunter says the constant need to explain her psoriasis is not a ‘scab’ can be exhausting. Over the years, she says, she’s learned rather than correct the bad advice it’s easier to take the path of least resistance. “Just smile and nod, smile and nod,” she says.

Best Advice: Don’t Let Psoriasis Hold You Back

                                                   GettyImages/Goodboy Picture Company

“I’ve had psoriasis since I was five, so I don’t really remember life without it,” says Hunter. “It also means I navigated a lot of my younger, self-conscious years with it,” she says. “My mother was matter-of-fact about the condition. She always said just because I have it doesn’t mean I should let it hold me back. That always stuck in my head and made me face the condition head on—I didn’t shy away from explaining what it was and how it impacted me.”

Worst Advice: Try Snake Skin Powder

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No, that’s not a joke. Howard Chang, 53, a minister in Woodland, CA, says the worst advice anyone ever gave him about his psoriasis came from a friend of his parents, who suggested drinking actual snake skin powder mixed in water. “They theorized that since snakes shed their skin, ingesting their skin would help me shed my psoriasis,” explains Chang. “Unfortunately, the snake skin powder mixture caused me to retain water, I quickly gained weight, my face puffed up, and my psoriasis worsened.”

Best Advice: Bathe in Moderation

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“After college I found a dermatologist who asked about my skin care routines—at that time I showered twice a day and didn’t apply regular moisturizer,” says Chang. “He lightly scratched my leg to show how dry my skin had become from over-bathing,” he says. Ever since, Chang has showered once daily and moisturized immediately afterwards. “My skin became less irritated with my new bathing and moisturizing routine,” he says. “It’s hard to change lifelong habits, but I’m glad I made the change that has helped me better manage my psoriasis.”

https://www.healthcentral.com/slideshow/best-and-worst-advice-on-managing-psoriasis?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGcqcFAEcERJWnIgu8D88bUJsmqE7Qyo7zRM77KzKZszQ4KxPZusYjACD7d3qSnvGej-LBtBh9FOa3mFPJa9DLvLtBQPewB7TPV1t-imhPTanFLWck

Why Psoriasis Itches—And How to Stop It

From healthcentral.com

Up to 90% of people with psoriasis experience itch—here’s why it happens and how to find relief, from expert treatments to simple at-home remedies 

Thick, scaly, discoloured patches of skin are a hallmark of plaque psoriasis, the most common form of this chronic autoimmune condition. While not everyone with psoriasis experiences itching, it’s a prevalent and often distressing symptom. “In my experience, most psoriasis patients do itch,” says board-certified dermatologist Debra Jaliman, M.D., who has a private practice in New York City. In fact, research shows that 60% to 90% of people with psoriasis experience itch (also known as pruritus), which the American Academy of Dermatology (AAD) notes can be the most bothersome symptom for many.

Why Is Psoriasis Itchy?

So why does psoriasis itch—and why does it happen for some people with the condition, but not others? To answer this, we need to go back to the root cause of psoriasis, which is an overactive immune system that triggers inflammation in the skin, leading to the overproduction of skin cells and resulting in those thick, scaly patches. As part of this immune response, skin cells release inflammatory molecules called cytokines, says Shari Lipner, M.D., Ph.D., board-certified dermatologist at Weill Cornell Medicine in New York City. “These cytokines irritate nerves, and signals get transmitted to the spinal cord (the collection of nerves in the center of the spine that carries messages between the brain and the body), which then results in itch,” Dr. Lipner explains.

One of the cytokines released in psoriasis is interleukin-31 (IL-31), which is associated with inflammation and itchiness. “Patients with a higher level of IL-31 seem to have a higher level of itching,” says Dr. Jaliman. However, research to date hasn’t established the exact role of IL-31 in psoriasis, or a clear link between itch severity and IL-31 levels in psoriasis patients.

The amount of skin covered by psoriasis and the severity of disease are all factors that can affect whether a psoriasis patient experiences itch (and to what extent), says Dr. Lipner. “These factors cause different degrees of inflammation,” she explains. “For example, someone with thick plaques covering their whole body will generally be itchier than someone with one small patch.”

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The location of psoriasis plaques is also relevant, notes Dr. Jaliman. “If you have psoriasis on your scalp or your lower back, where there’s a higher density of nerve endings to begin with, you might be itchier,” she says.

Factors That Worsen Psoriasis Itching

On top of the itching that occurs as part of the inflammatory response itself, other factors can exacerbate psoriasis itch. The following are common itch triggers, say our experts.

Dry Skin

It’s important to keep your skin hydrated at all times and especially when it’s more susceptible to dryness, such as during cold weather. If you’re prone to dry skin, opt for a heavier moisturizing product, such as an ointment or a cream rather than a lotion. “This forms more of a protective barrier between your skin and the environment,” says Dr. Jaliman. With that protection in place, more moisture will stay in your skin to help keep itch (along with other psoriasis symptoms like cracking and flaking) to a minimum.

Stress

The relationship between stress and psoriasis goes both ways—stress can trigger a psoriasis flare, and living with psoriasis can, in turn, increase stress levels. Experts believe that chronic stress overstimulate the hypothalamic-pituitary-adrenal (HPA) axis, a brain-body pathway that releases hormones and chemicals, fuelling inflammation throughout the body.

Weather

According to the National Psoriasis Foundation (NPF), four out of 10 PsO patients who took part in global NPF research chose winter as the season that most aggravates their condition. But, as the Mayo Clinic points out, being too hot can also exacerbate psoriasis itch.

Certain Fabrics

Many people with itchy skin conditions like psoriasis find that they have to dress accordingly. “Wool, mohair, and synthetic materials like polyester and nylon can irritate the skin, which can then cause itching, says Dr. Jaliman. She recommends wearing natural, lightweight, breathable fabrics that won’t cause discomfort, like cotton or silk. And keep your garments loose if you’re having a flare, so that air can circulate and you’re less likely to sweat (which can also add to the itch factor).

Scratching

The temptation to scratch can often be too much to resist, but it can lead to a frustrating itch-scratch cycle that can be tough to break. Keep your nails clean and trimmed and wear cotton gloves to bed if you have a habit of nocturnal scratching. The AAD suggests reaching for your moisturizer whenever you have the urge to scratch (it’s a good idea to have travel sizes of your favourite hydrating ointment so it’s easy to take out with you, wherever you go). Another way to get instant relief from itch is by placing something cool on your skin, like a cold compress. (The nerves that send those “itch signals” to your brain are less effective when they’re cold, says the AAD.)

How to Relieve Psoriasis Itching

The best way to relieve psoriasis itch is to work with a board-certified dermatologist to find a treatment plan that works for you, says Dr. Lipner. “The better managed your psoriasis is, the less you will itch,” she explains.

It’s important to follow the treatment plan that’s right for you—and everyone is different in how they respond to certain medications and therapies. But you might want to consider some of these suggestions from our experts.

Topical Treatments

Many over-the-counter topicals are available to help relieve psoriasis symptoms, including itch. Dr. Jaliman recommends Sarna Anti-Itch Lotion, which contains menthol and camphor to help with itching and CeraVe Itch Relief Moisturizing Cream, which contains pramoxine (a topical anaesthetic) to numb the area. Many skin care products marketed for eczema can also be great for psoriasis (itch is central to eczema), such as Eucerin Eczema Relief Cream, which contains colloidal oatmeal and ceramides to strengthen the skin’s protective barrier.

Corticosteroids (commonly known as steroids) may help to relieve itch as well as reducing irritation and swelling and slowing the growth of skin cells. Stronger formulations are available on prescription, but an over-the-counter option is Cortizone-10 Intensive-Healing Formula Hydrocortisone 1% Cream. A study published in the Journal of the American Academy of Dermatology found that a four-week course of topical hydrocortisone cream applied twice per day reduced the severity of the participants’ symptoms from a Target Lesion Score (TLS) of 8 (severe) to 2 (mild).

Phototherapy

Phototherapy for psoriasis involves regular exposure of the skin to ultraviolet light, typically ultraviolet A (UVA) and ultraviolet B (UVB) rays. Usually done at a doctor’s office or dermatology clinic, it’s been shown to help with itch. One of the benefits of phototherapy is that if it works for you, it usually works quickly: a study published in the Journal of the German Society of Dermatology found that about 50% to 75% of individuals who had UVB light therapy achieved at least 75% or greater improvement from their baseline within four to six weeks.

Systemic Medications

If you have moderate to severe psoriasis, topical treatments might not be enough to keep your symptoms under control. Your doctor may recommend systemic drugs like cyclosporine (Neoral) and methotrexate (Trexall), prescription drugs that work throughout the body, if topical treatments and phototherapy have been unsuccessful. Unlike topicals that you apply to your skin, systemic meds may be taken orally, by injection, or by infusion. By affecting how the immune system behaves, systemic drugs help to reduce inflammation, which eases itch and other symptoms.

Home Remedies

Tried-and-tested at-home ways to alleviate itch include applying aloe vera to affected areas of skin and taking oatmeal baths, says Dr. Lipner. Meanwhile, Dr. Jaliman recommends using a humidifier to help hydrate the skin and replacing hot baths with lukewarm showers. “Use a moisturizer immediately after getting out of the shower to hydrate your skin, and make sure it’s a fragrance-free product as fragrance can dry out and irritate sensitive skin, leading to more itching,” she adds.

Avoiding Triggers

Knowing your personal psoriasis triggers is a big step in figuring out how to manage your symptoms and avoiding itch. For instance, if stress is a trigger for you, practical tips from the AAD include yoga, support groups, deep breathing exercises, and keeping daily gratitude lists.

Itch may be a common psoriasis symptom—and one that’s not always easy to control—but that doesn’t mean you have to let it take over your life. “If your psoriasis itch is making you uncomfortable, interfering with your ability to concentrate or perform your daily activities, disrupting your sleep, it’s important to see your board-certified dermatologist,” says Dr. Lipner.

If you’re experiencing sore joints alongside severe itch, this may be a sign of psoriatic arthritis. And if your itch is intense to the point that it feels like a burning sensation, this may be erythrodermic psoriasis, a rare type of psoriasis that can appear suddenly and may require emergency medical treatment.

Bottom Line

Psoriasis itch can be one of the trickiest symptoms of the condition but there are different ways to manage it—so persevere until you find the right one. Sometimes, managing symptoms involves a combination of medications, treatments, and lifestyle changes—with some trial-and-error along the way! Remember, your dermatologist is there to help you determine the best way forward.

https://www.healthcentral.com/condition/psoriasis/is-psoriasis-itchy

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.

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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