6 Surprising Things That Can Trigger a Psoriasis Flare, According to a Dermatologist

From people.com

From “good” stress to your skincare routine, a dermatologist breaks down the unexpected factors that may make psoriasis worse 

NEED TO KNOW

• Psoriasis is a chronic condition linked to immune system overactivity that can worsen with lifestyle and environmental factors
• Dermatologist Dr. Adrienne Rencic emphasizes the importance of managing stress, sleep and diet to reduce the frequency of flare-ups
• Psoriasis can be triggered by skin trauma including scrubbing or irritation from skincare products, according to experts

If you have psoriasis, you may already know flares seem to come out of nowhere, no matter how well you’re managing the condition. But some of the things that can trigger or worsen psoriasis may be counterintuitive, or possibly not on your radar at all.

Psoriasis is a chronic disease in which the immune system becomes overactive, causing inflamed, scaly patches of skin. Symptoms can cycle between flares and periods of improvement, and common triggers can include stress and skin injuries, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

Get to know six surprising factors that may contribute to a psoriasis flare.

1. “Good” stress

Turns out you don’t necessarily have to feel anxious or upset for your body to experience stress. Even positive events can put physiological stress on the body. 

“People understand stress as working too long or experiencing ‘bad’ stress,” says Dr. Adrienne Rencic, a board-certified dermatologist and clinical investigator with more than 25 years of experience, who consults for RELAB, a new psoriasis-focused skincare brand. “But what people don’t understand is ‘good’ stress.”

“You could be staying up all night for two weeks preparing for your sister’s wedding, and that’s stress on your body,” she explains. “You can get flare-ups when you don’t necessarily feel stressed in a bad way.”

The takeaway: Pay attention to periods when your routine is disrupted, you’re not sleeping enough or your body is under unusual strain — even if you’re having a great time.

2. Lack of sleep

Sleep is another lifestyle factor that can contribute to psoriasis, Rencic says, along with stress, diet, smoking and alcohol. And the connection can become a frustrating cycle. Psoriasis can cause itching, burning and discomfort that interferes with sleep. 

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3. Scrubbing away your scales

When psoriasis leaves behind thick, flaky skin, aggressively scrubbing it away might seem like a logical solution. But it can backfire.

“Some people use a loofah or scrub their skin to try to remove the scale, and that’s actually trauma to the skin,” Rencic says. “That can make things worse.”

That’s because people with psoriasis can experience what’s known as the Koebner phenomenon or reaction, in which trauma to the skin can trigger psoriasis in that area. So when it comes to removing scale, more aggressive isn’t necessarily better.

4. A skincare product that irritates your skin

A reaction to a new skincare product and a psoriasis flare can sometimes look similar and, according to Rencic, one can actually trigger the other. “In a patient with psoriasis, there is a phenomenon called the Koebner reaction,” she explains. “Any trauma to the skin can trigger a psoriasis flare-up.”

A product reaction will generally affect the area where the product was applied, while psoriasis may appear as a distinct patch within that area. “You may have one or both going on at the same time,” Rencic says.

If you’re unsure whether a rash is an irritation or psoriasis, it’s best to have a dermatologist evaluate it rather than repeatedly applying products that could further irritate the skin.

5. Smoking and alcohol

Smoking and alcohol may not be the first things that come to mind when you think about psoriasis, but Rencic says they’re worth paying attention to. “These things can contribute, even though people don’t necessarily think of them as triggers,” she adds.

That doesn’t mean an occasional drink will automatically cause a flare, Rencic clarifies, but rather that the use of alcohol or nicotine can contribute to the disease, particularly when it’s part of a broader pattern of lifestyle factors. NIAMS concurs, noting that smoking and excessive alcohol consumption can worsen psoriasis symptoms.

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6. Your overall diet

One candy bar isn’t going to give you psoriasis, and Rencic is careful to make that distinction.

“It’s not that eating a candy bar causes psoriasis,” she tells PEOPLE. But she does note that “consistently eating a diet that’s high in sugar and saturated fat and low in fibre is bad for psoriasis.”

Rencic points to the Mediterranean diet as an example of an eating pattern that may be beneficial. Most importantly, she says people shouldn’t feel as though they’re powerless when it comes to managing their disease. 

“This is simply something they live with,” she says, adding that people with psoriasis “aren’t doing anything wrong.” But she does note that there are factors — diet, activity, stress relief — that can help reduce flares.

“All of those things can be modified,” Rencic says, suggesting stress-reducing activities such as exercise, meditation, spending time with friends and being in nature.

(And if your psoriasis is widespread, isn’t responding to your usual treatment or is accompanied by joint pain, stiffness or swelling, talk to a doctor. Psoriasis is associated with other health conditions, including psoriatic arthritis and cardiovascular and metabolic conditions, and NIAMS recommends medical evaluation when joint symptoms occur.)

https://people.com/6-surprising-things-that-can-trigger-a-psoriasis-flare-12060302

Have Psoriasis? Here’s What You Need to Know Before Your Next Cosmetic Treatment

From newbeauty.com

What to consider before your next injectable or laser appointment 

Psoriasis can be a very frustrating skin condition. With severity varying from person to person—from plaque location and medications used to flare frequency—these factors can influence how you approach in-office skin treatments. While patients with psoriasis can safely undergo aesthetic procedures, dermatologists say that timing, treatment selection and inflammation control are essential when it comes to choosing the right approach for you.

                                                                                                                              Photo by Fleur Kaan on Unsplash

Skin treatments to avoid if you have psoriasis

“Psoriasis doesn’t automatically mean you can’t have cosmetic procedures, but it does mean you need to be more selective and strategic,” explains New York dermatologist Jody A. Levine, MD. The biggest concern, says West Palm Beach, FL dermatologist Jacob Beer, MD, is patients experiencing “a clinical phenomenon called the Koebner phenomenon, which means that when someone experiences some form of injury, like microneedling, psoriasis plaques can appear in those areas.” Essentially, trauma to the skin can trigger new psoriasis plaques in previously unaffected places.

Because of this phenomenon, Dr. Levine generally advises patients to avoid skin treatments that can create significant or unnecessary injury to the skin during an active psoriasis flare. “This includes avoiding procedures such as microneedling, deep chemical peels, aggressive ablative laser resurfacing or other treatments that intentionally wound the skin,” she says.

Injectable fillers and neurotoxins should also be used with caution. “While not absolutely contraindicated, they should be avoided in areas of active inflammation or plaques,” says Dr. Levine. Additionally, intense pulsed light (IPL) and photodynamic therapy are also not recommended for psoriasis treatment. “The 2019 AAD/NPF guidelines specifically recommend against topical 5-ALA-photodynamic therapy or methyl ALA-photodynamic therapy for localized psoriasis,” she adds.

What to consider before going for a cosmetic treatment

Active vs. inactive psoriasis

Whether psoriasis is active or well controlled makes a significant difference in treatment planning. “Active psoriasis generally indicates a more acute or subacute disease process,” says Dr. Beer. Active psoriasis is characterized by inflamed, scaly or expanded plaques, which is when the skin is at its most vulnerable and at risk of triggering additional lesions as a result of skin trauma. During this time, dermatologists recommend postponing elective cosmetic procedures until the flare is adequately treated.

However, “when psoriasis is inactive or well controlled, patients often become candidates for a much broader range of aesthetic treatments. Even then, I still recommend proceeding cautiously, choosing less aggressive options or spacing treatments farther apart to minimize the risk of irritation,” says Dr. Levine. In fact, certain vascular laser treatments can actually help treat persistent redness associated with psoriasis, but again it depends on how well a patient’s psoriasis is controlled.

Seasonal timing

Timing of cosmetic treatments can also make a difference. “Many people notice their psoriasis naturally improves during the warmer months because moderate sunlight and higher humidity can be beneficial for the skin,” explains Dr. Levine. Conversely, she says that winter can be even more challenging, especially with cold temperatures, low humidity and indoor heating, which dries skin and can often contribute to flares even though there’s a lower risk of post-inflammatory pigmentation.

This doesn’t necessarily mean that cosmetic procedures should only be performed in the summer. “Seasonality matters less than if the psoriasis is well-controlled. If the patient is on a biologic or treatment that controls the psoriasis well, then many treatments can still be done, albeit cautiously,” says Dr. Beer.

Featured experts

• Jody A. Levine, MD is a board-certified dermatologist in New York
• Jacob Beer, MD is a board-certified dermatologist in West Palm Beach, FL

https://www.newbeauty.com/view/psoriasis-treatments-what-to-know

How to Recognize and Treat Psoriasis on the Face

From verywellhealth.com

What you can do about plaques on this delicate skin 

Key Takeaways

• Psoriasis on the face can cause red or pink sores with silvery-white plaques.
• Treatments for facial psoriasis include creams, oral medicine, and light therapy.
• A dermatologist can help you figure out the best way to treat psoriasis.
• Facial psoriasis can cause red, itchy patches around your eyebrows, ears, and mouth. Learn how to recognize and treat this condition effectively.

What Does Psoriasis on the Face Look Like?

                                                 Reproduced with permission from © DermNet dermnetnz.org 2023.

Psoriasis on the face starts as small, red bumps that develop into red or pink sores, often topped with silvery-white plaques that can flake. The look of facial psoriasis varies by type:

• Plaque psoriasis looks like dry, discoloured, scaly skin on your face.
• Guttate psoriasis appears as small, scaly patches that show up on your skin after you’ve had a strep infection.
• Pustular psoriasis displays as pus-filled bumps on top of dry skin on your face.
• Scalp psoriasis looks like dry patches of skin on top of your head that can hurt.

Types of Facial Psoriasis

True Facial Psoriasis

True facial psoriasis looks like classic psoriasis plaques on the face. The red, scaly plaques are usually the same on both sides (symmetrical) and also appear on other areas of the body. The affected skin is often painful and itchy.

Hairline Psoriasis

Around half of people with psoriasis have scalp psoriasis, which can include the upper forehead.

Scalp and hairline psoriasis can be mild and may look like fine flakes of dandruff. Some people get severe psoriasis with thick plaques covering the hairline and behind the ears. The plaques can be greasy and yellow-coloured. 

Sebo-Psoriasis

Sebo-psoriasis is a combination of facial psoriasis and seborrheic dermatitis.

Sebo-psoriasis causes thin, pink plaques on the face that can be covered in greasy, yellow scales. They can show up on the hairline, eyelids, eyebrows, sides of the nose, and beard area. While the eyebrows, forehead, hairline, and the skin above the lip are the most common places affected by facial psoriasis, the condition can also spread to other parts of the face.  

worklater1 / Getty Images

Symptoms and Complications 

Facial psoriasis that spreads can cause symptoms specific to where on the face it is—for example, near the eyes and the mouth. 

Vision Issues

Psoriasis around the eyes is rare. It may cause dry, red patches of skin. Facial psoriasis that’s too close to the eyes can cause pain or impaired vision.

If you have psoriasis near your eyes, it’s important to work with your dermatologist to find a safe treatment that will not affect your vision. 

Nose Discomfort

Nasal psoriasis can look like peeling, cracked, sore, or scaly skin on your nose or nostrils. It’s very rare to get psoriasis inside your nose, but it can happen.

If you think you have psoriasis near your nose, see a dermatologist to make sure it’s not another more common condition like an infection. 

Hearing Trouble

Facial psoriasis can affect the inner and outer ears. The symptoms include redness, itching, and patches of scaly skin on the ears. The patches may show up on the skin behind the ears, around the ears, or inside the ear canal.

When scales build up inside the ear, it can lead to temporary hearing loss. However, never try to push or remove the scales from your ears yourself. Only your provider should treat psoriasis plaques in your ears. 

Mouth Pain and Bleeding

In rare cases, people with facial psoriasis have psoriasis symptoms in their mouths. You may have redness, burning pain, and bleeding along the gums, tongue, or inner cheeks. The symptoms can make it hard to eat and drink. Mouth psoriasis usually needs to be treated by both your dermatologist and your dentist.

Conditions With Similar Symptoms

There are some skin conditions that can look and feel similar to psoriasis on the face. Certain conditions can cause redness, rashes, and other symptoms that could be confused for psoriasis, such as:

• Eczema (atopic dermatitis)
• Seborrheic dermatitis
• Pityriasis rosea
• Lupus rash
• Rosacea
• Lichen planus
• Shingles (herpes zoster)
• Dermatomyositis
• Ringworm (tinea capitis)
• Intertrigo
• Skin cancer

What Causes Face Psoriasis?

Psoriasis is a chronic autoimmune condition that causes inflammation. With psoriasis, the skin cells grow too fast and pile up. The dead skin cells do not slough off like they’re supposed to, leading to silvery-white skin plaques building up on the skin’s surface.

It’s not totally understood why some people get psoriasis. There is a genetic component and psoriasis tends to run in families. If someone in your family has facial psoriasis or psoriasis elsewhere on their body, you might be more likely to have it, too.

Face Psoriasis Triggers

Certain things can cause a facial psoriasis flare-up including:

• Emotional stress
• Skin injury
• Infections (especially on the skin) 
• Cold, dry weather
• Prescription medications

Spending too much time in the sun and smoking can also worsen facial psoriasis symptoms.

How to Treat Psoriasis on the Face

Psoriasis cannot be cured but there are treatments. Since the skin on and around the face is sensitive, finding the best treatment for facial psoriasis can be challenging. Your provider may suggest several treatments, including topical medications, oral prescriptions, phototherapy, and immune therapies.

Medications and Procedures

The treatment you need will depend on the severity of your symptoms and which parts of your face are affected. Your dermatologist may recommend one or more treatments for facial psoriasis:

• Topical treatments include medicated creams, ointments, and shampoos that treat psoriasis symptoms. First-line treatment often includes a steroid cream. Hairline psoriasis may need to be treated with a medicated shampoo.
• Systemic medications are usually considered when you have psoriasis symptoms all over your body. Medications can include methotrexate, cyclosporine, retinoids, biologics, and others.
• Phototherapy uses ultraviolet light (UV) treatments to help slow skin cell growth and reduce inflammation. This can improve facial psoriasis symptoms over time.

How Can I Treat Facial Psoriasis at Home?

It’s not always possible to prevent psoriasis symptoms, but there are steps you can take to avoid triggers and take care of your skin. 

Skincare

Your skincare routine will be an important part of managing facial psoriasis.

• Choose skincare products carefully and avoid any harsh ingredients. Check the labels to make sure the products do not contain irritating ingredients (e.g., they should say “hypoallergenic,” “fragrance-free,” “for sensitive skin,” “alcohol-free,” and/or “dye free”).
• Use a gentle daily moisturizer, especially after washing your face.
• Do not over-wash your face, even if it feels greasy.

Lifestyle Changes

There are methods you can use to treat facial psoriasis at home:

• Learn your triggers for a psoriasis flare-up and work with your dermatologist to figure out how to avoid them. 
• Find techniques for managing stress, such as mindfulness and physical activity. 
• Avoid smoking and being around those who do.
• Wear quality sunscreen any time you’re in the sun.

Using Medicated Shampoos

If you have psoriasis on your scalp or hairline, talk to your dermatologist about using a medicated shampoo at home. You can also look for an OTC product that contains both salicylic acid and tar. Salicylic acid softens and removes the thick plaques, while tar helps slow skin growth and reduce inflammation.

https://www.verywellhealth.com/psoriasis-on-face-5180877