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

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/ 

Psoriasis Triggers: How Your Environment Can Cause Flare-Ups

From msn.com

Psoriasis is a complex condition that affects millions, but its exact causes remain a mystery. While genetics play a significant role, environmental factors often act as the triggers that bring psoriasis to the surface.

W​eather Conditions

For those predisposed to psoriasis, life can be symptom-free until a specific environmental trigger, like cold or extremely dry weather, sets off a flare-up. Extremely dry weather is also one of the most common psoriasis triggers. That's because cold, dry weather can strip moisture from the skin, weakening its protective barrier and making it more prone to irritation. The lack of humidity in winter air, combined with indoor heating, dries out the skin further, exacerbating inflammation and scaling.

R​educed sunlight exposure during colder months can also decrease natural vitamin D levels, which play a role in regulating skin cell growth and immune responses, potentially worsening psoriasis symptoms. 

O​ther Concerns

It's not just weather —factors like smoking, alcohol consumption, and even exposure to air pollution can all impact your skin.

Smoking tobacco, or being exposed to secondhand smoke, not only increases the risk of psoriasis but also may increase the severity of the disease. Heavy alcohol consumption can increase inflammation in the body, which can trigger psoriasis. Alcohol can also dry out skin that's already prone to dryness and flaking. And high exposure to air pollutants has been linked to an increased risk of severe psoriasis, research shows.

Flares of psoriasis are common after the use of certain medications, including lithium, high blood pressure drugs, and antimalarial drugs. Infections, like strep throat or even skin infections, can send the immune system into overdrive, worsening psoriasis symptoms. Injury to the skin, such as a cut, bug bite, or a severe sunburn can increase the chances of a psoriasis flare-up.

Understanding these triggers is crucial for managing psoriasis effectively. By knowing more about how your environment and habits might be affecting your psoriasis, you can keep tabs on common triggers and keep flare-ups at bay. Always consult with your doctor before making changes to your psoriasis treatment strategy.

https://www.msn.com/en-ca/health/other/psoriasis-triggers-how-your-environment-can-cause-flare-ups/ar-AA1pxcLY?apiversion=v2&noservercache=1&domshim=1&renderwebcomponents=1&wcseo=1&batchservertelemetry=1&noservertelemetry=1

Living Better with Psoriatic Arthritis: How Lifestyle Changes Can Make a Difference

From medscape.com

Psoriatic arthritis (PsA), a chronic inflammatory condition characterised by dactylitis, enthesitis, peripheral arthritis, skin and nail psoriasis, and spondylitis, occurs in around 10%-30% of people with psoriasis. While several pharmacological treatment strategies exist, PsA continues to significantly impact patients' pain levels, functional capacity, and mental well-being. 

Along with joint and skin manifestations, PsA is associated with several comorbidities, including cardiovascular disease (CVD), central sensitization syndrome, diabetes mellitus, dyslipidemia, fatty liver disease, gout, infections, inflammatory bowel disease, kidney disease, metabolic syndrome, obesity, osteoporosis, and uveitis, all of which negatively impact quality of life (QOL). Patients with PsA are also more likely to experience psychological issues, such as anxiety and depression. Given these challenges, nonpharmacological interventions play a key role in disease management. Healthy lifestyle changes, including dietary modifications, regular exercise, and quitting smoking — along with psychological interventions — are essential to improve PsA and QOL. Here are common nonpharmacological interventions that can improve symptoms and QOL of patients with PsA.

In their treatment guideline, the American College of Rheumatology and National Psoriasis Foundation (ACR/NPF) recommend nonpharmacological interventions for PsA, including acupuncture, low-impact exercise, massage, occupational therapy, physical therapy, smoking cessation, and weight loss despite weak evidence for all except smoking cessation.

The Importance of Physical Activity in Reducing Inflammation

Physical activity and targeted exercises play an important role in reducing inflammation, disease severity, and outcomes in patients with PsA. Studies have found that exercise, particularly when combined with dietary modifications, can improve PsA symptoms. The ACR/NPF recommend low-impact exercise over high-impact exercise for managing PsA. In their guideline, the European Alliance of Associations for Rheumatology notes regular physical activity as an integral part of care for patients with PsA.

Regular exercise, including resistance training, aerobic, and flexibility exercises may improve and preserve joint function, reduce inflammation, and enhance QOL in patients with PsA. A 12-week single-blind parallel randomized controlled trial by Silva et al found functional training and resistance training similarly improved disease activity, functional capacity, functional status, general QOL, and muscle strength in patients with PsA. 

The Link Between Diet and Inflammation in PsA

Dietary interventions focused on weight loss alleviate mechanical strain on the joints and reduce the risk of CVD in patients with PsA. Weight loss has also been shown to improve disease activity. Moreover, research suggests some dietary modifications, along with exercise, can improve PsA disease outcomes independent of weight loss. Diets rich in saturated fats or certain omega-6 fatty acids while anti-inflammatory diets can improve PsA symptoms and disease activity. Among various anti-inflammatory diets, the Mediterranean diet has gained the most popularity as studies have found it to be associated with lower disease activity in patients with PsA. 

According to the Medical Board of the National Psoriasis Foundation, patients with PsA may consider the Mediterranean diet on a trial basis in conjunction with pharmacotherapy. The NPF medical board also emphasizes increased intake of fibre, complex carbohydrates, monosaturated fatty acids, and omega-3 fatty acids. Although other dietary interventions for improving PsA are less studied, a case report by Lewandowska et al found a whole-food vegan diet improved PsA symptoms a 40-year-old woman. Further research, however, is needed to confirm the role of vegetarian or vegan diets in modulating PsA disease activity.

Smoking: What Role Does It Play?

The association between smoking and the development of PsA remains inconclusive, with studies yielding mixed results. At the population level, smoking is positively associated with PsA. However, some studies suggest smoking increases the risk of developing PsA, while others indicate no significant association between cigarette smoking and the progression of joint damage. Beyond disease onset, smoking has been linked to poorer treatment outcomes in PsA. An observational cohort study by Højgaard et al found that patients with PsA who smoke had poor responses to treatment with tumour necrosis factor-α inhibitors and were also less likely to adhere to their treatment plan. Additionally, smoking is a risk factor for CVD and other comorbidities common in PsA. Therefore, smoking cessation is an important lifestyle intervention for patients with PsA — not only to improve treatment efficacy but also to reduce the risk of other comorbidities, thereby improving the QOL.

Integrating Weight Management in PsA Care

The relationship between PsA and obesity appears to be bidirectional: Research has shown obesity is a common risk factor for developing PsA and that joint dysfunction and reduced physical activity due to PsA itself may result in weight gain. Patients with PsA and obesity often exhibit higher disease activity and poor response to treatment. An interventional study by Klingberg et al showed weight loss treatment with a very low energy diet improved disease activity, pain, fatigue, and C-reactive protein in patients with PsA and obesity. Similarly, another study by Klingberg et al also reported improvement in PsA disease activity after 12 months of weight loss treatment.

In addition to diet and exercise, GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonists and incretins associated with weight loss may benefit patients with PsA and obesity. However, research on the effect of such drugs on PsA is quite limited still and requires further investigation. 

The Bidirectional Link Between Sleep and Inflammation

In addition to obesity, there also appears to be a bidirectional relationship between PsA and sleep disorders. Persistent sleep disorders in PsA may be interconnected with inflammatory disease activity, chronic pain, fatigue, and psychological distress, creating a vicious cycle where each factor intensifies the others. Prolonged and significant decline in sleep quality reduces overall QOL and increases a patient’s risk of developing CVD, hypertension, and metabolic disorders, comorbid conditions associated with PsA. Prolonged deterioration of sleep quality can negatively impact the QOL of PsA patients and increase the risk of developing hypertension, CVD, and metabolic disorders. 

Several lifestyle changes can help to improve sleep quality in patients with PsA. These include maintaining regular sleep-wake cycles, limiting alcohol and caffeine intake, and improving the patient's sleeping environment. Additionally, medications used to treat PsA — such as guselkumab, tumor necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab), and the Janus kinase inhibitor filgotinib — have shown potential in improving sleep outcomes in patients with PsA.

The Psychological Burden of PsA

Pain, fatigue, anxiety, and depression are common psychological comorbidities of PsA that have a negative impact on QOL. The odds of being diagnosed with behavioural and mental health disorders are higher in patients with PsA compared to the general population. Even with treatment, studies have shown that PsA affects patients emotionally, socially, and occupationally, underscoring the importance of comprehensive management since targeting the inflammatory activity of PsA alone may not improve the QOL. 

Cognitive behavioural therapy is a well-established psychological intervention that can improve symptoms of depression, anxiety, and sleep disturbances in patients with PsA. It can also improve sleep quality in PsA patients. Although research is limited, the effectiveness of cognitive behavioural therapy (CBT) to improve psychological distress may in turn improve overall QOL in patients with PsA. Although research on this is limited, CBT can prove to be beneficial in improving mood disorders and the overall QOL of PsA patients.

https://www.medscape.com/viewarticle/living-better-psoriatic-arthritis-how-lifestyle-changes-can-2025a1000cvn?src= 

Living Day to Day With Psoriasis

From webmd.com

Steven Siracuse was about 19 years old when his psoriasis got bad. Rash-like patches showed up on his elbows, forearms, knees, calves, and scalp. A college freshman at the time, he covered up in long-sleeve shirts to avoid questions and stares. He also used steroid creams that didn’t help.

Now, more than 10 years later, his skin is mostly clear. It didn’t happen overnight. It took several years of dermatology appointments and plenty of self-discipline.

Steven Siracuse

“Even at my worst, my case would be considered moderate,” says Siracuse, a financial analyst for a credit union in Buffalo, NY. “Some people have it all over their bodies. They have it all over the face. ... I always tried to keep that in perspective and tell myself that I was fortunate compared to other people.”

Over the years, Siracuse did what he could to manage the physical and mental effects of psoriasis. He worked closely with his dermatologist to find the right treatment and get his insurance company to cover it. He made the move from a high-stress job to a lower-stress one. He quit smoking cigarettes and cut back on alcohol. He patiently explained what the patches on his skin were when people asked questions or made comments that hurt.

Basically, he did many of the things that psoriasis experts recommend.

Making certain lifestyle changes can have a powerful impact on your health, and it may help your treatment work well.

There are some changes you can start making today, if you need to.

Lose Extra Weight

When you have psoriasis, your immune system releases chronic inflammation inside your body. It can affect your skin and other organs and tissues.

The more weight you carry, the more inflammation your body creates, which makes psoriasis worse, says Francisco Tausk, MD. He’s a professor of dermatology, allergy, immunology, and rheumatology at the University of Rochester Medical Centre in New York.

Tausk says studies show that biologic drugs used to treat psoriasis work better when people drop extra pounds.

Your goal should be to gradually get to a weight that’s healthy for you, says Dawn Marie R. Davis, MD, a professor of dermatology and paediatrics at Mayo Clinic in Rochester, MN.

Ask your doctor or dermatologist to help you get there.

Eat Healthier and Exercise

A balanced, nutritious diet with sensible portion sizes can help you lose weight. Tausk says ideally, the best eating plan would be a plant-based diet of whole foods. If you’re not ready for that, try to eat more vegetables and legumes, and cut back on red meat and saturated fat.

“You may want to give up on yourself, but you’re not going to want to give up and no-show on your friend. So find an accountability buddy.”

Dawn Marie R. Davis, MD, professor of dermatology and paediatrics, Mayo Clinic, Rochester, MN 

Make a grocery list of healthy foods before you go to the store so you don’t buy tempting snacks that aren’t on the list, Davis says. And swap out your favourite treats for healthier substitutes. For example, buy baked veggie chips instead of potato chips, or sparkling flavoured water instead of soda.

Exercise can also help you drop pounds. If you’re not active already, ask your doctor to help you get started -- especially if you also have psoriatic arthritis, which makes joints painful and stiff. In that case, you can try low-impact exercises like swimming, yoga, or walking in supportive shoes, Davis says.

When you find a type of workout that you like, make it a habit, she says. If you like to swim, for example, set out your goggles, swimsuit, and towel the night before. Then call a friend who’s into swimming and ask them to meet you at the pool the next morning. That helps make you accountable.

“You may want to give up on yourself, but you’re not going to want to give up and no-show on your friend. So find an accountability buddy,” Davis says.

Cut Back on Booze

Research shows that limiting how much alcohol you drink can make your treatment more effective and help keep symptoms at bay longer.

Even drinking in moderation may affect your psoriasis, though, Davis says.

Francisco Tausk, MD

If you drink while you’re taking the medication methotrexate for psoriasis, your odds of liver damage will go up. What’s more, Tausk says, people with psoriasis already have “a much higher incidence” of fat in their liver along with inflammation and damage, a condition called non-alcoholic steatohepatitis.

“So if you add another insult, which would be the alcohol, you’re stressing the liver much more,” Tausk says.

Talk to your doctor or dermatologist about what’s safe for you. Ask if you need to think about giving up alcohol.

If You Smoke, Quit

Kicking the habit is linked to fewer psoriasis flare-ups. Let your doctor know if you need help quitting. And if you live with someone who smokes, ask them if they’d be willing to quit or at least light up outside.

“Direct smoking and perhaps even second-hand or third-hand smoke” can impact someone’s psoriasis, Davis says.

Take Care of Your Mental Health

Some people with psoriasis see their condition get worse due to ongoing stress, Tausk says. “Chronic stress is very associated with depression, and it’s very pro-inflammatory,” he says.

Talk to your dermatologist if you notice that your psoriasis flares up when you’re stressed. Depending on things like your personal situation and how bad your flare is, they might add a medication to your usual regimen or change your treatment until your stress gets under control, Davis says.

Things that can help you take charge of stress include:

• Meditation apps
• Mindfulness-based stress reduction
• Exercise or yoga
• Making time for hobbies you enjoy

It’s important to speak to your doctor or dermatologist if you’re feeling anxious or depressed. They can refer you to a mental health specialist like a psychologist or psychiatrist, so you can get the help and relief you need -- and deserve.

“We have surveys on our psoriasis patients that prove that they have a higher rate of depression and anxiety,” Davis says. “It is not uncommon for people to share that they feel different, they feel left out, they feel picked on.”

“[People] with psoriasis have more loneliness,” Tausk says. “They feel stigmatized. They tend to not participate in a lot of activities because they’re embarrassed.”

If that’s you, consider meeting other people with psoriasis, who may be able to relate to what you’re going through. Your dermatologist can point you to local support groups and other online resources.

“The National Psoriasis Foundation has groups in different cities,” Tausk says. “If [people] think that what they have is the worst thing in the world, they realize that there’s always people [who] are worse, and they’re able to share their experiences.”

Stay on Top of Your Physical Health

Having psoriasis makes you more likely to get other health conditions.

“We used to see it as just [affecting] the skin. Well, not anymore,” Tausk says. “Nowadays we see psoriasis as a systemic disease that affects different parts of the body.”

He says more and more research links psoriasis with problems like inflammatory bowel disease and a type of eye inflammation called uveitis.

Other serious conditions tied to psoriasis include:

• Psoriatic arthritis
• Heart disease
• High blood pressure
• Metabolic syndrome
• Type 2 diabetes
• Dyslipidemia

Make sure your doctor tests you for related health conditions and get treatment if you have any of them, Davis says. Often, getting another condition under control can make your psoriasis easier to treat, she says.

The key is to go to all of your medical appointments.

“It’s so important for patients with psoriasis to maintain a relationship with their dermatologist or their primary care provider because psoriasis is a complicated disease,” Davis says. “If patients don’t come back to visit us, we don’t know what’s going on, and we can’t help them with all the variables that they have to address.”

Make Lifestyle Changes That Last

“We understand that we’re asking our patients to do a lot,” Davis says. “And while it appears to be uncomplicated, it’s difficult to put into practice.”

You don’t have to change everything about your lifestyle at once, she says. You can work on changing one thing at a time, and that can help you turn it a habit.

Your psoriasis may still act up at times, but “you should be so proud of yourself for being proactive, resilient, dedicated, and empowering your own health,” Davis says.

https://www.webmd.com/skin-problems-and-treatments/psoriasis/features/cm/living-day-to-day-with-psoriasis