If you're living with psoriasis, you probably already know how frustrating and challenging it can sometimes be to cope with the condition. Symptoms like itchy, scaling skin can affect your ability to perform daily activities, take a toll on your emotional health, and impact your quality of life.
The good news: There are ways to make life with psoriasis easier. Follow these dos and don’ts to help get your symptoms under control.
Do talk to a dermatologist. Make an appointment with a dermatologist who specializes in treating psoriasis — he or she will be aware of the latest developments regarding treatment plans. Be prepared to discuss the details of your condition with your doctor, including when you first noticed it, what your symptoms are, any situations that seem to make your symptoms worse, and what treatments have and have not worked for you in the past.
Do moisturize. Dry skin is more susceptible to outbreaks of psoriasis, so keep your skin well lubricated. After bathing or showering, seal in moisture by applying a generous amount of moisturizing cream or ointment to your skin. Vaseline, Cetaphil cream, and Eucerin cream are a few commonly available moisturizers reported to provide good results. Avoid lightweight lotions, which don't contain enough emollients.
If over-the-counter products don't help, your doctor may prescribe a moisturizing cream that contains medication.
Be especially diligent about moisturizing during the winter months, when cold outdoor weather and overheated buildings are a particularly drying combination. "In psoriasis, the epidermis builds up rapidly, producing a thick scale," says James W. Swan, MD, professor of medicine in the division of dermatology at Loyola University Medical Center in La Grange Park, Illinois.
When the skin is hydrated, the scales soften and fall away, alleviating itch and dryness. “But not using anything on the skin for three days will allow the scale to get very thick," says Dr. Swan.
Do take a soak. Soaking in a warm (not hot) bath for 15 minutes can help loosen scales and help reduce the itching and inflammation caused by psoriasis. Adding sea salt, oatmeal, bath oil, or a bath gel containing coal tar to the water can further soothe and moisturize your skin. If you live or vacation in an area with mineral or salt baths, take a dip in one. Both are associated with relieving psoriasis.
Do get some sun. For reasons experts still don't fully understand, psoriasis lesions often diminish when exposed to ultraviolet light. So while sunbathing is discouraged for most people because of the risk of skin cancer, it can be helpful for those with psoriasis. The trick is to make sure that only the areas affected by psoriasis are exposed.
Cover unaffected skin with clothing or a sunscreen with an SPF (sun protection factor) of at least 30. Limit sun exposure to 15 minutes, and be careful to avoid sunburn, which will only make matters worse. It may take several weeks to see an improvement. Avoid tanning beds, which don't produce the same healing effect and may actually be harmful.
Your doctor may also recommend ultraviolet light therapy, either in the doctor's office or at home. According to Swan, "One of the gold standards for treatment of psoriasis is phototherapy," which involves exposing the skin to ultraviolet light on a regular basis and under medical supervision. According to the National Psoriasis Foundation, UVB light in particular penetrates the skin and slows the growth of affected skin cells.
“Ultraviolet B (UVB) light reduces the inflammatory cells from the skin that is causing psoriasis,” says Swan. “It also slows the cell proliferation that results in the scaling.”
Do reach out. Having psoriasis isn't just physically tough — it can be difficult emotionally as well. Feelings of depression, frustration, and isolation are common. Body image issues related to the appearance of psoriasis lesions are normal. While it may feel as if you're the only person struggling with this condition, in fact the World Health Organization reports that at least 100 million people are affected worldwide.
Discuss your feelings about the disease with your family, friends, and doctor. In-person and online support groups for those with psoriasis can also provide support and help you remember that you're not alone. Psoriasis organizations, such as the National Psoriasis Foundation, can connect you with others who are living with psoriasis, as well as keep you informed about research developments and opportunities to get involved in fundraising walks and other events.
Don't overdo it. The best way to handle psoriasis is to do so gently. Avoid the temptation to scratch or scrub lesions, which will only irritate them, making them worse. Try not to pick at scales, which can cause bleeding and increase your risk of infection. Instead, talk with your doctor about creams and ointments that can gently remove the thick scale. Bathing in very hot water or using abrasive cleaners can also make your symptoms flare up.
Don't stress out. Some people with psoriasis say their condition worsens when they're under stress. Avoid stressful situations when you can, and take extra steps to take care of yourself — such as eating well, exercising, and getting enough sleep — when you can't avoid stress. Hypnosis, relaxation, meditation, biofeedback, and other stress management techniques may also help.
Don't ignore flare-ups. Psoriasis is a lifelong condition, and one that tends to wax and wane over time. But that doesn't mean you just have to live with it. If your psoriasis returns after a period of being under control, schedule a visit with your doctor to find out why, and to decide what can be done to treat it.
Don't give up. One of the most frustrating things about treating psoriasis is that something that works well for one person may not work at all for another. It may take some time to find the right therapy or combination of therapies that works best for you. Be patient and don't give up. It's important to be consistent with your treatment plan, day in and day out, even when your symptoms aren't so bad. With psoriasis, slow and steady wins the race.