Psoriasis is a common chronic, inflammatory skin condition that effects 2-3% of the population. This disease typically presents as scaly pink red bumps and plaques on the skin. There are a few patterns of this disease. Most commonly, patients develop localized plaques over extensor surfaces like the elbows and knees, as well as the scalp, lower back and groin. Other patterns include numerous small bumps on the trunk and extremities, or disease localized to the palms and soles.
“Chronic is unfortunately the nature of this disease,” says Dr. Miriam Hanson, board-certified dermatologist in Austin, Texas. While Dr. Hanson notes that many patients struggle with their symptoms for years, others appear to be able to control their condition with an occasional or intermittent breakout. “This disease can come and go. Patients can experience flares and periods of clear skin.”
“Psoriasis flares can definitely take their toll,” claims Dr. Adam Mamelak, board-certified dermatologist at Sanova Dermatology. “We’ve seen the effects of this condition on patients’ health, as well as their emotional well-being.”
Dr. Hanson and Dr. Mamelak both agree that treating psoriasis patients not only involves minimizing active disease, but also minimizing flares and their triggers.
What Triggers Psoriasis?
There are a few well known factors that can flare or worsen psoriasis symptoms:
1. Medications
A number of prescription medications have been associated with disease flares and worsening psoriasis skin lesions, including beta blockers, antimalarial pills, quinidine, lithium, and indomethacin. “Taking one of these medications doesn’t guarantee that your disease will get worse,” says Dr. Mamelak. “However, if you are prescribed one of these medications for your health and well-being, you might ask your physician if there is an alternative therapy.”
2. Stress
Patients often report a worsening of their psoriasis skin lesions or new breakouts during stressful times. “We see it a the time,” says Dr. Mamelak. “Whether it’s job stress, a relationship, moving or family. It’s unclear if it is the areas itself that makes the disease flare, or if patients don’t take care of their skin as well during these times. It is clear that de-stressing and relaxation can help.”
3. Alcohol
Psoriasis has been associated with heavy alcohol consumption, particularly in men. How specifically alcohol causes psoriasis flares is unclear, but limiting your alcohol intake can have positive effects on tot skin disease.
4. Skin Injury
A number of patients report psoriasis skin lesions developing on skin that is cut, scraped, and evened sunburned. The Koebner phenomenon is well described in psoriasis patients. This means that you can develop psoriasis in areas of the skin that are traumatized or damaged.
5. Infections
Some psoriasis patients develop significant flares after a Strep infections. Often, these flares result in gutatte psoriasis on the skin. HIV infection has also been reported to worsen psoriasis.
6. Weather
Patients often report that the psoriasis worsens or flares in colder weather or climates. “Early scientific studies suggested that the farther you get form the equator, the more cases of psoriasis you can see,” says Dr. Mamelak. This is not as clear cut as we used to believe, however he beneficial effects of sun and UV light on psoriasis skin disease are well recognized. “Many patients report their skin gets better in the summer. Dermatologists have taken advantage of this observation and now use phototherapy to treat our patients.” The metered UV doses used in phototherapy are considered much safer than tanning beds or laying out.
7. Smoking
A 2012 scientific study demonstrated that the risk of developing psoriasis is double in smokers compared to non-smokers. “With its other detrimental effects on the body, and new observations that link psoriasis with heart disease, I advise all my psoriasis patients not to smoke.”
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