(LifeWire) - If prevention truly is the best medicine, then one of the smartest ways to manage psoriasis is to learn your triggers and avoid flare-ups.
But that realization comes with a strong caveat: psoriasis is not completely controllable even with the best of efforts. If it were, it would be curable instead of chronic, a one-time problem instead of a lifelong condition that at times can be a mere nuisance, at others, a nightmare.
About 2% of Americans - roughly six million people - are afflicted with psoriasis, which occurs when skin cells mature far too rapidly, piling up in red, scaly patches on any part of the body. Two-thirds of psoriasis patients, known as "psoriatics," have a mild form of the disease, with the remaining third suffering lesions on anywhere from 20 to 100% of their skin.
Scientists have identified many triggers for psoriasis, which has a genetic basis and usually strikes for the first time between the ages of 15 and 35. Those wide-ranging triggers include stress; skin damage such as sunburn, bug bites or abrasions; a cold, dry atmosphere; smoking or excessive alcohol consumption; some types of infections, such as strep throat; and some prescription and over-the-counter (OTC) medications.
Knowing the triggers is at least part of the solution to preventing psoriasis flare-ups, which can happen at any time and even after years of remission. Armed with this information, psoriatics can keep their skin as clear as possible for as long as possible.
Flare-prevention tips include:
- Moisturize daily: "We're not exactly sure why moisturizers help, but skin that's well-hydrated is more healthy and normal and less stressed in itself," says Doris J. Day, MD, clinical assistant professor of dermatology at New York University Medical Center. Slathering a liberal layer of cream (more skin-quenching than lotion) over the entire body each morning after bathing protects against cracking and chafing, which in some psoriatics leads directly to a flare through the process known as the Koebner phenomenon.
- Decrease stress: This is easier said than done, of course, but many stress-busters are there for the taking, such as regular exercise, yoga, deep-breathing exercise or even short, simple vacations.
- Prevent fatigue: Getting enough relaxation and sleep, which is important for the immune system.
- Use a humidifier: And not just in the winter, when dry air is more obvious. Even air conditioning can dry skin out and aggravate psoriasis. Place individual room humidifiers in the bedroom, office or any space where you spend a great deal of time.
- Get a handle on vices: In short, smokers should stop smoking and heavy drinkers should cut back. The caution to "drink responsibly" isn't just an add-on to the end of beer advertisements: with research establishing a direct link between severe psoriasis and heavy alcohol consumption, psoriatics would be wise to watch their intake or refrain entirely. Those taking the medication methotrexate, which is used for moderate to severe cases, should avoid alcohol entirely.
- Keep a flare diary: On first glance it may sound corny, but writing down when flare-ups occur (which may happen up to two weeks after their trigger) can help reveal patterns in psoriasis outbreaks. Did you get a nasty sunburn? Just get over strep throat? Lose sleep over a stressed-out week of work or school? Record dates of flares and what was happening in the week to two weeks before that. Not only can it help you, it can clue your doctor in to potential remedies that may work best in your individual case.
- Don't pick, don't scratch: Picking and scratching skin - and not just psoriasis lesions, which often itch - can create cracks and openings for bacteria to enter, potentially leading to infection, which can prompt psoriasis to appear. For the significant number of psoriatics vulnerable to the Koebner phenomenon, this behavior can also lead to flares. Avoid shaving nicks, insect bites, tattoos or acupuncture.
- Get some sun: Short, limited exposure to natural sunlight (say, 20 minutes several times weekly) helps slow the rapid skin cell turnover ubiquitous to psoriasis. It makes sense, then, that regular sun exposure can help stem budding psoriasis patches before they're visible. Just be careful to avoid sun burn.
Doris J. Day, MD, assistant clinical professor of dermatology, NYU Medical Center. Phone interview. 16 May 2008.
"Psoriasis." National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse. May 2005. National Institutes of Health. 1 Jun 2008. <http://www.niams.nih.gov/Health_Info/Psoriasis/psoriasis_ff.asp>.
"Psoriasis Triggers." Psoriasis.org. Oct 2005. National Psoriasis Foundation. 3 Jun 2008 <http://www.psoriasis.org/about/living/triggers>.