Coping With Psoriasis

How to Reduce Flares and Maintain a High Quality of Life

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Psoriasis often requires lifelong management, and, even with the best of care, can suddenly flare and disrupt your confidence and well-being. As frustrating as this can be, there are things you can do to better cope. Psoriasis cannot be cured, but it can be managed, and—over time—you can find the strategies that help minimize symptoms and maintain the highest possible quality of life.

Emotional

If you have psoriasis, you can feel any number of emotions, from embarrassment and aggravation to anger and shame. You may also feel stigmatized by others who don't understand what psoriasis is or think that it's contagious. It can even interfere with your sex life if you fear rejection or are too self-conscious to expose yourself to others.

It may come as no surprise, then, that people with psoriasis are twice as likely to experience depression and anxiety than people without.

Beyond the emotional impact, untreated depression and anxiety can act as a trigger for psoriatic flares, making your condition all the more difficult to control.

To overcome this, you need to find ways to manage your stress and deal with the occasional ups and downs that characterize the disease.

Mind-body therapies are often used by people with psoriasis to overcome the daily stress of living with psoriasis. Most of the therapies involve focusing on immediate sensations—the here and now—rather than projecting into the future or fixating on anxieties or insecurities. Modalities include:

  • Meditation
  • Yoga
  • Tai chi
  • Deep-breathing exercises
  • Guided imagery
  • Progressive muscle relaxation (PMR)

If these efforts aren't enough to provide relief, consider seeing a therapist or psychiatrist experienced in chronic diseases. Mental health professionals like these can help you work through your emotions using one-on-one counseling or group therapy. If needed, medications can be prescribed to treat persistent depression or anxiety.

Physical

One of the challenges of living with psoriasis is the multitude of triggers that can set off a flare. In addition to stress, common ones include medications, infection, skin injury, and weather. Some of these triggers—like drugs—are relatively easy to avoid. Others may not be so easily side-stepped.

Skin Injuries

Skin injuries can cause psoriasis to flare along the line of the trauma, a phenomenon known as the Koebner phenomenon. This may be caused by cuts, scrapes, bruises, sunburn, insect bites, rashes, and even the friction from tight clothing. To better avoid this:

  • Treat skin injuries immediately using ice application or a compression bandage, as applicable, to reduce inflammation.
  • Use sunscreen whenever outdoors.
  • Limit your sun exposure to 20 minutes if you have active psoriasis symptoms.
  • Use an insect repellent to avoid bites.
  • Avoid wearing tight belts.
  • Choose softer fabrics to avoid friction around your collar, cuffs, or waistband.
  • Avoid scratching bites or rashes.
  • Moisturize regularly to reduce itchiness.
  • Use an over-the-counter antihistamine or topical hydrocortisone cream to help reduce inflammation and itchiness.
  • Avoid hot baths or showers, which can inflame the skin and make your condition worse.

Weather

Extreme climates are common triggers for psoriasis. This is especially true with respect to extremely dry cold temperatures or intense heat with high humidity. During winter or summer months, extra care needs to be taken to avoid psoriatic flares. Among some of the more helpful tips:

  • Bundle up with a coat, hat, scarf, leggings, thick socks, and gloves during cold weather.
  • Remove wet boots or clothing when coming indoors.
  • Warm your skin with a warm (not hot) bath or shower, moisturizing afterward to prevent dryness and chafing.
  • In hot humid climates, limit your outdoor exposure and wear light, breathable clothing to reduce moisture build-up.
  • Take extra care to moisturize after swimming in a pool, as chlorinated water can quickly dry out the skin.
  • Whatever the season, use a humidifier in the bedroom at night to prevent dryness.

Sex

According to a 2018 study in the journal Psoriasis, no less than 40% of adults with psoriasis experience sexual dysfunction as a result of their disease. Beyond causing emotional stress that can factor into this, psoriasis can make sex uncomfortable if the plaques are situated on or around the genitals.

As frustrating as this can be, there are things you can do to cope:

  • Speak honestly with your partner about what you are going through. Don't let your isolation be misconstrued as rejection or disinterest.
  • Use a polyisoprene condom with plenty of lubricant to help reduce skin-to-skin friction during intercourse.
  • Try a lanolin-based moisturizer, which can help skin "glide" over skin, reducing friction.
  • If the skin around your genitals is itchy, speak to your doctor about the hydrocortisone cream best suited for delicate tissues. Never apply these creams internally.
  • Keep the room temperature cool to prevent overheating.
  • Explore other types of sexual encounters. For many, role-playing, touching, using toys, and engaging in fantasy can be just as emotionally satisfying as intercourse.

Social

It is not uncommon for people with psoriasis to isolate themselves. This not only fuels feelings of hopelessness, but makes it that much harder to manage your condition effectively. Rather than turning inward, look outward to build the support network you need.

Friends and family are a great place to start, although you will likely need to educate them on what psoriasis is and how it affects you personally. Don't be afraid to open up. If others don't know how you feel, they can't possibly interact with you in a way that is truly supportive. If needed, ask a counselor to meet with you and a loved one to work through any of the concerns you may have.

Support groups are also an important lifeline, allowing you to connect with people who know exactly what you are going through. You can search for groups on Facebook or connect with TalkPsoriasis, which is offered by the National Psoriasis Foundation (NPF). In-person support groups can often be found through your rheumatologist or local NPF chapter.

A 2012 study in the Archives of Dermatological Research found that people with psoriasis experienced a "higher quality of life, lower depression levels, and higher acceptance of life with the disease" as a result of social support.

Practical

One of the tricks to living with psoriasis is minimizing the outward signs of the disease. While you can't always conceal the plaques completely, there are ways to reduce their appearance and increase your confidence in public:

  • Use an emollient-rich moisturizer to lock moisture into the upper layer of skin. Reapply as needed, especially after bathing.
  • Remove scales by soaking in a lukewarm tub of water and gently exfoliating with a loofah and a mild soap. Do not scrub, and stop if there is any pain or bleeding.
  • Use a mild salicylic acid shampoo if you have scalp psoriasis to prevent dandruff-like flakes. Massage moisturizer into the scalp afterward to help lock in moisture.
  • Use a hypoallergic concealer, like Dermablend or Covermark, to reduce the appearance of redness and scars. Never apply concealer to broken or bleeding skin.
  • Wear light-color clothing so that any flakes are less obvious.
  • Be sure to avoid tight or scratchy headbands, clothing, or jewelry, as they can sometimes trigger a flare.
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Article Sources

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