Managing Psoriasis As You Get Older

Psoriasis is an autoimmune disease in which skin cells regenerate more quickly than normal, causing itching, flaking, and lesions called plaques. Although it's a chronic condition, psoriasis doesn't tend to get worse over time. However, if you have psoriasis you can expect to experience changes in the way it affects your skin, scalp, and overall health as you get older. This means you'll likely need to adjust and adapt to how you manage the condition.

Skin and Hair

Over time, skin naturally loses elasticity, becomes thinner and dryer, and develops wrinkles and other signs of aging. Although genetics plays a role in how skin changes over time, exposure to the sun's ultraviolet rays over time is the biggest factor.

Psoriasis flares in skin that has been damaged by the sun often are challenging to treat. If you have psoriasis, wearing sunscreen daily and taking other measures to protect your skin from sun damage throughout your life may help to save your skin later in life.

If you have psoriasis on your scalp and your hair is starting to turn grey, be careful before covering up the incoming silver. A molecule in hair dye, paraphenylenediamine, may exacerbate psoriasis flare-ups. Wait until after the flare-up is under control and symptoms have subsided to make an appointment at the salon.

The thinning of hair that naturally occurs with age also may be exacerbated by psoriasis, often as a result of frequent head-scratching as well as dryness. Using conditioner when you wash your hair and limiting the use of heating styling tools (hair dryers, curling irons, and such) may be helpful.

Overall Health

Having psoriasis can put you at an increased risk for serious health conditions that are common with age. Among the comorbidities associated with psoriasis are heart disease, metabolic disorders, osteoporosis, psoriatic arthritis, and depression.

Heart Disease

There is growing evidence psoriasis linking psoriasis to an increased risk of heart disease. In addition, psoriasis may contribute to other risk factors for heart disease such as high blood pressure. 

Psoriasis on its own might be considered a risk factor for heart disease to the same degree family history and smoking are. Managing your psoriasis should be part of an overall plan to prevent heart problems, along with eating a healthful diet and getting regular exercise.

Metabolic Disorders

A 2018 review in the journal Clinical Dermatology revealed a strong link between psoriasis and metabolic syndrome, a cluster of disorders that are more common with age. They include high blood pressure, high cholesterol, type 2 diabetes, insulin resistance, and non-alcoholic fatty liver disease.

Between 20% and 50% of people with psoriasis have a metabolic disorder. The risk of metabolic syndrome in people with psoriasis is twice that of those who do not have the condition and is more common in people who have severe psoriasis than in those whose disorder is mild. 

Osteoporosis

A study in 2019 in the Indian Journal of Dermatology, Venereology, and Leprology found a connection between psoriatic disease (psoriasis and psoriatic arthritis) and low bone mineral density. Low bone mineral density can lead to bone loss and osteoporosis with age.

Reducing the risk for osteoporosis whether you have psoriasis or not involves including adequate calcium and vitamin D in your diet and doing regular weight-bearing activities.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is an inflammatory condition that causes joint pain and stiffness in up to 30% of people with psoriasis, according to the National Psoriasis Foundation. PsA is often diagnosed in people ages 30 to 50, although it can affect anyone of any age.

Little is known about how to prevent PsA as highlighted in a 2019 medical review in the journal Nature Reviews Rheumatology.The best way to prevent PsA, experts agree, is to manage your psoriasis diligently.

Depression

Depression is a common, but not normal, part of aging, with or without psoriasis. Psoriasis is strongly connected to depression and research shows all people with psoriasis are at risk for major depression.

Depression is treatable and there many effective treatments available. Share with your doctor if you experience any signs of depression.

Menopause

The severity of psoriasis can fluctuate with hormonal changes: The onset of psoriasis sometimes occurs during puberty or, in response to decreasing levels of estrogen, during menopause.It's believed this may occur as a result of a strong higher inflammatory response, which is the driving force in psoriasis.

Menopause can also cause dry skin, reduce collagen production (a cause of thinner skin), and decrease skin elasticity.

Caring for Aging Skin

As you get older, there are many simple measures you can take to preserve the appearance of your skin and help prevent flares of arthritis.

Steer clear of skincare products that contain alcohol, fragrances, and sulfates, ingredients that are known to cause irritation and dryness.

Try to avoid trauma to our skin: An injury can lead to a psoriasis breakout—also known as the Koebner phenomenon.

Cleanse your skin with gentle, hydrating non-soap products that won’t disrupt the skin barrier. Shower in lukewarm water for no longer than 10 minutes. Pat skin dry and moisturize.

If you have scales on your scalp or other places of your body, use skincare products containing salicylic acid., which can gently exfoliate skin and remove scales from psoriasis plaques.

A Word From Verywell

Serious exacerbations of psoriasis or other complications of the condition are not inevitable as you get older as long as you work closely with your doctor to manage the condition. Do be aware of the role stress can play in flares, as there are many life events that occur later in life that can take an emotional toll—from the birth of a grandchild to the death of a loved one. To the degree it's possible, anticipate the possibility of such events, have strategies in place for dealing with them, and make stress-reducing practices like yoga or meditation a part of your regular daily routine.