Managing Psoriasis As You Get Older

Psoriasis affects people of all ages. 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.

Psoriasis causes itching, flaking, and lesions called plaques. It's an autoimmune disease characterized by abnormal skin cell growth. Although it's a chronic condition, psoriasis doesn't tend to get worse over time.

Skin and Hair Care

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, ultraviolet sun exposure plays an even bigger role.

Psoriasis flares of sun-damaged skin can be challenging to treat. If you have psoriasis, wearing sunscreen daily and taking other measures to protect your skin from sun damage throughout your life will protect your skin from psoriasis flares later in life.

As people get older, the hair and scalp can get dryer, and many people don't need to wash their hair as often. Washing hair more frequently can help with psoriasis. 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

Psoriasis is linked with an increased risk of serious health conditions that are common with age. Among the comorbidities associated with psoriasis are heart disease, metabolic syndrome, osteoporosis, psoriatic arthritis, and depression.

Heart Disease

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

Psoriasis on its own is not as strong of a risk factor for heart disease as family history and smoking are.

But it isn't psoriasis that causes these issues—the same inflammatory process that contributes to psoriasis also contributes to other diseases.

This means that if you've been diagnosed with psoriasis, you need to make sure you're getting screenings for heart disease—even if your skin condition is getting better as you get older.

Metabolic Syndrome

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, hypertension, being overweight, and insulin resistance.

According to the review, between 20% and 50% of people with psoriasis have metabolic syndrome. The risk of metabolic syndrome in people with psoriasis is twice that of those who do not have the skin 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 regularly doing weight-bearing activities.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is an inflammatory condition that affects up to 30% of people with psoriasis, according to the National Psoriasis Foundation. PsA causes joint pain and stiffness and 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 according to a 2019 medical review in the journal Nature Reviews Rheumatology. Some experts suggest that managing your psoriasis diligently may help reduce the risk of PsA.

Depression

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

Depression is treatable and there are many effective treatments available. Share your concerns with your healthcare provider 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 associated inflammation, 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. Talk to your healthcare provider about changes that are affecting your skin—you might need a temporary adjustment to your skin care routine.

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 psoriasis.

• 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 your skin. An injury can lead to a psoriasis breakout, described as a Koebner phenomenon.
• Cleanse your skin with gentle, hydrating non-soap products that won’t disrupt your skin's barrier.
• Shower in lukewarm water for no longer than 10 minutes. Pat your skin dry and moisturize.

If you have scales on your scalp or other places of your body, use skin care 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 healthcare provider to manage the condition. Be mindful of the role that stress can play in flares. All kinds of life events 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 impact of such events and have strategies in place for dealing with them. Consider making stress-reducing practices like yoga or meditation a part of your regular daily routine.