Nearly 7.5 million Americans suffer from psoriasis, the autoimmune disease that occurs when the immune system mistakenly identifies the skin as an enemy and attacks it. To compensate, skin cells grow at an accelerated pace, accumulating on the surface of the body in dry, itchy patches of skin that can be red, white, or silvery and covered in scales.
But there's more to the chronic condition than its hallmark skin symptoms. Here, we're highlighting 10 things you need to know about living with psoriasis, from how warm weather and exercise affect the skin, to whether it's safe to get a tattoo.
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Exercise can help your psoriasis
"Exercise is beneficial for psoriasis because it relieves stress and reduces the risks of cardiovascular disease and obesity, which are linked to psoriasis," says Michael Traub, ND, author of Essentials of Dermatological Diagnosis and Integrative Therapeutics. "If you exercise outdoors, your skin may also benefit from the exposure to ultraviolet light." (Ultraviolet light can be used, under a doctor's supervision, as a treatment for psoriasis.)
What's more, a 2012 study published in the Archives of Dermatology found that vigorous exercise was associated with a 25% to 30% lower risk of psoriasis compared to no vigorous physical activity. Aim for 105 minutes of running or 180 minutes of swimming per week, according to the research.
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"Sun exposure is usually beneficial for psoriasis," explains Dr. Traub. "One reason is because ultraviolet light initiates the production of vitamin D in the skin. However, we need to balance the risks with the benefit."
First, avoid sunburn, which can increase your risk for skin cancers and accelerate signs of aging on the skin. Wear sunscreen daily and add a protective hat and sunglasses if you plan to spend time in the sun.
There's no reason to keep your distance from someone with psoriasis. Though the skin condition is in part hereditary, it can't be passed from person to person via physical contact, says Dr. Traub.
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Warm weather may soothe psoriasis symptoms
"Cold, dry weather seems to make psoriasis worse for many patients," says Steven Feldman, MD, PhD, a professor of pathology and dermatology at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. In contrast, sun or other forms of ultraviolet light exposure can help the skin condition.
Standard injuries like scratches, burns, and sunburns can also make psoriasis symptoms worse, so it's important to take care of your skin, especially if you are planning on spending time in the sun.
Be aware that certain medications like lithium for mental illnesses and inderal for high blood pressure can worsen psoriasis, as can respiratory infections like strep throat.
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Psoriasis can strike anyone, anytime
Psoriasis affects men and women equally, and often starts in the late teens or 20s, says Dr. Feldman. But it's possible for the skin condition to begin later in life too. A second peak period of psoriasis onset occurs between ages 50 and 60, according to the Cleveland Clinic.
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You may want to avoid tattoos
"Patients with psoriasis can get a tattoo, but psoriasis can develop in the tattoo," explains Dr. Feldman. "If a person has psoriasis, lesions can develop when the skin is injured. So the needle stick of a tattoo can cause psoriasis to occur."
In many cases, you could easily treat that localized spot of psoriasis, he says, but it's up to you to decide if the risk of making your psoriasis symptoms worse is worth the fresh ink.
Keep in mind it's possible that tattooing might trigger larger psoriasis flare-ups. One 2014 case report published in the Journal of Medicine and Life detailed the experience of an 18-year-old man with scalp psoriasis who developed plaques on other areas of his body, including his trunk and upper limbs, just two weeks after he got his first tattoo.
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Some people with psoriasis may not need treatment
In many cases, psoriasis doesn't worsen over time, says Dr. Feldman. "Early treatment of psoriasis isn't critical for preventing progression of the disease," he explains. "So if there are just a couple spots and they aren't bothersome, then treatment may not be needed."
Mild to moderate psoriasis can usually be treated with topical treatments like corticosteroids that reduce inflammation and diminish itching. Other helpful psoriasis therapies can include synthetic forms of vitamin D that can help slow skin cell turnover, topical retinoids, and light therapy.
For more severe cases, oral or injected medications may be prescribed by your doctor.
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Psoriasis can bring on depression
People with psoriasis are twice as likely to develop depression compared to the general population, according to the National Psoriasis Foundation, and "the degree of itching is strongly correlated with depressed mood," says Dr. Traub.
Some people may also feel ashamed or embarrassed about their psoriasis, causing them to pass up activities like playing sports with friends or spending a day at the beach. Doing so can deprive them of the benefits of exercise and sun exposure for psoriasis and of social interaction for mental health.