14 Ways to Manage Your Psoriasis

Psoriasis is without a doubt, a challenging condition. People don't understand that the red, scaly skin patches are due to an autoimmune condition. (You can't catch it!) And it can be tough to find the right treatments and cover ups to get through flare-ups. But if you've been diagnosed with psoriasis, you don't have to let the condition manage you. Follow these tips to help soothe and subdue symptoms, while boosting your confidence in your ability to cope.

"UV light is freely available for everyone, and I think it plays a key role in controlling psoriasis,” says Marian T. McEvoy, MD, a professor of dermatology at the Mayo Clinic in Rochester, Minn.

Psoriasis is caused by overactive white blood cells that accumulate in the skin, causing skin cells to overproduce. Ultraviolet light kills those white blood cells, slowing the overgrowth of skin. Inflammation subsides and scaling and flaking are often reduced.

A 2004 study published in Clinical & Experimental Dermatology found that 60% of psoriasis patients reported improvement with exposure to sunlight. But don't overdo it. Sunburn can sometimes trigger psoriasis—an effect called the Koebner phenomenon.

A study published in Psychosomatic Medicine showed the benefits of meditation: Patients with moderate to severe psoriasis who received phototherapy and simultaneously listened to meditative stress reduction tapes experienced accelerated skin clearing, compared with patients who received phototherapy alone.

Jarrod Taylor, 32, a psoriasis support group leader in Los Angeles, became a believer in the powers of meditation after visiting a spiritual center in Brazil. “Every night I went into myself and focused on my body being clear. Within 10 days, I was 100% clear,” he says.

Most dermatologists agree that the effectiveness of meditation depends on the patient. “Some people are more responsive to meditation. If that’s something that fits with your lifestyle, go for it,” says Dr. McEvoy.

If you're not at a healthy weight, make an effort to get there. "There's some evidence that if you lose weight, the psoriasis actually gets better," says Gary Goldenberg, MD, assistant professor of dermatology and pathology at the Icahn School of Medicine at Mount Sinai in New York City. This is especially important if you have psoriatic arthritis, as shedding extra weight will minimize stress on your already beleaguered joints.

Keeping your nails short and neatly trimmed will prevent you from accidentally nicking your skin. These snags and other injuries to the skin are common causes of psoriasis flare-ups.

Shorter nails do less damage, especially if you're prone to scratching your psoriasis flare-ups. Longer nails are more likely to pull scales away from underlying skin, creating more inflammation, says Dr. McEvoy.

Just take care not to clip or push back cuticles, and finish off your nail spa with clear polish.

Exercise may be one of the best ways to prevent flares and it could even help prevent or delay a psoriasis diagnosis. In one study, women who engaged in vigorous physical activity, such as running or doing aerobics, reduced the risk of a flare by 36%. Try to follow U.S. fitness guidelines and engage in at least 30 minutes of moderate-intensity exercise at least five times a week (the more the better).

Exercise may be one of the best ways to prevent flares and it could even help prevent or delay a psoriasis diagnosis. In one study, women who engaged in vigorous physical activity, such as running or doing aerobics, reduced the risk of a flare by 36%. Try to follow U.S. fitness guidelines and engage in at least 30 minutes of moderate-intensity exercise at least five times a week (the more the better).

Certain medications can exacerbate or even trigger psoriasis, including lithium (used to treat bipolar disorder), beta-blockers (prescribed for heart problems), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin.

Sulfonamide drugs, often used to treat urinary tract infections, can have adverse interactions with methotrexate (a commonly prescribed systemic medication for psoriasis), according to Steven Feldman, MD, PhD, a professor of dermatology at Wake Forest University in Winston-Salem, N.C. They can also cause photosensitivity, making you more sensitive to the sun.

Before beginning any new medication, consult your doctor.

Smoking and heavy drinking aren’t part of a healthy lifestyle, and they're especially detrimental to people with psoriasis. Smoking increases the risk of developing psoriasis, heavier smoking increases it further, and the risk decreases slowly after quitting, according to a 2007 study published in the American Journal of Medicine.

Studies have found that heavy drinking can exacerbate psoriasis and lower treatment response. Patients on methotrexate should avoid drinking alcohol because the combination can cause liver damage, adds Dr. Feldman.

That said, this doesn't mean people with psoriasis have to give up alcohol entirely, but rather be mindful about how much they consume. "There's a difference between consuming too much and consuming a healthy amount," says Gary Goldenberg, MD, assistant professor of dermatology and pathology at the Icahn School of Medicine at Mount Sinai in New York City. "A patient with psoriasis who doesn't have medical contraindications could have a glass of wine with dinner."

A shower that's too long or too hot can dry the skin out. If a shower is part of your daily routine, keep it brief and lukewarm. Use softer soaps such as Dove and Aveeno products for sensitive skin. Gently pat yourself dry to avoid traumatizing or over drying the skin. Then apply moisturizer while your skin is still slightly damp.

Coal-tar shampoos can slow the rapid turnover of skin cells on your scalp and reduce irritation. Other medicated liquids, mousse, shampoos, sprays, gels, tar products, and soaps are made especially for this difficult area. About half of people with psoriasis have psoriasis on their scalp.

If you find tar shampoos helpful, make sure you add conditioner to cancel the smell and give back some of the moisture the shampoos strip away. Popular choices among posters on the National Psoriasis Foundation's message boards include Paul Mitchell Tea Tree Special Conditioner, Aveda Scalp Benefits Balancing Conditioner, and Head and Shoulders Dry Scalp Care.

Regular moisturizing can reduce dryness and scaling, says Dr. Goldenberg. Inexpensive ointment options include Vaseline and Aquaphor. Also try creams such as Cetaphil, Nivea, CeraVe and lotions like Aveeno. Olay and Neutrogena have makeup remover pads that aren't drying, says Doris Day, MD, a dermatologist with Lenox Hill Hospital.

While "alternative" does not always mean "effective" or "safe," some may be helpful for psoriasis. According to the National Psoriasis Foundation, many people say applying an aloe vera cream can reduce redness and scaling; apple cider vinegar can reduce itching when applied to the scalp; over-the counter creams with capsaicin (the compound that gives chili peppers their heat) can ease pain, redness, inflammation, and scaling; and turmeric, also an anti-inflammatory, can help when added to the diet.

People with psoriasis may suffer if they wear skin-tight clothing. Cinched-waist belts are okay if you don't have problems around your waist. On her web site, Stacy London suggests lightweight, breathable fabrics on hot days and layering with natural fibers in winter. When you work out, high-tech fabrics that wick the moisture away from your skin can make you more comfortable, she says.