In addition to following your doctor's orders, there's a lot that you can do on your own to help control and prevent flare-ups of psoriasis.
Use moisturizing lotions.Psoriasis symptoms get worse when your skin is dry, so keep it moist with creams and lotions. Thick and oily moisturizers are often the best, since they're good at trapping moisture beneath the skin. Moisturizers are also useful for removing scales, especially if you use occlusion -- applying moisturizer and then wrapping the area with tape or plastic wrap.
Take care of your skin and scalp. People with psoriasis should always be careful with their skin. Never pick at lesions or scales, since that can just make your psoriasis worse. Trimming your nails regularly can be a good way to prevent psoriasis from flaring up. But, do it carefully, since any cut might cause symptoms to get worse. If you have psoriasis on your scalp, follow your doctor's suggestions. Make sure that any topical treatments -- such as tar shampoos -- get on your scalp and not just your hair. Also, regular bathing with soothing products, such as tar solutions, may help.
Avoid dry, cold weather. Climate can have a big effect on psoriasis. For a lot of people, cold and dry weather can make the symptoms of psoriasis worse. In general, hot weather is better for people with psoriasis, although some have worsening symptoms when the heat and humidity rise.
Use a humidifier. Keeping your skin moist is important, so use a humidifier during dry seasons of the year.
Avoid medications that cause flare-ups. Tell your doctor all the medications you take, and ask if any could affect your psoriasis. Drugs that are known to make psoriasis worse in some people include:
Lithium, used to treat psychiatric disorders
Propranalol and possibly other beta-blockers, which are prescribed for heart conditions
Cardioquin or Quinidex, medications for heart arrhythmias
If you're using any of these medications, ask your doctor about substitutes.
Avoid scrapes, cuts, bumps, and infections. Obviously, most people don't go around trying to hurt themselves. But, it's very important for people with psoriasis to avoid bumps and cuts. Trauma to the skin can cause a flare-up of psoriasis at the site of the injury, a condition called "Koebner's phenomenon." Infections can also cause psoriasis to appear. Be especially careful when shaving. Avoid insect bites, chafing, acupuncture, and tattoos.
Get some sun, but not too much. Because ultraviolet rays in sunlight slow the growth of skin cells, getting moderate doses of sun is a good idea. However, make sure they're brief -- about 20 minutes or so. Use sunscreen if you're out in the sun for any longer period of time. Remember that sunburn can make your psoriasis worse, and too much sun raises your risk of skin cancer. If you're on medication that makes your skin more sensitive to ultraviolet rays as part of your phototherapy, ask your doctor about whether you should always use sunscreen when outside.
Decrease stress. Although it hasn't been proven, a lot of people feel that their psoriasis tends to flare up during stressful times. So, try to reduce your stress levels. That's easier said than done, but there are some things you can do. Practice relaxation techniques or give yoga a try.
Reduce alcohol intake. The connection between alcohol and psoriasis isn't clear, but some think that alcohol can worsen psoriasis, at least in men. Alcohol can also be dangerous if you're using certain systemic drugs to treat psoriasis.
Exercise, eat right, and maintain a healthy weight. Although no studies have shown a connection between diet and psoriasis, experts recommend that people with the condition should eat a well-balanced diet, high in fruits and vegetables. Some people report that psoriasis symptoms improve when they eliminate dairy or gluten from their diets. Exercise may also help, and will improve your mood. In some cases, excess weight can worsen psoriasis symptoms, so maintaining a healthy weight may help prevent flare-ups.
Bruce E. Strober, MD, PhD, associate director of dermatopharmacology, Department of Dermatology, New York University School of Medicine; co-director of the Psoriasis and Psoriatic Arthritis Center; consultant for Amgen, Biogen, Genentech, Fujisawa, and 3-M. Jeffrey M. Weinberg, MD, director of the Clinical Research Center, St. Luke's andRoosevelt Hospital Center, New York City; associate clinical professor of dermatology, Columbia University College of Physicians and Surgeons; consultant for Amgen and Genentech. National Institute of Arthritis and Musculoskeletal and Skin Diseases web site. American Academy of Dermatology web site. WebMD Medical Reference with Healthwise: "Psoriasis." American Academy of Dermatology, PsoriasisNet web site. National Psoriasis Foundation web site. Abel, E. "Dermatology III: Psoriaisis," ACP Medicine, April, 2005.