Psoriasis -- the chronic condition that causes red, scaly, itchy patches on your skin -- comes and goes. Your psoriasis can change in how serious it is and how often you have symptoms.
What Are Symptom Cycles and Psoriasis Remission?
Psoriasis commonly happens in cycles. Your symptoms get worse for a while, then eventually get better or even seem to disappear. They will usually return at some point. Periods of serious or active symptoms are called flares or flare-ups. If you go an extended time with no symptoms, you may be considered to be in psoriasis remission.
What Does Psoriasis Remission Look Like?
Psoriasis remission is when your skin clears up and you have no noticeable symptoms. There is no clear-cut guideline for what qualifies as psoriasis remission. That’s because the symptoms and their cycles can vary widely from person-to-person, and also by the type of psoriasis you have. Psoriasis symptoms affect the skin of people of color differently. That means remission may be less likely or may not last as long.
Most periods of psoriasis remission last between 1 month and a year. But some people can stay in psoriasis remission for years.
Effective Treatments Can Clear the Way for Remission
Often, psoriasis remission may follow a successful course of treatment. Again, treatment plans and the results you might see will vary widely because each case of psoriasis is different. Recommended treatments also often must be tailored according to skin tone. Darker skin tends to produce thicker lesions and may respond better to treatments specifically made for those symptoms.
Some treatments that have been effective at helping to reduce or control symptoms for many people include:
- Topical medications. Corticosteroid ointments and creams are the topical treatments most often prescribed for mild to moderate psoriasis symptoms. Other topical treatments include salicylic acid, lab-made forms of vitamin D, and nonsteroidal topicals such as roflumilast (Zoryve) and tapinarof (Vtama).
- Oral or injected medications. Steroids, retinoids, apremilast (a PDE4 inhibitor), deucravacitinib (Sotyktu, an oral tyrosine kinase inhibitor), methotrexate, and biologics are among the most commonly prescribed psoriasis medications taken by mouth or by injections. Retinoids can also come as a gel, lotion, foam, or cream.
- Light therapy. Some form of light therapy -- which could mean sunlight or some type of UVB light exposure -- is often included in a treatment plan for moderate to severe cases of psoriasis. If the UVB exposure doesn’t work, some doctors will prescribe oral psoralen (a drug that temporarily makes your skin more sensitive to UVA light) and brief UVA exposure. This treatment is called PUVA.
Any combination of these treatments could noticeably reduce your psoriasis symptoms, maybe to the point where you will experience remission. Other times, psoriasis will just disappear (temporarily) for no apparent reason. This is known as spontaneous remission.
Remission Is More Likely if You Avoid Triggers
Psoriasis has no cure, and there’s no guaranteed way to get rid of symptoms for good. You cannot force psoriasis to go into remission. But you can improve your chances of going into remission and staying in remission longer by avoiding psoriasis triggers, including:
- Stress. This is one of the most common psoriasis triggers. For many people, avoiding stress completely can be almost impossible. That’s especially true if your psoriasis symptoms are causing you to feel stressed or anxious. Trying things like meditation, walking, or relaxation may help.
- Infections. Anything that stresses or affects the immune system can be a psoriasis trigger. People with psoriasis may have a flare-up after getting sick with strep throat, bronchitis, or an ear infection, among other things.
- Injuries to the skin. This could include anything from a scrape to a bug bite to getting a tattoo.
- Weather. Some people with psoriasis say that cold, dry conditions are especially likely to cause symptoms.
Other triggers of psoriasis symptoms include smoking, drinking a lot of alcohol, allergies, and certain medications.
Here are a few other steps you can try to make your time of remission last longer or keep your symptoms under control:
- Get a little bit of sun (responsibly). Exposure to sunlight can help psoriasis symptoms. Obviously, you want to use sunscreen and take other precautions to avoid sun damage. UVB light is most effective in treating psoriasis. You can get it through phototherapy, when bulbs give off artificial UVB light.
- Be gentle when cleaning your skin. Avoid loofahs and anything else that’s rough on your skin. Shorter showers and warm (not hot) water are best.
- Moisturize your skin. Use a cleanser that has a lot of moisture in it. After you bathe, blot most of the water, then moisturize within 5 minutes.
Should You Stop Treatment During Periods of Remission?
It may be tempting to stop your psoriasis treatment if you think you may be in remission. After all, your symptoms have stopped or gotten better. But you should talk to your doctor before making any changes to your treatment routine.
Stopping treatment can result in one of three possible outcomes:
- Your skin may stay clear and you may not have any symptoms, meaning you stay in remission.
- Your symptoms may return and look about the same as they were before. This is called a relapse.
- Your symptoms may come back and become even worse than they were before, which is known as a rebound.
Your dermatologist can provide advice on what to do. Some treatments can be stopped right away without issues. But others may need to be stopped more gradually, or they might trigger a relapse or rebound. In the case of a rebound, you may experience a different type or form of psoriasis than you had previously, or your symptoms may change. Treatments that worked before may no longer be as effective, so you may need to adjust.