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Psoriasis Flare-Up? One Dermatologist's Words of Wisdom

Facing a flare-up is always a challenge. Dr. Katie shares the most popular tips that she has heard from patients about facing a flare-up. 

Kate

Dr. Katie Beleznay is a clinical Instructor with the University of British Columbia Department of Dermatology. She focuses her research and specializes in the areas of acne, rosacea, psoriasis and urticaria. You can follow Dr. Beleznay on Twitter here or on LinkedIn here.

Flare-ups: Often worthy of making those with psoriasis cringe when they think about them. A flare-up can surface many problems – both physical and emotional – and many grapple with how to deal with them when they occur.

But first, what exactly is a flare-up? Although it takes an emotional toll, a flare-up is the physical manifestation of psoriasis. It’s the itching, burning, soreness on your skin followed by red patches of inflamed skin covered with silvery scales (or plaques).1

So, what do you do when a flare-up occurs? In the moment, you may feel helpless, embarrassed and ashamed. You may immediately wonder, “What can I do to get through this?” In fact, I’m regularly asked this by people living with psoriasis and have some insight to share.

To be clear, the four topics below are not treatment options. They are simply trends that many of my patients have flagged as “helpers” when navigating a flare-up. Please speak with your doctor if you want to discuss specific treatment options (if you haven’t already!)

1. Sun (in moderation). Sunlight could possibly be soothing for the skin.2 Here is why this is a possibility: The sun’s UV rays stimulate the skin to produce vitamin D, which we know has an anti-inflammatory effect on the body.3 This makes sense too, seeing as people with psoriasis tend to have lower levels of the so-called sunshine vitamin.4 In a recent study, UV rays actually helped to clear the skin from itchy psoriatic plaques,5 showing that regulated skin exposure to UV rays may be beneficial.

As with everything, moderation is key. Even five minutes of exposure may help soothe the skin, but overexposure can cause skin damage. It’s a difficult balancing act, and it varies from patient to patient. Always check with a doctor (like me!) to figure out what is best for you.

2. Yoga. Namaste-ing your way into mindfulness and relaxation may reduce stress, which can also be associated with flare-ups.6 It may also change your mood7 and boost your immune system.8 Be wary though, as Yoga can be sometimes taken too seriously and be considered the magical elixir to cure all ailments. Let’s use the mantra that talking to your doctor before practicing yoga will be your best bet.

3. Vacationing. Easier said than done, I know. It isn’t easy to pack your bags and say, “Au revoir!” the moment you have a flare-up. But if you need even more motivation to take a vacation, some people living with psoriasis say that their symptoms lessen while on holiday. It could be that a reduction of stress may help the skin – or perhaps it is the sun from a tropical holiday, as we mentioned above. 

4.  Changing your diet. Although this isn’t a proven way toreduce your symptoms, some in the psoriasis community feel like it’s worth a try. Avoiding items such as histamines9 10, pseudo allergens11 and gluten12 may be a good place to start. Add in Vitamin D1314, omega 315 and antioxidants16– and you may have a good recipe for symptom reduction. Again, these aren’t proven - just suggestions among the psoriasis community. You can find out more about clean eating and the possibility of improving your skin here

If anything, thinking about the above and approaching your flare-ups head-on can help you gain confidence, which is an important companion when living with psoriasis. The ups and downs of psoriasis can be tough to deal with, but always remember that you are not alone in your fight against flare-ups.

  1.  American Academy of Allergy Asthma & Immunology (AAAAI) website. "Skin Allergy Overview." Accessed July 2016. Available at: http://www.aaaai.org/conditions-and-treatments/allergies/skin-allergy.aspx
  2.  The Psoriasis and Psoriatic Alliance. Psoriasis and the Sun. http://www.papaa.org/further-information/psoriasis-and-sun
  3. Mpandzou G, Aït Ben Haddou E, Regragui W, Benomar A, Yahyaoui M. Vitamin D deficiency and its role in neurological conditions: A review. Rev Neurol (Paris). 2016 Feb;172(2):109-22. doi: 10.1016/j.neurol.2015.11.005. Epub 2016 Feb 8.http://www.ncbi.nlm.nih.gov/pubmed/26867662
  4. Gisondi P, Rossini M, Di Cesare A, Idolazzi L, Farina S, Beltrami G, Peris K, Girolomoni G. Vitamin D status in patients with chronic plaque psoriasis. Br J Dermatol. 2012 Mar;166(3):505-10. doi: 10.1111/j.1365-2133.2011.10699.x. Epub 2012 Feb 6. http://www.ncbi.nlm.nih.gov/pubmed/22013980 
  5. Weatherhead SC, Farr PM, Jamieson D, Hallinan JS, Lloyd JJ, Wipat A, Reynolds NJ. Keratinocyte apoptosis in epidermal remodeling and clearance of psoriasis induced by UV radiation. J Invest Dermatol. 2011 Sep;131(9):1916-26. doi: 10.1038/jid.2011.134. Epub 2011 May 26. http://www.ncbi.nlm.nih.gov/pubmed/21614017
  6. Stress and quality of life in psoriasis: an update. Basavaraj KH1, Navya MA, Rashmi R. Int J Dermatol. 2011 Jul;50(7):783-92. https://www.ncbi.nlm.nih.gov/pubmed/21699511
  7. Exploring the Health Benefits of Yoga: A Review. Theresa A. Schreiber, Brandi S. Niemeier. World Journal of Medical Research Volume No 6. http://www.npplweb.com/wjmr/fulltext/2/1#ref1
  8. Penetrating Postures: The Science of Yoga. Alice G Walton. Forbes.http://www.forbes.com/sites/alicegwalton/2011/06/16/penetrating-postures-the-science-of-yoga/#33226d696722
  9. Website “urticaria day” – Diet. Last accessed: 13.10.15 http://urticariaday.org/urticaria/diet/
  10. Histamine plasma levels and elimination diet in chronic idiopathic urticaria. Guida B, De Martino CD, De Martino SD, Tritto G, Patella V, Trio R, D'Agostino C, Pecoraro P, D'Agostino L. Eur J Clin Nutr. 2000 Feb;54(2):155-8. http://www.ncbi.nlm.nih.gov/pubmed/10694787
  11. Diet and psoriasis, part II: celiac disease and role of a gluten-free diet. Bhatia BK, Millsop JW, Debbaneh M, Koo J, Linos E, Liao W. J Am Acad Dermatol. 2014 Aug;71(2):350-8. http://www.ncbi.nlm.nih.gov/pubmed/?term=24780176 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104239/
  12. Vitamin D status in patients with chronic plaque psoriasis. Gisondi P, Rossini M, Di Cesare A, Idolazzi L, Farina S, Beltrami G, Peris K, Girolomoni G. Br J Dermatol. 2012 Mar;166(3):505-10. http://www.ncbi.nlm.nih.gov/pubmed/22013980
  13. Website “National Psoriasis Foundation” – Can a gluten-free diet help your psoriasis? Last accessed: 13.10.15. https://www.psoriasis.org/about-psoriasis/treatments/alternative/gluten-free-diet
  14. Website “NHS UK” – Vitamins and minerals – Vitamin D. Last accessed: 13.10.15. http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-D.aspx
  15. Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. G Márquez Balbás, M Sánchez Regaña, and P Umbert Millet. Clin Cosmet Investig Dermatol. 2011; 4: 73–77. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133503/
  16. Diet and psoriasis: experimental data and clinical evidence. Wolters M. Br J Dermatol. 2005 Oct;153(4):706-14. http://www.ncbi.nlm.nih.gov/pubmed/?term=16181450 http://www.medscape.com/viewarticle/514108_5

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