But it is not enough to have a genetic connection. Flare-ups often occur when certain triggers start the psoriasis process. The most common is stress. Mental stress causes the body to release chemicals that boost the inflammatory response. Scientists suspect this is the mechanism for stress-induced psoriasis flare-ups. Psoriasis tends to worsen with weight gain.
Flare-ups also can be triggered by certain common medications, like beta blockers used to control high blood pressure or heart rate, or lithium used to treat bipolar disorder. Other triggers include strep throat, injury to the skin, and respiratory infection.
Once psoriasis has cleared up, it can stay away for months or even years, and then reappear. Still, you should try to manage and avoid triggers, or at least keep them to a minimum. For instance, lose excess weight, and review your medications with your doctor to see if you should use an alternative or a different dose. Can your diet help keep psoriasis under control?
An observational study published online July 25, , by JAMA Dermatology found that people with psoriasis who followed a Mediterranean diet — an eating pattern rich in fruits and vegetables, legumes, whole grains, fish, fruit, nuts, and extra-virgin olive oil — experienced fewer severe flare-ups. This was only an association and more research is needed, but experts believe the Mediterranean diet contains many foods that have an anti-inflammatory effect in the body and may offer extra protection against psoriasis triggers.
There is no cure for psoriasis. After that, check with your doctor every six months to review how well your therapy is working. If you still don't meet the target after six months — or if you're not seeing an acceptable response after three months — talk to your doctor about other options, like increasing the dosage of a medication or adding or switching to a new approach.
There are many kinds of psoriasis treatments available. Finding the right one, or the right combination, can be tricky. Your doctor can work with you to find the best option for you, but here is a summary of the most common ones:. Topical treatments. These over-the-counter and prescription treatments are applied directly to the skin. They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.
Calcineurin inhibitors are not recommended when you're pregnant or breast-feeding or if you intend to become pregnant. This drug is also not intended for long-term use because of a potential increased risk of skin cancer and lymphoma. Coal tar. Coal tar reduces scaling, itching and inflammation. It's available over-the-counter or by prescription in various forms, such as shampoo, cream and oil.
These products can irritate the skin. They're also messy, stain clothing and bedding, and can have a strong odor. Light therapy is a first-line treatment for moderate to severe psoriasis, either alone or in combination with medications. It involves exposing the skin to controlled amounts of natural or artificial light.
Repeated treatments are necessary. Talk with your doctor about whether home phototherapy is an option for you. This treatment involves taking a light-sensitizing medication psoralen before exposure to UVA light. This more aggressive treatment consistently improves skin and is often used for more-severe cases of psoriasis. Short-term side effects include nausea, headache, burning and itching. Long-term side effects include dry and wrinkled skin, freckles, increased sun sensitivity, and increased risk of skin cancer, including melanoma.
If you have moderate to severe psoriasis or other treatments haven't worked, your doctor may prescribe oral or injected systemic drugs. Because of the potential for severe side effects, some of these medications are used for only brief periods and might be alternated with other treatments.
Usually administered weekly as a single oral dose, methotrexate Trexall decreases the production of skin cells and suppresses inflammation. It's less effective than adalimumab Humira and infliximab Remicade. It might cause upset stomach, loss of appetite and fatigue. People taking methotrexate long term need ongoing testing to monitor their blood counts and liver function.
Men and women should stop taking methotrexate at least three months before attempting to conceive. This drug is not recommended when you're breast-feeding. Taken orally for severe psoriasis, cyclosporine Neoral suppresses the immune system. It's similar to methotrexate in effectiveness but cannot be used continuously for more than a year. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer.
People taking cyclosporine need ongoing monitoring of their blood pressure and kidney function. These drugs are not recommended when you're pregnant, breast-feeding or if you intend to become pregnant. These drugs, usually administered by injection, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. Several of these drugs are approved for the treatment of moderate to severe psoriasis in people who haven't responded to first-line therapies.
Psoriasis is not curable, but it is treatable. Anyone who believes that they might have psoriasis should speak with a doctor so that they can begin treatment as soon as possible.
As with all medical conditions, researchers continue to investigate ways in which it might be possible to manage the symptoms more effectively.
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Helpline About Psoriasis. That is more than 7. Armstrong et al. What Is Psoriasis? Plaque Psoriasis. Scalp Psoriasis.
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