Ten tips to help man­age pso­ri­a­sis over win­ter

Dis­or­der can be more se­vere at this time of year, but there are ef­fec­tive treat­ments

The Irish Times - Tuesday - Health - - Health Lifestyle - Dr Anne-Marie Tobin Dr Anne-Marie Tobin is a con­sul­tant der­ma­tol­o­gist at Tal­laght Hos­pi­tal, Dublin

The red, raised scaly patches of pso­ri­a­sis can af­fect any part of the skin sur­face, but most com­monly in­volve the el­bows, knees, lower back and scalp

Pso­ri­a­sis is a very com­mon, non-con­ta­gious, long-term in­flam­ma­tory skin dis­or­der in which there is an in­crease in the rate at which skin cells are pro­duced and shed from the skin. It af­fects at least 73,000 peo­ple in Ire­land.

The red, raised scaly patches of pso­ri­a­sis can af­fect any part of the skin sur­face, but most com­monly in­volve the el­bows, knees, lower back and scalp.

Pso­ri­a­sis is a con­di­tion that tends to run in fam­i­lies – both the im­mune sys­tem and ge­net­ics are im­por­tant in its de­vel­op­ment. En­vi­ron­men­tal fac­tors can also play a role. In some cases, emo­tional stress, in­fec­tion (such as a strep­to­coc­cal throat), in­jury to the skin or cer­tain med­i­ca­tions can trig­ger the first episode of pso­ri­a­sis, while cer­tain lifestyle fac­tors (such as heavy drink­ing and smok­ing) may worsen it.

Pso­ri­a­sis is not con­ta­gious, in­fec­tious or the re­sult of poor hy­giene.

Some peo­ple with pso­ri­a­sis no­tice sea­sonal changes in the sever­ity of their con­di­tion, some­times ex­pe­ri­enc­ing a wors­en­ing of symp­toms in win­ter. Things such as dry air from cen­tral heat­ing and re­duced ex­po­sure to sun­light can con­trib­ute to this de­te­ri­o­ra­tion. More gen­er­ally, pso­ri­a­sis tends to im­prove in warmer cli­mates and worsen in colder ones.

Although there is no cure as yet, there are a range of ef­fec­tive treat­ment op­tions. Treat­ing pso­ri­a­sis is im­por­tant for good dis­ease man­age­ment, as well as gen­eral health.

1 Emol­lient ther­apy:

While the treat­ment of pso­ri­a­sis de­pends on its sever­ity and lo­ca­tion, the use of emol­lients (com­monly known as mois­turis­ers), and emol­lient wash prod­ucts (used in­stead of soap and shower gel), play an im­por­tant, but of­ten un­der­val­ued, role in man­age­ment. Used ev­ery day, emol­lients help to soften the scale, soothe dry, itchy skin and in­crease the ef­fec­tive­ness of pre­scribed treat­ments.

2 Avoid or­di­nary soap, shower gel and bub­ble bath:

Win­ter con­di­tions can be very dry­ing on the skin, and soap-based prod­ucts can fur­ther dry out the skin. In­stead, choose soap sub­sti­tutes/emol­lient wash prod­ucts when bathing or show­er­ing.

3 Choos­ing an emol­lient:

Emol­lients come as lo­tions, creams and oint­ments. Find­ing the right emol­lient is of­ten a mat­ter of trial and er­ror – the best emol­lients are those that you pre­fer to use and will con­tinue to use ev­ery day. Your health­care pro­fes­sional will be able to give ad­vice about the dif­fer­ent emol­lient prod­ucts avail­able.

4 Ap­ply­ing emol­lients to the skin:

Do not stick your fin­gers into a tub of emol­lient. Al­ways use a clean spoon or spat­ula to pre­vent con­tam­i­na­tion. Emol­lients should be ap­plied in a smooth, down­ward mo­tion, in the di­rec­tion of hair growth, af­ter a bath/shower and be­fore go­ing to bed.

5 Treat­ment op­tions for pso­ri­a­sis:

Talk with your doc­tor to find a treat­ment that is suit­able for you. Try not to be­come dis­il­lu­sioned if one treat­ment does not work – there are many ef­fec­tive treat­ment op­tions avail­able: top­i­cal treat­ments (prepa­ra­tions ap­plied di­rectly to the skin), pho­tother­apy (a form of ar­ti­fi­cial ul­travi­o­let light ther­apy, de­liv­ered in hos­pi­tal der­ma­tol­ogy de­part­ments), and medicine taken in tablet form or by in­jec­tion. Be sure to talk to your doc­tor about your symp­toms and progress, and if nec­es­sary al­ter­na­tive treat­ment op­tions or on­ward re­fer­ral to a der­ma­tol­o­gist.

6 Pso­ri­a­sis af­fects peo­ple in dif­fer­ent ways:

Liv­ing with pso­ri­a­sis can af­fect you emo­tion­ally and so­cially, as well as phys­i­cally. Its un­pre­dictable na­ture (pso­ri­a­sis can vary in sever­ity in the same per­son at dif­fer­ent times) and vis­i­bil­ity can neg­a­tively im­pact on a per­son’s qual­ity of life and per­sonal re­la­tion­ships. Ev­ery­day ac­tiv­i­ties like try­ing on clothes when shop­ping, go­ing to the swim­ming pool or even go­ing to a hair­dresser can be a chal­lenge, some­times lead­ing to feel­ings of self-con­scious­ness and em­bar­rass­ment be­cause of wor­ries about what oth­ers will think or say.

7 Ac­knowl­edge your feel­ings and emo­tions about your con­di­tion:

If you are feel­ing anx­ious or down, it is im­por­tant to share your feel­ings with your doc­tor.

8 As­so­ci­ated con­di­tions( co­mor­bidi­ties ):

Although pso­ri­a­sis af­fects the skin, it is an in­flam­ma­tory dis­or­der, which means it is re­lated to ir­reg­u­lar­i­ties in the body’s own im­mune sys­tem, and has been as­so­ci­ated with a num­ber of other con­di­tions, in­clud­ing car­dio­vas­cu­lar dis­ease and pso­ri­atic arthri­tis. Ask your doc­tor about your risk for heart dis­ease, di­a­betes, high choles­terol and high blood pres­sure. Your GP is an ex­pert in screen­ing and treat­ing these if nec­es­sary. If you have symp­toms of arthri­tis, ask for a re­fer­ral to a rheuma­tol­o­gist.

9 Iden­tify and avoid pso­ri­a­sis trig­gers:

Things such as in­fec­tions, in­juries to your skin, stress, en­vi­ron­men­tal con­di­tions, smok­ing, al­co­hol and sun­burn may make it worse.

10 Learn more about pso­ri­a­sis:

This will make it eas­ier to have a con­ver­sa­tion with your doc­tor about treat­ment op­tions and treat­ment progress.

The Ir­ish Skin Foun­da­tion – a na­tional char­ity which sup­ports peo­ple with skin con­di­tions – has re­launched its SaySome­thing cam­paign, which aims to em­power peo­ple with pso­ri­a­sis, and dis­pel the myths and stigma that can sur­round the con­di­tion. For more in­for­ma­tion or sup­port, con­tact the Ir­ish Skin Foun­da­tion at irish­skin.ie or call 01-4866280.

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