If I Were a Horse, I’d Have Been Put Down By Now:Tips for Minimizing Psoriasis Flare-Ups

On February 12, 2024 I was diagnosed with guttate psoriasis. It had long been undiagnosed since the condition is normally found in children and not 55 year old Mimi’s! So I’ve gone around the web trying to learn as much as I can about guttate psoriasis. It is pretty rare, occurring in less than 8% of psoriasis cases. (https://www.psoriasis.org/guttate/)

My symptoms first appeared in July 2021 with a single lesion on my left leg. Though it normally follows a strep infection or sore throat, I cannot remember the circumstances around the first lesion showing up. A few days later I had 20 lesions and took my fat ass to the ER. I was given a topical antibiotic and sent on my way. Newsflash – it didn’t do anything. I wound up in my Nurse-Practitioner’s office, showing my bare bottom to more women than I cared to at one time. Ideas were batted about but ultimately I was referred to a dermatologist. I had a subsequent check up with a student NP, who told me it was actinic keratosis.

Cue panic.

I was seen yesterday and told very quickly it was NOT actinic keratosis but. that it was something called “guttate psoriasis”. It is more common in children, but can appear at any age. It is also not a typical “look” for psoriasis, but rather is characterized by tear-drop shaped lesions with a silvery covering. I am thankful for being given a diagnosis.

Living with psoriasis can be a continuous challenge, as the condition is chronic and often unpredictable. However, with the right strategies, it’s possible to minimize flare-ups and manage symptoms more effectively. Here are some practical tips for those seeking to keep their psoriasis under control.

Understand Your Psoriasis Triggers

Identifying and avoiding personal triggers is essential for minimizing flare-ups. Common triggers include:

• Stress: Incorporate stress-reduction techniques like yoga, meditation or deep-breathing exercises into your day.
• Injury to the skin: Be gentle to avoid skin injuries such as cuts, bruises and sunburns.
• Infections: Maintain good hygiene and seek prompt treatment for infections which can exacerbate psoriasis.
• Certain Medications: Always discuss potential side effects with your doctor, as some drugs can worsen psoriasis symptoms.

Keep Your Skin Moisturized

Dry skin can lead to itching and the potential worsening of psoriasis lesions. Regular moisturization can help:

• Use fragrance-free moisturizers immediately after bathing to lock in moisture.
• Opt for thicker creams and ointments that provide a barrier to keep skin hydrated.
• During dry weather, use a humidifier to keep the air in your home moist.

Diet and Nutrition

There is no definitive psoriasis diet, but certain dietary choices can help control inflammation:

• Focus on a balanced diet rich in fruits, vegetables, lean proteins and whole grains.
• Include anti-inflammatory foods like omega-3 fatty acids found in fish and flax seeds.
• Limit alcohol consumption as it can interfere with treatment and increase the risk of flare-ups.

Get Some Sunshine for Your Psoriasis Spots

Moderate sunlight exposure can improve psoriasis symptoms because the ultraviolet (UV) light slows down skin cell turnover. However, too much sun can lead to skin damage and potentially trigger a flare-up. Follow these guidelines:

• Aim for short, daily exposure to the sun, avoiding the peak intensity times between 10 am and 2 pm.
• Protect unaffected skin with sunscreen and wear a hat.
• Consult with your dermatologist before starting any new sun exposure regimen.

Avoid Smoking and Limit Alcohol

Smoking and excessive alcohol consumption can both trigger flare-ups. Consider:

• Seeking help to quit smoking through support groups or smoking cessation aids.
• Limiting alcohol intake as per health guidelines or abstaining entirely.

Manage Your Health Conditions

Comorbidities such as diabetes, heart disease and obesity can make psoriasis worse. Managing these conditions effectively can, therefore, reduce the frequency and severity of flare-ups.

Seek Medical Guidance for Dealing with Psoriasis

Regular appointments with your dermatologist are crucial:

• Discuss any new or worsening symptoms with your healthcare provider.
• Stay informed about the latest treatments and management strategies.
• Consider therapies such as topical treatments, phototherapy, oral medications or biologics as directed by your doctor.

Living with psoriasis requires a whole-life approach. By understanding and avoiding triggers, maintaining skin care, following a healthful diet, managing overall health and seeking medical advice, we can reduce the impact on our daily lives. Remember that each person’s experience with psoriasis is unique, so it’s important to work closely with your primary care team to create a management plan tailored to your specific needs.