Psoriasis is a chronic, autoimmune skin disorder characterized by itchy, scaly patches that most commonly show up on "high-pressure" areas like the scalp, elbows, knees, and lower back. But if you're someone who deals with it, you're probably already aware that it doesn't necessarily mean your skin is perpetually inflamed. Typically, the condition flares as a result of certain triggers—and it's just as important to know what to do after an outbreak as it is to understand how to prevent them in the first place.
To clue you in on everything you need to know about how to deal with psoriasis on both sides of a flare-up, we chatted with board-certified dermatologists Stephanie Saxton-Daniels, MD, and Loretta Ciraldo MD, FAAD. Keep reading to learn more.
What causes psoriasis to flare?
There's no one-size-fits-all reason that psoriasis can start to flare, but there are a few common culprits that become especially prevalent during the winter months—including cold, dry weather, and infections like strep throat.
Beyond these seasonal factors, smoking and exposure to secondhand smoke, heavy drinking, high-sugar diets, weight gain, stress, and certain medications (such as lithium, high blood pressure drugs, and antimalarial drugs) can also play a role.
The common thread here, dermatologists explain, is inflammation. While psoriasis is a genetic condition (meaning that if you're dealing with it, it doesn't mean you did something wrong–it simply means you're predisposed), excess inflammation in the body can lead to flare-ups.
“The medical community sometimes struggles to find the exact cause of psoriasis or psoriasis pain, but [the pain] is thought to be caused by inflammation that irritates nerves in the skin,” board-certified dermatologist Ife J. Rodney, MD, FAAD, previously told Well+Good. When this happens, the immune system sends signals to skin cells that cause them to grow too quickly. “This process results in a buildup of skin cells. When these skin cells die and fall off the skin, they cause red, scaly patches that can be itchy and painful.”
Exactly what to do after a psoriasis outbreak
Once your psoriasis is triggered, you may experience severe itching and redness, and potentially scaly patches on your scalp and skin. When this occurs, you want to resist the urge to itch and start your prescription medications as soon as possible, says Dr. Saxton-Daniels. If, however, these sensations are entirely new to you, then your first step should be to book an appointment with your dermatologist to determine the best next steps.
Assuming you’ve experienced this before and are merely searching for relief, though, we have you covered. “When you have a psoriasis outbreak it will make our skin red, scaly, and often—but not always—itchy,” says Dr. Ciraldo. “If it is just scaly and flaky, you can sleep in Aquaphor Healing Ointment at night, and apply CeraVe Psoriasis Moisturizing Cream in the morning to smooth and hydrate the skin. If it is red and/or itchy, apply 1 percent hydrocortisone twice a day.” (Cortizone-10 Maximum Strength Soothing Aloe Creme is a popular pick.)
If these methods don’t clear the psoriasis outbreak within one to two weeks, Dr. Ciraldo says to consult your dermatologist. “[They] can explain the many effective prescription treatments available,” she points out, noting that prescription Vitamin D cream and topical steroids are often offered.
How to prevent future flare-ups
Knowing how uncomfortable a psoriasis outbreak can be, you’ll want to do everything in your power to avoid such irritation in the future. According to Dr. Saxton-Daniels, if you have psoriasis, you should steer clear of irritants like fragrances. She also suggests tailoring your diet and workout routine. “Eat a low-inflammatory diet, such as a Mediterranean diet, and get regular exercise,” she says.
Another way to prevent psoriasis from flaring as severely? Do your very best not to scratch or pick at your flares, Dr. Ciraldo says. “This can make it worse and even cause bleeding,” she warns.
While there isn't a cure for the condition (yet!), these steps will keep you as comfortable as possible any time you have to manage it.
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