The harsh winter weather can trigger or worsen the skin condition known as psoriasis. Mysterious, uncomfortable, and in some cases downright debilitating, this skin condition is no fun. About seven million Americans suffer from it, and each year another 150,000 – 260,000 get diagnosed, says board-certified dermatologist,Dr. Ava Shamban, MD, who is also author of Heal Your Skin. Dr. Shamban shares her insight on how to detect, treat and prevent this stubborn condition below.

In its most common form, psoriasis is characterized by itchy, red, inflamed patches of skin, often covered with silvery scales.  We don’t know yet exactly what causes it—although it seems to be rooted in an autoimmune dysfunction—and haven’t discovered a permanent cure.  We do know that when ‘triggered’ psoriasis causes skin cells to develop at too quickly a rate.  A normal skin cell takes about a month to mature, but in those with psoriasis, this process takes only three or four days. These skin cells are improperly formed, and they can’t shed fast enough. Instead, they pile up–forming raised, scaly “plaques” that itch and leave skin below red and inflamed.

The good news is, although we’re still researching the permanent solutions, there are some proven ways—inside of the doctor’s office and out—to keep psoriasis under control. 

Types of Psoriasis

Psoriasis takes several forms.  If you’re suffering from any of the symptoms described below, Dr. Shamban recommends that you see your doctor for diagnosis; it’s the first step towards treatment and control.  

• Plaque psoriasis – 80% of psoriasis sufferers have this most common form. Characterized by raised, inflamed, red lesions covered by a silvery white scale; it is typically found on the elbows, knees, scalp and lower back.
• Guttate psoriasis – often starts in childhood or young adulthood, appears as small, red, individual spots on the skin, usually on the trunk and limbs. These spots are not usually as thick as plaque lesions. 
• Inverse psoriasis – appears as smooth and shiny bright red lesions, and is found in the armpits, groin, under the breasts, and in other skin folds around the genitals and the buttocks.
• Pustular Psoriasis – begins with the reddening of the skin followed by formation of pustules and scaling, usually occurs in adults, and may be localized to hands and feet. 
• Erythrodermic psoriasis – affects most of the body surface and is particularly inflammatory. It entails periodic, widespread, fiery redness of the skin and the shedding of scales in sheets; often accompanied by severe itching and pain, heart rate increase, and fluctuating body temperature, causing protein and fluid loss leading to severe illness including infection, pneumonia and congestive heart failure. Patients suffering from a flare of this condition should see a doctor immediately and may require hospitalization.

Psoriasis Triggers 

• Stress –Stress can cause first time flare-ups or aggravate existing psoriasis.
• Injury to skin –Skin trauma, such as vaccinations, sunburns, and scratches, can trigger a flare up (called the Koebner phenomenon). 
• Certain medications –Lithium, anti-malarials, inderal, quinidine, and indomethacin consistently trigger flare-ups; as does abrupt withdrawal from certain systemic medications, like cortisone. 
• Infections – Strep infections and other bacterial infections can trigger psoriasis flares.
• Alcohol  consumption and cigarettes – Many patients report links between drinking, smoking, and flare-ups.
• Dry skin – Psoriatic skin tends to dry out more easily; winter weather, wind, and excessive indoor heating can trigger lesions. 
• Diet – Some psoriasis sufferers report consumption of certain foods such as red meat, pork, tomato products, and even caffeine can exacerbate their condition.

Take Control

• Psoriasis sufferers can take prophylactic measures to guard against flare-ups; they also have options for treatment inside and outside of the doctor’s office when skin goes into overload.

Prevention

• Maintain a Healthy Lifestyle – Good nutrition, hydration, rest and regular exercise reduce stress and maintain the equilibrium your mind and body need to reduce psoriasis flare ups. These healthy habits strengthen the immune system and reduce chances of contracting psoriasis-aggravating infections.
• Keep Positive – Attitude can go a long way towards decreasing psoriasis-inducing stress. 
• Avoid scratching, rubbing or picking at skin – Any injury to the skin can produce new psoriasis lesions or cause existing lesions to worsen. 
• Treat any infections as soon as possible –Whether its sinusitis, a urinary tract infection, or strep throa, any bacterial infection in your body can compromise your system and act as a trigger. 
• Moisturize, protect, and take special care of your skin – Babying your skin will go a long way towards keeping flare-ups at bay.  Bathe and shower in lukewarm water; pat skin dry and avoid scrubbing; apply sensitive skin moisturizers regularly and especially after bathing and in wintertime (the ingredients lactic acid and urea seem to have especially positive effects); use sunscreen; shave with an electric razor; and avoid synthetic clothing.

Treatment

• Treat the disease before it worsens –The most effective way to stop the itching and appearance of new lesions in psoriasis is to treat the psoriasis properly as soon as the lesions appear. Consult your dermatologist at the earliest sign of a break out.
• Light therapy – Lightbox treatments at your doctor’s office and/or some exposure to sunlight can ease symptoms; a moderate amount of sunlight enhances the production of vitamin D, which may be effective in controlling psoriasis. Sunscreen is still important, however, as a sunburn will trigger more lesions. 
• Anti-inflammatories and topical corticosteroids –can have successful results and alleviate symptoms.
• Coal tar combined with light therapy (the Geockerman Treatment) – often alleviates flare-ups.
• Vitamin D analogues (calcipotriene) & Vitamin A analogues (retinoids) – can help to control psoriasis. 
• Certain biologic agents – neutralize inflammation and successfully lessen the condition. 
• Anthralin and/or Anthralin combined with light therapy – this topical medication works to slow skin cell growth and thereby decrease lesions.
• Bag Balm – the heavy-duty moisturizer used on cracked cow udders, can fill cracks on lesion-covered skin and lessen pain and discomfort.
• Soaks – a lukewarm bath with added olive oil and milk or oatmeal can help alleviate dryness and itching associated with flare-ups; also, apply a washcloth soaked in diluted apple cider vinegar or baking soda to lesions for a similar effect.

Psoriasis is not contagious.  But your positive attitude can be.  Take heart, and stay flexible.  With education, exploration, and support from your dermatologist, you can successfully manage the condition and have many more good days than bad.  Kim Kardashian – a prominent psoriasis sufferer – certainly isn’t sitting at home.  Why should you?