If you have psoriasis, you've probably been told that it's a chronic disease for which there's no cure. The reason for this is that it's an autoimmune disease that occurs as a result of the immune system mistakenly attacking your skin cells causing its rapid growth on top of each other leading to inflammation, redness, and other symptoms of psoriasis.
Even though psoriasis is not considered a life-threatening disease it can negatively impact a person's life both on the physical and emotional levels. Additionally, 1 in 3 people who have psoriasis is said to develop psoriatic arthritis (PsA) as well.
Read MoreFlare-Up Symptoms for Psoriasis and Psoriatic Arthritis (PsA)
Flare-Ups (also known as flares) refers to the time when your symptoms become severe and worsen. These symptoms can differ from person to person according to the type of psoriasis you might have, but they generally include the following:
- Patches on the skin that are red, dark, or thick
- Silvery scales
- Itching excessively
- Bleeding and inflammation
- Rashes on the scalp on genitals
- Skin folds (especially in regions like armpits, under the breasts, or groin)
- Changes in the nails (in thickness, color, and texture)
In the case of psoriatic arthritis, flare-up symptoms include the following:
- Pain, throbbing, warmth, and stiffness in the joints
- Sausage-like fingers in the fingers and toes
- Fatigue and tiredness, especially after sleep
- Tender and swollen tendons
- Weakness in the muscles
- Lower back pain
- Swelling in the joints
- Limited movement
- Inflammation in the eye which may lead to impaired vision
How Long Does a Psoriasis Flare-Up Last?
Psoriasis flare-ups can last from weeks to months according to the different lifestyles and treatment responses of each patient. After these flares, the body usually goes into a state of remission where the symptoms subside or go away. It's impossible to say how long remission may last, but any psoriasis treatment aims to prolong remission and manage symptoms.
“It is a chronic condition, which can ebb and flow,” Dr. Saakshi Khattri, a dermatologist/rheumatologist at Mount Sinai Health System, previously told SurvivorNet. “You can have good days and bad days.”
Remission can be different from patient to patient, while some patients will experience complete skin clearance with their symptoms gone completely. Others can be in remission with very mild symptoms that are not burdensome. Although remission can last for months to years, it's important to note that being in remission is not a permanent state.
So, it's important to avoid being exposed to triggers that can end remission and cause flare-ups as well as consult your doctor about the best treatment plan for you that can reduce your symptoms.
Triggers that Cause Flare-Ups
The first thing to do when you get a diagnosis of psoriasis or psoriatic arthritis is to look for what's causing your symptoms to be aggravated and flare-up. These can be routine activities that you do every day like washing the dishes, taking a bath, or having a presentation at work that you're being stressed about.
Mundane tasks like these may not look like much at the first glance, however, they can be the root cause of all your flare-ups. By learning what they are and how to manage them, you can significantly reduce your symptoms and increase your remission time.
Here's a list of the most common triggers that can cause psoriasis and psoriatic arthritis flare-ups:
Stress. According to a research study published in the International Journal of Dermatology in 2018, there's a strong relationship between stress and psoriasis flare-ups where it was revealed that around 33-88% of patients report stress as being one of their triggers.
Skin injuries. The second cause on the list is skin injuries. Take notice after your skin has been cut, scraped, bruised, or even bitten by a bug. Do you get psoriasis afterward? If so, this can be one of your triggers. This can happen within two weeks after you injure your skin.
Alcohol drinking. Although drinking alcohol won't directly cause symptoms of psoriasis, it can have an inhibitory effect on your psoriasis medications which in turn will lead to psoriasis flare-ups.
Smoking. Many patients report back that they have experienced psoriasis symptoms after smoking or sitting with people who do.
Changing weather. Your flares may also happen as a result of weather changes like cold and dry weather in the winter or strong sunlight exposure in the summer.
Infections. Infections like strep throat, bronchitis, or ear infection can be the reason you get psoriasis flares after two to six weeks of infection. Children are particularly at a higher risk for this trigger.
Medication. Even medication can be the reason behind your flares. You can notice this when you start treatment with a certain drug and experience flares within 2-3 weeks.
Skin trauma. This can happen when you expose your skin to some external factors like getting tattoos or shaving.
Obesity. Excess weight can lead to the formation of psoriasis plaques in skin folds caused by obesity as well as be a burden on the joints.
This list only covers the most common triggers for psoriasis and psoriatic arthritis flare-ups. However, it's different for everyone. So, you should do your own investigation about what causes your flares and stop them.
How to Prevent Psoriasis Flare-Ups?
You can't prevent psoriasis completely, but what you can do is avoid your triggers to stay in, reduce the severity of flare-ups and stay in remission as long as possible. You can start by doing the following:
- Manage your stress by practicing mindfulness and relaxation techniques.
- Implement a healthy lifestyle and avoid obesity by regular exercise and eating healthily.
- Quit smoking and drinking.
- Avoid shaving roughly.
- When scrubbing, use gentle products and always apply moisturizers.
If psoriasis rebounds again, you should be prepared and start treatment right away to get better results and avoid severe symptoms. You have many treatment options that your doctor will discuss with you, the important thing is to find a treatment that's right for you.
Treatment for Psoriasis Flare-Ups
There are varying treatment options for psoriasis and psoriatic arthritis, all carrying their risks and benefits. Before deciding on a treatment, your doctor will take into consideration the following parameters:
- Your overall health
- Underlying health conditions
- Any previous treatment taken
- Any medications you might be taking right now
- Type of your psoriasis/psoriatic arthritis
- The severity of your condition
- Your response to treatment
Psoriasis treatment includes the following:
- Topicals treatment
- Phototherapy or light therapy
- Retinoids
- Coal Tar
- Vitamin D analogues
- Steroids
- Immunosuppressants
- Biologics
While treatment for psoriatic arthritis includes the following:
- Biologics
- Corticosteroids
- Disease-Modifying anti-rheumatic Drug (DMARD)
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Topical Analgesics
- Phosphodiesterase 4 inhibitors
- Janus Kinases (JAK) inhibitor
- Joint replacement therapy
Questions to Ask Your Doctor
- Which treatment do you recommend for my case?
- What should I do to improve my quality of life?
- What should I avoid doing to reduce my flare-ups?
- How can I achieve remission for as long as possible?
- Am I at high risk of developing psoriatic arthritis?
The Bottom Line
It's true that a diagnosis of psoriasis or psoriatic arthritis significantly affects a person's life. However, by knowing your triggers and avoiding them, you can prolong your remission time and reduce your flares which in turn will reduce the emotional and physical influence these diseases have on you.
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