Your 4-Step Psoriasis Flare Action Plan
Preparing for a flare is like preparing for a fire. Here's your stop, drop, and go-to plan for when your skin becomes inflamed.
For some people,a psoriasis flare “feels like you’re being bitten by fire ants.” It itches a little, but mostly it burns and stings something fierce.
And while there is no cure for psoriasis (a chronic condition that affects abour 7.5 million Americans), dermatologists recommend having a psoriasis flare action plan, which is a mapped out instruction manual designed to reduce the duration and intensity of psoriasis flares. Having a psoriasis flare action plan can help you better manage your symptoms and kick burning plaques to the curb.
Jason Rizzo, M.D., a board-certified dermatologist and clinical assistant professor at the University of Buffalo, says that the exact cause of psoriasis flares is unknown. “It’s a complex multifactorial disease, where both genetics and environment play a role,” Dr. Rizzo says. “As far as the psoriasis flare, trauma to the skin can actually trigger it.”
According to Lucy Chen, M.D., a board-certified dermatologist at Riverchase Dermatology in Miami, FL, flares can be triggered by a variety of factors, including stress, anxiety, weather, and sunburns.
Research also shows that people who smoke or drink alcohol can experience worse side effects from psoriasis compared to folks who do not participate in those activities.
Another thing that makespsoriasisso precarious is that flare-induced plaques can pop up anywhere on your body including your eyelids, ears, lips, hands, feet, scalp, and fingernails, to name a few.
“Flares of psoriasis can range in both intensity and duration but are often progressive in nature if not controlled well during the initial flare. By having a flare action plan, a patient can respond quickly and efficiently to help calm a flare before it progresses,” Dr. Rizzo says.
Flares can happen at any time so it’s best to print out your action plan or memorize it.
Atypical flare action planwill look something like this:
Step 1: Notice Your Symptoms
The first step to combatting a flareup is to notice the signs and symptoms. The beginning signs are red patches of skin covered with thick scales, and the symptoms include itchiness, burning, and soreness. When people experience these symptoms, Dr. Chen says, it means the immune system is overreacting, causing the body to generate new skin cells at an unusually high rate.
“Inflammation occurs so the body can protect itself against disease-causing agents and respond to wounds. However, when you have psoriasis, the immune system incorrectly triggers inflammation which leads to itchiness,” Dr. Chen says.
Action:As soon as you experience itching or burning on your skin, apply moisturizer or prescribed creams daily. Soak in Epsom salt or a milk bath once in a while when the entire body has been impacted. You can also use a humidifier each night to help keep the air moist and reduce itchy symptoms.
Secondly, maintain good skin hygiene by making sure your skin is well hydrated. Utilize lotions and creams made with key anti-itch ingredients like calamine and oats, says. Dr. Chen. She recommendsAveeno’s anti-itch concentrated lotionandCeraVe’s psoriasis moisturizing cream.
Dr. Rizzo also recommends greasier and heavier lotions that “tend to bring more lubrication to the skin.” You can also find over-the-counter topical steroids with a low amount of hydrocortisone, which calms the body’s immune response by reducing itching, inflammation, and swelling.
Additionally, Dr. Rizzo encourages people with psoriasis to use vitamin D analogs, which are topical non-steroidal treatments, because they can help calm down the skin and reduce the redness and scaling. “They have a pronounced anti-proliferative and anti-inflammatory effects in the skin,” Rizzo explains. It can be applied directly on the skin right when you feel an itch.
Outside of moisturizing, another way to keep your skin healthy is by using a humidifier, especially during winter months when the drier air can zap moisture from the skin. “Keeping a humidifier in your room can ensure the air stays moist,” Dr. Chen says.
Step 2: Figure Out the Irritant
Psoriasis can be triggered by a variety of irritants, including products that contain fragrances. People can conduct the process of elimination to figure out the irritant. Irritants trigger a change in the immune system, which can result in the onset of a psoriasis symptom. According to Chen, triggers vary from person to person. Therefore, it’s best to consult with a dermatologist.
You’re going to want to avoid any irritants that could make your skin react. Avoid fragrances in body lotions, haircare, deodorant, and perfumes. Fragrances can be irritating to the skin and cause a psoriasis flare. “Always look for fragrance-free or sensitive skin labels when purchasing products that may come in contact with the skin,” Dr. Chen says.
Action:If your skin is getting itchier after using certain products, avoid those products and treat your skin with lotion or prescribed creams to calm the flare. You can also soak in an Epsom salt or milk bath for extra relief.
Step 3: Monitor the Flare's Spread
Sometimes, applying topical treatments becomes unfeasible when psoriasis impacts a larger surface area of the body. “Psoriasis flares may progress to involve an increased surface area of the skin as the underlying activation of the immune system persists and extends its reach,” Rizzo says. Flares are more likely to spread when areas are left untreated.
Action:For folks with larger areas of skin impacted by psoriasis, Rizzo recommends using light therapy during active flares (active treatment) or between flares (maintenance therapy) to help control the disease. Utilizing light therapy can help psoriasis become milder because the ultraviolet radiation does have immune-suppressive effects, Rizzo says.
“Phototherapy is delivering a very select wavelength of UV rays,” Rizzo says. It is like tanning beds; however, the therapy is safe as it does not fully consist of ultraviolet radiation. “Select wavelengths of ultraviolet radiation have been shown to have anti-inflammatory effects in the skin without the harmful DNA damaging/skin cancer causing effects known to occur with most UV rays.” Phototherapy down regulates the key immune cells and signals the skin to calm down, which can be a great method for treating the whole body.
Step 4: Go See Your Dermatologist
It is possible that your flareup persists, even after applying lotions or over-the-counter topical steroids, and trying in-office treatments. That’s because psoriasis can become resistant to therapy or a flare could fail to respond to therapy due to inadequate control of the flare with current therapies.
Action:Oftentimes, psoriasis flares require a more potent steroid, according to Rizzo. These stronger steroids, such as triamcinolone, clobetasol, desonide, flucinolone, and fluocinonide, require a prescription. If your flareups continue to persist, schedule an appointment with a dermatologist as soon as possible.
According to Rizzo, topical steroids are safe when used appropriately. The appropriate use of steroids can reduce inflammation and the overproduction of cells. Side effects of overuse include the thinning of the skin and flares diminished response to the steroids. “Patients should use topical steroids sparingly to avoid those side effects,” Rizzo says.
Bottom line:
A psoriasis flare action plan will allow you to take back control to maintain strong and healthy skin. Your regimen should include topical treatments, moisturization, and destressing. These steps are necessary to keep the itchiness at bay.
Flare Management:National Psoriasis Foundation. “Life with Psoriasis.”https://www.psoriasis.org/life-with-psoriasis/
