Managing Psoriasis during winter

Dr. Deepali

Reema Singh* has looked forward to Delhi winters every year. Between the crisp air when you wake up to the warmth of the hot water bottle snuck in the blanket, winters have been her favourite season since a child.
That is until 2 years ago when she got diagnosed with Psoriasis.
“Now I dread winters” she tells me when we meet for her consultation. “I’m scared of the flare ups”
Knowing she’s not the only one who felt like this, it’s important to understand the ins and outs of psoriasis before figuring out ways to help with the flare ups.
Why is psoriasis worse in the winters?
Psoriasis is an immune-mediated skin disease that causes rashes with itchy areas. The most commonly affected areas are knees, elbows, trunk and scalp.
While psoriasis flare ups are immune system related, the outside environment plays a role in the intensity and frequency of a flare up. In winters, it is supposed that the low levels of exposure to the sun’s UV rays and the dryness of the winter air contributes to the psoriasis symptoms worsening. Add to that, you have people bundled up more in winters, thus reducing the chances of sunning themselves and it just adds to the exacerbation to much less ultraviolet light from the sun, which may ease psoriasis in spring and summer.
Managing winter psoriasis
While medication and regular follow ups with your doctor is the best way to make sure your flare ups are under control, there are certain tips and tricks to support you through the cold weather!
Dress for the best:
As tempting as a bulky, insulating jacket may be, the overall incubatory environment of a puffer jacket or overcoat may exacerbate a flare-up. Best to swap it out for layering styles - inner wear, cotton thin weathers, sweatshirts that can be removed at any time, without leaving you in the cold. For those who feel extra cold, keeping hand warmers in pockets of these jackets will help you manage the flare up and ensure a nice toasty dress up!
Self Care
Self care is an important part of taking care of a chronic illness such as psoriasis. Small changes in your daily routine can make a world of a difference.
? Hydrate yourself: Make sure you’re drinking at least 2 litres of water everyday. Hydrating not only prevents dryness of skin, but reduces inflammation in the body
? Meal prep: Eat soups and stews to reduce the dryness and nourish your body with nutrient dense meals.
? Stress management: Be it meditation, journaling, working out or going to therapy, having a control on your stress triggers will help reduce the chances of a flare up.
? Take psoriasis friendly vacations: make sure to go to a sunny place, possibly avoiding beaches if you’re in an active flare up. Planning a good vacation that is skin friendly will help your physical and mental health.
? Adopt an anti-inflammatory diet. Using garlic infused oils and avoiding nightshades helps with the homeostasis of the immune system.
Adaptive hygiene habits:
Your regular routine may need a bit of an adjustment to keep the flare ups at bay. The most confusing one for winters? Avoid using too much hot water.
Yes, as contradictory as that sounds, using hot water for a long time such as showers dry out the skin. In fact, according to The American Academy of Dermatology, people with psoriasis should keep their showers at 5 minutes and baths at 15 minutes or less.
Your moisturizer is your best friend, keep it handy at all times. Moisturizers help lock the moisture in the skin. Best time to use is right after a shower, the combination of freshly washed skin, steam and cream really helps soak in moisture for a healthier you.
Getting a humidifier is a game changer for some of my patients. They add moisture to the dry, brittle cold air of winters causing your skin to be less irritated.
Medical support:
While these tips and tricks are helpful to most, it is equally important to make sure you have a good dermatologist to follow up with.
Vitamin D deficiency can exacerbate symptoms so make sure to get your levels tested and take supplements according to your dermat’s advice.
Ask your dermat about phototherapy. Phototherapy, or light therapy, uses the medium of UV rays to reduce the activity of overactive immune cells.
Wintering with an invisible illness
While all these ways for an easier winter for you may be easy to write on paper, I understand what a pain it must be to follow through. Who amongst us doesn't find long showers the best thing about our winter day? To avoid those, well, that’s just unfair.
I’ll tell you what I tell all my patients: we take it one at a time. These flare ups are your body’s way of telling you that something isn’t right so we listen and we course correct. All these options may seem annoying and frustrating but they guarantee you a better quality of life. You are dealing with something that not many can fathom, so you deserve every kind of ease you can get.
So lather up that moisturizer, sip some hot water and welcome the winter sun.
Ref:
https://www.medicalnewstoday.com/articles/managing-psoriasis-in-the-cold#:~:text=Colder%20weather%20may%20trigger%20psoriasis,in%20the%20fall%20and%20winter.
https://www.webmd.com/skin-problems-and-treatments/psoriasis/psoriasis-fall-winter
https://www.everydayhealth.com/psoriasis/living-with/cold-weather-remedies-for-psoriasis/
https://www.dermatologytimes.com/view/the-challenges-of-winter-and-psoriasis-flares
https://www.bassmedicalgroup.com/blog-post/s-your-psoriasis-getting-worse-in-winter-try-these-treatments
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4417560/
(Dr DEEPALI BHARDWAJ, MBBS, MD (USA, IM), DVDL, M.Phil (Cosmetology)
Allergy Fellowship Munich, Germany; Cosmetic surgeries, Iran
www.skincareindia.in)