Psoriasis is an autoimmune disease which causes discoloration, cracking, and flaking skin. One of the most common complications of the disease is psoriatic arthritis, a condition in which the joints between fingers, toes, and limbs become inflamed and irritated, too. Fortunately, many of the treatments used against psoriasis are also effective against psoriatic arthritis. Talk to your doctor in order to get prescription drugs that can help manage your symptoms. Depending on the severity of your condition, your doctor will probably give you anti-inflammatory medications, immunosuppressants, or some combination of these.
Method One of Four:
Getting Medical CareEdit
1Talk to your doctor. Consulting with your doctor should be your first response if you detect any symptoms of psoriasis or psoriatic arthritis. They will be able to diagnose your condition and advise you as to what actions you should take to manage it.
- Don’t neglect to mention any of your symptoms to your doctor.
- Your doctor will also want to know about your family history. People with psoriasis and psoriatic arthritis often have a family member who also has it.
2Get a medical diagnosis. Depending on the nature of your psoriasis and/or psoriatic arthritis, your doctor might do a skin biopsy in order to learn more about your condition. This is a routine procedure in which the doctor will numb a portion of psoriatic skin, then scrape some of the cells away for examination beneath a microscope.
- Your psoriatic arthritis might also require closer examination, and your doctor might perform an x-ray.
3Try topical treatments. Topical treatments include creams, lotions, and shampoos applied to the skin that can relieve your psoriasis. These treatments contain either corticosteroids, salicylic or lactic acid, or retinoids as their active ingredient. Your doctor will help you determine which topical treatment — if any — is right for you.
- Corticosteroids are drugs that mimic cortisol, a naturally occurring hormone that reduces inflammation and immune system activity.
- Retinoids are a class of drugs produced using vitamin A. They enable better cell communication, limit skin cell production, and promote healthy skin.
- Salicylic or lactic acid treatments are used to reduce the thick layers of scaly skin that build up over time due to psoriasis. These acidic treatments are often combined with moisturizing creams and/or corticosteroids.
- You might also try a dandruff shampoo and mild soap to reduce unnecessary irritation of the skin.
- Topical steroids can cause skin irritation if too much or too high of a concentration is used for too long. Always use the lowest percent that still helps the symptoms.
4Try systemic treatments. While topical treatments are used to treat isolated, localized patches of psoriatic skin, more widespread or persistent cases of psoriasis require a more aggressive approach. There are a number of drugs that could be effective against psoriasis. Methotrexate, cyclosporine, and biologics are the most common systemic drugs.
- Methotrexate combats psoriasis by slowing down the growth of skin cells.
- Cyclosporine, like methotrexate, slows down cell growth and suppresses the immune system. You should be able to see a difference in symptom severity after about two weeks.
- Biologics are a class of drugs, not a specific medication. They are applied through an IV drip or an injection. Biologics are useful for limiting inflammation of the skin. TNF-alpha inhibitors are one of the most common biologics. They prevent inflammation of the skin and joints associated with psoriasis.
- Methotrexate can lead to liver damage, kidney failure, and flu-like symptoms. Other systemic drugs like cyclosporine can lead to ulcers, flu-like symptoms, high blood pressure, and increased chance for infection. Talk to your doctor if you experience these or other adverse side effects after beginning your treatment. Your doctor will probably adjust your dosage or switch you to another medication. Minimize the force of these side effects by exercising regularly and eating a healthy diet of primarily whole grains, fruits, and vegetables.
- Systemic drugs are usually taken daily in liquid or capsule form. Consult your doctor for specific use directions.
- Your doctor may give you oral steroids for flare ups or at a low dose for treatment. Oral corticosteroid treatment may cause several adverse effects. For instance, you might experience emotional instability, psychosis, anxiety, and depression. You might also develop high blood pressure, diabetes, and an increased likelihood for infections. You can minimize many of these effects with regular exercise. Working out 30-60 minutes each day has benefits for both the mind and body. If you suffer from prolonged depression, psychosis, or other disruptions to your emotional or mental well-being, talk to a therapist. Let your doctor know, too, as they might be able to put you on a different medication with fewer side effects.
5Take a new oral treatment. New “small-molecule” treatments can target molecules within immune cells that cause inflammation, reducing inflammation and swelling of the joints. Apremilast (marketed commercially as Otezla), for instance, can be taken twice daily as a tablet and can effectively manage swollen joints associated with psoriatic arthritis. These drugs are only available with a doctor’s prescription, so talk to your doctor if you’re interested in obtaining a new oral treatment.
- Similar treatments include ustekinumab (Stelara) and secukinumab (Cosentyx).
- Side effects of apremilast include depression and weight loss. Monitor your weight carefully and if you notice yourself becoming too thin, increase your caloric intake. If you suffer with depression as a result of taking apremilast, talk to friends and family to cheer you up, and let your doctor know. They might recommend you see a therapist, or dial back your medication’s dosage in order to relieve your depression.
- Side effects of ustekinumab and similar drugs include an increased risk for certain types of cancer, swelling of the brain, fatigue, an increased incidence of infection, and headaches. If you have a headache, try an over-the-counter pain reliever like acetaminophen. Consult your doctor for advice on how to best deal with cancer, infectious diseases, and swelling of the brain.
6Try over-the-counter medications. There are a number of nonsteroidal anti-inflammatory drugs (NSAIDs) that can help relieve pain from cracked, inflamed skin as well as pain in joints afflicted with psoriatic arthritis. Common over-the-counter options include ibuprofen and naproxen sodium.
- Commercial varieties of ibuprofen include Advil and Motrin IB.
- Aleve is the most common commercial variety of naproxen sodium.
- Over-the-counter medications have few serious side-effects, but you might experience bloating or gas, dizziness, abdominal pain, mild itching, or nausea. If you experience any of these side effects, discontinue use of the medicine and try an alternative.
- Take extra caution with regular use if you are at risk for, or have a history of, stomach ulcers or bleeding or kidney problems. Tell your doctor about any non-prescription medications you take.
Method Two of Four:
Adopting Lifestyle ChangesEdit
1Reduce stress in your life. If you have a high-pressure job, or are facing other obligations that cause excessive stress, take some time to relax. Stress could cause or worsen psoriasis and psoriatic arthritis. If you’re prone to anger or other forms of emotional imbalance (including depression and anxiety) you should find ways to reduce your stress.
- Learn to recognize feelings of anxiety. You might feel as if an icy hand has gripped your heart, or feel sick to your stomach with worry and anticipation of something bad happening.
- When you feel yourself getting frustrated or angry, close your eyes and breathe in slowly through your nose for three seconds. Exhale out of your mouth for five seconds. Remind yourself that your anger will pass. Repeat several times until you feel relaxed.
- Use positive self-talk to work yourself out of anger, depression, or anxiety. When a negative thought comes into your mind — for instance, “I am not going to do well on this project” — counter it with a positive, relaxing thought. For instance, you might respond to a negative thought by thinking “I am going to do well on this project, just as I have on so many others before.”
- Get more sleep. Lack of sleep leads to higher levels of irritability, depression, and anxiety. Adults should get seven to nine hours of sleep each night.
2Exercise regularly. In order to prevent and reduce the severity of psoriasis, integrate exercise into your daily schedule. Exercise can reduce the stress and anxiety that lead to depression and anxiety, and can help you reduce inflammation and pain in psoriatic limbs.
- For instance, you could walk to the store or to work. If you have low energy levels, try walking for just 10 minutes each day. After a week, start walking 20 minutes each day. After another week, increase your walks to 30 minutes. Continue in this way until your walks reach 60 minutes.
- Try tai chi and gentle yoga for strengthening and stress reduction. Studies show that tai chi can improve arthritis pain, as well as increase balance and reduce stress.
- Ride a bike. Riding a bike is a great way to relax stiff muscles. You could ride your bike outside, at the park, or visit your local gym and use the stationary bike.
- Swimming is also a great way to ease psoriatic pain or reduce stress. Water will help you float, making movement easier.
3Eat anti-inflammatory foods. Some people believe that eating anti-inflammatory foods can help reduce the swollen, painful joints associated with psoriasis. Foods with high levels of anti-inflammatory compounds — like cold-water fish, fruits and vegetables, seeds, and nuts — could produce an improvement in your condition.
- On the flip side, you should avoid eating foods that are known to increase inflammation. These foods include red meat, vegetables in the nightshade family (potatoes, tomatoes, and peppers), refined sugars, dairy products, and processed foods.
4Lose weight. If you’re overweight, you might be more likely to develop psoriasis and less likely to experience success during treatment. To lose weight, you need to ingest fewer calories than you burn.
- For example, if you ingest 1,000 calories each day, but burn 2,000 calories each day, you will use fat to make up for the extra energy you didn’t consume.
- The best way to figure out your daily caloric needs is to invest in a quality fitness tracker to help you monitor what you’re eating and how much exercise you’re getting.
- As you lose weight, you can use the fitness tracker to post your progress to social media. When your friends and family see all the effort you’re making, they’ll encourage you to keep going, which will in turn give you the energy you need to make even more progress.
- Assuming you’re already exercising and eating a healthy diet based primarily of fruits, vegetables, nuts, and seeds, you’re on the right track. Add some lean protein (about 20% of your daily calories) like soy, tofu, and nuts.
5Avoid skin/joint injuries. Some skin injuries can set in motion a long-term biological reaction, known as the Koebner response. The Koebner response could produce psoriasis long after you sustain an injury. For instance, sunburns, vaccinations, and scratches might result in psoriasis later.
- Be careful playing sports. Injuries to the elbows or knees — even if they are not severe — could produce psoriasis later. Always wear knee pads and elbow protectors.
6Take care of your hands. In order to minimize the harm psoriasis causes your hands, keep your hands as clean and dry as possible. Trim your nails regularly and clip any hangnails you might have. Use hand moisturizer and don’t neglect to work it into the webbing between each finger.
- In addition, you might consider wearing gloves in order to minimize the embarrassment caused by psoriasis.
- Don’t bite your fingernails.
7Be careful with sun exposure. Sunlight can help clear psoriasis, but you must be careful not to overdo it and put yourself at risk for skin cancer. In addition, sunlight can cause some medications to be less effective, while it can intensify the side effects of other medications. Talk to your doctor or dermatologist to determine how many times a week you should expose yourself to the sun and for how long.
- Sunscreen blocks the rays that can help psoriasis, but it also protects your skin from burning and skin cancer. Ask your doctor if it is appropriate for you to go into the sun without sunscreen for a short period — about five minutes — and then apply.
- Some medical professionals recommend sun exposure three times weekly.
Method Three of Four:
Identifying Symptoms of Psoriatic ArthritisEdit
1Look for swollen fingers or toes. Psoriatic arthritis might cause your fingers or toes to bulge and take a more tube-like shape. Some people compare the appearance of toes and fingers affected by psoriatic arthritis to sausages. The swelling might extend to the hands and feet themselves, as well as their respective fingers and toes.
- Note that there are other forms of arthritis that might need other types of treatment, such as gout, which can also present in a similar fashion.
2Check for foot pain. If you have psoriatic arthritis, you might experience foot pain where your tendons and ligaments meet your bones. The pain might be especially acute near the back of the heel or the sole of your foot.
3Pay attention to pain in your lower back. One of the common consequences of psoriatic arthritis is a condition known as spondylitis. Spondylitis causes inflammation between your vertebrae and within the joints connecting the spine and pelvis.Advertisement
Method Four of Four:
Identifying Symptoms of PsoriasisEdit
1Look for patches of red skin. Red, inflamed skin is the most obvious and common symptom of psoriasis. These patches may appear anywhere on the body and vary in size and shape. The red color can vary from a brighter red to a dull pinkish-white.
2Look for a silvery sheen. The red patches caused by psoriasis are often covered by a rougher whitish or grayish layer of skin not unlike a scab. This second layer of raised skin is often referred to as a “silvery sheen” or “silvery scales.” This rough, scaly skin might flake off when rubbed or touched.
- If your psoriasis is on the scalp, this white, dead layer of skin might appear similar to dandruff.
3Check for deformities of the nails. If you have psoriasis, you might have vertically-oriented striping or discoloration of the nails. You’ll probably also experience pitting of the nails – small holes or indentations in the surface of the normally smooth nail. The nails could become thick and rough. In extreme cases, your nail might become detached from the nail bed.
- These nail deformities could occur with your fingernails or toenails.
4Monitor for irritation. As you might imagine, cracked, rough, scaly skin is also incredibly irritating. If your skin feels itchy and irritated as well as raised and inflamed, you almost definitely have psoriasis; however, no matter how irritated it is, do not pick or scrape your skin. This will only cause bleeding and further irritation.Advertisement