8 tips to help manage winter psoriasis

There’s no doubt that the winter months can cause dry skin. But for a skin condition like psoriasis, winter can exacerbate its symptoms. Psoriasis is a long-term, autoimmune skin disorder that causes dry, thickened patches of skin that are often covered in silvery scales.

Even though it affects people of all ages, it often appears in early adulthood. It’s estimated that psoriasis affects one million Canadians and 125 million worldwide. The exact cause of psoriasis is still unknown, but there are contributing factors, such as genetics, the immune system, and environment. And although there isn’t a cure, there are many different treatments.

If you’re having trouble managing your psoriasis, you can always turn to Maple. Maple‘s a telehealth platform with Canadian-licensed doctors and specialists you can connect with from your phone, tablet, or computer. Instead of waiting months to see a dermatologist in person, you can see one without a referral and within hours from the comfort of your home.

Here’s why winter can make psoriasis worse and some of the best ways to manage your symptoms in the cold weather with our psoriasis tips for winter.

What are the different types of psoriasis?

Psoriasis is a chronic skin disorder, but it doesn’t appear the same in everybody. There are many types of psoriasis — each one affects different areas of the body and can have its own symptoms and appearances. You also can have one or more forms of psoriasis at one time or appear at different times. Here’s a rundown of them all.

Plaque psoriasis

The most common type that affects 85 to 90% of people with psoriasis. It usually appears as red plaques with silvery scales over the elbows, knees, scalp, and back. It can be mild to severe, covering small or large and extensive areas of the body.

Guttate psoriasis

This type of psoriasis is mostly seen in children following an upper respiratory tract infection with group A Streptococcus (strep throat). Guttate psoriasis appears as red, scaly lesions (similarly shaped to raindrops) over the torso and down the back. It can resolve on its own and never come back, become recurrent, or require treatment.

Pustular psoriasis

Pustular psoriasis causes small, red, pus-filled lesions. The pus isn’t contagious, but the lesions can be quite painful. It can be widespread (all over) or localized to the palms and soles. Scales form as the pustules dry out. This form can be debilitating and even life-threatening.

Erythrodermic psoriasis

The rarest form of psoriasis, which affects roughly 2% of people with the condition. Erythrodermic psoriasis is the result of severe, poorly-controlled plaque psoriasis, following a severe sunburn, using some medicines like oral corticosteroids or lithium, or abruptly stopping treatment. It covers more than 90% of the body and can cause severe itching, swelling, and pain that can be life-threatening. This is because your skin can no longer fight against pathogens or regulate body temperature.

Inverse psoriasis

Inverse psoriasis occurs as shiny, smooth, red patches in the skin folds, such as in the armpits, groin and buttock area, and under the breasts. It typically occurs in skin folds where there’s pressure, friction, and perspiration or moisture.

Sebopsoriasis (scalp psoriasis)

A form of psoriasis which causes red plaques and greasy scales. Sebopsoriasis typically affects areas with increased sebum production — an oily substance produced by the sebaceous glands — such as the scalp and forehead.

Nail psoriasis

Nail psoriasis triggers damage to your fingernails and toenails. It can appear as pitting or dents on the nails, have brown “oil spots”, and can cause nail separation from the skin on the fingers or toes. In severe cases, nails become thick and crumbly.

Psoriatic arthritis

A form of chronic inflammatory arthritis that’s closely related to psoriasis. Psoriatic arthritis commonly occurs in conjunction with skin and nail psoriasis. It involves painful inflammation of the joints and connective tissue affecting the joints of the fingers and toes. It triggers swollen fingers and toes, and can also affect the hips, knees, and spine.

Is psoriasis worse in the winter?

If you’ve noticed your psoriasis flares up in winter, there’s a reason for that. The colder, dryer air causes dry skin and irritation — even for those without psoriasis. Winter triggers psoriasis flares because it strips your skin of moisture, prompting symptoms.

On top of that, there’s the factor of indoor heat. Because we spend more time indoors in winter, the heating can irritate your skin, as it’s another culprit for removing moisture from the air, worsening your psoriasis symptoms.

In addition to reduced humidity, less sunlight can cause psoriasis to flare up. In the warmer seasons, the sun’s UVB rays have been shown to reduce skin cell growth, which can improve symptoms. However, this doesn’t mean that you should sit in the sun for hours on end. Sunburns can trigger more severe forms of psoriasis — 30 minutes is more than enough time to help improve your skin. And, you should always wear sunscreen with an SPF of 30 or higher when you’re exposed to the sun.

What parts of the body do psoriasis flare-ups affect?

Psoriasis can affect any part of the body, from your scalp to your toes, and everything in between — even your nails. And depending on the type of psoriasis, you’re more likely to get flare-ups in certain areas. Plaque psoriasis, the most common type, for example, often shows up on the scalp, elbows, knees, and lower back.

8 tips to help manage psoriasis in the winter

While psoriasis is a chronic skin condition, there are many lifestyle changes and treatment methods to help prevent flare-ups.

1. Exposure to sunlight

As mentioned earlier, psoriasis and sun go well together. The sun’s UVB rays can help reduce skin cell growth, preventing intense flare-ups. But if it’s winter and you’re not spending enough time outside, or your skin isn’t exposed under all your layers, how do you soak up the sun?

You might turn to light therapy for psoriasis instead. Also known as phototherapy, this treatment uses cabins with fluorescent lamps that emit UV light. It’s typically given three times a week at a dermatology office or hospital. It should be noted, however, that this type of light is therapeutic narrowband UVB, unlike UVA from a tanning bed. Tanning beds can increase your risk of skin cancers and aren’t safe treatment methods for psoriasis.

There are other types of light therapy available too, like balneotherapy. This uses bathing in warm water with added minerals like dead sea salt while being exposed to UV light.

Finally, there’s psoralen plus UVA (PUVA) therapy, where a patient’s exposed to UVA light after being given psoralen medication — a type of medication that makes the skin more responsive to UVA light.

2. Drink plenty of water

It’s easy to become dehydrated in winter, and if you have psoriasis, this can really affect your skin. Drinking water for psoriasis helps your skin stay hydrated, which may contribute to fewer or less intense flare-ups. And not just any liquid will do. Sugary drinks — or anything with sugar — can actually make your psoriasis worse since it leads to an imbalance in the gut’s microbial culture.

3. Wear soft layers

The types of clothing people with psoriasis wear in cold weather make a big difference. So if you’re wondering what clothes to wear with psoriasis, soft, breathable cotton layers are your best bet. Tight clothing made from nylon or polyester that traps heat can irritate your flare-ups further. Additionally, rougher fabrics like wool can painfully catch and pull on psoriasis plaques.

4. Moisturize your skin regularly

Cold-weather skin care means making moisturizer your new best friend. Keeping skin soft and moist can minimize itching or discomfort. If you have psoriasis, moisturizing regularly should definitely be part of your daily routine, especially after washing, since dry skin can put you at risk for more flare-ups. Checking in with a dermatologist can also help you determine which moisturizer is safe and most effective for your skin, and how often to use it.

5. Use humidifiers

Indoor heating can wreak havoc on psoriasis, prompting dry, flaky skin. One way to combat the dry, indoor air is with a humidifier. Setting up humidifiers in your home adds moisture to the air, helping your skin stay moist.

Be sure to keep your home between 30 to 50% humidity. You can also incorporate a central humidifier into your heating and cooling system to help achieve this.

6. Reduce stress

Stress is known to make many health conditions worse, including psoriasis. Stress affects psoriasis since it causes the body to release hormones that trigger an inflammatory response, resulting in a flare-up. Additionally, having a flare-up on its own can cause stress. The cycle can be broken, however, with relaxation techniques, cognitive stress management, and maybe even hypnosis or meditation.

7. Boost your immune system

Since an overactive immune system stimulates psoriasis flare-ups, improving it with a healthy diet may play a part in easing the immune response. And while there’s no conclusive evidence about which diet is best for psoriasis, studies show that eating plenty of vegetables, fruits, vegetable oils, nuts, fish with omega-3 fatty acids (like salmon), legumes, and whole-grain products has many health benefits.

On the flip side, eating certain foods may worsen psoriasis due to the inflammatory effects of saturated fatty acids. This is found in red meat, simple sugars, and highly processed foods. Research supports a caloric deficit for obese patients. Avoiding alcohol is also recommended since it too can increase the severity of flare-ups.

8. Take soothing baths

One of the best non-medicated ways to get relief from the itch and pain of a psoriasis flare-up is to take a soothing bath. You might be tempted to make the water hot, but be warned — psoriasis and hot water aren’t a good mix.

That’s because hot water can dry out your skin even more. Instead, take lukewarm oatmeal baths or use bath oil or sea salt during your temperate soak. Keep in mind if you’re going to use sea salt, it can be very drying, so you should always moisturize right after.

Can you prevent psoriasis?

While you can’t prevent psoriasis from starting, there are a few changes you can make on your own to help avoid flare-ups. These include:

• Not smoking
• Managing your weight
• Preventing damage to your skin (from insect bites, razor cuts, burns, blisters, etc.)
• Avoiding certain medications (for heart diseases, anti-malaria drugs, or mental health — you’ll need to speak to your provider about other options).

What types of treatments are recommended for psoriasis?

There are many treatments available for psoriasis. Milder forms of the skin condition typically require topical medications like steroid-based creams or prescription retinoids. In moderate to severe cases, your dermatologist may prescribe phototherapy sessions or a combination of therapies.

If neither of these treatments is working for you, the dermatologist might prescribe biologics — a type of medication that targets parts of the immune system. While effective, biologics can lower your body’s defence against other illnesses, so you’ll want to ensure you have regular check-ups with a healthcare provider.

How Maple can help with psoriasis

The physical effects of psoriasis aren’t its only repercussions. The pain, itching, and stiffness can be debilitating for some people, leading to inactivity, isolation, and low self-esteem. If you’re struggling with your mental health because of your skin condition, it may be time to connect with a mental health therapist on Maple. Our Canadian-licensed therapists treat mental health conditions and emotional difficulties through talk therapy and are available online within hours.

If you’re grappling with how to control psoriasis in winter, our dermatologists are here to help. You can connect with one from your phone, tablet, or computer within hours, and you don’t need a referral for your appointment. The dermatologist will look at your medical history, assess your symptoms, and provide the appropriate treatment, including prescription medication, if necessary.

Psoriasis can significantly impact your quality of life, but it doesn’t need to control it. Connect with a dermatologist on Maple today to learn how to manage your psoriasis this winter.

This blog was developed by our team and reviewed by a medical professional.