Managing Chronic Inflammation With Psoriasis: An In-Depth Guide

Psoriasis is far more than a skin-deep condition. At its core, it’s an immune-mediated disease characterized by chronic inflammation, leading to the hallmark symptoms of red, scaly skin plaques. But for those living with psoriasis, understanding and managing the underlying inflammation is key—not just for clearer skin, but for overall health and well-being.

In this comprehensive article, we’ll explore:

• What causes inflammation in psoriasis
• How inflammation can be treated
• Lifestyle tips to help manage inflammation
• When it’s important to contact your doctor

Inflammation Causes in Psoriasis

The Immune System’s Role

Psoriasis is primarily driven by an overactive immune response. In people with psoriasis, certain immune cells (T-cells) mistakenly target healthy skin cells as if they’re fighting off an infection. This triggers the release of inflammatory chemicals (cytokines), which accelerate the growth cycle of skin cells and produce the classic plaques and scales.

Triggers That Worsen Inflammation

Several factors can spark or worsen inflammation in psoriasis, including:

• Stress: Emotional and physical stress can trigger flares.
• Infections: Strep throat, skin infections, or other illnesses can provoke immune activity.
• Injury to the Skin: Cuts, sunburns, or even bug bites can cause the “Koebner phenomenon,” where new plaques form.
• Certain Medications: Lithium, beta-blockers, and some antimalarial drugs may exacerbate psoriasis.
• Lifestyle Factors: Smoking, excessive alcohol consumption, and obesity are linked to increased inflammation and more severe disease.

Systemic Effects

It’s important to realize that the inflammation in psoriasis isn’t limited to the skin. Chronic inflammation can affect the joints (psoriatic arthritis) and is associated with increased risks of cardiovascular disease, diabetes, and metabolic syndrome.

 

Treating Inflammation in Psoriasis

Medical Therapies

Managing psoriasis typically involves treatments aimed at reducing inflammation and slowing skin cell turnover. Treatment options include:

1. Topical Treatments

• Corticosteroids: Reduce inflammation directly on affected areas.
• Vitamin D analogues: Slow skin cell growth and calm inflammation.
• Coal tar and tazarotene: Help manage scaling and inflammation.

2. Phototherapy

• Ultraviolet B (UVB) Light: Slows skin cell turnover and reduces inflammation.
• PUVA: Combines UVA light with psoralen medication for more severe cases.

3. Systemic Medications

• Traditional Systemics: Methotrexate, cyclosporine, and acitretin suppress the immune system and inflammation.
• Biologic Therapies: Target specific inflammatory pathways (such as TNF-alpha, interleukin-17, and interleukin-23 inhibitors) for moderate to severe psoriasis.

4. Newer Oral Treatments

• Apremilast (Otezla) and other small-molecule drugs target specific inflammatory mediators.

Importance of Adherence

Consistently using prescribed medications and following up with your healthcare provider is crucial for long-term control of inflammation.

 

Lifestyle Tips for Managing Inflammation

While medical treatment is essential, lifestyle choices can make a significant difference:

1. Diet and Nutrition

• Anti-Inflammatory Diet: Focus on fruits, vegetables, whole grains, lean protein, and healthy fats (e.g., omega-3s from fish, flaxseed, walnuts).
• Limit Processed Foods & Sugar: These can promote inflammation.
• Maintain a Healthy Weight: Obesity increases inflammation and can worsen symptoms.

2. Physical Activity

• Regular Exercise: Lowers inflammation, improves cardiovascular health, and boosts mood.
• Joint Protection: If you have psoriatic arthritis, opt for low-impact activities (swimming, cycling, walking).

3. Stress Management

• Mindfulness, Meditation, and Yoga: These techniques can help reduce stress, which may decrease flare frequency.
• Adequate Sleep: Poor sleep can worsen inflammation.

4. Avoid Smoking and Excessive Alcohol

• Smoking: Strongly associated with more severe psoriasis and poorer response to treatment.
• Alcohol: Can trigger flares and interact with some medications.

5. Skin Care

• Moisturize Regularly: Hydrated skin is less likely to crack and flare.
• Gentle Products: Fragrance-free and sensitive skin formulas minimize irritation.
• Sun Protection: Sunburn can trigger new plaques.

 

When to Contact a Doctor

It’s vital to stay in close communication with your healthcare provider. Contact your doctor if you:

• Notice New or Worsening Symptoms: Sudden increases in redness, pain, swelling, or joint problems.
• Experience Side Effects: From medications or treatments.
• Have Signs of Infection: Such as fever, pus, or rapidly spreading redness around plaques.
• Develop Joint Pain or Stiffness: These can be signs of psoriatic arthritis, which requires prompt attention.
• Feel Overwhelmed Emotionally: Psoriasis can take a toll on mental health; don’t hesitate to seek support.

 

Psoriasis is a lifelong condition, but managing chronic inflammation is possible with a combination of medical treatments, healthy lifestyle choices, and regular medical support. By understanding the mechanisms of inflammation and actively working to reduce it, you can improve your symptoms, lower your risk of related health problems, and enjoy a better quality of life.

Remember: Every individual’s experience with psoriasis is unique. Work closely with your healthcare team to develop a personalized, comprehensive plan for managing inflammation and living well with psoriasis.