Dermatologist's tips for lifestyle changes that support healing psoriasis.
I have cared for many hundreds of psoriasis patients over my 35+ year career. In the beginning, we doctors thought that psoriasis was purely a skin problem. We offered prescription medications and treatments with side effects, and we had nothing else to offer for self-care that patients could do to gain some measure of control over their 'skin' disease. Now we know that psoriasis is part of an overall inflammatory physiology that responds to lifestyle changes that reduce inflammation. This means that people with psoriasis can make lifestyle changes to heal psoriasis AND help to lower their risk of other big inflammatory conditions such as heart disease and diabetes! It's an ominous change of perspective on psoriasis, and yet it is also exciting; now you can modify physiologic inflammation with your lifestyle choices! In my last post, I talked about our new understanding of psoriasis as a systemic disease.
In this 3-part article series on psoriasis I am updating you on how I care for my psoriasis patients in my dermatology practice. This has changed during my 35+ year career. Now we know that psoriasis is much more than a "skin-deep" condition. (If you would like to read the other articles, please find links to them in this post.)
Psoriasis may actually be just the "tip of the iceberg" indicating an increased risk for some of our worst diseases.Dermatologist Dr. Cynthia Bailey
Click here to read about the Health Conditions Linked to Psoriasis.
The good news is that you can make lifestyle choices that will help both your psoriasis and your overall health. Yes, you don't have to give in to genetics and fate, and that's the message I want you to hear. If you have psoriasis, your exercise routine, diet, and preventative health check-ups are really important. Here's what I want you to know:
How can lifestyle changes help to heal psoriasis?
Making healthy lifestyle changes to heal psoriasis will also reduce your risk for the psoriasis comorbidity diseases! Yes, if you have psoriasis, your skin will improve when you make choices that are good for your heart, and that reduce your risk of diabetes and cancer. Plus, this new information on comorbidities gives you and your doctor guidance regarding the diseases you need to be screened for during your checkups.
What makes your psoriasis worse?
Obesity. Even without metabolic syndrome, being significantly overweight increases the risk of psoriasis.
Smoking. People who smoke are more at risk for psoriasis. Heavy smoking is associated with severe psoriasis, especially the type of psoriasis called pustular psoriasis (which can cause significant disability because it can be severe on the hands and feet).
Alcohol consumption. Excessive drinking is associated with psoriasis and especially severe psoriasis and pustular psoriasis of the palms and soles.
What are the 6 most important lifestyle changes that you and your doctor can do to help control your psoriasis and keep your body healthy?
First, be sure that your doctor regularly screens you for high blood pressure, diabetes, and high cholesterol.
Because people with psoriasis have a higher risk of cancers, be sure to keep up with your cancer screening tests such as your pap smear, mammogram, colon cancer screening, skin cancer screening, etc.
Second, maintain a healthy weight and a healthy body with diet and exercise.
Make lifestyle choices that help prevent and control metabolic syndrome, diabetes, and heart disease and help lower your risk of cancer.
The best diet for your heart, to prevent diabetes and lower your risk of cancer, is a diet filled with veggies. The majority of what you eat and drink should be low fat and low glycemic (the sort of foods that are safer for diabetics because they are low carbohydrate/low sugar). They should be whole foods. Also, you should eat only lean animal products.
It means that the same diet that is good for your heart, for preventing cancer, and for controlling diabetes is now good for your psoriasis - it lowers your risk of obesity and the psoriasis comorbidity conditions.
I've simplified these diet guidelines by creating my Alkaline Mediterranean Diet. It's the diet I live on (and psoriasis runs in my family), and it's the basic diet that I recommend to my patients. I used the word "alkaline" to describe it because I created the food pyramid from the list of "alkaline foods", but really, it's a low-fat, low-glycemic whole foods diet with relative proportions of food types as your goal. Click the pyramid below for the details.
Get regular exercise!
I recommend a regular exercise program that fits your fitness level. The idea is to aim for 150 minutes of cardio every week. I get mine in 3 50-minute segments but 5 30-minute segments work too. That may be walking, swimming, jogging, or whatever works for you. If you have health issues then be safe and consult your physician before starting your exercise program - but do start one! I recommend adding strength and stretch fitness such as yoga too. (Click here to see why yoga rocks your fitness and health.)
Use alcohol in very limited amounts and never to excess. Alcohol is high glycemic and it adds fuel to the psoriasis fire.
Third, don’t smoke.
It, too, seems to fuel psoriasis and you also know that it's bad for your heart, causes vascular disease, and increases your risk of getting cancers.
Fourth, if your psoriasis is not getting better, consider having your dermatologist do a skin biopsy.
Other skin conditions can masquerade like psoriasis. You want to be certain that your skin "rash" is psoriasis and not the skin lymphoma called mycosis fungoides.
Fifth, people with psoriasis have a higher incidence of depression.
If you think you might be depressed or anxious, seek evaluation and treatment.
Consider meditation and/or seeing an expert in cognitive behavior therapies, because they’ve been shown to help increase psoriasis treatment success.
Sixth, create a daily anti-psoriasis skin care routine.
Psoriasis skin care is an entire subject in itself. In my next post I'll outline the 5 Skin Care Tips to Control Psoriasis that I give to my psoriasis patients. It makes a huge difference to your flare-ups of psoriasis when you know how to care well for your psoriasis-prone skin.
This overview of psoriatic comorbidities is adapted from an educational session I attended, presented by Joel Gelfand, MD at the 2013 Hawaii Dermatology Meeting