Feature Archive

As Cool Winds Blow, Psoriasis Flares

When the fall season approaches, this skin disorder can worsen. Here's how to cope.

By Colette Bouchez
WebMD Feature

Reviewed By Brunilda Nazario

As the hot, humid days of summer give way to cool autumn breezes, most folks breathe a sigh of relief. But this may not be the case if you suffer from psoriasis -- a chronic condition affecting the skin and joints of upwards of 4.5 million adults, as well as many children.

Indeed, as fall ushers in colder, drier air, psoriasis can worsen -- sometimes inviting more of the dry, scaly, itchy red patches associated with this condition to develop.

"The lack of humidity in the air allows the skin to retain moisture less well, and when that occurs, tiny cracks or fissures can develop on the surface of the skin," says Bruce Strober, MD, director of the Psoriasis and Psoriatic Arthritis Center at NYU Medical Center in New York City.

Psoriasis most commonly appears on the scalp, knees, elbows, and torso but can develop more readily in areas where skin is traumatized or "broken." Strober says anything that causes that to happen -- like cool, dry air -- can also exacerbate the disease.

According to the National Psoriasis Foundation, this irritating skin condition comes in several different forms with varying levels of severity. In nearly all cases, however, it begins when the normal system of cell turnover goes awry.

"Normally the top layer of skin makes itself over every 28 to 30 days -- the old cells are microscopically shed, while the new ones take their place," says Mark Lebwohl, MD, PhD, chairman of the department of dermatology at the Mt. Sinai Medical Center in New York City. In psoriasis, however, Lebwohl says that this natural process is sped up dramatically.

"In psoriasis, cells turn over as quickly as every two to three days," says Lebwohl.

The old cells don't shed off normally and new cells multiply so quickly they stick together and form lesions called patches or plaques. In the most common form of this condition, the end result can be dry, scaly, red, and sometimes itchy patches of skin. And the drier your skin gets, the worse the patches can look -- and feel.

The good news: Judicious use of moisturizer can make a huge difference -- particularly as the seasons change. Not only can this help keep tiny cracks in the skin from forming, it can also help the dry patches already there look and feel better.

"Continued use of a good penetrating moisturizer, as well a bath oil, is absolutely vital to controlling psoriasis in any weather, but particularly during dry, cold weather," says Milton Moore, MD, assistant professor of dermatology at the Baylor College of Medicine in Houston.

In fact, getting moisture deep into the skin is so important that Moore used his degrees in pharmacy and medicine to develop a patent-pending pretreatment lotion known as "Hydroglide Pre Application Lotion." When applied to psoriatic plaques first, he says, studies presented before the American Academy of Dermatology showed it can help almost any moisturizer or topical medication penetrate more deeply.

Other doctors say any bland but greasy moisturizer will work it's way into the skin as well, as long as you apply a lot of it and use it often, particularly after bathing.

Stressful Seasons for Psoriasis

Although psoriasis is believed to be the result of an immune system malfunction, Lebwohl says there have also been a number of genes identified with this condition. And like most genetic conditions, he tells WebMD that there is also a unique, genetically determined time frame in which psoriasis is triggered into action, and it's different for everybody who has it. Still, he says, something does have to act as the initial trigger, and often, that "something" is stress.

Indeed, in a study published in the Journal of the American Academy of Dermatology in 1988, doctors from the Baylor College of Medicine concluded that stress can not only trigger a psoriasis flare-up, but in some instances it may also play a significant role in the initial onset of the condition.

Since the fall season frequently kicks off an activity-packed school year -- stressful for parents as well as students -- it's not hard to see why this time of year can make psoriasis worse. Toss in a stress-filled holiday season, and some psoriasis patients can suffer well into the New Year.

But doctors say you can head off the effects of stress by engaging in some form of relaxation beginning at the start of the fall season. The Baylor research notes that several studies found hypnosis and biofeedback are effective stress reducers in some people with psoriasis.


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