Psoriasis Flares As Cool Winds Blow (cont.)

And in at least one study published in a Swedish dermatology journal, doctors from McGill University in Quebec found that both meditation and guided imagery were effective relaxation methods in reducing psoriasis symptoms. Lebwohl reports that in another study, patients undergoing UV light therapy who practiced guided imagery -- imagining their psoriasis being healed -- experienced a quicker remission than those undergoing UV therapy alone.

Indeed, Moore tells WebMD that anything that helps you relax -- including meditative yoga, vigorous exercise, acupuncture, or even just taking time out of your day to listen to a favorite CD or drift away with a great novel -- can help keep your psoriasis under control, particularly during a stressful season. Remember that these techniques work best with traditional medical therapy instead of alone.

Eat, Drink, Be Merry -- but Don't Overdo

When it comes to diet and psoriasis, most speculation has surrounded foods high in essential fatty acids, particularly omega-3s -- abundant in fish, flaxseed, and some vegetables. But while some studies have found these foods helpful for a number of inflammatory immune disorders, at least some doctors are convinced that help doesn't extend to psoriasis.

"I don't buy it," says Strober, who says there is no convincing evidence that any foods play a role in either helping or harming psoriasis.

Lebwohl agrees: "There were some preliminary data in open trials suggesting eating more fish might be effective ... but in the end it was found not to help at all," he says.

Moore is a bit more flexible. He tells WebMD that "overall, omega-3s are good for the skin, particularly dry skin, and when skin is in better condition, you're going to have easier time controlling psoriasis, so in this respect these foods might make some difference."

The National Psoriasis Foundation reports that some people have found relief using small doses of fish oil capsules -- a potent source of omega-3s.

What everyone seems to agree can help, however, is skipping that wine cocktail with your dinner, as well as any other type of alcoholic beverage.

"There's a group of patients who notice, a day or two after drinking alcohol in significant amounts, or even a couple of beers for that matter, that their psoriasis worsens," says Strober. If you're one of those people, experts say don't drink, especially in fall and winter.

Psoriasis and Your Environment

In addition to ushering in cooler, drier temperatures, the start of fall can also mean less sunshine. And in the case of psoriasis, that's not a good thing.

While getting too much sun -- and particularly a sunburn -- can worsen this condition, Lebwohl says getting 15 to 20 minutes of exposure daily can be beneficial, helping to keep breakouts under control. As such, experts say that as seasons change, try to spend at least a little time outdoors in direct sunlight. If that's not possible, talk to your doctor about UV light therapy -- a way of mechanically re-creating the healing effects of the sun.

"It's the treatment I use most often for psoriasis, and it's actually safer than sunlight," says Lebwohl. In use for more than 80 years, he says it also does not increase the risk of skin cancer.

You can also make your indoor space a more healing place if you use a humidifier -- a way of mechanically putting more moisture into your personal space. Doctors say it's a leading way to combat psoriasis symptoms all year round. If you can't afford an electric humidifier, try putting pots of water on or near your radiators or air vents, and leave one on a nightstand by your bed.

Psoriasis Solutions: How Your Doctor Can Help

When it comes to trying alternative remedies -- including popular treatments such as aloe vera, echinacea, or peppermint oil -- you may want to think twice. Although frequently recommended by natural medicine enthusiasts as helpful for psoriasis, the doctors we spoke to don't put much stock in these home remedies. Moore, however, says aloe vera gel does have important healing properties for the skin and might help reduce the tiny fissures that exacerbate a psoriasis flare.

"As a treatment it's not going to make or break your psoriasis, but aloe vera does have healing properties that allow skin to do what it needs to do to heal on it's own, only just a little bit better," says Moore.

In addition to whatever self-help measures you try, there are also a number of both prescription and over-the-counter topical preparations that can help. These include prescription strength moisturizers (usually in the form of heavy ointments), hydrocortisone cream to control itch and inflammation, and, one of the oldest remedies on the medical books: a preparation known as "coal tar." It treats the scaling, inflammation, and itch of psoriasis. While considered carcinogenic in high amounts, doctors say it's safe and effective in the amount used to treat psoriasis.

If you still need more help, a new class of medications known as "biologics" may be just what the doctor orders. Lebwohl says these new injectable drugs, including Enbrel, Raptiva, and Amivive, are thought to be safer than older systemic medications (like methotrexate or cyclosporine) with fewer side effects. However, Moore cautions that the treatments do require injections several times a week -- some given by your doctor -- and they are expensive, "costing up to $1,000 a month or more," he says. And, be aware that insurance, if you have it, can give you a hard time about picking up the tab.

Published Sept. 20, 2004.


SOURCES: Bruce Strober, MD, co-director, Psoriasis and Psoriatic Arthritis Center, NYU Medical Center, New York. Mark Lebwohl, MD, chairman, department of dermatology, Mt. Sinai Medical Center, New York. Milton Moore, MD, associate clinical professor of dermatology, Baylor College of Medicine, Houston. Journal of the American Academy of Dermatology, January 1988; vol 18: pp 101-104; Acta Dermato-Venereologica (Suppl), 1991; vol 156: pp 37-43.

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