You have more options than prescriptions
By Deborah Jeanne Sergeant
If taking medication is not your ideal only means of addressing psoriasis or you would like more tools to reduce flare-ups, you have more options than prescriptions.
Tips from Emily Gottstein, physician assistant, Orchard Park Dermatology, Orchard Park:
• “Moisturizing is always important, especially using fragrance-free moisturizers. There are creams and there are lotions. Creams tend to be a little thicker and they provide a better barrier to the skin than lotion, which is thinner.
• “Not smoking can help manage psoriasis.
• “Psoriasis is an inflammatory condition. Decreasing weight can help.
• “Sometimes some short sun exposure can help psoriasis. It’s a delicate balance because you don’t want a lot of unprotected exposure. Try 10 minutes of indirect exposure two to three times per week.”
Physician Francisco Tausk, professor of dermatology, allergy, immunology and rheumatology at University of Rochester School of Medicine:
• “The National Psoriasis Foundation supports the Mediterranean diet. The only study that had controls was one in Iran where they looked at a vegan diet with low sodium. They saw patients’ psoriasis improve in a month with low calorie, low carb, plant-based eating. These diets are a little difficult to follow in that they are strict. They are anti-inflammatory as there are antioxidants in vegetables and fruits. There’s not been too much scientific work done on the effect of diet.
• “If you lose weight, you respond much better to the biologic—medication. By far, patients will improve overall. Fat tissue produces a lot of inflammatory issues. A lot of mediators, molecules involved in producing psoriasis, are the same as those made by fat tissues. If you have a lot of waist circumference fat, it makes sense your psoriasis will be worse.
• “Mindfulness meditation has been shown to help psoriasis. It became extremely popular in the US. It helps patients deal with the stress and it leads them into the path of meditation. Stress makes most patients with psoriasis worse. Addressing that is important. With depression, the brain releases inflammatory markers. It’s a vicious cycle. Psychotherapy and anti-depressants are of importance. Exercise is also important in the same vein as depression and meditation. Yoga can help.
• “I do recommend to patients certain supplements, including turmeric. Studies show it reduces psoriasis. For others, there are not that many control trials, but I recommend certain supplements as anti-inflammatories, like vitamin D. Everyone here has very low vitamin D levels. Resveratrol is an extract from grapes that is a strong antioxidant that protects against inflammation. I tell patients to take omega-3 fatty acids. I prefer they take them not from fish but algae. If you go with fish, buy wild caught fish, not farmed. The wild caught salmon feeds itself on plankton that has the omega-3. To get the right oils, you need salmon that were feeding off the algae that contain the oils. Since it’s very expensive, I tell patients to buy plant-based omega-3 oils. Some studies have been for it and some are against it. But there are more for consuming the oil. I also tell patients to try sulforaphane supplements. It turns on your natural antioxidants in your own cells.”