Does tanning help psoriasis, or make it worse?

When you have psoriasis, everyday habits can affect your skin.

A little sunlight may help some people, but too much can irritate the skin and trigger a painful flare-up. The right skin-care routine can make a big difference.

Psoriasis, which speeds up the growth of skin cells, affects people of all skin tones and is an autoimmune condition that increases the turnover of skin.

The most common form of psoriasis is plaque psoriasis, which appears as thick, pink, scaling plaques. Common areas include the elbows, knees and buttocks, although it can affects all parts of the skin. In patients with darker skin tones, inflammation can be harder to detect.

Psoriasis isn’t contagious, but it loves to jump to injured skin (called the Koebner phenomenon), so in patients with psoriasis, new plaques can spread to areas that are vigorously scratched or injured.

Tanning doesn’t help psoriasis, but controlled phototherapy might

In some people, limited sunlight can help slow the rapid skin-cell turnover seen in psoriasis. But if you stay out too long and get burned, that extra inflammation can trigger a painful flare-up, instead.

Without guidance, it can be difficult to tell when sun exposure may be helping and when it may be harming your skin.

Talk to your dermatologist about what’s safe for your skin.

If you’re looking for a more controlled option, ask a dermatologist about phototherapy. In a medical setting, a clinician can tailor the type and dose of light treatment to your skin and symptoms.

This is safer and more precise than using tanning beds or over-the-counter UV lamps. Medical phototherapy uses controlled light treatment – often, narrowband ultraviolet B (UVB) – to target psoriasis while limiting unnecessary exposure to other wavelengths. The narrowband UVB is much safer than using tanning beds.

Tanning beds include mostly UVA, as well as broadband UVB. UVA penetrates the skin deeper than UVA and is associated with a marked increase in skin cancers (as well as premature aging!)

Broadband UVB is also associated with an increased risk of skin cancer. However, narrowband UVB is a very narrow subset of the UVB spectrum that markedly decreases inflammation without a documented increased risk of skin cancer.

People with psoriasis usually must experiment a bit to find skin-care routines and products that work for them.

Other tips to soothe psoriasis symptoms

Trade your hot shower for a warm one

Hot water can cause inflammation that might make you itchier, and if you harm skin while scratching, the condition can get worse or show up in new areas. Psoriasis can flare up on skin that’s irritated, injured or otherwise traumatized. It’s the heat that you should dial back.

Moisturize frequently, and apply all over right after you get out of the shower

Use a high-quality lotion without fragrances, which can be irritating. Many brands have National Psoriasis Foundation recognition advertised on the bottle. Find one that works for you.

Take good care of all of your skin – not just psoriasis patches – to help protect the skin barrier and reduce irritation. During the winter, some people use humidifiers at home to help their skin.

Try over-the-counter remedies

• Salicylic acid: This anti-dandruff shampoo ingredient helps soften and remove scales. You can find creams with it, too.
• Coal tar: This is found in shampoos and ointments. It helps get rid of scaling and can decrease inflammation, which reduces the itch. Some people dislike the smell, but you can wash your hair with your regular shampoo afterward to help with the odor.
• Sunflower oil, jojoba oil and other oils: Oil helps break down plaques, but steroid medication is what helps prevent flakiness from returning. Sunflower oil and jojoba oil have been shown to have beneficial effects to skin and skin barrier. In some studies, olive oil has a higher oleic acid concentration that has been shown in some studies to be irritating to some people.

Skin-care habits to avoid with psoriasis

Just as some skin-care steps can help soothe psoriasis, others can irritate the skin and trigger flare-ups. Avoid or use caution with the following below.

• Anti-aging products: If you want to use anti-aging products, such as retinoids, it depends on where psoriasis bothers you and how controlled your symptoms are. Talk about the issue with your doctor.
• Exfoliating: Any benefit from sloughing off dead skin cells isn’t worth possible irritation to delicate skin that could cause new psoriasis patches.
• Diet: I recommend a diet rich in vegetables, fruits and lean meats. Avoid fried foods or food with high sugar content, which can be pro-inflammatory.
• Stress: Psoriasis can flare up significantly when someone is going through an illness or major stress. Learning stress management techniques is a good idea.
• Smoking and alcohol: Don’t smoke, because it worsens some types of psoriasis. Most people with the disease should minimize alcohol, which could trigger flare-ups, could interfere with medication and add unnecessary calories when dealing with high blood pressure or diabetes (both more likely for people with psoriasis).

Prescription treatments for psoriasis

At some point, you’ll likely need a prescription.

Many people treated for psoriasis use a prescription topical corticosteroid in a liquid, cream, ointment, foam or other solution. Over-the-counter hydrocortisone usually isn’t strong enough to treat psoriasis effectively. More extensive or difficult-to-treat cases may require phototherapy or prescription medicines taken by mouth or by injection.

Additionally, if you have the following symptoms, considering getting evaluated by a physician for psoriatic arthritis:

• Joints that are stiff for more than 30 minutes after walking up
• A whole finger or toe that is swollen
• Swollen joints

At Ohio State, we have a multidisciplinary psoriasis-psoriatic arthritis clinic, so we can offer a comprehensive management plan for both psoriasis and psoriatic arthritis.