Plus, three viral infections making the rounds — COVID-19, flu, and RSV — are adding yet another layer of concern and complexity. Still, there are things you can do to enjoy both good health and good cheer. Here are six strategies to help you manage your psoriasis and make the most of the season.
1. Keep Stress in Check
Even a somewhat pared-down holiday schedule can mean added responsibility and pressure. But it’s important to keep a lid on stress. “Sometimes people don’t realize how profoundly stress affects psoriatic conditions,” says Elaine Rodino, PhD, a psychologist in State College, Pennsylvania. Fortunately, there are many proven ways to keep stress in check. Some tricks to try:
Get Moving
Whether it’s a quick walk around the neighborhood or an at-home yoga session, physical activity boosts production of the brain’s feel-good neurotransmitters called endorphins. Exercise can also increase your self-confidence, reduce symptoms associated with mild depression and anxiety, and improve your sleep, according to the Mayo Clinic.
Try a Relaxation Technique Like Meditation
A daily meditation practice can help reduce the inflammation that is part of the body’s response to stress. You can find free guided meditations online or get a meditation app for your phone. Even just deep breathing — taking a breath, holding it, and then exhaling slowly — can help when you’re stressed out, says the American Academy of Dermatology (AAD).
Say No When You Need To
Set reasonable boundaries about how much you can do — and what you feel comfortable doing. “If there’s a particular holiday tradition causing you a lot of stress, talk to those involved about skipping it or making a change,” advises Dr. Rodino. Taking charge of your life may provide a needed emotional boost. Research suggests that people with psoriatic disease are 1.5 times more likely to experience depression than those without psoriatic disease, according to the National Psoriasis Foundation (NPF). “If you feel like anxiety or sadness are causing a lot of problems in your life, be sure to bring it up with your doctor,” says Jennifer Stein, MD, PhD, a dermatologist at NYU Langone Health in New York City. Any viral or bacterial infection, however, will cause the immune system to kick into high gear, potentially resulting in a psoriasis flare. The best way to stay healthy this season is to get vaccinated against both the flu and COVID-19. If you’re eligible for a COVID-19 booster shot, get it. If you take medications that suppress your immune system, such as high-dose steroids or a biologic, you may not be fully protected against COVID-19 even if you are fully vaccinated, says the NPF. As a result, you should continue to take precautions, including frequent hand washing, social distancing, and masking at indoor gatherings. To boost the safety of indoor holiday gatherings, you may want to have everyone attending get tested for COVID-19. At-home antigen tests provide results in 15 to 30 minutes.
3. Stick With Your Treatment Plan
Whether you plan to travel or stick close to home this holiday season, any change in your daily routine can throw off your treatment regimen. Unfortunately, medications are usually not as effective if you stop and start. So stick with your regimen no matter how busy life gets in the coming months. While you may worry that immunosuppressive medication could put you at a higher risk of contracting COVID-19, the AAD currently recommends that people taking these drugs continue as directed unless they have symptoms of COVID-19 or test positive. If you have any concerns about your use of systemic therapies this winter, discuss them with your doctor. Don’t travel without your moisturizer and prescription topicals or injectables. Flares can set off a vicious cycle of scratching, which then triggers more plaques and more itchiness. If your psoriasis tends to get better in the summer when your skin is exposed to more sunlight, talk to your dermatologist about adding light therapy, also known as phototherapy, to your fall and winter regimen. “Phototherapy is a good treatment for psoriasis,” says Dr. Stein. Treatments can be done in a healthcare provider’s office or psoriasis clinic, or at home with a phototherapy unit, says the NPF.
4. Watch What (and How Much) You’re Eating
It’s tempting to overindulge around holiday time, but putting on pounds can spell trouble for people with psoriasis. A review of scientific literature on the connection between food and psoriasis, published in 2018 in JAMA Dermatology, found a strong connection between weight and symptom severity. In part due to body fat’s pro-inflammatory role, the researchers report, people who are overweight or obese face a host of issues — from more severe symptoms to reduced treatment response — when trying to manage their disease. The NPF generally recommends eating an anti-inflammatory diet, rich in fruits and vegetables, lean protein, whole grains, and healthy fats. Limiting foods that can promote inflammation, such as processed sugars, flours, and red meat, is good for your overall health and may help you manage your psoriasis symptoms, notes Lynn M. Ludmer, MD, a rheumatologist at Mercy Medical Center in Baltimore. Research has yet to confirm a connection between certain foods and psoriasis flares, notes Stein. But because psoriasis is an inflammatory disease, many people with the condition believe that avoiding certain foods relieves their symptoms.
5. Be Mindful of Your Alcohol Intake
While enjoying a glass or two of wine might seem like a good way to relieve holiday-induced stress, this strategy can backfire. Consuming too much alcohol can trigger a psoriasis flare by making your medication less effective or not effective at all. Also keep in mind that some medications require limitations in alcohol intake, Dr. Ludmer points out. Methotrexate (Rheumatrex, Trexall), for example, has a long-term side effect of liver damage; and excessive alcohol consumption, even without methotrexate, can damage the liver. People with more severe psoriasis may benefit from eliminating alcohol entirely, says the AAD. If you are going to drink occasionally, the AAD recommends a limit of one drink per day for women, two for men.
6. Check In With Your Dermatologist
A good relationship with your dermatologist can help you manage your psoriasis no matter what bumps this holiday season may bring. Your doctor may be able to tweak (or reinforce) your treatment regimen or put you on a short-term medication that can help you get through a particularly stressful time. “There are so many good treatments now,” notes Stein. “There are treatments that can completely clear many patients. If you’re suffering from psoriasis, it always makes sense to see a dermatologist because there’s so much we can offer to improve patients’ lives.”
