What my unpredictable psoriasis will do next is never far from my thoughts. My wish is for it to get better on its own, but it never does. I dread my next flare, checking my skin often for signs of one coming. I’m also continually on the lookout for tips on how to manage my psoriasis better, scouring the internet for news on psoriasis therapies or advice from fellow patients. At doctor appointments I’m always asking whether I can try something new or make a change to my treatment plan. The problem is that even when I get the go-ahead to switch things up, my follow-through may not be great. If a new approach requires too much time or effort, I’m more likely to discontinue it. Still, over the years I’ve had my successes. Here are my experiences attempting to follow four deceptively simple pieces of advice.
1. Moisturize Right After Bathing
Until about 10 years ago, I didn’t fully understand the importance of moisturizing my dry skin. Then I heard about the effectiveness of emollients used within three minutes of toweling off. Bathing can strip oils from the skin, but creams and ointments applied immediately afterward trap moisture. Eventually this became a habit I felt good about in caring for both my psoriasis and eczema. Then I decided I would use my phone’s stopwatch to see how long it took me to apply cream to my whole body. The first time, it took more than five minutes. I couldn’t believe how fast the minutes went by. The next day I made sure that the cream was ready to go before showering, or I’d lose too much time looking for it, priming the pump, or getting a new container out. I also sped up the moisturizing process once I got out of the shower. It took 2 minutes and 50 seconds. Through trial and error, I discovered that staying moisturized is not an Olympic sport, but it does require preparation and commitment. RELATED: 9 Psoriasis Dos and Don’ts
2. Take Short, Lukewarm Showers
Moisturizing after bathing is good, but short showers with lukewarm water are just as important. It’s the drying-out-the-skin concern again. In the summer, I’m not tempted to take hot showers. And during a heat wave, I can’t get the water cold enough. But on a cold winter’s night, a lukewarm shower leaves me feeling chilled. Applying creams and medications afterward in a cold bathroom is no fun either. So many times, I’ve started to shower with lukewarm water only to slowly turn up the temperature to hot-tub levels. When I shared my situation on a social media post, one commenter said they could give up a lot to improve psoriasis, but not hot showers in the winter. I decided I could have a hot shower once in a while, but in general I would try to keep the temperature down as much as possible. RELATED: How to Get the Most Out of Your Shower or Bath if You Have Psoriasis
3. Don’t Scratch!
Many people with psoriasis consider itching to be one of the hardest symptoms to live with. And most know that scratching those plaques and lesions only worsens the inflammation. It makes sense not to scratch. So why is it that when I tell myself not to scratch, the urge only intensifies? When my willpower weakens, I’ll scratch until my skin is red and even bleeding. Then I feel horrible about making my condition worse. People tell me not to scratch. I hear it from my family, and once, in a meeting at church, someone told me to stop scratching my arm. I felt offended even though I knew they were right. I’ve woken up with bloody sheets from scratching. When I’m sleeping, I can’t tell myself not to scratch. “Don’t scratch” definitely fits into the easy-to-say-but-hard-to-do category of psoriasis management. Willpower alone often is not enough. Moisturizers and some topical medications help, and my dermatologist has prescribed an antihistamine to lessen nighttime scratching. RELATED: The Psoriasis-Insomnia Connection and How to Get the Sleep You Need
4. Be Open With Your Doctor
One of the most inconvenient treatments I’ve ever been prescribed was for my scalp psoriasis. When the doctor told me to put a lotion on my scalp, cover it with a shower cap, then sleep with it on all night, I thought, “That’s easy for you to prescribe, but that’s hours of work on my part!” But how do I tell my doctor that? “Be honest with your doctor” is a great piece of advice, but it’s easier said than done. When I was younger, I saw doctors as authority figures and felt intimidated, especially when they seemed to be in a rush. Although it didn’t come naturally, I’ve worked hard at developing the kind of rapport I need to collaborate closely with my doctor. I’m glad I finally spoke up about that shower-cap scalp treatment, for instance, because when I did, my dermatologist prescribed a convenient-to-apply foam instead. Managing psoriasis is not easy, and taking action can be much harder and more complicated than anyone who doesn’t have psoriasis might think. But take a tip from me and keep at it until you find what works for you. You can read more about my experiences on my website, PsoHoward.
