Aggravating factors for psoriasis such as stress, alcohol intake, infection, being very overweight, lack of exercise and smoking, should be avoided as much as possible.
Miss Jane Olver: I was going to ask you about diet, that was next on my list, so diet.
Miss Jennifer Crawley: Yes. So there are no direct links between any particular food groups causing or flaring psoriasis, but there is more and more research evolving that a well-balanced diet is essential for proper skin health in general. So we know we all need to keep hydrated and drink lots of water. Also, it is imperative that we ingest lots of good vitamins and minerals.
Miss Jane Olver: What about smoking, should that be avoided?
Dr Jennifer Crawley: Absolutely, one should avoid smoking. Smoking causes laxity of the skin and accelerates ageing and skin pigmentation. It can also delay wound healing. Another important and essential aspect of good skin health, and vital for the prevention of skin cancer is sunscreen. So to protect your skin from UV rays, it is crucial to apply a high SPF sunscreen, not forgetting to re-apply often. Protection again UVA is essential too. You can evaluate this via the ‘star’ rating on sunscreens.
Miss Jane Olver: I have a couple of questions relating to what you have just said, one is about diet. I noticed that quite a few patients with psoriasis are overweight…
Dr Jennifer Crawley: Yes, that is common Jane.
Miss Jane Olver: In fact, some of them have what is called metabolic syndrome.
Dr Jennifer Crawley: Exactly.
Miss Jane Olver: So is it best that they restrict their diet as well as just eating healthfully.
Dr Jennifer Crawley: Absolutely Jane, and they must especially remember to avoid all of those saturated and sugary foods. You are quite right Jane that in patients with psoriasis the trend tends to be that they have an increased BMI (body mass index). Furthermore, smoking prevalence is higher in psoriasis patients. I always counsel regarding smoking cessation, increasing daily exercise, monitoring calorific intake, in addition to trying to keep sugar to a minimum because we know metabolic syndrome can predispose one to diabetes. It is essential that patients are educated and aware of this. Just to mention as well Jane, sometimes psoriasis can affect the joints.
Miss Jane Olver: Oh! I did not know that.
Dr Jennifer Crawley: Yes, so you can get something called psoriatic arthritis, some people can have bad psoriasis but not much in the way of joint problems, some other people present to my rheumatology colleagues with severe psoriatic arthritis and not much skin psoriasis to see. It is always important to ask patients about joint symptoms. When I visit with any new patients, I always inquire and discuss joint symptoms. Consequently, light exercise, for example, swimming, can be extremely beneficial.