What to know about prevention and treatment of psoriasis

In psoriasis, skin cells mature almost 10 times faster than normal, then pile up, creating silvery scales and patches of thick, red, scaly skin on elbows, knees, legs, scalp and elsewhere. A few lifestyle changes can help to lessen flare-ups.

• Genes raise your risk of psoriasis, but experts aren't certain what triggers the immune system malfunction that leads to the condition. It begins when infection-fighting T cells in the skin become too active, stimulating the overgrowth of skin cells.
• Psoriasis appears as patches of thick red skin with silvery scales on the elbows, knees, other parts of the legs, scalp, lower back, face, palms and soles of the feet. Less often, they appear on the fingernails, toenails and genitals and inside the mouth.

These steps can help you avoid the condition and, if you have it already, lower your odds of a flare-up.

1. Quit smoking. Tobacco use triples your risk of plaque psoriasis, the most common form of this condition. If you already have psoriasis, smoking lessens your chances of having clear, calm skin.
2. Limit alcohol. Alcohol boosts psoriasis risk. For people who already have psoriasis, the amount of skin affected increased with their alcohol intake. If you're in the midst of a flare-up, abstaining makes sense. If your psoriasis is under control and you find that an occasional drink doesn't aggravate your skin, enjoy in moderation.
3. Watch your weight. Gaining extra pounds raised the risk by 40% in one study of more than 78,000 women. Doctors aren't certain how excess body fat contributes to psoriasis, but they do know that it can make existing skin problems worse.
4. Try new treatments. If you have psoriasis, your goal is to prevent flare-ups. For people with just a few spots of psoriasis, newer sprays or foam products are preferable. For psoriatic arthritis, newer injectable medications are available. One of them, etanercept (Enbrel), improves psoriasis symptoms by 75% in 57% of the people who use it. Two others, adalimumab (Humira) and infliximab (Remicade), are even more effective.
5. Dead Sea magic? A month of sunbathing and swimming at one of the psoriasis spas along the Dead Sea is virtually guaranteed to improve or completely clear up your skin, studies show. A more affordable option: fill your bathtub with warm water, sprinkle in Dead Sea salts (available at health food stores) and soak.
6. Moisturize. Lubricating your skin every day can also help cut your odds for flare-ups. Go for a greasy cream or ointment. Even cooking oils and vegetable shortening are effective.
7. Reduce stress. Coping with psoriasis can be extremely stressful — and stress can trigger new flare-ups. Break the cycle by building relaxation into your day, even if it's just 10 minutes of quiet, calm breathing. Or try mindfulness-based stress reduction (MBSR). Many hospitals offer MBSR classes.
8. Sunbathe safely. Exposing your skin to sunlight for a few minutes each day can reduce inflammation and scaling. Eighty percent of people with psoriasis who try daily sunbaths see an improvement. Use a broad-spectrum sunscreen on skin that's not affected by psoriasis. Commercial tanning beds may help, but some dermatologists discourage their use.
9. Avoid these meds. Some prescription drugs can trigger a flare-up. If your doctor recommends antimalaria pills, beta-blockers, indomethacin (Indocid) or lithium, ask whether a substitute is possible.
10. Baby your skin. For about half of all people with psoriasis, it worsens 10 to 14 days after any sort of cut, bruise, bug bite or scrape. Even shaving or removing an adhesive bandage could trigger a flare-up.
11. Watch for gluten. In studies, people with celiac disease who avoided gluten, a protein found in wheat, barley and rye, saw their psoriasis improve.