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Psoriasis can be challenging to manage in the winter. Psoriasis is a skin disease that causes a rash with itchy, scaly patches, most commonly found on the knees, elbows, abdomen, and scalp. Unfortunately, the cold, dry air, indoor heating, and reduced sunlight of winter can all work to trigger flare-ups, making symptoms even worse. It can feel like you want to scratch your skin right off.
This guide will outline expert advice on managing psoriasis during the winter months. From creating a winter-proof skincare routine to understanding the role of light therapy and stress management, you’ll find actionable tips to help you prevent flare-ups and maintain your skin’s health. Whether you're newly diagnosed or have been managing psoriasis for years, these strategies can make a real difference in how you navigate the colder months.
What Is Psoriasis?
Psoriasis is a skin disease characterized by a rash with itchy, scaly patches. According to the Mayo Clinic:
“Psoriasis is a common, long-term (chronic) disease with no cure. It can be painful, interfere with sleep, and make it hard to concentrate. The condition tends to go through cycles, flaring for a few weeks or months, then subsiding for a while. Common triggers in people with a genetic predisposition to psoriasis include infections, cuts or burns, and certain medications.”
The National Psoriasis Foundation notes that psoriasis (psoriatic arthritis, together called psoriatic disease) is an immune-mediated disease. This means that those with psoriasis have an overreactive immune system, causing inflammation that impacts not just the skin but also other organs and tissues in the body.
Lifestyle habits and treatments can help you manage your symptoms, but that can be harder in the winter months.
Understanding Psoriasis Triggers in Winter
Psoriasis flares occur when the inflammation in the body is increased, and new symptoms appear, or the symptoms existing symptoms worsen. Flares vary from person to person, with some being long and extreme and others being short and mild. Some people have many flares, while others have few.
It’s important to note that flares are caused by different things for different people. One common flare trigger is the winter, though. According to the American Academy of Dermatology (AAD), this may be due to:
• Less sunlight
• Changes in humidity
• Cold temperatures
• Drier indoor air
• Stress and illness (which tend to increase in the winter)
• Drinking frequently or in excess (such as during the holidays)
If you notice a worsening of scales, redness, itchiness, and cracked skin, you have a flare. It’s critical to handle flares as early as possible to prevent them from becoming severe.
Building a Winter-Ready Skincare Routine
However, you don’t have to just wait around for a flare to hit. You can do this to avoid psoriasis flares in the winter, according to the AAD; here are some important steps to take:
1. Moisturize, moisturize, moisturize! It’s critical to use heavy, fragrance-free moisturizers, such as ceramide-rich creams, during the winter. Use an ointment or cream rather than a lotion. Make sure you slather on this moisturizer immediately after bathing and any time during the day when your skin feels dry. Also, use a gentle, moisturizing cleanser instead of soap.
2. Keep your skin away from dry air. A humidifier in the home can be a godsend during the winter months. Staying away from fireplaces, radiators, or other heat sources can also protect you from dry air.
3. Protect your skin. Your skin is the biggest organ in your body, and it deserves conscientious protection. Limit your showers to 10 minutes or less and use warm water instead of hot water. Also, stay warm and protect your skin from the elements. A hat, gloves, waterproof boots, and a winter jacket are always a good idea.
The National Psoriasis Foundation adds that comfortable clothing made of breathable materials like cotton can help. Avoid materials like wool or polyester.
The one thing that everyone agrees with is this: treat your psoriasis, and if your existing treatment isn’t working, see your dermatologist as soon as possible.
Treating Psoriasis Flare-ups in the Winter
The treatments for psoriasis whether in a flare or not are not a one-size-fits-all. While this makes finding the proper treatment for you more challenging, it does mean it’s more likely that there is a treatment out there that will help soothe your symptoms.
1. Topical corticosteroid treatments for psoriasis – The most frequent treatment option for psoriasis is topical steroids, which are derived from the natural corticosteroid hormones. Corticosteroids control inflammatory responses in the body (among other things), and mild ones are available over the counter, while others require a prescription. According to the AAD, commonly used corticosteroids include:
a. Ultrahigh potency: clobetasol propionate (Clobex) and halobetasol propionate (Bryhali)
b. High potency: betamethasone valerate (Celestoderm) and mometasone furoate (Asmanex)
c. Moderate potency: triamcinolone (various formulations)
d. Low potency: desonide (Desowen) and betamethasone valerate (Valisone)
2. Other topical treatments for psoriasis– There are also topical treatments outside of corticosteroids. The AAD says these include:
a. Calcineurin inhibitors (immunosuppressants), like tacrolimus (Protopic Ointment) and pimecrolimus (Elidel)
b. Vitamin D analogues like calcipotriol (Dovonex)
c. A retinoid like tazarotene (Arazlo)
d. Other topical agents that may be combined with others include emollients, salicylic acid, hydrocarbons such as anthralin and coal tar products.
3. Phototherapy for psoriasis – This type of light therapy is generally prescribed by a dermatologist and involves exposing the skin to ultraviolet light on a regular basis and under medical supervision. The National Psoriasis Foundation says phototherapy includes:
a. There are both ultraviolet light B (UVB) and psoralen + ultraviolet light A (PUVA) options.
b. Sunlight can be used but is not recommended for everyone. Sunlight is not as effective as a prescription phototherapy treatment.
c. Home phototherapy can be an option only when used as directed and with the proper precautions. See the details here.
4. Systemic treatments – These prescription drugs work throughout the body. The National Psoriasis Foundation says they are often used when other treatments aren’t effective and include:
a. Traditional systemics include acitretin (Soriatane), cyclosporine, methotrexate, and off-label systemics like hydroxyurea (Hydrea), among others.
b. Biologic drugs (biologics) and biosimilars are given by injection (shot) or intravenous (IV) infusion. A biologic is a protein-based drug derived from living cells cultured in a laboratory.
c. Oral treatments that selectively target specific molecules inside immune cells are also available.
5. Complimentary and integrative medication – These therapies may enhance your current treatment plan, but you should always consult your healthcare provider to determine what is right for you. The National Psoriasis Foundation notes the following options:
a. Diet and nutrition – there is no diet that will cure psoriasis, but some diets, foods and ingredients may reduce or prevent inflammation in the body. See information on some healthy eating options, vitamins, and supplements here.
b. Active and mindful lifestyle—Physical activity is important for all bodies, but especially for those with psoriasis. Information on getting more physical activity into your day is here.
c. Integrative approaches—Approaches like acupuncture, physiotherapy, or herbs can be helpful for some when combined with traditional treatment. It's critical to talk to your healthcare provider before starting any new approach. Read more about it here.
Tips for Managing Psoriasis Flare-Ups During Winter
While a wintertime skincare routine for psoriasis and knowing about psoriasis treatment is critical, there are additional tips you can use to manage psoriasis in the winter and all year long.
Here are some additional psoriasis coping tips:
1. Avoid scratching – Of course, if your skin is itchy, you’re going to want to scratch it, but according to the National Psoriasis Foundation, scratching can trigger the Koebner phenomenon (when new plaques appear on previously healthy skin where the injury to the skin occurred). In other words, while scratching might feel great at the moment, it will just make things worse over time.
2. Protect yourself from illness with vaccinations – It’s more common to get sick in the wintertime, which will worsen your psoriasis, so you should always discuss whether the COVID and flu vaccines are for you with your healthcare provider. According to the National Psoriasis Foundation, “Generally, you can still receive a flu shot (an inactivated vaccine) and the COVID-19 vaccine if you are on a systemic treatment, such as a biologic, biosimilar, or oral treatment. It is not recommended for you to receive live or activated vaccines, such as a flu mist, if you are on a systemic treatment.”
3. Avoid or reduce stress – Stress is one of the most common psoriasis triggers, and, a psoriasis flare can cause stress, so it can be a vicious cycle. You can reduce your stress by prioritizing self-care and setting aside time to do things just for you. Stress-reduction techniques like meditation, yoga, and mindfulness can also be helpful. Look for evidence-based smartphone apps to help you practice these techniques at home.
4. Ask for help – Whether you’re feeling stressed because you have too many entertaining obligations over the holidays or feeling an oncoming flare, make sure to ask for help when you need it. Asking for help is a strength, and so is recognizing your limits.
5. Be prepared—People often forget about prescriptions over the holidays, especially if they go on vacation. Make sure you keep your health a priority by ensuring appropriate clothing and enough prescription medications and over-the-counter products, including moisturizers and scalp products, are available.
Thriving Through Winter with Psoriasis: Final Thoughts
Managing psoriasis during the winter months can be challenging, but with the right strategies, it's possible to keep flare-ups under control and maintain your skin's health. By understanding winter-specific triggers like dry air, cold temperatures, and stress and implementing a winter-ready skincare routine, you can reduce the season's impact on your condition. Incorporating treatments like phototherapy or systemic medications when needed and focusing on overall wellness is also a crucial step.
Remember, psoriasis is a complex condition that varies from person to person. Regular check-ins with a dermatologist can help ensure your treatment plan is effective and adjusted to your needs. Don't hesitate to seek professional guidance, especially if your symptoms worsen during the colder months.
Winter doesn't have to be a season of struggle for those with psoriasis. With these expert-backed tips and proactive care, you can navigate the season with confidence and comfort. Stay consistent, stay prepared, and embrace the self-care your body deserves.
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