Psoriasis is an inflammatory condition that speeds up the life cycle of skin cells, causing red, scaly patches that can be itchy, painful, or cracked.
Managing psoriasis can be tricky: There are oral, topical, and injectable therapies to try, a daily skin-care routine to maintain, and lifestyle habits to keep front of mind. And even with the best intentions, flare-ups can still occur.
To keep psoriasis in check and improve your overall health, experts recommend avoiding the following common mistakes.
1. You Delay Seeking Help During a Flare or When Symptoms Worsen
Whether it’s a busy schedule, procrastination, or the hope that psoriasis symptoms will simply go away on their own, it’s common for people to put off seeing a dermatologist when new spots appear, says Lawrence Green, MD, a clinical professor of dermatology at the George Washington University School of Medicine in Washington, DC.
But delaying care often means inflammation has more time to escalate, which can make symptoms harder to control. “The earlier you can treat it, the easier it is to treat — and the less stress it’ll be on your body,” Dr. Green says.
Schedule an appointment with your dermatologist if you see changes in your skin, such as a rash that’s not going away, a rash that’s worsening, or flare-ups that are becoming more frequent, severe, or widespread.
Even if plaques aren’t itchy or bothersome, getting them checked early puts you on the front foot before they get more difficult to manage, Green says.
It also gives your doctor a chance to reassess whether your current treatment plan is still appropriate or needs adjusting.
2. You Don’t Give a New Medication Enough of a Chance — or You’re Reluctant to Try New Therapies
Finding the right psoriasis treatment takes patience — and some trial and error.
While it’s tempting to stop a new medication if you don’t see immediate results, it’s worth the wait to find the right combination of therapies for you, according to Steven Daveluy, MD, a professor and the program director at Wayne State University’s School of Medicine in Detroit, where he specializes in treating patients with skin diseases such as psoriasis and eczema.
That’s because — with the right combination of therapies — psoriasis should be contained to 1 percent of your skin or less. “That’s the size of the palm of your hand, including fingers and thumb. If you have more than that, it’s time to do something to reach that goal,” Dr. Daveluy says.
Different treatments work at different speeds, taking between weeks or even months to show their full effect. But by the three-month mark, the target for a new treatment is a 75 percent improvement or for psoriasis to cover 3 percent or less of your body. By six months, you should hit the 1 percent threshold.
Stick with a treatment for this recommended period — often three months — before making changes, Daveluy says.
3. You Neglect Daily Skin Care
Daily skin care is crucial for managing psoriasis, but it takes time and commitment. And it’s easy to overlook when you’re not battling flare-ups.
But your skin-care routine helps to keep plaques at bay, Green says. “If you’re not moisturizing on a regular basis, especially on dry skin areas like the arms and legs, you’re more likely to get psoriasis there,” he says.
Take a bath or shower for about 5 to 15 minutes a day using warm — not hot — water, then follow up with a fragrance-free moisturizer.
For the winter months, Green recommends using thick, heavy creams or ointments over lighter pump lotions, which can be saved for warmer temperatures.
This applies to your topical prescription medications, too. “Some patients use their topical medications sporadically and wonder why they don’t work. You have to use the medicine as directed in order for it to work,” he says.
4. You Forget to Apply Sunscreen
Severe sunburn can lead to skin injury, which may create new plaques or worsen existing ones. But while sun exposure can trigger short-term problems, it can also lead to long-term skin damage and risk of skin cancer.
When choosing a sunscreen, look for a broad-spectrum formula with SPF 30 or higher, ideally containing zinc oxide or titanium dioxide, which help block harmful UV rays. Sunscreen should not be applied to open wounds or actively inflamed, cracked plaques, as this can cause irritation or stinging.
“It’s always a good habit to get into to maintain the healthiest skin you can,” Dr. Garshick says.
5. You Don’t Take Your Mental Health Seriously
Mental health is an important part of psoriasis treatment, and it’s worth discussing with your doctors, including your dermatologist and primary care provider, if symptoms are affecting your daily life, Daveluy says. While it can feel awkward to bring up, addressing mental health early can lead to better overall care and support.
Daveluy checks in on his patients but suggests patients be proactive. Patients can initiate the conversation by asking, “I heard that psoriasis and mental health can be related. Would it be all right if we discuss my mental health?”
Support extends beyond the doctor’s office, too. There are resources like patient support groups, such as those offered by the National Psoriasis Foundation, Daveluy says. “Talking to someone who truly understands the lived experience of psoriasis is so valuable,” he says.
6. You Rely on Unproven Treatments or Home Remedies Rather Than Medical Treatments
Home remedies and internet “hacks” can be tempting when psoriasis is frustrating or slow to improve, but many of these approaches are unproven and may do more harm than good.
Green has also dissuaded his patients from trying things like applying apple cider vinegar to plaques. “As a physician, we give things that we know work,” he says. “We want things that the [U.S. Food and Drug Administration] FDA approves or we know there’s scientifically sound evidence that it works.”
7. You Focus Only on Psoriasis Control and Neglect Overall Health
It’s easy to focus all your attention on managing psoriasis itself, especially if you’re seeing a dermatologist frequently. But this can sometimes lead people to overlook other important aspects of their health, such as regular primary care visits or recommended screenings.
“It’s very important that everyone with psoriasis has a primary care provider to help detect and manage any of these other problems,” Daveluy says. If you’re at an increased risk of skin cancer because of medications or phototherapy, make sure you’re getting your skin and moles checked regularly, too, Garshick says.
Don’t look at psoriasis in a silo, and take account of your overall physical and mental health, Daveluy says. “Diet, exercise, mental health, and psoriasis are all connected, so it’s really important that patients are addressing their whole health. It can be intimidating, but you don’t need to change everything at once,” he says.
8. You Don’t Follow a Healthy Diet
If you’re not paying attention to what’s on your dinner plate, you may be making psoriasis harder to manage.
Nutrition plays a real role in inflammation, weight, and overall health — all of which can influence symptom severity and how well treatments work, according to Caylee Clay, RDN, a registered dietitian-nutritionist in Brooklyn, New York, who has psoriasis and specializes in helping clients manage autoimmune diseases.
Diet also affects psoriasis patients’ risk of developing comorbidities like heart disease and diabetes, Clay says.
Despite this, researchers say that many people with psoriasis have “imbalanced” diets, leaning toward carbohydrates, sugar, and fried foods, that can fuel inflammation.
An anti-inflammatory eating pattern, such as the Mediterranean diet, is a strong place to start when making changes to your eating habits. Clay suggests taking elements from the diet that work for you, such as a focus on fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil, while limiting ultra-processed foods, excess sugar, and alcohol.
9. You’re Still Smoking and Drinking Alcohol
Smoking or having a glass of wine may feel like a way to de-stress during a flare, but these habits can make psoriasis worse.
“Unfortunately, smoking and alcohol are linked to more severe psoriasis, poorer treatment response, and higher risk of comorbidities like heart disease. Both smoking and alcohol increase inflammation plus add toxins to our system that strain our organs and immune system,” Clay warns.
Cutting back or quitting isn’t easy — Clay suggests turning to healthier ways to unwind, such as journaling, going on walks, seeing a therapist, or exploring your religion or faith.
The Takeaway
- Effective psoriasis management involves regular consultation with your healthcare providers, especially during flare-ups, to adjust any treatment plans as necessary.
- Commit to daily skin care and consistently use prescribed topical treatments to keep psoriasis under control, even if symptoms aren’t currently present. While treatment for psoriasis may involve some trial and error, it’s important to give medical therapies time to work.
- If psoriasis is taking a toll on your emotional health, don’t hesitate to tell your doctor and seek help from mental health professionals or peer support groups.
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