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Summer and psoriasis: Control your skin rash and soak up the sun

eczema skin on neck

Summer is approaching and most people are thinking of ways to devote as much of their busy schedules as possible to soaking up the summer sun. However, if you’re one of the 2.5% of Australians who experience psoriasis, you are more likely to be strategising how to get through the summer without wearing shorts, t-shirts and other clothes which expose your red, scaly skin. Psoriasis can be embarrassing at any time of year, but the psychological impact is greater in summer, when people with the condition have to choose between soaking up the sun and swimming at the beach, or covering up their skin rash to avoid humiliation. Yet these activities are not just important for summer fun, they are also good ways to treat psoriasis; exposure to summer sun and salt water reduces the skin rash caused by psoriasis. If you suffer from the condition, get your rash under control before summer begins and find the confidence to expose your skin. You’ll not only enjoy the sun and surf, you will be treating your psoriasis at the same time.   For more information about psoriasis including types, treatments and more, see Psoriasis.  

Recognising psoriatic skin

The key symptom of psoriasis is a red, scaly skin rash. The rash may occur at any site although the elbows, knees, scalp and trunk are most commonly affected. The proportion of body surface area affected depends on the severity of disease. While the majority (80%) of people with psoriasis have mild disease which affects < 2% of their body surface area, a substantial minority (20%) have extensive rash. Many people also experience physical symptoms associated with psoriasis including itching and burning sensations. However, according to Dr Rodney Sinclair, a Professor of Dermatology at Melbourne University and consultant Dermatologist at the Epworth Specialist Centre, “the biggest issue for people with psoriasis is a feeling of embarrassment,” about the appearance of their skin.

Why psoriasis presentations increase in summertime

Summer weather and clothing which exposes the skin go together. People with psoriasis who have hidden their skin lesions with clothing in the cooler seasons may therefore be more likely to seek treatment in the summer months. Professor Sinclair noted that, “people with psoriasis commonly seek treatment in summer when they want to expose their skin regularly… so that they can begin treatment, get the condition under control and then get out and enjoy the season.”

Although UV exposure is a treatment option for the condition and psoriatic skin rash is more likely to improve without treatment in summer, the need to expose more skin to cope with warmer conditions means that the psychological impact of psoriasis may be greater at this time. When “there is a desire to wear summer clothing … People with psoriasis often find themselves in situations where, due to embarrassment, they have to exclude themselves from activities.  For instance, they may avoid going to the beach for a swim because they don’t want to be in a situation where removing clothing is required,” said Professor Sinclair.

A large proportion of people with psoriasis report feeling embarrassed to participate in swimming and other sports due to their skin rash. About two-thirds (64%) report avoiding short sleeved shirts, summers dresses and shorts in an attempt to hide their condition. However, wearing long pants, skirts or sleeves which are inappropriate for the summer weather can also draw unwanted attention.

Summer fun is a great prevention strategy

Getting out and enjoying the summer sun is a useful strategy for preventing psoriasis. “Sunlight and salt water help psoriasis,” Professor Sinclair said. Summer recreation is also an opportunity to relax, enjoy yourself and get some exercise, all of which are important measures for reducing stress, a key risk factor for psoriasis.

If you’re trying to get your psoriasis under control before summer, make sure you pay attention to reducing stress at work and at home. Depending on your lifestyle and circumstances, resolving personal conflicts and postponing major life changes like moving house might be important. If you find you’re constantly stressed out by work, finding the support and confidence you need to say ‘no’ to too much responsibility at work, and putting aside time for rest and recreation, is important. You might also want to learn techniques such as muscle relaxation and deep breathing to help deal with stress when it occurs.

Another important prevention measure is quitting smoking and you’ll be more likely to quit with a bit of help. Be sure to talk to your doctor and get the support you need.

Getting psoriasis under control

Getting treatment started early is an important measure to ensure your skin rash is under control in time to enjoy the summer. Professor Sinclair notes that the most common form of psoriasis therapy, topical treatments which are rubbed on to the rash, “must be used daily for 6–8 weeks to achieve and maintain benefit.” While topical treatments like creams and gels are safe and effective for many people, those with severe psoriasis usually need to combine topicals with systemic and/or phototherapies, to control their rash effectively.

Instituting treatment well before the start of summer allows time to step up to more aggressive treatments, should topical therapy fail to achieve adequate results. Professor Sinclair believes, “Treatments [need to] match the impact that the disease is having on quality of life.” Thus, in summertime when the psychological impact of psoriasis is increased, more aggressive treatment may be warranted. Recent advances in treatment, including the approval of new biological therapies which target the processes which cause psoriasis rather than treating the skin rash symptoms, provide greater and more effective treatment options.

Psoriasis image

 

For more information about the different treatment options for psoriasis and when they should be used, see Treatment Options for Psoriasis.

 

Soaking up the summer sun without psoriasis

The range of treatments currently available for psoriasis means it is possible to get your skin rash under control before summer, and enjoy the sun and surf. The combination of sun, salt water and recreation all have positive effects on psoriatic skin rash. If you experience psoriasis and need treatment, see your doctor well before the start of summer and before you start feeling embarrassed or stressed about needing to expose your skin. Instead of strategising to avoid exposing your skin, get the support and advice you need to confidently show off your skin and soak up the summer sun.

References

  1. Magin P, Adams J, Heading G, et al. Patients with skin disease and their relationships with their doctors: a qualitative study of patients with acne, psoriasis and eczema. Medical Journal of Australia. 2011; 190: 62-64. [Abstract | Full text]
  2. GriffithsCE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007; 370(9583): 263-71. [Abstract]
  3. Gelfand JM, Neimann AL, Shin DB, et al. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006; 296(14): 1735-41. [Abstract | Full text]
  4. Dediol I, Buljan M, Buljan D, et al. Associations of psoriasis and alcoholism: psychodermatological issues. Psychiatria Danube. 2009; 21(1): 9-13. [Abstract | Full Text]  
  5. Krueger G, Koo J, Lebwohl M, et al. The impact of psoriasis on quality of life: Results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol. 2001; 137(3): 280-4. [Abstract | Full text]
  6. Lassus A, Geiger JM, Nyblom M, et al. Treatment of severe psoriasis with etretin. Br J Dermatol. 1987; 117(3): 333-41.  [Abstract]
  7. Barankin B, DeKoven J. Psychosocial effects of common skin disorders. Can Fam Phys. 2002; 48: 712-8. [Abstract | Full Text]
  8. Ramsey B, O’Reagan M. A survey of the social and psychological effects of psoriasis. Br J Dermatol. 1988; 118(2): 195-201. [Abstract]  
  9. Beyond Blue. Fact Sheet 6: Reducing stress. 2010. [cited 22 September 2012]. Available from: [URL Link]
  10. Chuh A, Wong W, Zawar V. The skin and the mind. Aust Fam Phys. 2006; 35(9): 723-5. [Full Text]
  11. Murphy G, Reich K. In touch with psoriasis: topical treatments and current guidelines. J Eu Acad Dermatol Venereol. 2011; 25(S4): 3-8. [Abstract | Full text]
  12. Herrier RN. Advances in the treatment of moderate-severe psoriasis. Am J Health Sys Pharm. 2011; 68: 795-806. [Abstract]

Dates

Posted On: 26 September, 2012
Modified On: 16 September, 2014

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