Managing psoriasis means much more than applying a cream to your skin. Psoriasis treatments aren’t just about the skin. The condition can also affect your immune system, your joints, and your mental and emotional health.

Treating psoriasis often involves a holistic approach. This can include medications, dietary changes, skin care regimens, and stress management techniques.

Medications

Medications are an important part of your psoriasis management. Take some time to familiarize yourself with the available treatment options so you have an idea of what to expect when you visit your doctor.

Your doctor or dermatologist will typically start with a topical or light therapy treatment. They will then progress to systemic medications if the initial treatments are unsuccessful.

For mild to moderate psoriasis, treatment options include:

  • vitamin D creams, like calcipotriene (Dovonex)
  • steroid creams
  • topical retinoids
  • calcineurin inhibitors, such as tacrolimus (Prograf)
  • coal tar
  • medicated shampoos
  • light therapy

For moderate to severe psoriasis, options include:

  • oral medications, such as methotrexate, cyclosporine, or apremilast (Otezla)
  • biologics, like adalimumab (Humira) and secukinumab (Cosentyx)

Your doctor may also want to rotate through some therapies or try a few in combination.

Diet

There’s no conclusive research to support dietary modifications for treating psoriasis. But many people find that these dietary changes are helpful:

  • eating more vegetables
  • cutting out sugar and processed foods
  • reducing saturated fats
  • increasing intake of lean proteins that contain omega-3 fatty acids, like salmon
  • including plant sources of omega-3 fatty acids like flax seed, soy, and walnuts
  • avoiding dairy and alcohol

Vitamins and supplements

Many people with psoriasis find that their symptoms improve after adding the following vitamins or supplements to their diet:

  • fish oil supplements
  • oral vitamin D supplements
  • probiotics
  • glucosamine
  • chondroitin

Keep in mind that the U.S. Food and Drug Administration doesn’t regulate the safety and effectiveness of dietary supplements. Speak to your doctor before you try a supplement.

Skin care

Skin care routines are essential for managing and preventing a flare-up. There are many techniques to keep your skin moisturized that can also help relieve some of your itchiness or irritation.

A skin care routine for psoriasis can include:

  • moisturizing with heavy creams and ointments, especially right after bathing
  • daily lukewarm baths
  • bathing in Dead Sea salts
  • a colloidal oatmeal bath
  • scale-softening (keratolytic) products
  • over-the-counter (OTC) lotions containing salicylic acid, lactic acid, or phenol
  • cold showers
  • OTC itch creams like calamine lotion or hydrocortisone

In addition, you’ll want to avoid creams, soaps, and other products with fragrance or alcohol. Also try wearing light, soft clothing to prevent irritation.

Mental health

Taking care of your mind is just as important as taking care of your skin. Stress is a very common trigger for anyone with psoriasis. Like other chronic illnesses, psoriasis treatment and appearance can increase stress. It can also lead to depression and other mental health disorders. In fact, researchers have recently learned that people with psoriasis experience higher rates of depression.

A support group, such as the National Psoriasis Foundation (NPF)’s Psoriasis One to One community or the TalkPsoriasis online forum, is a great way to meet others who understand what you’re going through. Your doctor can also recommend a therapist or counselor who specializes in helping people with psoriasis.

Stress management is also incredibly important for your mental health. Seek out different ways to reduce stress, such as:

  • meditation
  • hypnosis
  • counseling or therapy
  • deep breathing exercises
  • writing in a journal
  • exercising
  • nature hikes
  • aromatherapy
  • yoga

In some cases, prescription antidepressant medications may be necessary to help you manage your depression.

Alcohol and smoking

Smoking tobacco and drinking alcohol can increase your risk of psoriasis. They can also increase the severity of your symptoms. Drinking large amounts of alcohol can trigger a flare-up and also reduce the effectiveness of your medications.

To manage your psoriasis, quit smoking and consider cutting alcoholic beverages completely out of your diet.

Weight

If you’re overweight or obese, losing weight could be the key to managing your symptoms. Obesity not only increases a person’s risk of having psoriasis, but can also make the symptoms worse.

Some ways to achieve a healthy weight include:

  • including more whole foods into your diet, such as fruits and vegetables
  • increasing your fiber intake
  • eating lean meats and other healthy proteins
  • eating less sugar and highly processed foods
  • exercising daily
  • meeting with a nutritionist or dietitian

The bottom line

The right approach, medication, and some lifestyle changes can help put psoriasis into remission.

As you work with your doctor to find a medication that helps relieve your symptoms, make sure to take care of your mental and emotional health, practice good skin care habits, and eat a healthy diet.