When you’re living with psoriasis, you’re at an increased risk of developing psoriatic arthritis (PsA). While there is no proven way to prevent PsA, there are ways to help reduce inflammation and manage your symptoms.
Both psoriasis and PsA are inflammatory conditions caused by an overactive immune response. In psoriasis, this immune response affects your skin. In PsA, it mainly targets your joints.
Psoriasis and PsA are conditions that often occur together. However, not everyone living with psoriasis will develop PsA. In fact, a 2013 study involving 949 people with plaque psoriasis suggests that
There’s no proven way to prevent PsA from developing, but you can take some steps to help reduce inflammation in your body, manage your symptoms, and improve your overall health. These steps are detailed below.
For many people, psoriasis is diagnosed first. However, PsA can be diagnosed before psoriasis. The joint condition can even occur in people who do not have psoriasis.
A standard immune system is designed to protect the body from harmful invaders. In psoriasis and PsA, your immune system activity increases and attacks healthy parts of your body instead.
In psoriasis, this overactive immune response mainly affects the skin, though it can also affect the scalp and nails. In PsA, it mainly targets the joints and associated tendons and ligaments, though it can also affect the eyes or nails. Over time, unmanaged inflammation in the joints can lead to permanent damage.
Some psoriasis treatments that help lower inflammation can also be used to treat PsA. Early detection and treatment are key to managing symptoms and preserving joint function.
If you’re living with psoriasis, several factors may increase your risk of developing PsA. They include:
- receiving a PsA diagnosis early on
- having a more severe case of psoriasis
- having psoriasis that affects the nails or scalp
Other factors can also increase the risk of PsA, such as:
- family history of the condition
- alcohol use
A 2021 study suggests it’s possible to predict the development of PsA in people living with psoriasis. The study screened people who had psoriasis, using ultrasound imaging on specific joints. Based on findings, researchers predicted which individuals would develop PsA, even if they didn’t experience symptoms.
If you’re living with psoriasis, talk with your doctor about regular screening for PsA. Early detection and treatment can help protect your joints. It may be possible to diagnose PsA even before symptoms start to affect your day-to-day life.
Although there’s no proven way to prevent PsA, there are certain steps you can take to help lower inflammation in your body. This can have a direct impact on your skin and joints, as well as your overall health.
Start with these tips.
Maintain a moderate weight
A 2020 study found that having obesity or overweight is associated with an increased risk of PsA in people who have psoriasis. Maintaining a moderate weight can help decrease overall inflammation in the body and take pressure off the joints.
Fat tissue creates proteins that increase inflammation. These proteins are called cytokines, chemokines, and adipokines. These proteins may allow further disease development in PsA.
Additionally, excess fat may affect the effectiveness of biologic medication. For those with overweight or obesity, losing weight can help improve medication effects, reduce inflammation, and improve PsA symptoms.
Eat more fruits and vegetables
Following an anti-inflammatory diet may help lower inflammation in your body. One of the most well-researched anti-inflammatory diet plans is the Mediterranean diet. This way of eating emphasizes incorporating a variety of fruits and vegetables into your diet.
Try these strategies to add more fruits and vegetables into your day:
- Wash and cut up fruits and vegetables ahead of time so they are ready to grab and eat.
- Add extra vegetables to casseroles, soups, stews, and pasta or rice dishes.
- Cut up vegetables into small pieces and add to omelets.
- Bake a batch of carrot, zucchini, apple, or pumpkin muffins.
- Use frozen vegetables for a quick addition to your meal.
Add more healthy fats
- fish and seafood, such as salmon, tuna, and sardines
- nuts and seeds, such as walnuts, chia seeds, and flaxseeds
- plant oils, such as flaxseed oil, soybean oil, and canola oil
- foods fortified with omega-3s, such as eggs, milk, or juice
You might also consider taking an omega-3 supplement. Make sure your supplement contains EPA and DHA. Those are the types of omega-3 that are best for reducing inflammation. Speak with a healthcare professional before taking any supplements.
Olives and olive oil also have anti-inflammatory properties. They’re another major part of the Mediterranean diet. If you enjoy olives, simply eat them on their own or add them to pizza, salads, or sandwiches. You can use olive oil for roasting or sautéing, or for making dressings.
Nut butter and avocados are some other sources of healthy fats to incorporate into your diet.
Consider working with a registered dietitian, if you have access to one, to come up with an anti-inflammatory eating plan tailored to your individual needs.
According to a 2020 research review, studies suggest that exercise may help reduce inflammatory markers in the body. It’s also a great way to boost mood and reduce stress. Building muscle strength can help take some of the pressure off your joints and keep you limber.
Consider adding low impact exercises into your routine. This includes things like:
High impact activities such as running or jumping can put extra stress on your joints.
Consider meeting with a physical therapist if you’re trying to become more active. This type of specialist can work with you to help develop an individual exercise plan targeted to your current fitness level and goals.
Care for your mental health
Living with a chronic condition like psoriasis or PsA can be stressful. Many people who have psoriasis or PsA also find that periods of intense stress can trigger symptoms. Stress can increase inflammation throughout the body and worsen symptoms.
It’s not possible to avoid stress altogether. But it can help to find ways to manage it. Consider trying activities like:
- practicing mindfulness
- doing meditation
- staying social
If you feel you could use more support, consider joining a support group or talking with a therapist.
Avoid physical injury
People living with psoriasis often have flares at the site of a cut or scratch on their skin. This is known as the Koebner or isomorphic phenomenon. A large 2017 study explored whether injuries could increase the risk of PsA.
The study looked at both people living with psoriasis and those without the condition. Researchers found that people with psoriasis who experienced a joint or bone injury were more likely to develop PsA. Nerve and skin injuries were not associated with a greater risk of PsA.
Of course, it’s not always possible to avoid an injury. If you experience any type of injury, follow up with your doctor.
Monitor for nail changes
There’s a strong link between nail changes and the development of PsA. Nail psoriasis is thought to be a more aggressive condition, and people with psoriasis who experience nail changes are more likely to develop PsA than those who do not.
Nail involvement is one of the early signs of PsA, so you’ll want to watch for any changes in your nails. One or more nails can be affected. You may notice changes in fingernails or toenails.
Some of the most common nail changes to look out for are:
- deep grooves
- pulling away from the nail bed
If you notice changes in your nail health, talk with your doctor.
Take medications as directed
Several medications and treatments are available for managing psoriasis. Options like topical ointments and phototherapy can help affected skin from the outside. Other options work by reducing inflammation inside the body.
One class of medication that addresses inflammation is known as disease-modifying antirheumatic drugs (DMARDs). They work to suppress the immune response in your body.
Traditional DMARDs work on a broader level to lower immune system activity. Biologic DMARDs work in a more targeted way to address the overactive immune system.
Both options are also used to treat PsA. Reducing inflammation helps preserve joint function and prevent permanent damage.
For these medications to work as well as they should, you must take them exactly as prescribed. If you’re unsure whether you’re taking your medications correctly, talk with your healthcare team.
If you’re following your treatment plan exactly as directed and still feel that your psoriasis is not well managed, talk with your doctor. There may be a better treatment for you.
Keep in touch with your healthcare team
When you’re living with a chronic condition like psoriasis, it’s important to schedule regular checkups. Your healthcare team may include one or more specialists, such as:
- a primary care doctor, who can monitor your overall health
- a dermatologist, who specializes in treating skin conditions like psoriasis
- a rheumatologist, who specializes, treats, and monitors inflammatory autoimmune conditions like PsA
Monitor for any changes in your health and let your healthcare team know if anything pops up. Diagnosing and treating PsA earlier is important in managing the condition.
Living with psoriasis increases your risk of developing PsA. There’s no guaranteed way to prevent the condition. But taking steps to help reduce inflammation in your body can help manage skin symptoms and prevent joint damage.
Be aware of early signs of PsA. Follow up regularly with your healthcare team so any changes to your health can be diagnosed and treated early.