How to Manage Psoriasis Flares Through Winter

Some people dislike winter for the cold temperatures, gloomy skies, and snowy roads. But if you have psoriasis, you may experience more psoriasis flare-ups compared to the warmer weather. 

If cold, dry weather is a trigger for your skin, you’re not alone. In a 2021 study, 53% of psoriasis patients surveyed said their symptoms worsened in fall and winter. However, as frustrating (and painful) as a seasonal psoriasis flare-up can be, Rachel Day, MD, Lead Dermatologist at Zest, says there are proven methods you can use to manage. 

These include adjusting your self-care habits, medications, and lifestyle factors. With the right combination of strategies, you can minimize the impact winter has on your skin.

Why does psoriasis flare in winter?

You know winter triggers psoriasis, but why? “Less sunlight is probably the biggest psoriasis cause in winter,” Dr. Day explains. The days are shorter and most people spend less time outside. 

According to research, the sun’s UV rays help control the immune system and suppress the rapid skin cell growth that leads to plaque psoriasis. 

“The next biggest trigger is a decrease in humidity, with the dry outdoor air and dry indoor heating.” Dry air damages your skin barrier—the outer layer of skin intended to retain moisture and protect you from outside irritants—leading to a lack of moisture and increased irritation. 

Dr. Day says other possible reasons that winter worsens psoriasis include heavier clothing, more stress, and the greater excess of food and alcohol common amidst the holiday season. 

To narrow down what’s triggering your flare-ups, try keeping a psoriasis journal. Jot down your symptoms alongside any notable factors like stress levels, what you’re eating, and how much you’re drinking. 

This can help you identify patterns and know if you should be targeting factors outside of just the weather.

Top tips for managing winter psoriasis flares

When cold weather comes around, your care routine will likely look different than it does in summer or spring. 

And if you know that the winter season is likely to trigger psoriasis symptoms, keep in mind, “You can start pre-treating. You don’t have to wait until it’s there,” Dr. Day says. Be proactive using some of the following strategies, but keep in mind there’s no universally best psoriasis treatment—it’s all about finding what works for you. 

Focus on psoriasis self-care 

As you establish a solid self-care routine, it’s essential to make a plan you can stick to. 

For example, don’t like the greasy feeling an ointment leaves behind? Don’t pick an ointment for your daily moisturizer. These are Dr. Day’s top tips:

1. Moisturize, moisturize, moisturize. Dr. Day explains that the most important thing is to ensure you’re putting moisture back into the skin. “This would be a good time to switch from a lotion or gel to a cream or ointment,” which are more heavy-duty and work harder to lock in moisture.
2. Ditch liquid soap. The problem with liquid soap is that it has to get on your body somehow, typically with a loofah or washcloth. However, the friction that causes on your skin can further damage the skin barrier. Go for a gentle bar soap instead.
3. Keep your showers short. When the weather is cold, it’s tempting to take long, hot showers, but this can dry out your skin even more. To help your skin retain as much moisture as possible, keep showers short and comfortably warm but not hot.
4. Use gentle, fragrance-free skincare products. You might be doing this anyway, but if you’ve become lax in what products you put on your skin, now’s the time to double down on choosing gentle, unscented soaps and moisturizers. 
5. Be mindful of your clothing choices. You’re going to wear warmer clothes in the winter, but make sure they’re still breathable and comfortable. Don’t wear clothes that make you itchy or sweaty.

Medical treatments

During the spring and summer, it’s possible that you can manage your symptoms through self-care, lifestyle factors, and sunlight exposure without the help of medication. “It’s not uncommon to have periods where pharmaceuticals are necessary and periods where they aren’t,” Dr. Day explains. 

If you need them to combat the cold weather, these are some common prescription and over-the-counter (OTC) drugs effective for psoriasis: 

1. Topical treatments include prescription creams and ointments and tend to be the first line of defense against mild to moderate psoriasis. Mild topical treatments can be found over-the-counter, but for stronger doses of these drugs, you’ll need a prescription.

• Corticosteroids are anti-inflammatory drugs that help reduce itching, redness, and swelling. 
• Vitamin D analogues slow down the growth of skin cells, correcting the hyperactive skin cell turnover that characterizes psoriasis.
• Coal tar, strange as it may sound, is a treatment that has been prescribed by dermatologists for over a century to effectively reduce scaling and itchiness. 

2. Phototherapy, or light therapy, mimics sunlight and exposes your skin to ultraviolet light under the guidance of a doctor. It’s often recommended for people with moderate to severe psoriasis, especially during the winter months. 

• UVB therapy uses a specific wavelength of light (found in sunlight) that slows skin cell growth.
• PUVA therapy is used more rarely and combines a medication called psoralen with UVA therapy, making the skin more responsive to light. 

Light therapy is usually done in a clinical setting, but with the right equipment, it’s possible to do it at home. Watch this video from The American Academy of Dermatology before trying it yourself.

3. Oral or injectable medications are often utilized when topical treatments or phototherapy don’t provide enough relief, often in the case of moderate to severe psoriasis. 

• Methotrexate reduces skin cell production. 
• Sotyku is an oral medication that interrupts and inhibits the process of inflammation,
• Otezla is another oral medication that works to reduce inflammation.
• Biologics are injectables that target specific parts of the immune system, like proteins involved in inflammation. Common biologics include adalimumab and etanercept.

Ready for a prescription that works? Contact Zest for a next-day appointment to adjust your treatment plan.

Modify lifestyle factors

A variety of small lifestyle changes, particularly ones that support your overall health and minimize stress, can make a big difference. 

Here are the top lifestyle factors to pay attention to:

1. Manage stress. Stress is one of the most common psoriasis triggers, and as Dr. Day noted, higher stress levels are especially common during the winter holiday season. Prioritize doing things that relax you, say no to extra obligations or responsibilities when you can, and set healthy boundaries with friends, family, and work.
2. Reduce alcohol intake. Research shows that alcohol can lead to skin inflammation for anyone, meaning those who already have an inflammatory skin condition like psoriasis could be at extra risk. 
3. Eat a balanced diet. There isn’t a one-size-fits-all diet for psoriasis, but many people find relief from eating a wide variety of anti-inflammatory foods, like fruits, vegetables, and Omega-3-rich fish. 
4. Exercise. As you know, exercise is good for your overall health, and importantly, it can be a major factor in reducing stress. Research has also shown that exercise can be effective in reducing psoriasis symptoms specifically.
5. Get enough sleep. Sleep gives our bodies and brains time to recharge. When you get enough sleep, your immune system is better equipped to fight off infections or flares, and you’re better able to manage stress, too.
6. Take care of your mental health. If your stress or mood feels consistently unmanageable and hinders your functioning, it might be time to talk with a mental health professional. One mental health condition to be particularly aware of in winter is seasonal affective disorder (SAD). Look through this post from the National Institute of Mental Health to learn the signs.

Will winter psoriasis ever go away?

It’s natural to wonder, will my psoriasis be triggered by winter forever? 

The answer is, not necessarily. According to Dr. Day, things can change over time. “Our immune system is learning constantly throughout our lifetime, and so there are different points at which it can be ‘educated’ on new allergens or irritants.” She notes that certain events, like pregnancy, viruses, or infections, can change your body and increase the likelihood that you’ll develop new triggers or prior ones will go away. 

How can I get help for managing winter psoriasis?

Getting help from a trusted dermatologist when you need it can be a challenge. 

Costs may be high and wait times long. At Zest, we offer next-day appointments and personalized treatment so you don’t have to suffer through a winter flare-up (or any flare-up) alone. 

Zest dermatologists take a holistic approach, including a combination of self-care practices, medications, and lifestyle modifications, to help you find maximum relief and take your life back from psoriasis. 

‍Reach out now for personalized psoriasis treatment, next-day appointments, and 24/7 messaging support.