Psoriasis Guide 4 Top Tips for managing your psoriasis Tip 1 Exercise If you’re struggling with your psoriasis, exercise might be the last thing on your mind. But exercise isn’t just about getting fit. Exercise has also been shown to help ease stress and depression,1 which can often be associated with the worsening of psoriasis symptoms.2 Here are some tips and hints to help get you started: 1 Ask your doctor 2 Be flexible 3 Start gentle 4 Heart health The kind of exercise which may be best for you will depend on your age and general health – it’s best to speak with your doctor before starting a new exercise regime. 5 Strength and endurance 6 Keep it fun 7 Don’t go it alone! Exercises which help improve flexibility, such as yoga and pilates can be a gentle introduction to getting active. Start with 15 minutes of activity and build up from there. Swimming and walking are great ways to have a gentle work out. Swimming is particularly good if you cannot do any weight-bearing exercise. Introducing aerobic exercises (e.g. continuous exercise for 20 minutes that leaves you slightly out of breath e.g. – cycling, running, swimming, aerobics) to your routine will help improve circulation, strengthen your heart and benefit your lungs. Adding strengthening (e.g. pilates, light weights and resistance exercise) will help build your muscles and increase your stamina. Whatever exercise you choose make sure it’s something you enjoy and look forward to. Once you get into a routine and start to feel the benefits, you’ll find it’s easier to motivate yourself. Exercising with a friend will help motivate you especially if you are not used to exercising regularly. Friends are great at encouraging you and keeping you going when you might not want to! Psoriasis Healthy eating Tip 2 1 Healthy eating is an important part of living well. A balanced diet should provide all of the nutrients you need. Here are some top tips to get you started: Variety and balance!3 Eat a variety of foods, ensuring you get the right amounts of the main food groups (carbohydrates, protein, fruit and vegetables, dairy): Carbohydrates (e.g. bread, pasta, rice, potatoes) should make up about one third of your diet. Try to eat unrefined carbohydrates where possible (such as brown rice and brown bread). Protein (e.g. meat, fish, eggs, pulses, seeds, nuts) needed to help build and repair your body. Try to vary the types of protein you eat. Two servings of fish a week can be beneficial, and alternate between red meat and other proteins. Fruit and vegetables (e.g. banana, apple, kiwi, spinach, broccoli) aim to eat at least 5 portions of fruit and vegetables a day. Dairy (e.g. cheese, yoghurt, soya) good source of calcium, protein, vitamins and minerals. 2 3 4 Interactions 5 Food triggers 6 Eat fresh 7 Extra measures 8 Treat yourself! 9 Rehydrate Watch your weight3 Maintain a healthy weight by controlling food portions and reducing the amount of foods you eat which are high in fat (especially saturated fat) and cholesterol. For example, you can use low-fat spread instead of butter. Keep it low 3 Use salt and sugar in moderation. Choose food with reduced salt content, or no added salt. Many foods contain natural sugars but try to avoid having too much of foods which are high in added sugars such as soft drinks, cakes and biscuits. Some medications may be less effective if you eat certain foods. Your doctor or pharmacist will tell you if this applies to the treatment you are taking and will be able to give you more information. You may notice that certain foods trigger a worsening of symptoms. It’s useful to keep a note of this in a diary, so you can track any affects. Before cutting out foods make sure you speak with your doctor. Try to cut down on processed foods. If you can, it’s great to try to cook meals from scratch at least a couple of times a week. This will allow you to use more fresh ingredients and cut down on the amount of cooking oil used (a good tip is to buy a spray oil so you only use the small amount you need to cook with). Ideally you should try to lower alcohol intake and cut out smoking. If you are struggling with this, your doctor will be able to advise you and offer support. There is evidence to suggest that excessive alcohol consumption can increase the risk of health problems.4 Smoking has also been linked to the increased risk of developing psoriasis.5 It’s fine to have a treat every now and again as long as you generally stick to a healthy diet. Try to drink two litres of water a day. If you are hydrated, it will help your body to function at its best. Psoriasis Tip 3 General skin and nail care Together with your treatment, by making good skin and nail care part of your daily routine, you can help improve your psoriasis and lessen the likelihood of flare-ups caused by drying, or external irritants. Here are a few hints for better skin and nail care: 6 1 Washing hands and feet 2 Gentle cleanse 3 Try to minimise hand washing and do so only when necessary for hygiene. After washing, pat dry thoroughly, especially around nails and apply moisturiser, or medicated cream. There are specialist products which can be bought or prescribed by your doctor called emollients. These are a gentle way to wash and can help avoid scratching or irritating your skin. Drying When drying your skin, pat dry rather than rub. Be careful not to irritate or scratch psoriatic patches. 4 Protect hands 5 Be natural 6 Sun protection 7 Footwear Wear gloves if you are doing housework, gardening or activities which involve contact with irritants. Wear natural fibres, such as cotton and linen next to your skin. This will help minimise irritation, particularly in hot weather. Use a high protection factor sunscreen to protect yourself from sunburn which can damage skin and cause flare-ups. If your feet are affected by psoriasis, keep them clean and dry to prevent bacterial or fungal growth, wear cotton socks and open shoes or sandals where practical. If you are doing strenuous outdoor activity, or exercise, you may want to wear sturdy footwear to protect your feet. 8 Keep it short 9 Loosen up 10 Summer feet Keep the toenails short and smooth to reduce the risk of infections. Do not cut nails too close to the nail bed and cut toenails square to help avoid damage. Wear shoes that are not too tight and give the toes enough room to move. if your toenails are affected, you may want to consider wearing shoes, or sandals by the beach, or pool to help avoid them getting knocked or irritated by chemicals, salt or sand. Also see the Treatment options section. Psoriasis Tip 4 Seasonal skin care7 Your skin may react differently through the changing seasons. We want you to be able to make the most of life all year round, so we’ve included some advice to help you take extra care of your skin and manage your psoriasis, whatever the weather: Spring and summer 1 Moderation! Exposure to sunshine can be beneficial, Autumn and winter Drying times 8 Switching on your heating in cold weather but in moderation! 2 Be sensible in the sun It’s good to enjoy the sun and we need sunlight to help us absorb vitamin D to keep us healthy. When the sun is at its strongest (between 11am and 2pm), as well as using sunscreen, cover-up sensitive areas with suitable clothing i.e. t-shirt, hat. Remember, sunlight can penetrate glass, clouds, water and thin clothing. Even shade can’t provide complete protection. Be aware that some treatments for your psoriasis may increase your sensitively to sunlight. 3 Protect 4 Medication aware 5 can dry out the air in your home and this may affect your psoriasis. You can use a humidifier to add moisture to the air in your home. Everyone can burn, especially those with paler skin. Always use a high protection factor sunscreen and remember to reapply regularly and particularly after swimming. Your doctor or pharmacist can help you find a sunscreen that’s right for you. Be aware if your medication increases sensitivity to light. Your doctor or pharmacist will let you know if this applies to your treatment. 9 Night 10 Hydrate 11 Wrap up 12 Lock in moisture 13 Moisture wash Chemical irritation Chemicals used to clean swimming pools or salt in sea water can irritate or dry out skin. Shower when you leave the water. Pat dry, apply moisturiser and sunscreen. 6 Keep it light 7 Hydrate Wear loose light and comfortable clothing that allows the air to circulate and sweat to evaporate. Keep well hydrated by drinking at least two litres of water a day. References Date of preparation: March 2012 STE pso WEB FEB2012 EMEA 204 Turn heating down or off during the night. Cool air is less drying. If you’re feeling cold at night, wear bed socks and get a warmer duvet. Keep well hydrated by drinking at least two litres of water a day. The wind and cold can blast your skin but it’s good to get out from centrally heated buildings into the bracing air. If skin feels cold or irritated you can wrap up with warm clothing to keep cosy and help prevent winter skin damage. Apply moisturiser while still wet from the bath, leave to soak in for a minute or so and pat dry. Re-apply moisuriser and any medicated treatment throughout the day, as directed by your doctor, or pharmacist. Use moisturising soaps, or shower gels.