Did you know that 1 out of 4 people with skin condition psoriasis develop arthritis? Dealing with skin and joint conditions can be troublesome and frustrating if it affects your daily activities. However, with the right treatment and coping strategies, you can manage its symptoms well and improve your quality of life. Learn about the management and coping strategies of psoriasis and arthritis in this article. If you notice changes in the appearance of your skin, you can consult the best dermatologist in East New York. Please contact Doral Health and Wellness Dermatology Center.

Management

Psoriatic arthritis management is tricky because this disease affects both the skin and joints. Its treatment includes a combination of medication and therapies like exercise, massage, heat, and cold. The treatment depends on several factors, including:

• How severe the symptoms are
• How to decrease the progression of the disease or put it into remission
• Protect the skin and joints that are affected.
• How these symptoms impact your daily activities.

Usually, treatment is given based on any of these options or their combinations:

Medications

Different medications are used to manage psoriatic arthritis symptoms. Here are some of the following:

1. Non-steroidal anti-inflammatory drugs:

These are the most common drugs to reduce mild arthritis symptoms. This can reduce inflammation, pain, and stiffness by preventing your immune system from releasing chemicals that cause inflammation. However, NSAIDs don’t work well at first for some people or become less effective after a few weeks. If this happens, you ask your doctor to prescribe a different NSAID. There are at least 20 different NSAIDs available. The most common ones are:

• Aspirin
• Ibuprofen
• Naproxen
• Etoricoxib
• Etodolac

Like all drugs, NSAIDs also cause side effects too. That’s why doctors may prescribe the lowest effective dose for the shortest time. Its side effects include upset stomach, indigestion, and damage to the stomach lining. To overcome these side effects, your doctor may prescribe you a drug called a proton pump inhibitor (PPI), such as omeprazole or lansoprazole, to protect your stomach.

Besides side effects, you should avoid NSAIDs if you have:

• Stomach ulcers or bleeding in the digestive system
• Kidney or liver disease
• Gastroesophageal reflux disease
• Crohn’s disease or ulcerative colitis
• Uncontrollable diabetes
• High blood pressure that is difficult to manage
• Heart failure
• Bleeding disorders
• History of heart attack or stroke
• Pregnancy
• You’re 65 or older
• You have asthma that gets worse when you take aspirin
• You drink alcohol excessively every day.

2. Biologics:

These medications are also known as biologic response modifiers, which is a newer class of DMARD medication that is prescribed for people with severe psoriasis arthritis (PsA). Usually, doctors recommend tumor necrosis factor (TNF) inhibitors as the first medication for active PsA. TNF inhibitors include:

• Adalimumab
• Etanercept
• Infliximab
• Golimumab
• Certolizumab pegol

If your disease is very severe or does not respond to one or more TNF inhibitors, then your doctor may try a biologic that blocks interleukin-17 or interleukins 12 and 23, Secukinumab, Guselkumab, Risankizumab, Ustekinumab, or Ixekizumab. For some people, these are more effective for skin symptoms while for others it works well for joints. Only one biologic will be prescribed at a time because it can increase the risk of infections.

3. Steroid injections:

These injections are given into the joint to lower the pain and swelling, however, their effects wear off after a few months. Even taking too many steroid injections into the same joint can cause some damage to the surrounding area. That’s why doctors usually don’t recommend more than 3 injections a year. While these injections are helpful, they can increase the risk of psoriasis getting worse when their effects wear off. If you use them for long-term it can even cause some serious side effects such as:

• Increased appetite and weight gain
• Easily get bruised
• Muscle weakness
• Increased risk of infection
• Acne
• Osteoporosis
• Increase the risk of diabetes or worsen if you already have diabetes.
• Increase the risk of high blood pressure or worsen if you already have it.
• Difficulty sleeping.

That’s why your doctor only prescribes them when you actually need them, for instance, you are experiencing a lot of joint pain and swelling. When they prescribe them, they give the lowest dose that makes you feel better, and its effect wears off sooner.

4. Disease-modifying anti-rheumatic drugs (DMARDs):

If your PsA symptoms are not severe, but mild to moderate or don’t respond well to NSAIDs, then your doctor may prescribe you a disease-modifying antirheumatic drug (DMARD). This medication is the best choice for rheumatoid arthritis; however, it is also used to treat many other autoimmune conditions like psoriatic arthritis and multiple sclerosis. This makes your immune system stop attacking your tissues. They do this in different ways – by stopping the path of your immune system or targeting specific proteins in your immune system, which either slows or stops your pain, swelling, and joint and tissue damage.

This medicine has 2 different types – traditional DMARDs and biologics. Traditional DMARDs are older versions of medicines that block a specific pathway of your immune system. Your doctor may prescribe this one first because these are cheaper and come in pill form, whereas biologics are expensive and usually given in the form of injection into a vein. Your doctor may prescribe DMARDs in combination with NSAID or a low-dose steroid drug such as prednisone or cortisone. These medications should not be given to people with tuberculosis and hepatitis B and C patients because they can reactivate these infections. When you take them regularly, you should check your blood tests to ensure they don’t harm your kidneys and liver.

5. Topical treatments:

To treat psoriasis, the doctor may prescribe several ointments, creams, and gels, including:

• Ointments that are derived from a medicine called dithranol.
• Steroid-based creams and lotions
• Vitamin D-based ointments such as calcipotriol and tacalcitol.
• Vitamin A-based creams and gels such as tazarotene
• Salicylic acid
• Tar-based ointments

If these creams and ointments don’t work, your doctor may suggest light therapy, which involves being exposed to strong ultraviolet light in the hospital. Once this treatment starts, you need to take it regularly and follow all the appointments to get the best results. This treatment is not a good option for people at high risk of skin cancer or for children. In some people, it can make their psoriasis worse. Some DMARDs that are used for PsA can be helpful with psoriasis.

Therapies

Physical therapies are an important part of treating PsA because they help you stay active, relieve pain and stiffness, boost energy and mood, and improve overall health and function. The ideal physical therapy includes a mix of aerobic exercises, strength training, and stretching.

For low-impact aerobic exercises, you can try walking, swimming, and biking because it doesn’t put too much load on sore joints. Just avoid the pool during flares up because chlorine in the pool can irritate your skin. Yoga, and tai chi combined with deep breathing can allow you to relax with fitness. Your physical therapist will teach you exercises and techniques that improve your strength and joint range of motion. The program your physical therapist makes will maximize your mobility without causing pain. It also makes your daily activities easier and less painful.

Coping and support

Besides PsA treatment, you can follow several tips to relieve your symptoms and lower the impact of PsA symptoms on your life. It includes:

• Stop smoking: Quit smoking can not only protect your lungs and heart but also improve your joint and skin symptoms. Smoking can boost the progression and reduce the effectiveness of PsA treatments. You can seek help from your doctor to get quit-smoking aids like nicotine replacement therapy and counseling.
• Relieve stress: Stress can impact your immune system in different ways that could trigger more disease flares and worsen PsA pain. You can relieve stress with exercise and relaxation techniques like deep breathing, meditation, guided imagery, and massage. If you can’t handle your stress on your own, consider seeing a therapist or mental health professional.
• Eat well: There’s no specific diet for psoriatic arthritis, but some foods may help to lower inflammation like fatty fish, nuts, and olive oil, which are good for your joints and cardiovascular health. You can add in lean protein, fruits and veggies, and whole grains for well-balanced nutrition. Avoid foods that can lead to inflammation like red meats or highly processed foods and sugars.
• Take it easy: While exercise is important, you should not strain or injure your joints or trigger a flare. When you’re in pain, take a break and allow your joints to rest. You can start your activity again once the pain is better.
• Lose weight: Excess body fat increases inflammation and strains your joints. Follow a healthy diet and exercise program that helps you reduce your weight. Even losing just 10% of your weight can significantly improve your treatment response.

Dealing with psoriasis and arthritis can be very troublesome in everyday life. However, you can manage psoriasis arthritis by taking treatment and therapies as prescribed. Along with treatment, lifestyle changes like eating well, relieving stress, quitting smoking, taking it easy, and losing weight can improve your symptoms and quality of life.

If you need help with psoriasis, visit our dermatology clinic in Brooklyn to get the best skin care treatment you deserve. Call us to book your appointment now!!!!

At Doral Health and Wellness Dermatology Center, we have the best dermatologists that can help you take care of your skin. As dermatology experts in East New York, we provide the best services. You can visit us at 1797 Pitkin Avenue, Brooklyn, New York to schedule an appointment. You can also call us at 1-347-384-5690 or visit our website at https://www.bestbrooklyndermatologist.com.