Psoriasis remission occurs when the symptoms of psoriasis disappear temporarily. There is no cure for psoriasis, so remission is the primary goal of treatment.
Psoriasis develops when the immune system mistakenly attacks the skin cells, causing red, scaly, or painful patches to appear. During remission, the immune system stops these attacks, and the skin has time to heal.
Psoriasis treatments and lifestyle changes can bring about remission, but when and how it occurs is different for everyone. Read on to learn more about achieving and maintaining psoriasis remission.
Cycles of remission and symptom flare-ups
Psoriasis remission may occur as a result of treatment. However, it is difficult to predict how a person's psoriasis will behave over time and how it will respond to treatment.
Some people may experience spontaneous remission, which happens for no apparent reason.
During remission, some people will notice a marked reduction in symptoms, while others may find that their skin becomes completely clear. However, symptoms usually come back at some point, even for those who continue their treatment program.
Psoriasis is an unpredictable condition. The duration of remission can vary from a few weeks to a few months or, in some cases, years.
However, most remission periods last for between 1 month and 1 year.
Several factors can affect the onset and length of a psoriasis remission. For example, some people may have a remission during summer and experience a flare-up during the colder months.
Psoriasis is a chronic, long-term condition, so flares will usually return even after remission. However, certain treatments and lifestyle changes may help people prolong their remission periods.
Experts believe that psoriasis occurs due to a combination of genetic factors and external triggers, but not everyone who inherits one or more of the specific psoriasis-causing genes goes on to develop the skin condition.
Therefore, avoiding triggers may be key to reducing the risk of psoriasis development and the return of symptoms following remission. Triggers vary from person to person, but some of the most common are:
The following medicines may trigger psoriasis flares:
- antimalarial drugs
- propranolol (Inderal), for high blood pressure
- indomethacin (Indocin), a nonsteroidal anti-inflammatory drug
- lithium, for certain psychiatric disorders
- quinidine, a heart medication
Psoriasis often develops on injured areas of skin. Picking or scratching the skin, receiving a bug bite, and severe sunburn can all cause symptoms to appear.
Stress is a potential trigger for many chronic and autoimmune conditions, and psoriasis is no exception. Stress reduction techniques may lessen or even prevent symptoms.
Infections weaken the immune system, and this affects psoriasis in turn. Streptococcus infection, or strep throat, may trigger a type of psoriasis called guttate psoriasis.
Other infections that may cause psoriasis flares include:
Both smoking and heavy alcohol use may cause the onset of psoriasis.
One common psoriasis cycle is for symptoms to improve during the summer and get worse during the winter. Cold weather is a common trigger for psoriasis flares.
Receiving prompt treatment for psoriasis flares may help people re-enter remission or, at least, reduce their symptoms to more manageable levels.
Sometimes, a previously effective treatment stops working, which suggests that it is time to try an alternative. Treatment options include:
Mild-to-moderate psoriasis may improve after using creams or ointments, such as:
- calcineurin inhibitors to stop inflammation and plaque formation
- coal tar for scaling, itching, and inflammation
- corticosteroids to relieve inflammation and itching
- moisturizing creams to reduce itching and dryness
- salicylic acid, which removes dead skin cells and scaly skin
- topical retinoids, which are derivatives of vitamin A that reduce inflammation
- vitamin D analogs, which are synthetic forms of vitamin D
Not all of these medications are suitable for everyone. Some retinoids are unsuitable for use during pregnancy, for example. Many people will require a combination of treatments for effective psoriasis control.
Phototherapy, or light therapy, uses ultraviolet (UV) light to reduce psoriasis symptoms. The extent of the treatment can range from exposure to natural sunlight to receiving controlled doses of artificial UVB rays at a clinic or doctor's office.
People who wish to use light therapy should speak to their doctor about the benefits and potential side effects, which include skin dryness, nausea, and a rash.
Systemic and biologic treatment
People with severe psoriasis may need to use oral or injected medicines, which are systemic treatments. These medications include:
- cyclosporine, which suppresses the immune system
- methotrexate to slow down skin cell formation and reduce inflammation
- oral retinoids or vitamin A derivatives
Systemic treatments can have severe side effects, so people typically use them alongside topical creams or light therapy and only take them for short periods.
Biologics aim to reduce the impact of psoriasis by targeting a specific part of the immune system. They can help prevent flares and relieve symptoms, and they are part of a long-term treatment plan.
Lifestyle changes and home remedies
The most important lifestyle change that people with psoriasis can make is to avoid triggers, which might include cold weather, stress, or smoking.
People may also wish to try the following home remedies. While they will not cure psoriasis, they may reduce itching, dryness, and other types of discomfort:
- applying aloe vera gel to reduce redness and itching
- avoiding alcohol and tobacco
- bathing in colloidal oatmeal or Epsom salts
- taking omega-3 supplements to treat inflammation
- using moisturizer every day, especially during the winter months, to treat dry skin
Psoriasis tends to occur in waves of flares and remission. Although psoriasis is a lifelong condition, people can reduce the duration and severity of flares using treatments and lifestyle changes.
People with psoriasis are likely to have the best chance of achieving remission if they avoid triggers and discuss treatment options with a doctor. Many different treatments are available for psoriasis, and a person may need to try several before they find what works best for them.
Even when psoriasis symptoms return, people can use home remedies and topical ointments to minimize their appearance and the discomfort that they cause.