Psoriasis Q&As
Published by Bupa's health information team, September 2008.
Answers to questions about psoriasis
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Why does my psoriasis seem to be affected by the weather?
- Can I go swimming if I have psoriasis?
- Is there anything I need to do to prepare before having PUVA treatment?
- How long will I have to wait after taking psoriasis treatment until I can try for a baby?
- Why do I need to have check-ups while taking medicines for psoriasis?
Why does my psoriasis seem to be affected by the weather?
Sunlight, humidity of the air and temperature can all have an effect on psoriasis.
Explanation
For many people with psoriasis, their condition seems to get worse in the winter. However, some people get more flare-ups in the summer, while others aren't affected by the weather at all.
In the summer, most people have a greater exposure to natural sunlight, which can often help with psoriasis. When it is humid (there is more moisture in the air), your skin is less likely to dry out, which can also help psoriasis. In the winter however, a combination of dry air, decreased exposure to sunlight and colder temperatures can all contribute to psoriasis getting worse.
For a small number of people, exposure to sunlight seems to worsen their psoriasis - these people may, therefore, be more likely to get flare-ups in the summer.
Sources
- Frequently asked questions. National Psoriasis Foundation. www.psoriasis.org, accessed 12 June 2008
Can I go swimming if I have psoriasis?
Yes. It is common to feel reluctant to go swimming if you have psoriasis. However there is no reason why you can't swim because of psoriasis. It isn't contagious.
Explanation
Many people find that swimming in a pool or using a hot tub can help their psoriasis, although some people may find lengthy bathing can increase itching and irritation.
The chlorine in a swimming pool may also dry out your skin, so it is a good idea to shower as soon as possible after being in a swimming pool with chlorine-removing shampoos and soap. You should also apply moisturiser after swimming.
Swimming in the sea is widely recognised to be beneficial to many people with psoriasis. This is probably mainly due to the associated exposure to sunlight.
Sources
- Frequently asked questions. National Psoriasis Foundation. www.psoriasis.org, accessed 12 June 2008
Is there anything I need to do to prepare before having PUVA treatment?
There are certain precautions you must take when having PUVA treatment, to make sure that nothing interferes with your treatment. Your doctor will advise you of these before you start a course of therapy.
Explanation
You may be advised to take the following precautions when you have a course of PUVA treatment.
- Don't expose your skin to sun during the treatment course, by wearing suitable clothing to protect your skin - and don't sunbathe or use sunbeds.
- Don't use any topical preparations that may block UV light, such as topical steroids and vitamin creams. Check with your nurse or doctor if you aren't sure.
- Don't use fragranced products on treatment days, including perfumes and aftershaves, as they can occasionally cause the skin to become more sensitive to light treatment.
- Tell your doctor of any other medicines you are taking, as some medicines may make your skin more sensitive to light.
- Certain vegetables, fruits and plants, such as celery, figs and limes, may cause sensitivity to UVA so don't handle them before treatment. Eating these foods can also occasionally make your skin more sensitive to the light used in PUVA, although this is unlikely.
- Use effective contraception as it is important that you don't become pregnant while receiving PUVA therapy.
- Wear sunglasses that have protection against UVA light whenever you go outside for 24 hours after treatment. UVA can also pass through your car and house windows, and is emitted from fluorescent lights, so you will also need protection in these settings.
- You should also make sure that you expose the same area of skin to the light therapy every time you have treatment - if you wearing clothes that block a certain area, make sure you wear the same piece of clothing every time you go for treatment. You should also wear the same jewellery and not cut your hair during the treatment course.
Sources
- Treatments for moderate or severe psoriasis. British Association of Dermatologists. www.bad.org.uk, accessed 4 June 2008
How long will I have to wait after taking psoriasis treatment until I can try for a baby?
Some medicines for psoriasis are harmful to an unborn baby. Some of these can stay in your system for some time after you stop taking the medicine, so you will need to take your doctor's advice on when it is safe to start trying for a baby.
Explanation
The following medicines for pustular psoriasis may cause harm to an unborn baby. Some may also affect a man's sperm, so men will be advised not to get their partner pregnant.
- Acitretin - this can cause severe birth defects. You must avoid getting pregnant while taking this drug and for two years after stopping treatment.
- Methotrexate. You must not become pregnant or get your partner pregnant while on methotrexate, and for at least three months afterwards.
- Hydroxycarbamide. You shouldn't get pregnant or get your partner pregnant while taking hydroxycarbamide, and for two months afterwards.
- Ciclosporin can potentially interfere with the growth of an unborn baby, so it is not recommended to take this drug if you are pregnant or intend to try for a baby. However, it is not thought to cause severe birth defects, like the medicines listed above, so your doctor may prescribe this medicine if there is no alternative.
- Psoralen and ultraviolet A light treatment (PUVA) is not usually used during pregnancy.
You should discuss your contraception with your GP or family planning doctor, to check that you are using an effective method.
Sources
- Guidelines for the general management of psoriasis. British Association of Dermatologists. www.bad.org.uk, accessed 29 May 2008
- Treatments for moderate or severe psoriasis. British Association of Dermatologists. www.bad.org.uk, accessed 4 June 2008
Why do I need to have check-ups while taking medicines for psoriasis?
All of the medicines used to treat psoriasis have the potential to cause side effects, some of them quite serious. For this reason, it is important that you attend regular check-ups at your hospital, so your doctor can monitor your treatment.
Explanation
You will need to have regular check-ups with the following medicines for psoriasis.
- Methotrexate can interfere with your production of blood cells, which can lead to conditions such as anaemia. Methotrexate can also cause liver damage over the long-term. You will have regular blood tests to monitor your blood count (how many blood cells you produce) and check how well your liver is functioning.
- Ciclosporin can cause damage to your kidneys and high blood pressure over the long-term. You will have regular blood pressure checks, and blood and urine tests to check your kidney function.
- Hyrdroxycarbamide can interfere with your production of blood cells - you will have regular blood tests to check your blood count.
- Acitretin can cause liver damage, and changes to your blood lipids. Rarely, problems with bone growth have also been recorded. You should tell your doctor about any new joint or back pain.
You will usually need to have weekly check-ups when you first start treatment. These may become less frequent as your psoriasis settles down.
Sources
- Treatments for moderate or severe psoriasis. British Association of Dermatologists. www.bad.org.uk, accessed 4 June 2008
- Systemics. The Psoriasis Association. www.psoriasis-association.org.uk, accessed 11 June 2008
- Joint Formulary Committee, British National Formulary. 54 ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2007: 603-610
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: September 2008
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