Your psoriasis and psoriatic arthritis is under control–now what?

By Emily Delzell

Your psoriasis and psoriatic arthritis is under control–now what?Greater–and more effective–treatment options mean greater numbers of people with psoriasis and psoriatic arthritis who have clear skin and pain-free joints.

Although the inflammation that is the hallmark of these conditions may be "quiet," the underlying disease remains, and maintaining your "clear" or "pain-free" status is a priority, said Benjamin D. Ehst, M.D., assistant professor of dermatology at Oregon Health & Science University in Portland and co-director of its Center of Excellence for Psoriasis and Psoriatic Arthritis.

There's a lot you can do to maximize your health, say Ehst and other experts.

Don't stop therapy. But do discuss with your dermatologist the potential for stepping down your regimen, which may include fewer trips to the light box or lowering doses of some medications. You may need to continue on biologics for the long run, however.

"Some biologics may not be as effective if you stop and start them," said Charles E. Crutchfield III, M.D., a dermatologist in private practice in Eagan, Minn. "With psoriatic arthritis, which can be both progressive and debilitating, it's particularly important to continue treatment to keep inflammation under control."

Prioritize prevention. "Obesity, hypertension, diabetes and cardiovascular disease are more common in people with psoriasis," said Joseph F. Merola, M.D., a dermatologist and rheumatologist at Brigham and Women's Hospital and instructor at Harvard Medical School in Boston. "Get a yearly medical exam to identify and treat issues such as high blood pressure or cholesterol and a dental exam to keep inflammatory gum disease under control."

Do your best to avoid illness, which can lead to flares. "Get your flu shot," Ehst said.

Look to your lifestyle. Reach and maintain a healthy weight, get enough sleep, stop smoking and keep alcohol intake low can help prevent skin and joint flares. Exercise is another good way to keep inflammation at bay, said Merola, who recommended people with psoriatic arthritis consider low-impact activities such as yoga, swimming or cycling to protect joints.

If you do start to flare, jump on it early, said Crutchfield. "The faster you treat it, the quicker you'll get it under control."

Merola also emphasized quick action, and noted it's important to see a physician who specializes in treating your condition. "With psoriatic arthritis, for example, problems may not present as typical joint pain, but show up instead as tendonitis (inflammation of a tendon) or plantar fasciitis (inflammation of ligaments in the foot)," he said.