Most people develop psoriasis between the ages of 15 and 35. While psoriasis may get better or worse depending on different environmental factors, it doesn’t get worse with age.
Obesity and stress are two possible components that lead to psoriasis flares. However, the severity of your psoriasis is ultimately determined by your genetics.
The longer you live with psoriasis, the more likely you are to develop psoriasis-related health issues. But psoriasis itself won’t necessarily make you look older. People with psoriasis develop signs of aging, just like people without the condition.
As the skin ages, collagen and elastic fibers weaken and the skin gets thinner. This makes it sensitive to trauma, leading to easier bruising and even open sores in severe cases.
This is a challenge for anyone, but it can be even more challenging if you have psoriasis. Psoriasis plaques that occur on weakened skin can lead to pain and bleeding.
If you have psoriasis, it’s important to protect yourself from the sun because UV exposure is known to cause skin damage. You also must be careful when using topical steroid creams to treat psoriasis. Overuse of steroids is associated with skin thinning and development of stretch marks, especially with long-term use over years.
While psoriasis affects the skin, we now know that it’s actually a systemic disease. In psoriasis, inflammation exists throughout the body, but it’s only externally visible in the skin.
Especially in more severe cases, psoriasis is associated with metabolic syndrome, arthritis, and depression. Metabolic syndrome includes insulin resistance and diabetes, high cholesterol, and obesity. It increases your risk of heart disease and stroke.
The same type of inflammation that affects the skin may affect the joints, leading to psoriatic arthritis. It can even affect the brain, leading to symptoms of depression.
During menopause, hormone levels shift, resulting in lower levels of estrogen. We know that low estrogen levels in postmenopausal women is associated with dry skin, decreased collagen production with thinning of the skin, and loss of elasticity.
There’s no definitive data that menopause has a direct effect on psoriasis. But limited data suggests low estrogen levels may be associated with worsening of psoriasis.
Psoriasis may be harder to treat in people with weakened skin, so it’s important to do what you can to keep your skin healthy before menopause begins. Wearing sunscreen and practicing sun-protective behavior are the absolute most important things you can do to protect your skin when you are young.
It’s important to take special care of your skin if you have psoriasis. I generally tell my patients to steer clear of products with drying alcohols, fragrances, and sulfates. All of these can cause skin irritation and dryness.
Trauma to the skin can lead to a psoriasis breakout, known as the Koebner phenomenon. So it’s important to avoid activities or products that can cause irritation.
I tell my patients to use gentle, hydrating, non-soap cleansers that won’t disrupt the skin barrier. Shower with lukewarm water for 10 minutes or less, and moisturize the skin after patting dry.
If you have thick scales on your scalp or other parts of your body, skincare products that contain salicylic acid may be helpful. Salicylic acid is a beta hydroxy acid that exfoliates the skin to help remove the scale on psoriasis plaques.
Noninvasive cosmetic procedures are more popular now than ever. Injectables like Botox can improve the appearance of wrinkles, while fillers restore lost volume. Lasers can be used to even skin tone and texture, and even eliminate unwanted blood vessels or hair. These procedures are safe for people with psoriasis.
If you’re interested in a cosmetic procedure, speak to your doctor about whether it’s right for you. In some cases, your doctor may want to hold or adjust your medications. It’s important that they’re aware of your full medical history and current medications.
For the majority of people, psoriasis doesn’t go away on its own. It’s caused by a combination of genetics and the environment.
In genetically predisposed people, an environmental factor acts as a trigger to unmask psoriasis. In rare cases, behavioral modification like weight loss or smoking cessation may be associated with improvements or complete clearing.
If your psoriasis is caused by a medication, then stopping that medication may improve your psoriasis. Certain high blood pressure and depression medications are strongly associated with triggering psoriasis. Speak to your doctor about any medications you’re taking and whether they may contributing to your psoriasis.
Joshua Zeichner, MD, is the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. He actively lectures to international audiences and is involved in daily teaching to residents and medical students. His expert opinion is commonly called on by the media, and he’s regularly quoted in national newspapers and magazines, such as The New York Times, Allure, Women’s Health, Cosmopolitan, Marie Claire, and more. Dr. Zeichner has been consistently voted by his peers to the Castle Connolly list of New York City’s best doctors.