Psoriasis is a chronic inflammatory condition that causes flares and periods of remission. Most people experience psoriasis as plaques that form on the surface of the skin. These plaques may cause severe itching, burning, and pain.
The goal of psoriasis treatment is usually to keep symptoms under control.
A powerful way to manage psoriasis is to track your symptoms by logging your flares. You can do this using a smartphone app or even a pen and paper.
You may see patterns over time that help you to avoid triggers, and you can give your doctor this information to help assess how well your treatment plan is working.
A tracker works best when you use it consistently. Look for a tracker that works for your comfort level with technology and with your psoriasis experience.
If you have psoriatic arthritis (PsA) as well as psoriasis, you might want a tool that lets you track both separately. It can also be helpful to upload photos. The National Psoriasis Foundation (NPF), in partnership with Twill Care, created an app that can do both. It’s free to download on Android and Apple.
If phone apps aren’t your thing, you can download a simple, low cost paper tool or Google spreadsheet on sites like Etsy.
There are also free downloadable symptom trackers specifically for plaque psoriasis.
Decide how often you’ll log your symptoms. You may want to increase the frequency if you’ve just started a new treatment plan or if your current flare feels worse than previous ones.
You can log your symptoms daily or weekly. You can decide which schedule works best for you and your doctor.
If you experience plaques, you can use your hand to estimate their size. One hand size including the fingers is about 1% of your body surface area. If you have several small plaques, you can add them together to estimate how much hand size they take up.
You can use your hand size estimate to figure out how much of your body surface area is affected by plaques. Body surface area (BSA) is a key measurement of the severity of psoriasis.
BSA can provide a measurement of the severity of psoriasis.
| Affected body surface area | Severity of psoriasis |
|---|---|
| 3% | mild |
| 3–10% | moderate |
| more than 10% | severe |
You and your doctor may use BSA from your symptom tracker to gauge whether your psoriasis treatment is resolving your symptoms.
Make note of any pain you feel. You can estimate the pain level using the 5-point psoriasis symptom scale (PSS):
- 0 = none
- 1 = mild
- 2 = moderate
- 3 = severe
- 4 = very severe
If you also live with PsA, you may want to track this separately in a PsA tracker. You may also want to add it into your psoriasis log, indicating the site of the pain, such as the finger joints.
You can also use the PSS to track other symptoms that you experience. As you log whether plaques are painful, also note:
- itchiness
- burning
- color changes, for example, redness on white skin and gray, purple, or darker brown on brown skin
You may also want to note other psoriasis signs like:
- flaking
- scales
- bleeding
Knowing what may trigger psoriasis flares can help with prevention. Tracking possible triggers for a symptom can help you to know what to avoid in the future.
Note what changes happened in your life that may have led to your psoriasis flare. Some common triggers include:
- stress
- skin injury like cuts, scrapes, scratches, or bug bites
- excessive or frequent alcohol use
- smoking
- dry and cold weather
- sunshine
- warm weather
- infection
- medications
- shaving
- tattoos and piercings
Your personal triggers may not be on this list, so try to note anything different in the couple of weeks prior to your psoriasis flare.
Log any steps you took in response to the symptom or flare. Some examples include using moisturizers or topical treatments containing coal tar or salicylic acid.
Also note if you chose to make lifestyle changes, like limiting alcohol intake, quitting smoking, or reducing stress in response to a flare or symptom.
Psoriasis is a chronic condition marked by flares and remission. By tracking psoriasis flares, you can learn what triggers psoriasis symptoms and prolong the periods of remission.