Category Archives: Dermatology

9 Best Baby Eczema Creams of 2024 to Soothe Delicate Skin, According to Dermatologists – Allure

Editor Tip: Since this is recommended for toddlers over two years old, check with your pediatrician first to make sure it's okay to use. (Some might prefer to write their own prescription instead, too.)

Key Ingredients: Hydrocortisone, ceramides, hyaluronic acid

Aveeno

Aveeno Baby Eczema Therapy Moisturizing Cream

Why It's Worth It: The Aveeno Baby Eczema goes all-in on oats, which is why Dr. Chang is a fan. Along with oat oil and oat extract, "it's formulated with colloidal oatmeal to moisturize and calm down irritated, itchy skin due to eczema," she says. Plus, she likes that it's unscented and doesn't contain common allergens like parabens, phthalates, and fragrances, making it a good option if other formulas tend to set off or worsen flares.

Editor Tip: The brand also has an Overnight Balm to seal in moisture overnight for healthier, more comfortable skin by the A.M.

Key Ingredients: Oat oil, colloidal oatmeal, panthenol

There's no one cause of eczema in babies, but it's "likely caused by a combination of genetic and environmental factors," says Dr. Melnick. Eczema can also be triggered by external factors such as common allergens (like fragrance in skin-care products and laundry detergents), dry air, saliva or sweat, or long, hot baths, says Dr. Chang. The good news? Getting rid of these triggers can help alleviate or even prevent an eczema flare-up.

For itching, your baby's pediatrician might prescribe a steroid cream, which is "often prescribed to treat eczema flares and to use intermittently for relief of itch symptoms," says Dr. Chang. The key word here is "intermittently," since these shouldn't be used continuously for months on end. In fact, when used regularly over an extended period of time, steroids can actually weaken or thin skin, causing skin irritation and leaving it more vulnerable to infection. "A simple rule I use is two weeks on and two weeks off, and only as needed," Dr. Chang notes.

Consider moisturizer as your baseline, with or without a steroid cream. "One of the most important parts of treating eczema is maintaining a strong skin barrier by using frequent and liberal applications of emollients," says Nava Greenfield, MD, a board-certified dermatologist at Schweiger Dermatology Group in New York City. "Healthy skin is less prone to flares," Dr. Greenfield attests.

But not all moisturizers are created equal, and your go-to face lotion won't cut it. "For babies with eczema, I recommend using a gentle, non-fragranced, and hypoallergenic moisturizer," says Dr. Chang, noting that she also keeps an eye out for common allergens and irritants. "I typically recommend using thicker creams over more lightweight gels and lotions, which are more effective at moisturizing the skin due to a higher oil content," Dr. Chang adds.

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9 Best Baby Eczema Creams of 2024 to Soothe Delicate Skin, According to Dermatologists - Allure

A 30-Year-Old White Female Presented With a 4-Month History of Scaly, Erythematous Patches and Plaques on Her … – MDedge

Tumor necrosis factor (TNF)-alpha inhibitors are used to treat a variety of autoimmune conditions including psoriasis, psoriatic arthritis, rheumatoid arthritis (RA), spondyloarthritis, and inflammatory bowel disease (IBD). Interestingly, they have also been observed to cause paradoxical psoriasis with an incidence between 0.6%-5.3%, most commonly occurring in patients with underlying Crohns disease and rheumatoid arthritis (RA). Infliximab is the most common TNF inhibitor associated with this condition (52.6%-62.6% of cases) followed by etanercept (12%-29%). TNF inhibitor-induced psoriasis most often presents as plaque or palmoplantar psoriasis, but other subtypes have also been documented.

Psoriasis is traditionally divided into two types. Patients with type I psoriasis have a family history, develop symptoms before the age of 40 and are often positive for HLA-Cw6. Type II psoriasis is not related to HLA-Cw6, lacks a family history, and typically manifests after age 40. Psoriatic lesions are well-defined, erythematous plaques with silvery scales most commonly appearing on extensor surfaces and the scalp. Variants include nail psoriasis, pustular psoriasis, inverse psoriasis, and guttate psoriasis.

Although psoriasis is typically a clinical diagnosis, histologic examination may be used to differentiate from other dermatoses if necessary. The lesions of TNF inhibitor-induced psoriasis characteristically display patterns similar to primary psoriasis, including parakeratosis, microabscesses, and rete ridges. Eosinophilic hypersensitivity reactions and features overlapping with eczematous hypersensitivity (psoriasiform dermatitis) may also be present.

The pathogenesis of this condition is not well understood, but theories include a variety of immune processes including interferon overproduction, interleukin and T-cell activation, and the presence of an infectious nidus. Classical psoriasis is related to type 1 interferon release, so theoretically, immunosuppression caused by TNF inhibitor treatment may permit uncontrolled production of interferons, resulting in psoriatic lesions. Another theory is that interleukin (IL)-23, a pro-inflammatory cytokine, promotes activation of T-helper 17 (Th17) cells. Th17 cells are part of the pathogenesis of primary psoriasis and other inflammatory conditions, such as RA and inflammatory bowel disease. Of note, individuals with gastrointestinal inflammatory diseases are already known to be at a greater risk for developing psoriasis. Immunosuppression caused by a TNF inhibitor may leave patients more susceptible to other infections, which may induce psoriatic plaques.

There are multiple approaches to treatment depending on the severity of the disease. If the psoriatic eruption is mild, the medication may be continued. This treat-through method is often considered when stopping the current immunotherapy would cause the patient significant issues. Moderate to severe cases of TNF inhibitor-induced psoriasis may warrant switching TNF inhibitor therapy or completely changing the drug class used in the treatment of the underlying autoimmune condition. Additional treatments include topical and oral steroids, UV therapy, methotrexate, cyclosporine, and acitretin.

This case and the photo were submitted by Lucas Shapiro, BS, of Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, Florida, and Leon S. Maratchi, MD, Gastro Health, Hollywood, Florida. The column was edited by Donna Bilu Martin, MD.

Dr. Bilu Martin is a board-certified dermatologist in private practice at Premier Dermatology, MD, in Aventura, Florida. More diagnostic cases are available at mdedge.com/dermatology. To submit a case for possible publication, send an email to dermnews@mdedge.com.

1. Li SJ et al. J Psoriasis Psoriatic Arthritis. 2019 Apr;4(2):70-80. doi: 10.1177/2475530318810851.

2. Lu J and Lu Y. J Transl Autoimmun. 2023 Sep 6:7:100211. doi: 10.1016/j.jtauto.2023.100211.

3. Nair PA and Badri T. Psoriasis. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: http://www.ncbi.nlm.nih.gov/books/NBK448194/

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A 30-Year-Old White Female Presented With a 4-Month History of Scaly, Erythematous Patches and Plaques on Her ... - MDedge

QUIZ: Test Your Knowledge of Rosacea Etiology, Types, and Triggers – Dermatology Times

April is Rosacea Awareness Month, a period of time dedicated to raising awareness about the chronic skin condition that affects millions worldwide.

Through initiatives like Rosacea Awareness Month, the medical community aims to shed light on the condition's complexities, reduce stigma, and empower individuals to seek appropriate care.

As we delve into this awareness month, Dermatology Times remains committed to educating and engaging our audience with weekly quizzes aimed at increasing understanding and promoting proactive management strategies. Throughout the month of April, we will be sharing 5-question quizzes each Monday designed to test knowledge on rosacea symptoms, triggers, treatment options, and lifestyle management strategies.

Each quiz will cover different aspects of rosacea, drawing from the latest research and expert insights. In addition to the weekly quizzes, Dermatology Times will recap the answers later in the week, providing detailed explanations and additional resources for further learning.

Dermatology Times invites you to join us in advancing understanding, promoting dialogue, and ultimately improving outcomes for individuals living with rosacea. Stay tuned for our weekly quizzes, and let's work together to make a difference this Rosacea Awareness Month.

Which of the following is not considered a trigger of rosacea?

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QUIZ: Test Your Knowledge of Rosacea Etiology, Types, and Triggers - Dermatology Times

Empowering Patients: Effective Dermatologic Treatment Selection for Hand and Feet AD – Dermatology Times

This is a video synopsis of a discussion involving Alexandra Golant, MD, Assistant Professor at the Icahn School of Medicine at Mount Sinai, focusing on treatment options for patients with atopic dermatitis (AD), particularly those with hand and foot involvement.

Dr. Golant advocates for providing patients with a comprehensive overview of treatment options and discourages reliance solely on topical therapies without considering alternative approaches. She emphasizes early discussions about transitioning to systemic treatments if topical therapies fail to provide adequate control, offering patients a backup plan and instilling hope for improved outcomes.

In assessing patients for systemic therapy, Dr. Golant considers factors such as disease control, treatment burden, and quality of life. She discusses various systemic options, including biologics like dupilumab and tralokinumab, as well as oral Janus kinase (JAK) inhibitors. Each option is tailored based on patient preferences, comorbidities, and safety considerations.

Dupilumab, in particular, has shown consistent efficacy in hand and foot AD, with recent studies supporting its use in these areas. Dr. Golant recommends regular follow-up visits to monitor treatment response and adjust therapy as needed, with closer monitoring for patients on oral JAK inhibitors due to safety concerns.

Overall, Dr. Golant highlights the array of effective treatment options available for AD in 2024, emphasizing the importance of individualized care and shared decision-making to optimize outcomes for patients with this chronic condition.

Video synopsis is AI-generated and reviewed by Dermatology Timeseditorial staff.

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Empowering Patients: Effective Dermatologic Treatment Selection for Hand and Feet AD - Dermatology Times

How To Treat Strawberry Legs, According To Dermatologists – Women’s Health

If youre someone who suffers from

Read ahead to learn more.

Meet the experts: Sapna Palep, MD, is a board-certified dermatologist at Spring Street Dermatology in New York City. Dendy Engelman, MD, FACMS, FAAD, is a board-certified cosmetic dermatologist and Mohs surgeon at Shafer Clinic in New York City. Leonard Bernstein, MD, is a board-certified dermatologist at the Laser & Skin Surgery Center in New York City.

"Strawberry legs" are dark spots that resemble small black dots. The term comes from the dotted or pitted appearance that resembles the skin and seeds of a strawberry, says Sapna Palep, MD, a board-certified dermatologist at Spring Street Dermatology in New York City.

The open comedones that cause the appearance of strawberry legs are hair follicles or enlarged pores that contain a trapped mixture of oil, bacteria, and dead skin. When the follicle or pore is exposed to air after shaving, it may darken, explains Dr. Palep.

You can see the spots caused by keratosis, a.k.a. "strawberry legs," on this womans skin.

For starters, you can treat strawberry legs by first swapping out your razor more regularly. Always use shaving cream or bar soap when shaving to ensure the area is moisturized before it comes into contact with a razor. Dr. Bernstein suggests using an antibacterial soap such as Dial or Lever 2000 to decrease bacteria on the surface of the skin. After shaving, make sure to always moisturize your skin. Dr. Palep suggests using moisturizers with lactic acid or urea that will exfoliate the skin as well to help prevent ingrown hairs.

Body Wash

Body Wash

Lotion

Lotion

To prevent strawberry legs, experts suggest that you:

If at-home remedies aren't working, Dr. Engelman recommends talking to your doctor about getting an in-office chemical peel to exfoliate the skin and reduce the appearance of bumps. You can also consider laser hair removal to reduce the potential of shaving-related skin issues, such as ingrown hairs. Anything that kills the hair at the root like laser hair removal (which is a permanent solution) or an epilator (which can be painful)" would help prevent strawberry legs, says Dr. Palep.

Daley Quinn is a Connecticut-born, Texas-bred beauty and wellness writer living in New York City. Her work has appeared in Family Circle magazine, WWD.com, TheCut.com, TheFinancialDiet.com, and San Antonio magazine. In her off hours, you can find Daley stalking her queen, Vanessa Carlton. You canfind more of her work on herwebsiteor check outher blog,The Daley Dose.

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How To Treat Strawberry Legs, According To Dermatologists - Women's Health

Rosacea Awareness Month: Resources to Share With Your Patients – Dermatology Times

According to the National Rosacea Society (NRS), approximately 16 million Americans have rosacea.1

Furthermore, a report most recently updated in August 2023 notes that the worldwide incidence of rosacea is upwards of 5% of the global population.2 In 2018, the NRS shared details of a study indicating that approximately 415 million individuals are affected by rosacea globally.3

April is Rosacea Awareness Month, and Dermatology Times is spotlighting a variety of resources to share with your patients. If you have a specific resource or association that you recommend to patients with rosacea, email us at DTEditor@mmhgroup.com to share with us.

The American Academy of Dermatology's Rosacea Resource Center boasts a variety of patient resources, including an overview of rosacea, a rundown of available treatment options, skin care tips and advice for avoidance of triggers, and insider tips for newly-diagnosed patients, including potential risks associated with rosacea.

The National Rosacea Society offers resources to help the estimated 16 million Americans with rosacea better understand and manage their condition. They provide information on symptoms, treatments, triggers, and support. Resources include educational materials like newsletters, booklets, and patient guides, as well as photographs depicting symptoms and treatment results. The society also offers a Physician Finder service to help individuals locate healthcare professionals familiar with rosacea.

The American Acne and Rosacea Society offers a range of resources to assist patients with managing their conditions. These resources may include educational materials on understanding acne and rosacea, tips for skin care and symptom management, information on treatment options, and guidance on lifestyle modifications to minimize flare-ups.

The Rosacea Support Group was established in October 1998. With over 7,500 registered members as of July 2009, the group offers a platform for sharing experiences, discussing symptoms, treatments, skin care products, and insights from health care professionals. Complementing the email group is the Rosacea Support Community, a bulletin board-style interface launched in mid-2007, catering to those who prefer a different interaction format. The Rosacea Blog features over 800 articles covering a wide array of topics for patients with rosacea.

References

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Rosacea Awareness Month: Resources to Share With Your Patients - Dermatology Times

Understanding Drug Interactions in Systemic Treatment: Impact on Atopic Dermatitis Symptoms – Dermatology Times

This is a video synopsis of a discussion involving Alexandra Golant, MD, Assistant Professor at the Icahn School of Medicine at Mount Sinai, focusing on a case study of a 17-year-old African-American female with moderate to severe atopic dermatitis (AD), particularly affecting her hands and feet.

The patient, a student and waitress, has struggled with AD since childhood, experiencing persistent severe involvement despite various topical treatments, including topical calcineurin inhibitors and corticosteroids. Her occupation exacerbates her condition, with long periods of standing aggravating her foot symptoms, and visible hand lesions causing embarrassment in her customer service role.

Dr. Golant underscores the impact of AD on the patient's quality of life, especially during adolescence when self-confidence is developing. Given the failure of numerous topical treatments, Dr. Golant opts for a systemic approach, initiating dupilumab therapy due to its efficacy and favorable safety profile, even in combination with oral contraceptive pills and oral isotretinoin for acne.

Dupilumab's compatibility with other medications makes it a preferred choice, providing comprehensive disease control without significant drug interactions or adverse effects. Dr. Golant discusses the option of combining dupilumab with topical steroids for localized flare-ups, highlighting its safety and efficacy based on clinical trial data.

In summary, Dr. Golant's approach emphasizes tailoring treatment to the patient's individual needs, addressing both disease severity and psychosocial factors to improve overall well-being and treatment outcomes.

Video synopsis is AI-generated and reviewed by Dermatology Timeseditorial staff.

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Understanding Drug Interactions in Systemic Treatment: Impact on Atopic Dermatitis Symptoms - Dermatology Times

Derm In The News: March 31-April 6 – Dermatology Times

KGET: myDermRecruiter Launches Newly Expanded Job Board for Dermatology Support Roles

myDermRecruiter, a recruitment firm in dermatology, has expanded its job board to include a wide range of essential support roles within dermatology practices. The expansion aims to meet the increasing demand for professionals in roles such as dermatology medical assistants, office managers, instrument techs, and research coordinators. For more information, contact JobBoard@myDermRecruiter.com.

Top headlines from this week to share with your patients:

Incyte and China Medical System Holdings Limited have entered a collaboration to develop and commercialize povorcitinib for various dermatologic diseases in Mainland China, Hong Kong, Macao, Taiwan, and certain Southeast Asian countries. The agreement grants CMS an exclusive license to develop and commercialize povorcitinib in autoimmune and inflammatory dermatologic diseases, including non-segmental vitiligo, hidradenitis suppurativa, prurigo nodularis, and chronic spontaneous urticaria.

We covered this news! Read more here.

Kavya Odari, a Nepalese refugee who moved to the US at 3 years old, founded K.O. Cosmetics in 2020, driven by her own experiences of being bullied for her culture and appearance. Her brand aims to provide inclusive beauty products for all skin tones and types.

The FDA is considering updating its 2013 premarket guidance for pulse oximeter manufacturers due to research indicating inaccuracies in readings for patients with dark skin. Studies show that pulse oximeters may overestimate blood oxygen levels for these patients, leading to incorrect diagnoses and treatments. Attorneys general from 24 states, including Arizona, urged the FDA to take action, proposing clear warning labels for reduced effectiveness based on skin tone.

Have you seen any dermatology headlines this week that we may have missed? Share with us by emailing our team atDTEditor@mmhgroup.com.

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Derm In The News: March 31-April 6 - Dermatology Times

Dr. Hillary Johnson-Jahangir of Forefront Dermatology Designated as a Candela Center of Excellence – PR Newswire

CORALVILLE, Iowa, April 3, 2024 /PRNewswire/ --Candela Corporation announced today that it is partnering with Dr. Hillary Johnson-Jahangir of Forefront Dermatology Laser and Surgery Center in Coralville, Iowa as a new Candela Center of Excellence.

Forefront Dermatology joins this prestigious community of clinics across the country that are designated as Candela Centers of Excellence for their commitment to the practice and teaching of medical aesthetics using Candela's portfolio of energy-based devices.

Hillary Johnson-Jahangir, MD, PhD, MS, FAAD, FACMS, is a board-certified dermatologist and board-certified and fellowship trained Mohs micrographic skin cancer surgeon with over 15 years of experience. She is the founding director of the Forefront Dermatology Laser and Surgery Center. Specializing in the treatment and prevention of skin cancer, Dr. Johnson offers advanced laser care and has extensive experience with the GentleMax Pro, Vbeam, Nordlys, PicoWay, and CO2RE systems.

Dr. Johnson is a longstanding member of theAmerican Society for Laser Medicine and Surgery. Her aesthetic sensibility was honed by years of training and practice in New York City where she was Director of Dermatologic Surgery at Weill Cornell Medical Center. Dr. Johnson also practiced laser and surgical dermatology at the University of Iowa for 7 years where she received awards for teaching and making a difference in patient care.

Dr. Johnson has been recognized as an Iowa Medical Society Women in Medicine Month Leader and an Inspirational Leader by the American Medical Association Women Physicians Section. She is also a published author of several peer-reviewed journal articles and book chapters and has lectured at universities and national meetings of multiple medical associations.

"We are thrilled to announce our partnership with Dr.Johnsonin establishing a Candela Center of Excellence dedicated to advancing education in energy-based devices," says Mary Trout, Chief Commercial Officer,Candela Corporation. "Dr.Johnson's commitment to excellence and innovation aligns perfectly with Candela's mission to empower professionals in the field of medical aesthetics and spread patient awareness on the benefits of energy-based device procedures. Together, we look forward to shaping the future of energy-based treatments and education, setting new clinical standards, and delivering transformative experiences for patients."

Forefront Dermatology, Candela Center of Excellence is located at: 2769 Heartland Drive, Suite 303, Coralville, IA 52241.

About Candela Corporation

Media contact: Laurel Sanderson [emailprotected]

SOURCE CANDELA

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Dr. Hillary Johnson-Jahangir of Forefront Dermatology Designated as a Candela Center of Excellence - PR Newswire

How to Boost Your Immune System While Living With Psoriasis – Everyday Health

Your immune system is made up of cells, tissues, and organs that help your body stay healthy and fight infections. But when you have psoriasis, your immune system doesnt always work the way it should.

Psoriasis revs up your immune system like theres something that its trying to fight, but theres actually nothing there, says Anne Truitt, MD, a dermatologist at Skin Surgery Medical Group in San Diego. The resulting inflammation in your body leads to psoriasis symptoms such as skin plaques, according to the National Psoriasis Foundation (NPF).

Due to the nature of psoriasis, some of the medications used to treat it are also designed to affect the way your immune system works. Because psoriasis is a condition where the immune system is upregulated, when we use medicines to downregulate the immune system, the medications that treat psoriasis can decrease your immunity, says Marisa Garshick, MD, an assistant clinical professor of dermatology at NewYork-Presbyterian Weill Cornell Medical Center and dermatologist at MDCS Dermatology in New York City.

This is especially true of systemic drugs, such as methotrexate. Those drugs tamp down the entire immune system to slow down psoriasis. Newer drugs such as biologics act on the immune system in a different way. Because they only target specific immune cells or proteins linked to psoriasis, they dont affect the rest of the immune system the way systemic drugs do. That said, Some biologics may carry an increased risk of certain types of infections, based on the particular cytokine or marker that they are decreasing, Dr. Garshick says.

Treatment options such as topical medications dont tend to affect the immune system as much, either, because they arent ingested or administered inside the body.

No matter which medication you take, its good to keep your immune system working as well as it can. Heres how to do just that.

You may wonder if you need to do anything special to improve your immunity, especially in the colder months. I think its important for everybody to boost their immune system during cold and flu season. But its also well documented in literature that psoriasis patients are at a higher risk of catching the flu than the average person, says Dr. Truitt. This is especially true for those who take systemic medication.

The good news? Taking measures to prevent infections can not only help you stay healthy but also lower the frequency and severity of psoriasis flares. Start with these strategies.

Even though COVID-19 has died down, washing hands is still key to cutting down the risk of any infection. And for people with compromised immunity, proper handwashing can reduce the incidence of colds by up to 21 percent, according to research published in the Annals of Translational Medicine.

Wash your hands before and after eating or preparing food, after coughing or blowing your nose, after using the toilet, and when you arrive somewhere new.

Because psoriasis patches tend to be dry, opt for handwashing instead of hand sanitizers whenever possible. Stay away from sanitizers that have a lot of alcohol or drying components to it, Truitt advises. And then make sure that youre moisturizing with a bland moisturizer after drying your hands.

Just 31 percent of people with psoriasis got the flu vaccine during the 20182019 season, even though it was recommended to almost all of them, according to one study. This may be in part because people worry that the vaccine will trigger their immune system and lead to a psoriasis flare. But the opposite may be true, according to another study. Researchers found that people with moderate-to-severe psoriasis benefit from influenza, pneumococcal, and shingles vaccines.

Talk to your doctor about which vaccines are recommended for you, based on your age and vaccine history.

There are countless benefits to exercise, including better immunity. Research has found that regular physical activity can prepare and strengthen the immune system against communicable diseases such as COVID-19.

Theres also definitely a strong correlation between regular exercising and reducing your psoriasis flares, says Truitt. Exercise also helps reduce the comorbidities associated with psoriasis like obesity, diabetes, and cardiovascular issues.

Exercising regularly can also help with losing weight or maintaining a healthy weight. Doing so helps reduce inflammation in the body, which can improve psoriasis and reduce the risk of these comorbidities.

To both strengthen your immune system and reduce inflammation in your body, stick to an anti-inflammatory diet, suggests the University of Pittsburgh Medical Center. This includes plenty of:

You should also limit your intake of processed, packaged, and sugary foods, such as fried foods, processed meats, chips, and cookies.

Almost 90 percent of people with psoriasis have trouble sleeping, according to researchers at the University of California in San Francisco. When youre flaring and itchy, it can be hard to sleep. Unfortunately, lack of sleep is tied to poorer immunity.

To get the best rest possible, practice good sleep hygiene by sticking to a regular sleep-wake schedule and keeping your bedroom cool, quiet, and free of electronics. Talk to your doctor about other strategies that might help, based on your individual circumstances.

Research suggests people with psoriasis may have low vitamin D levels. Its not only linked to immunity. Vitamin D is essential for healthy skin. It calms inflammation and helps normalize skin turnover, says Truitt.

To get more vitamin D, eat dairy, fish, and soy alternatives fortified with the vitamin, or talk to your doctor about supplements. Spending time outdoors can help you absorb some vitamin D from the sun, too, which may also improve the appearance of psoriasis skin. Just be sure to limit your time in the sunshine and wear sunscreen.

A healthy lifestyle can go a long way toward helping your immunity and your psoriasis. If you have any concerns about infections, its always best to speak with your doctor to determine the specific risks related to your particular [psoriasis] medication, says Garshick.

Your doctor may be able to switch you to another medication that will manage flares without affecting immunity.

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How to Boost Your Immune System While Living With Psoriasis - Everyday Health