Winter Psoriasis: Why Flares Get Worse and How to Calm Them

Many people with psoriasis find their skin is at its worst between late fall and early spring. Dry air and indoor heating pull moisture from the skin, there is less of the ultraviolet light that calms plaques, colds and sore throats are more common, and the holidays bring stress and extra drinks. The American Academy of Dermatology lists cold, dry weather as a known psoriasis trigger.

The good news is that most winter flares can be eased with a few changes to how you bathe, moisturize and dress, plus a check-in with your provider before the season starts. This guide explains why winter psoriasis happens and what to do about it.

Why psoriasis gets worse in winter

Winter trigger	What it does to psoriasis
Dry air and indoor heating	Dries the skin, making plaques tighter, itchier and more likely to crack
Less UV light	Shorter days and covered skin mean less of the UVB light that helps psoriasis, so the summer improvement fades
Infections	Strep throat in particular can trigger a flare or a sudden outbreak of small, drop-shaped spots (guttate psoriasis)
Scratching and cracks	Injured skin can grow new plaques in the same spot (the Koebner response)
Holiday stress and alcohol	Stress and heavy drinking are both recognized triggers

Bathe in a way that protects your skin

Water strips moisture from the skin, so how you bathe matters more in winter. The American Academy of Dermatology recommends:

• One bath or shower a day at most, about 5 minutes for a shower and 15 minutes or less for a bath.
• Warm water, not hot. Hot water feels good on itchy skin but dries it out.
• A gentle, fragrance-free cleanser made for sensitive skin. Skip deodorant soaps, scrubs, loofahs and washcloths, and wash with your hands.
• Pat, do not rub, leaving the skin slightly damp.
• Moisturize within 5 minutes of getting out, while the skin is still damp.

Moisturize more, and choose thicker products

• Creams and ointments over lotions: thick, fragrance-free products such as petroleum jelly or a ceramide cream hold moisture in best. Use a lotion only if a cream feels too heavy.
• After every wash: reapply after bathing and after washing your hands, and once more before bed.
• Soften thick scale gently: over-the-counter products with salicylic acid or urea can lift scale so your prescription treatment reaches the skin. Ask your provider first, as they can sting cracked skin.
• Run a humidifier: keep indoor humidity between 30% and 50%, especially in the bedroom, and clean the unit regularly so it does not grow mold.

Calm the itch without scratching

Scratching injures the skin and can spread plaques. Instead, press a cool, damp cloth on the area, apply moisturizer when you feel the urge to scratch, or try an over-the-counter anti-itch product with menthol or camphor (follow it with moisturizer, as these can dry the skin). Keep nails short, and consider cotton gloves at night if you scratch in your sleep. Itch that keeps you awake is a sign your treatment needs to be adjusted.

Dress for your skin

• Soft layers: wear cotton or another soft fabric next to your skin and put wool or scratchy fabrics on top.
• Avoid overheating: sweat can irritate plaques, so take off a layer when you come indoors.
• Change out of wet clothes after rain or exercise.
• Protect your hands: wear gloves outdoors and when washing dishes, as cracked plaques on the hands are slow to heal.

Winter sun and light therapy

The UVB light in sunshine helps many people with psoriasis, which is why skin often improves in summer. Winter sun has less UVB, so a walk outside will do less. Avoid tanning beds: they mainly give off UVA, the dose is uncontrolled, and they raise melanoma risk. If your psoriasis always flares in winter, ask about medical light therapy, which delivers a measured dose of narrowband UVB two or three times a week, whatever the weather. Our guide to sunlight and psoriasis explains more.

Lower your other winter triggers

• Infections: wash your hands often, and see a provider promptly for a sore throat, as treating strep early may limit a flare. If you take a medicine that affects your immune system, ask which seasonal vaccines are right for you.
• Stress: exercise, sleep and saying no to a few holiday commitments all help. Ongoing stress or low mood is worth raising with your provider.
• Alcohol and smoking: heavy drinking and tobacco are both psoriasis triggers, and alcohol can interact with some psoriasis medicines.
• Medicines: lithium and hydroxychloroquine can trigger flares, and so can stopping oral steroids such as prednisone. Never stop a prescribed medicine on your own; ask your provider about alternatives.

No single diet treats psoriasis. If you are overweight, losing weight can make psoriasis milder and treatments work better, and a balanced, Mediterranean-style diet is a reasonable choice. Our guide to what causes psoriasis covers triggers in more detail.

Winter psoriasis care in Carlsbad

If your psoriasis flares every winter, a visit in early fall lets you start the season with a plan, such as stronger prescription creams for flares, injections for a few stubborn plaques, UV light therapy, or referral for biologics if your psoriasis is moderate to severe. Medical dermatology visits are $150 – $375. See our psoriasis treatment in Carlsbad page, read about psoriasis on Black and brown skin and whether psoriasis is contagious, or book a visit at our South Carlsbad studio on El Camino Real.