Once the temperatures drop and the air becomes less humid, many people experience red or raw hands as well as itchy or uncomfortable skin. But colder months may be particularly challenging for the more than 7.5 million U.S. adults living with psoriasis. The colder, drier air can trigger flare-ups of this chronic skin condition.
Psoriasis can cause a range of symptoms, including itchy, inflamed, and sometimes painful patches of white or red skin. Some may also have silvery scales, which form due to an overactive immune system.
Scientists are still working to find a cure, but there are some effective psoriasis treatments to help manage the condition. There are also steps you can take each day to help prevent flare-ups, particularly during the fall and winter.
Understanding cold weather psoriasis flare-ups
People with psoriasis often cycle through periods of time when they are symptom-free until a trigger—usually something in their environment—leads to a flare-up. One of the best ways to keep psoriasis under control is to try to avoid or manage these triggers.
For many, cold, dry air can worsen their symptoms. That’s because humidity and sunlight, which are lacking in the fall and winter, can have a protective effect, easing or preventing psoriasis symptoms.
Ultraviolet (UV) sunlight—UVA and UVB rays—help suppress the overactive immune response that occurs with psoriasis. But in many parts of the country, there tends to be less sunshine during colder seasons of the year.
During the fall and winter, it's also less humid. Humid air helps keep the skin from drying out, helping to keep psoriasis under control. When temperatures drop and people turn up the heat indoors, the air and your skin can become drier, leading to flares.
A 2021 study, involving 2,270 people, published in Clinical, Cosmetic and Investigational Dermatology adds to mounting evidence that links psoriasis flare-ups to cold weather. Researchers found that more than half of the study’s participants experienced flare-ups when the temperatures dropped.
The study’s authors theorize the link between colder weather and psoriasis flare-ups was not only due to less sunlight exposure and humidity, but also lower vitamins D levels.
Vitamin D is actually a prohormone—a substance the body converts to a hormone. And unlike other vitamins, such as C and A, which are readily found in a wide range of fruits and vegetables, only about 10 percent of the vitamin D you need comes from food. With some help from the sun, your body makes most of the vitamin D it needs. Its production is triggered when the sun’s ultraviolet (UV) rays hit your skin. That’s why the time of year, where you live, your skin tone, age and sunscreen usage and wearing sun-protective clothing could all affect your vitamin D levels. During winter, vitamin D production can drop.
Many people link vitamin D to strong bones, but its benefits don’t end there. It also promotes calcium absorption in the intestines, allows the kidneys to control blood calcium, and plays a role in cell growth, and muscle strength. Vitamin D also helps support the immune system, and eases inflammation. By helping to curb inflammation, it can help keep psoriasis under control. So, during fall and winter, if your vitamin D levels are lower, you may be more likely to experience a flare-up.
Another psoriasis trigger that may be more prevalent during the fall and winter: infection. Illnesses, such as bronchitis, cold and flu, and strep throat, are often more common during winter as more people gather in crowded, indoor spaces. An increase in risk for these infections and a greater burden on the immune system could make a psoriasis flare-up more likely to occur.
Seasonal stress, drinking, smoking, injury to the skin, such as abrasions, burns and cuts, as well as tattoos and piercings, can also contribute to a worsening of psoriasis symptoms.
How to prevent and treat cold-weather psoriasis flare-ups
Once you’ve identified cold-weather psoriasis triggers, it’s easier to help manage them and keep your symptoms in check. When the weather is cold and dry, try these preventative strategies:
- Use a humidifier. The added moisture in the air helps keep your skin from drying out and getting irritated.
- Sit further away from your space heater, fireplace, or radiator so you can’t feel the heated air directly on your skin. Turn it off or move farther away from it to help prevent your skin from getting overly dry.
- Wear comfortable, waterproof clothing, shoes, gloves, and wide-brim hat when outdoors to protect your skin when the weather is chilly.
- Remove extra layers of clothing and shoes once you’re indoors or in a warm environment, especially if they’re wet.
- Skip the hot baths, which you may be inclined to do to warm your body. Bathe and shower with lukewarm water for no more than 10 minutes to keep your skin from getting itchier and more inflamed.
- Replace harsh soaps with a gentle, fragrance-free cleanser that moisturizes your skin.
- Moisturize thoroughly with a gentle, fragrance-free ointment or cream right after you bathe or shower. Reapply your moisturizer throughout the day, especially when your skin starts to feel dry or itchy again. A 2022 review of studies published in Medicina found that emollient and exfoliating moisturizers with alpha- or beta-hydroxy acid and urea may help. These moisturizers come in over-the-counter and prescription strengths. Talk to your healthcare provider (HCP) about what might work best for you.
Phototherapy may be another option
If other preventative strategies don’t help prevent psoriasis flares during the fall and winter, the American Academy of Dermatology recommends talking to your HCP about adding phototherapy to your treatment plan. This noninvasive therapy involves the use of light-emitting diode (LED) devices equipped with varying wavelengths and strengths.
The LEDs expose your skin to controlled amounts of UV light—UVB being the most effective for psoriasis flare-ups. This helps support skin healing by helping to:
- Dissolve scales
- Ease inflamed, itchy skin
- Slow down the fast growth of skin cells
- Suppress an overactive immune system
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