Generalized pustular psoriasis (GPP) can be extremely unpredictable compared to the more common plaque psoriasis. Sudden, unexpected flares can be par for the course with this type of psoriasis. The nature of the condition can make it particularly hard to live with and manage.
While lifestyle changes alone won’t cure GPP or completely get rid of flares, there’s research to suggest that some of your daily habits can have an impact on the amount, severity, and duration of your GPP flares.
Here are some habits that might help.
Be Mindful of What You Eat
There are a few ways that your diet can play a role in how often you have flares and how bad they are.
Food and inflammation. First, psoriasis of any type, whether it’s pustular psoriasis or plaque psoriasis, is an inflammatory condition. Flares happen because your immune system is overactive and reacts to known or unknown triggers with inflammation. That inflammation leads to skin outbreaks.
While there aren’t specific foods that you can add to or remove from your diet that would cure your psoriasis or completely prevent flares, there are foods that may help support or prevent the inflammation that leads to flares. Adopting an anti-inflammatory diet could help.
Inflammatory foods include those that you probably already know aren’t good for you, such as:
- Foods that are high in added sugar, which means they don’t contain sugar naturally, like fruit, but rather sugar is added to it, like cookies and soda.
- Simple carbohydrates, like white bread and white rice, as the body processes these foods just like sweets.
- Foods high in saturated or trans fats, like red meat, full-fat dairy products, fried foods, fast food, and processed snacks, such as potato chips.
- Ultra-processed foods, like lunchmeats, candy, soft drinks, frozen meals, and sweetened cereals.
And on the opposite side of that coin, anti-inflammatory foods are those that you probably have a hunch are good for you anyway, such as:
- High-fiber fruits and vegetables in a variety of colors, such as leafy greens, mixed berries, carrots, apples, and red and yellow bell peppers.
- Healthy proteins, such as beans, eggs, and fish.
- Healthy fats, like those found in avocados, olive oils, and nuts.
- Omega-3 fatty acids, found in a variety of fish.
If you want to take guesswork out of choosing anti-inflammatory foods, the Mediterranean diet focuses on these foods heavily. Grab a book on it or search the internet for Mediterranean diet meal plans.
Inflammation and body weight. Diet also plays a role in psoriasis because weight does. People who are overweight or obese tend to have more inflammation in their bodies. Research shows that overweight people with psoriasis who lose weight through a low-calorie diet may reduce the overall severity of their condition.
For people who have GPP in particular, a low-calorie diet may not only improve symptoms but also help medications work better.
Food triggers. Some people report that certain foods seem to lead to a flare. Not everyone with psoriasis has food triggers. Which foods, if any, may lead to a flare are specific to each person.
It might be useful to keep a food log to help you figure out whether there’s a link between what you eat and when you have a flare. If you identify any suspect foods, you may want to cut them out of your diet to see if your symptoms improve.
Go Easy on the Alcohol
Research shows that people who have psoriasis tend to drink more alcohol than others and that drinking has a link to more severe disease. This may mean that alcohol triggers the condition by ramping up the inflammation that can lead to flares.
Alcohol may have other impacts on your body that promote psoriasis, too.
One study found that people with GPP who are heavy drinkers have lower levels of vitamin E. Low vitamin E has long been related to psoriasis and other chronic inflammatory skin conditions. It could be that alcohol contributes to this lack of vitamin E in people with GPP.
Limiting or cutting out alcohol altogether may lead to fewer or less severe flares.
Stay Active
Exercise might play a couple of roles in the frequency and severity of your GPP flares.
For starters, just like healthy food, regular physical activity is anti-inflammatory.
A sedentary lifestyle (one where you don’t move much) leads to a buildup of fat deep in your abdomen around your organs. This type of fat releases inflammatory substances into your body and can lead to an ongoing state of inflammation that may raise the risk for multiple diseases.
Regular physical activity, on the other hand, may fight inflammation in several ways. First, it burns that deep abdominal fat, which in turn reduces inflammation. But exercise itself, regardless of its effects on fat cells, might also help release anti-inflammatory substances in your body, which could slow down or stop the process of disease-causing inflammation.
Exercise, of course, can also help you lose weight or maintain a healthy weight. Overweight and obesity are known to make psoriasis worse.
Finally, exercise is a great way to combat stress, which is a common trigger of psoriasis flares, possibly because it may trigger inflammation.
Adults with psoriasis should get 30 minutes of moderate intensity exercise, like a brisk walk, swim or bike ride, every day in addition to strength training.
All of that said, flares can sometimes prevent people from exercising. Pain, itching, irritation from clothing, and heat intolerance often reported by people with psoriasis can all make a sweat session nearly impossible. What’s more, overexertion (working out too hard) is a trigger of GPP flares in some people.
If frequent flares keep you from getting regular exercise, talk to your doctor about physical activities that might be more comfortable.
Manage Stress
Stress may not only lead to psoriasis flares, but once a flare has happened, stress can make the itching worse.
Of course, stress is a fact of life. There are certainly some stressors in your life that you can expect, but others can be unexpected. What matters is how you deal with that stress.
When you’re living with GPP, it’s important to make stress-relieving activities a part of your weekly routine. Luckily, you can choose to ease stress with activities that you already enjoy.
If some of these practices aren’t already a part of your routine, consider adopting a few of these known stress relievers:
- Exercise
- Meditation, deep breathing, or yoga
- Laughter
- Socializing with friends and family
- Getting enough sleep
- Making or viewing art
- Practicing a hobby
These activities don’t have to take time away from other things you want to do. You may be able to kill two birds with one stone, for example, since many of these activities can be social activities, too. Want to get the most bang for your stress-busting buck? Go to an exercise class or start a walking group with the friends who make you laugh the most. Tap a friend with common interests to practice a shared hobby together.
Changes to your routine may also be a source of stress that could then lead to a GPP flare. You might find it helpful to stick pretty close to the same routine every day as a way to keep flares to a minimum. This might include eating, sleeping, and exercising at the same time every day. Try it out and see if you notice any benefits.
GPP itself can be a major source of stress in your life. People with any type of psoriasis may be up to 90% more likely to have depression, anxiety, or suicidal thoughts than other people. If you notice any of these, don’t stay silent. Talk to your doctor. There’s helpful treatment for these conditions. Taking care of your mental health may ease stress and improve your skin condition.
Don’t Smoke
Smoking is connected to higher risk for and more severe psoriasis, and that includes GPP. If you smoke, GPP gives you another reason to quit. Of course, you know better than anyone that it’s hard to quit smoking. Doctors have medicines and resources that can help. If you want to quit smoking but don’t know how, ask your doctor for help.
Take Care of Your Skin
A good skin care routine can help you prevent flares.
The National Psoriasis Foundation recommends that people with psoriasis choose gentle, fragrance-free personal care products. You might want to look for products that carry the National Psoriasis Foundation Seal of Recognition. These are known to go easy on easily irritated skin.
You might prevent flares by bathing with a gentle soap or cleanser and then moisturizing with a fragrance-free moisturizing cream while your skin is still damp after you bathe.
Avoid Ultraviolet Light
Ultraviolet (UV) light is a known trigger of GPP. This may sound counterintuitive since phototherapy, which involves UV light, is a treatment for GPP. But it’s important to understand that the UV light in phototherapy is a specific wavelength of only UVB light.
The sun, your main source of UV light, emits both UVA and UVB light and not at a wavelength that’s designed to help your skin. That’s why it’s important to use sun protection when you’re outdoors. That includes:
- Broad-spectrum sunscreen of SPF 30 or higher and zinc oxide 8% or higher on all exposed skin
- Wide-brim hats
- Long pants and long-sleeved shirts
- UPF-rated clothing that’s been tested to keep out the sun’s ultraviolet rays
Many people have said that tanning beds give them relief from psoriasis, but, like the sun, they radiate both UVA and UVB light. The National Psoriasis Foundation strongly discourages the use of tanning beds as their risks, which include causing skin cancer, are greater than any possible rewards.
Know Your Triggers
Some of the common triggers of GPP might affect you, too. Besides those mentioned above, other triggers include:
- A reaction to a medication
- Steroid withdrawal, for example after steroid treatment for a flare
- Infections, especially staph, strep, and upper respiratory tract infections
- Pregnancy
- Calcium deficiency
- Changes in season or weather
- Salicylates, which are found in over-the-counter drugs like aspirin and the diarrhea medicine bismuth subsalicylate
- Overexertion (overworking yourself)
- Menstruation
Besides common triggers of GPP flares, you may flare in response to your own unique triggers, too. You might not know what they are right away. Keeping a journal could help.
At the end of each day, take a few minutes to jot down the following information:
- What you ate
- How you slept
- Whether you exercised
- The day’s weather
- Whether you used any new personal care, laundry, or cleaning products
- Changes to your routine that day
- New sources of stress
- Any skin symptoms
- Anything else that may be relevant
When you have a flare, look back through your journal to see if you can find a connection between the day’s or week’s activities and your skin symptoms.
Show Sources
Photo Credit: Tetra Images/Getty Images
SOURCES:
Cleveland Clinic: “Psoriasis and Diet: How Foods Can Impact Inflammation,” “Pustular Psoriasis,” “Does Sun-Protective Clothing Actually Work?”
Hopkins Medicine: “Psoriasis Diet: Foods to Eat and Avoid If You Have Psoriasis.”
Dermatologic Therapy: “Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy.”
Psoriasis: “Psoriasis and Alcohol,” “Psoriasis and Exercise: A Review.”
Acta Dermato-Venereologica: “Vitamin A and E Blood Levels in Erythrodermic and Pustular Psoriasis Associated with Chronic Alcoholism.”
PLoS One: “Serum vitamin E levels and chronic inflammatory skin diseases: A systematic review and meta-analysis.”
Nature Reviews Immunology: “The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease.”
British Journal of Dermatology: “Are psoriatic patients at risk of heat intolerance?”
Expert Review of Clinical Immunology: “The clinical, humanistic, and economic burden of generalized pustular psoriasis: a structured review.”
National Psoriasis Foundation: “Life with Psoriasis,” “Must-Have Lotions,” “Fact Checking Kim Kardashian’s Psoriasis ‘Treatments.’”
Mayo Clinic: “Stress relievers: Tips to tame stress.”
Open Access Macedonian Journal of Medical Sciences: “Pustular Palmoplantar Psoriasis Successfully Treated with Nb-UVB Monochromatic Excimer Light: A Case-Report.”
