Part of any good summer fun includes going to the beach, lake or pool to cool off from the sizzling temperatures and blazing sun. But if you have psoriasis, heading to the pool may cause stress and anxiety around managing your symptoms.
No matter what type of water you're swimming in, there are steps you can take to manage your psoriasis and still have some fun in the sun.
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First, What Is Psoriasis?
Psoriasis is a chronic skin condition that causes a scaly rash to appear anywhere on your body, but most commonly on your elbows, knees, scalp and trunk. Approximately 7.5 million people in the U.S. have psoriasis, according to theAmerican Academy of Dermatology Association.
There are many types of psoriasis, according to the Mayo Clinic: plaque psoriasis, Guttate psoriasis, inverse psoriasis, nail psoriasis, pustular psoriasis and erythrodermic psoriasis. The most common form of psoriasis is plaque psoriasis, which is where skin appears red, scaly and may have silver or grey plaque-like pieces of skin during a psoriasis flare-up.
How Does Summertime Affect Psoriasis?
"People without psoriasis may not realize that psoriasis can cause psycho-social issues, like anxiety, depression and social isolation, due to the visible nature of the disease," says Reid Maclellan, MD, founder and CEO of Cortina Health. "This may be especially difficult in the summertime when people are wearing swimsuits and heading to the pool. Someone with psoriasis may feel unsure of how their psoriasis will be received in a swimming environment."
It's important to note that psoriasis is not contagious. However, due to its visibility on the skin, others may be curious about the rash that can form on someone with psoriasis. If you have this condition, you should never feel the need to explain yourself, and you only need to share what you are comfortable with with regards to psoriasis.
Dr. Maclellan, who helps people navigate psoriasis year-round (especially in the summer), notes that this time of year can also be difficult for someone with psoriasis due to increased sun exposure, which can trigger a flare-up.
"While some UV light exposure can actually be helpful for managing psoriasis, too much UV light or sun exposure can trigger a flare up of psoriasis," Dr. Maclellan says. "Heading to the beach or pool to swim means increased sun exposure, so it's important to take precautions before, during and after these situations to protect your skin."
Managing Psoriasis in a Chlorinated Pool
Chlorine is a disinfecting chemical frequently used to keep pools sanitary to swim in. While it's effective at keeping pool water safe, it is both a respiratory and skin irritant and can quickly dry out your skin.
"Spending too much time in a chlorinated pool can dry out the skin too much, which can trigger a flare-up," says Kristina Collins, MD, FAAD, a board-certified dermatologist in Austin, Texas. "However, some people find that spending limited amounts of time in any safe body of water may soothe the itchy, burning sensations that are commonly associated with psoriasis. It's all about finding a balance [of spending time in the water and sun] that works for you."
Dr. Collins recommends a pre-, during and post-swim routine for those with psoriasis who are heading into a chlorinated pool.
"Before getting into the water, it's a good idea to create some sort of barrier between your skin and the chlorine," Dr. Collins says. "This might look like oil-based moisturizers, sunscreen or even petroleum jelly. Creating a barrier between the skin's microbiome and the harsh chlorine can prevent disruption to that microbiome, limiting the likelihood of a flare-up." (You can learn more about the best creams and lotions for psoriasis here!)
While swimming, keep an eye on the amount of time you're spending the water and the sun. Both Dr. Collins and Dr. Maclellan recommend soaking in the pool for 15 to 20 minutes, then taking a break in the shade and reapplying sunscreen and moisturizer before diving back in.
When you've decided to call it a day at the pool, do some post-swim skin care to limit irritating an existing flare-up or causing a new one.
"It's a good idea to rinse off with clean, fresh water when you're done swimming," Dr. Collins says. "This removes any chemicals or irritants from the skin. In addition, reapplying a thick moisturizer after you rinse off will help soothe the skin and symptoms of psoriasis."
You'll want to use a gentle, clarifying shampoo and/or body wash to help remove chlorine and other sanitizing chemicals from the skin. Look for shampoos and body washes that specifically call out their ability to remove chlorine from the skin and hair.
In addition, Dr. Maclellan says not to rub or exfoliate your skin after rinsing off — this can irritate your skin, cause small fissures in existing flare-ups and feel painful. Instead, gently blot your skin until it is damp but not totally dry.
Managing Psoriasis in Fresh Water
Freshwater is water commonly found in non-salinated lakes, ponds and rivers. While fresh water doesn't contain chlorine, it's important to still take precautions for your psoriasis when taking a dip.
Fresh water may contain bacteria that can challenge your skin's naturally-occurring microbiome.
"Bacteria such as staph infections can easily trigger a psoriasis flare-up," Dr. Collins says. "Especially if you have an active flare up with any skin cracks or fissures, you could be potentially exposing yourself to a skin infection [by swimming in fresh water]."
Although the risks of swimming in fresh water are different than those of swimming in chlorine, the care measures for pre-, during and post-swim remain largely the same.
Before you swim, check out the area near the fresh water. If there are a lot of animal droppings, such as from geese, or algae floating in the water, it's best to avoid swimming as both are indicative of high levels of bacteria in and around the water. Additionally, it's best to avoid the water after rain storms — run-off from roads can introduce a bacteria and chemicals into the water as well.
If the water is safe to swim in, you should first check to be sure that you have no skin cracks or fissures that could invite an infection. Once you've determined your skin does not have any open areas, apply sunscreen and an oil-based moisturizer before getting into the water.
"Cooler water [like that of many fresh water bodies] may help soothe the symptoms of psoriasis," Dr. Maclellan says. "Psoriasis is all about inflammation management, so spending time in a cooler body of water will help bring down skin inflammation. You still shouldn't spend excessive amounts of time in water when you have psoriasis, but 15 to 20 minutes here and there may relieve some of your symptoms."
After your day at the lake, you should make rinsing off with clean water and a gentle shampoo and body wash a priority. Don't exfoliate or rub too hard with your towel — blot dry until your skin is comfortably damp. Then, reapply a thick moisturizer or petroleum jelly to lock in the moisture from the shower.
Managing Psoriasis in Salt Water
Just like chlorine, salt water can be skin irritant for people with psoriasis. However, salt water can benefit people with psoriasis when time spent in it is limited.
"Salt water dries out the skin, which can help remove dead or irritated skin cells," Dr. Maclellan says. "This can be beneficial for people with psoriasis who need to shed those skin cells, but just like with a chlorinated pool, spending too long in salt water will dry out the skin too much, potentially causing a psoriasis flare-up."
If the salt water body you're heading to also consists of cooler water, 15- to 20-minute soaks may feel exceptionally good on your skin thanks to the combination of the salt and cold water. Be sure to keep an eye on how much time you're spending in the water and sun in order to avoid creeping into skin irritation territory with psoriasis.
Similar to fresh water swimming, check your skin before running into the waves. Be sure you don't have any lesions or fissures, as those will sting and become irritated by the salt water.
Put on plenty of sunscreen and an oil-based skin barrier cream, especially if you're at the beach on a sunny day with lots of UV exposure. Continue to reapply sunscreen and moisturizer as necessary, focusing especially on the places where you are prone to a psoriasis outbreak.
Afterward, hit the shower to relieve your skin of any remaining salt and sand, blot yourself dry and finish up with a thick moisturizer to keep your skin happy.
Swimming with psoriasis can be a healing and restorative experience when done with care and attention.
Surrounding yourself with supportive loved ones as you head to the pool, beach or lake will help you gain confidence in your skin while in a bathing suit or other swim attire. Don't let preconceived notions from others hold you back from enjoying a day swimming with friends.
Be sure to keep your skin clean, protected from the sun and well-moisturized. After you're done swimming for the day, wash your skin with clean water, blot to dry and reapply a soothing moisturizer to cap off the day.
Psoriasis shouldn't be viewed as a limiter when it comes to swimming. It's simply a condition to manage with a few steps that will not detract from a great summer day with your loved ones.