There are a number of measures which you yourself can take to help improve and reduce aggravation of your psoriasis.

There is a well-known link between excessive alcohol consumption and severity of psoriasis. This is not observed with other skin disorders. Total abstention is not necessary but alcohol intake should be moderate and well within the recognised guidelines of 14 units a week for adult females and 21 units a week for adult males.

Likewise, smoking is associated with a particular type of psoriasis called palmoplantar pustular psoriasis and ideally should be discontinued in individuals with this disorder.

Medications known to aggravate psoriasis should be avoided where possible, eg. lithium, beta blockers, anti-malarials and sudden withdrawal of systemic steroids.

Psoriasis is not diet related and thus you should continue with a healthy balanced diet. Food allergy tests are of no proven benefit.

If you have ever experienced psoriasis which was brought on by a streptococcal throat infection, you should present to your GP at the earliest signs of this infection.

Psoriasis is aggravated by trauma and thus you should avoid picking at your psoriasis, since this can actually make it worse.

Sun exposure, as advised by a GP or dermatologist, can be helpful in clearing psoriasis but you must avoid sunburn, since this can make it worse. Sunbeds are not a good idea unless specifically recommended by a dermatologist, in view of the long-term risk of skin cancer.

OTC (over the counter) medications
It is important to maintain a good skin care regimen. Avoid soaps and use soap substitutes such as Emulave wash, Lipikar, Aqueous cream, Silcock's base, emulsfying ointment, Oilatum shower gel, etc.

The skin should be moisturised daily, eg. Diprobase, Eucerin (with /without urea), Emulave, E45, Silcock's base, etc. There are many similar soap substitutes and moisturisers available in the chemist and the choice is a personal one.

Coal tar therapy
Crude coal tar is the sticky black liquid left behind when coal has been heated to remove the volatile components. It works by decreasing the turnover of cells in the top layer of skin (epidermis), which are replaced too rapidly in psoriasis. Many OTCs are available containing both crude (mucky, but more effective) and refined (cleaner) coal tar. Some people find the smell intolerable and others find these products too messy for home use.

However, they can be an extremely safe and effective treatment for all types of psoriasis at all ages. Curea is the combination of coal tar and urea and can be applied liberally under old clothes. Avoid the body flexures with tar preparations since they can irritate the thinner skin at these sites. Other tar containing OTCs include Alphosyl, tar pomade, Pragmatar, Psoriderm, etc.

Coal tar products such as Cocois ointment and tar pomade can be applied to thick plaques of psoriasis in the scalp and left overnight, mainly as de-scalers. These are then washed out with tar shampoos such as Capasal, T-gel and Polytar.

Coal tar bath emollients are also available and can play a role in the overall skin care programme eg Polytar emollient, Balneum with tar and Psoriderm bath emulsion.

Coal tar products must not be put on exposed skin during sunny weather, since tar is a photosensitiser and will render the skin far more susceptible to sunburn.

Written by Rosemary Coleman, MD FRCPI, Consultant Dermatologist

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