Welcome Back Psoriasis: Diet, Stress & Sleep

I try to be a compliant patient. I take my meds. Go to most of my doctor appointments without rescheduling them. I ask for permission or a green light before doing certain things. Things like going off hormonal birth control pills for the first time in almost 20 years.

I was expecting to experience some hiccups from this. But what I wasn’t expecting at all was experiencing a spike in my mostly dormant psoriasis activity.

Triggers and remission from inflammatory diseases

I refuse to call this a flare, as I’ve fought too hard for remission. Also, I don’t feel like I’m at the point of it spiraling out of control yet. As someone living with multiple immune-mediated inflammatory diseases like psoriasis, psoriatic arthritis, and Crohn’s disease, the “r-word” is precious to me.

This isn’t denial speaking, it is sheer frustration. While my skin has seen worse days, but it also has had better ones too.

The stress of family planning

My husband and I decided to wait for my health to get to a better place before trying to start a family. This past August, I went through the usual regular inflammatory lab testing and some overdue Crohn’s diagnostic procedures.

I asked each of my specialists for permission to start family planning. Green lights were given by all. That’s why this whole thing took me by surprise and has left me a little ticked.

An improved quality of life

Back when I first started hormonal birth control, I didn’t know that I had several forms of psoriasis manifesting across my body. Nor did I know that I had Crohn’s disease. Each doctor brushed it off as teenage-girl issues and sent me on my way.

When I started “the pill” my quality of life actually returned. My scalp and skin were less painful and for the first time in years, I no longer had thick scaly crust behind my ears and scalp. My gut issues were helped, but that situation ebbed and flowed for another four years until my Crohn’s disease diagnosis.

What triggered my psoriasis flare-up?

At first, I was irritated by my medical team. I assumed they would've warned me that going off “the pill” would lead to psoriasis activity. But as I researched, there’s not a lot of information out there on the topic.

After childbirth, puberty, and menopause – there’s tons of info. Going off hormonal birth control and psoriasis flares? Not so much. Literally, I searched that phrase and a variety of others in hopes of finding some info. I joke to friends that if this had to do with erectile dysfunction somehow, there’d be tons of info available.

Truthfully, I do feel that going off the pill for the first time in two decades may play a little role in this scenario. While I haven’t experienced things other women complain about like PMS, I had a return of acne in the same places I did as a teen and I sometimes like chocolate these days. All anecdotal, I know.

Determining the right triggers

My Crohn’s and psoriatic arthritis symptoms didn’t change after coming off “the pill.” Just my psoriasis. The little red line of inverse psoriasis that comes and goes from under my left arm was bigger and redder. Small plaques on my scalp became bigger plaques.

I also started getting these raised bumps that are not acne popping along my hairline. And of course, acne came along for the ride. And inverse psoriasis that usually hitchhikes in between my legs and butt cheeks, yep, they came back too. Because, why not?

I know that each situation is mild in comparison to where I’ve been in the past. But this led me to take stock of the past few months and look past the obvious, which was stopping the hormonal birth control. I grabbed a note pad and jotted down: diet, stress, sleep. Then I made a column for the past few months: January, December, November, and October. I didn’t even need to flesh it out. I already knew what the problem was.

Diet, stress, sleep and their impact on psoriasis

In August, my mother was diagnosed with a rare and aggressive form of breast cancer. Her dog has been at our house through most of her treatment. The problem is that even when I have more space in the bed, my mom’s dog (who is old and not healthy) will keep me up all night and into the early morning hours.

As the holiday season came upon us, so did the stress eating lots of sugar and carbs. I try to not have those in my diet because they aren’t great for inflammatory diseases. But stress, man.

Accountability stinks! And yes, I am still convinced coming off “the pill” is part of the issue, because my Crohn’s and psoriatic arthritis are hanging in there. I also know there’s an organic issue here. That issue is me.

So, now I have a better grasp of the triggers for my upset skin. In the meantime, I’m working to re-implement better eating, sleep, and stress-relieving habits to help reduce and remove the inflammation and help prevent it from reoccurring.