Psoriasis is a frustrating and painful condition that’s not well misunderstood – In fact, scientists aren’t exactly sure what causes it (though they suspect it’s linked to the immune system).

People with psoriasis experience flare ups, oftentimes during times of stress or illness. For when that happens, there are treatments available to manage the condition. Here are four of the biggies.

Don’t Scratch

Psoriasis plaques can be incredibly itchy. Although you may be tempted to scratch or pick the scales off, you should avoid doing this at all costs. Psoriasis is linked to the Koebner Phenomenon, a condition that causes skin to become psoriatic when damaged. If your psoriasis is particularly itchy, consider using a moisturizer that contains vitamin A. Vitamin A has known anti-inflammatory properties and can help to soothe skin. You can also draw yourself a warm bath and use a natural anti-oxidant such as oat milk to soften plaques and reduce itching.

Reduce Your Stress Levels

Having psoriasis is stressful, and high-stress levels are frequently linked to psoriasis flare-ups. This can leave people living with psoriasis in a vicious circle of continuous stress — and can seriously affect their quality of life. According to the National Psoriasis Foundation, approximately 24% of patients with moderate to severe psoriasis report also report depression. Because stress causes inflammation in the body, it’s crucial to try and limit your stress levels as much as possible. Consider taking up a stress-busting hobby that can help you relax, such as yoga, meditation, or keeping a diary.

Get Some Vitamin D

One tried-and-tested method that medical professionals have used for many years to treat psoriasis is UV therapy. Because psoriasis skin cells multiply at a much faster rate than healthy skin, direct sunlight can improve the condition tremendously as ultraviolet light slows down skin cell growth. If you have psoriasis, getting out into the sun for a few days a week could help to keep your flare-ups under control. However, it’s important to remember that too much sun is also damaging to skin. Be sure to discuss the pros and cons of UV exposure with your doctor, especially if you have skin that sunburns easily. To protect yourself from sunburn and its dangerous effects, always lather up in sunscreen.

Change Your Psoriasis Treatment

Like most auto-immune diseases, the effects of psoriasis vary wildly between patients. This also means that the most effective treatment for one person may not work for another. Research into psoriasis and other auto-immune diseases is continually evolving, and new treatments are becoming available all of the time. For example, biologic medicines are currently at the cutting-edge of psoriasis treatment options and are giving sufferers of moderate to severe plaque psoriasis respite from their symptoms. Treatments work by decreasing the immune system response, and reducing inflammation. Brand name biologic prescriptions include: Humira, Enbrel, Cyltezo, Taltz and Siliq.

It’s important to remember that treating psoriasis is often a case of trial and error. It may take several different drugs, or a combination of them, to find the combination that meets your needs.