Dear Dr. Solomon: According to my doctor, one of the thing that causes my psoriasis to flare up is stress. I think that anyone who never gets stressed out these days isn't normal. I know you believe in prevention, but how is it possible to avoid stress? -- Mr. J.G., Severna Park.
Dear Mr. G.: Advising someone to relax and not worry is a lot easier said than done. That doesn't mean, however, that there is nothing that can be done to reduce stress.
It is generally agreed that exposure to stress affects psoriasis and other skin conditions. The sources of stress may be categorized as environmental, physiological and psychological.
Environmental stress includes pollution and overcrowding, physiological stress includes illness and injury, and psychological stress includes depression, anxiety and a whole range of interpersonal, work- and family-related problems.
Some of these sources of stress are not easily eliminated. Some people may be able to pack up and move to another neighborhood or even another part of the country, but this certainly is not true of everyone.
Similarly, illness and injury are equal-opportunity misfortunes, which strike without regard to sex, race, religion or socioeconomic status. Yet there are things that can be done to alleviate pressures.
Some patients with psoriasis have benefited from psychotherapy, while others have responded to biofeedback training and hypnosis. Still others have been helped by self-help groups, which permits patients to share their experiences and discuss treatment alternatives.
Even when the source of stress cannot be eliminated, patients may learn from these groups how best to cope with the stress.
Patients can also help themselves by learning about the nutritional aspects of psoriasis. Although there is no firm evidence that eating certain foods will lead to a remission, patients can at least avoid dietary indiscretions that could aggravate their condition.
For example, smoking, drugs and the use of alcohol and caffeine may worsen psoriasis, and irregular eating habits may cause an increase in stress.
On the other hand, appropriate exercise can not only have a beneficial effect on mood, but can lead to physiologic changes, such as a strengthened cardiovascular system.
* Dear Dr. Solomon: Is it possible that the side effects of a flu shot can be as bad as the real thing? Maybe it's not worth it. -- Dale, Washington, D.C.
Dear Dale: The side effects of flu shots are similar to mild flu symptoms. For example, the individual may feel achy and tired and possibly run a slight fever. The symptoms last about one or two days. In patients with flu, the symptoms are more severe and last longer.
For Terrence, Annapolis: The large majority of patients with acute polio infections -- as many as 90 percent -- make a full recovery.
Neil Solomon's book "Sick & Tired of Being Sick & Tired" is now available in paperback under the title "Chronic Fatigue and Other Ailments" (Wynwood Press).
Dr. Neil Solomon will answer questions from Baltimore area readers in his Tuesday column in Accent on Health.
To leave a question for Dr. Solomon, call SUNDIAL, the Baltimore Sun's directory of telephone information services at 783-1800, or 268-7736 in Anne Arundel County. You must use a touch-tone phone to be connected. It is a local call and there is no charge to ask your question.
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Readers without a touch-tone telephone can write Dr. Solomon at P.O. Box 36184, Baltimore, Md., 21285-6184