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In clinic, I often tell patients with psoriasis: “Get moving, your skin will thank you.” This is not mere consolation, but sincere advice based on substantial evidence-based medicine. In recent years, an increasing number of studies have confirmed that regular exercise not only improves cardiovascular health and weight control, but also significantly reduces systemic inflammation in patients with psoriasis and alleviates psychological stress — which is one of the key triggers of disease relapse.

Psoriasis is essentially a systemic immune-mediated disease characterized by a persistent low-grade inflammatory state, with elevated levels of cytokines such as TNF-α, IL-17, and IL-23. Aerobic exercise can promote the release of anti-inflammatory cytokines (such as IL-10 and IL-1ra) while inhibiting pro-inflammatory pathways (such as NF-κB), thereby “extinguishing” the fire of inflammation at its source. In addition, exercise can improve insulin sensitivity and reduce oxidative stress, which is particularly important for patients with concomitant metabolic syndrome (hypertension, hyperglycemia, hyperlipidemia).

So how should one exercise scientifically? I recommend choosing low-friction, low-impact moderate-intensity aerobic activities such as brisk walking, swimming, yoga, tai chi, or stationary cycling, 3–5 times per week, 30–45 minutes each session, with a target heart rate of (220 − age) × 60%–70%. Swimming is especially suitable because the buoyancy of water can reduce joint load (particularly friendly for patients with psoriatic arthritis), but note: after swimming, the body should be rinsed immediately with clean water to remove chlorine residues, and a non-irritating moisturizer should be applied within 3 minutes to prevent skin dryness and irritation.

Be especially alert for the “Koebner phenomenon” — that is, new psoriatic lesions appearing at sites of skin injury, friction, or excessive stretching. Therefore, avoid high-risk activities such as intense contact sports (e.g., combat sports, weightlifting where clothing repeatedly rubs elbows and knees), prolonged cycling (pressure on the sacrococcygeal area), or mountaineering (backpack rubbing the back). Exercise clothing should be made of soft, breathable, seamless materials to reduce local irritation.

Beyond physiological benefits, the mental health improvements from exercise should not be overlooked. The incidence of depression and anxiety in patients with psoriasis is as high as 30%–60%. Regular exercise can promote the release of endorphins and serotonin, improve mood, enhance sleep quality, and break the vicious cycle of “stress → worsening lesions → increased anxiety.”

Long-term adherence to exercise can not only improve lesion thickness, area, and pruritus, but also enhance treatment compliance and even reduce the need for antidepressant medication. Remember: even a 20-minute walk each day is an important step toward health. Exercise is not consumption, but the gentlest and most natural regulator of the immune system.