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Psoriasis, an immune-mediated disease that can cause painful and itchy patches of red, scaly skin known as plaques, can make getting the recommended amount of exercise and strength training more difficult than it already is.

First, there's the psycho-social factor: When you're in the midst of a flare-up, you may struggle with self-confidence and avoid populated spaces like the gym or your regular group fitness class. Plus, the physical stress caused by a workout can increase inflammation and tax your immune system, causing symptoms to worsen. And sweat and friction from clothing, equipment and surfaces can further irritate your skin.

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But that doesn't mean that people dealing with psoriasis need to sit on the sidelines. "Exercise can be beneficial to almost any type of disease or state of health, as long as it's appropriately dosed for the person," says Grayson Wickham, DPT, physical therapist and founder of Movement Vault.

Wickham, who's worked with patients with psoriasis, recommends a low-impact, low-intensity strength workout when you're in the midst of a flare, as it can provide the benefits of resistance training without overly stressing your body or aggravating your skin. The one outlined below requires zero equipment and a small patch of floor space so you can do it in the comfort of your own home.

Designed by Wickham, this 20-minute, low-impact workout provides full-body strengthening with no equipment. While each movement is challenging, this routine is more about maintaining a steady burn than breaking a crazy sweat. So, take your time and pay attention to form. Skip any movements that cause discomfort, or check out the tips below for modifying exercises and your space.

Perform the exercises in order as a circuit, completing 2 to 3 rounds. If you need to move slowly because you're feeling fatigued or need to limit perspiration, you can optimize your time by performing the lunge with rotation once and starting each of the following rounds with the squat. Also, feel free to reduce your reps as needed.

An exercise mat

Optional: medium-weight dumbbells or kettlebells

‌‌Check out more of our 20-minute workouts here — we’ve got something for everyone.‌

Also affectionately referred to as "The World's Greatest Stretch," this mobility drill will bring your tissues up to a working temp without getting you super sweaty. It engages every major muscle group while loosening and lubricating your joints, including your hips, knees and ankles. And that thoracic twist just feels great.

Work out in naturally cool, moderately humid spaces when possible. While heat and sweat can trigger a flare, a cranked-up air-conditioner (common in gyms and fitness studios) can be drying and irritating to the skin, according to the American Academy of Dermatology Association. If you’re stuck in an air-conditioned room, using a moisturizer can help.

The squat is a foundational movement that targets your quads and glutes while activating your core. You can add resistance by holding dumbbells at your sides or in the racked position at your shoulders. If you're up for a challenge but prefer to limit your skin's contact with equipment, try slowing down your reps or holding your position at the bottom of your squat for a few seconds.

"If something doesn't feel right, try limiting your range of motion," Wickham suggests. He explains that movement stretches the skin, which can irritate plaques. So, for example, if a full squat hurts the skin around your knees, go halfway or three-quarters of the way.

The dead bug strengthens your entire core, including the deep core muscles responsible for stability, alignment and posture. Your torso remains stationary throughout the exercise, so you won't experience the friction you get with other core exercises, including crunches, sit-ups and V-ups.

Don't be afraid to double up your exercise mat or place a folded towel under a painful contact point, Wickham says. "If someone does have an area that's a little irritated, sometimes adding some extra padding can be enough to make it OK," he says.

The reverse plank fires up your core and the entire posterior chain while giving you a deep stretch in your chest and shoulders. You'll also feel this hold in your triceps.

The right apparel makes a difference, so experiment with various materials and fits. Wickham notes that some of his clients with psoriasis prefer wearing compression garments that provide a layer of protection, while others opt for lighter, loose-fitting clothes that promote air flow and don't touch their skin.

Like the squat, the single-leg deadlift can be performed with added resistance (holding a dumbbell or kettlebell in both hands or the hand opposite the standing leg) or with your body weight alone. The hip hinge strengthens your glutes and hamstrings, and, because you're standing on one leg, challenges your balance.

The bear crawl is low-impact and demands a relatively small range of motion, but you'll feel it everywhere, especially in your core, arms, shoulders and chest. Also, because you're balancing on just your palms and the balls of your feet, it's a smart pick for when you want your skin to make minimal contact with the floor.

‌Check out more of our 20-minute workouts here — we’ve got something for everyone.