What are considerations for moisturizing skin with plaque type psoriasis
Psoriasis is often associated with symptoms of skin dryness, pain, scaling, and redness. Moisturizer can help to ease these symptoms by forming a protective barrier over the irritated or inflamed skin and helping the skin retain moisture. Emollients such as mineral oil, glycerin, ceramides, shea butter, and petrolatum, are ingredients found in moisturizers that can help to hydrate and smooth the skin.
Areas of skin affected by psoriasis plaques are usually thicker and thus may benefit from ointment-based moisturizers to soften the area and allow better absorption of the topical treatment. Moisturizers are often used in combination with other prescription treatments prescribed by your doctor.
Some considerations to keep in mind when selecting a moisturizer for skin with plaque psoriasis are skin texture (dry or oily), location of psoriasis on the body, the presence of plaques, and personal preferences.
Importantly, psoriasis may respond differently to certain ingredients and products depending on the person. Like pharmacological treatment, what works for one person may not work for another and individuals need to figure out what is most effective for them at different stages of their condition.
Tips for Skin Texture
- The best time to apply creams, ointments or lotion to dry skin is immediately after bathing or showering because the moisturizer works by trapping existing moisture in your skin. When drying your skin after a shower, gently pat the skin dry to avoid irritating the skin with vigorous rubbing.
- Dry weather can worsen skin dryness. Wearing gloves whenever you go outside in cold or dry weather can help. Gloves labeled hypoallergenic or made from cotton or silk may be better for sensitive skin. If the area you live in is naturally very dry, it can be helpful to use a humidifier.
- Try to limit showers and baths to 5 minutes if possible and use lukewarm water since hot water can exacerbate psoriasis symptoms.
- Creams and ointments may work better than lotions for dry skin because they have a higher oil content and form a better barrier to lock in moisture. However, some people do not like the greasy feeling of ointments and creams.
- Washing oily skin in the morning and at night helps to remove excess oils and dirt. When washing your skin, it’s better to gently pat the skin dry to avoid irritating the skin with vigorous rubbing.
- Wash your hands before touching your face to avoid transferring dirt, oil, or bacteria from your hands to your face.
- If you need to remove excess oil during the day, consider using a blotting paper and make sure to wash your hands before touching your face.
- Consider using a mild, water-soluble cleanser for your face and fragrance free, mild soap for your body. Use moisturizer after cleansing to keep your skin hydrated.
- People with oily skin may prefer to use lotions, creams, rather than ointments, due to their lower oil content.
Tips for Different Body Parts
- Use a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of at least 30 that blocks both UVA and UVB rays. Most products have UVB protection but may not have adequate UVA protection. Look for products that are labelled “broad spectrum” as these have both UVA and UVB protection. Sunscreens that meet the minimum requirement for UVA protection will have a UVA symbol on the label.
- Creams spread easily over the face and have a balance of oil and water content to hydrate the skin while not leaving an overly greasy texture. If you’re prone to oily skin, consider using light weight creams, gels, or lotions.
- For some medications, such as topical corticosteroids, lower strengths may be used on the face compared with the rest of the body. Talk with your doctor or pharmacist to ensure you’re using the correct dose or strength of medication for your face.
- Topical non-steroidal calcineurin inhibitors may also be an alternative.
Arms and legs
- If your arms and legs will be exposed to the sun, consider using a broad-spectrum sunscreen with a Sun Protection Factor (SPF) of at least 30 that blocks both UVA and UVB rays. Most products have UVB protection but may not have adequate UVA protection. Look for products that are labelled “broad spectrum” as these have both UVA and UVB protection. Sunscreens that meet the minimum requirement for UVA protection will have a UVA symbol on the label.
- Lotions are easier to spread over arms and legs compared to creams and ointments as lotions are thinner and water based. Lotion also evaporates quickly and doesn’t leave a greasy residue, generally making it a good option for covering large body areas such as the arms and legs.
- Creams, lotions, or ointments can be used on the hands based on your personal preference. If you have very dry skin, it may be a good idea to apply an ointment at night and cover your hands with cotton gloves to lock in the moisture.
- Apply moisturizer to your hands frequently throughout the day as your hands are frequently exposed to the air and may be more susceptible to moisture loss.
- Apply moisturizer every time after washing your hands or using hand sanitizer.
- Consider wearing gloves to protect your hands when going outside or when working with harsh soaps and chemicals.
Scalp and other areas with hair
- Lotions, gels, scalp lotions, shampoos, and other thin topical solutions are a good option for hairy areas as they offer better penetration to the skin and don’t get stuck in hair the way that ointments might.
- When using a shampoo, it’s important to follow the instructions on the bottle or those provided to you by your healthcare professional. Most medicated shampoos require you to leave the product on for a few minutes to allow for absorption into the skin before you rinse it off.
- If you’re diagnosed with scalp psoriasis, a common treatment is to wash your hair a few times per week with prescribed shampoo to remove the scaliness. Based on your hair texture, styling, and hair washing frequency, you may want to consider alternative topical regimens (e.g., oil-based vehicles, emollient foams, or lotion) compatible with your hair care practices.
- The skin in the genital area tends to be more sensitive than other areas of your body. Avoid irritating ingredients such as alcohol, alpha-hydroxy acid (AHA), fragrance, and retinoids on these areas.
- Strong medicated creams are not intended for use on the genital area and may not be safe. Always talk with your healthcare provider before starting a new treatment.
- Options may include considering a non-steroidal alternative (i.e., topical calcineurin inhibitor).
What are questions I can ask my doctor/dermatologist/pharmacists about over the counter (OTC) products?
- Do these OTC products interact with any of my current medications?
- What dosage form (i.e., cream, lotion, ointment, etc.) would work best for this area of skin (i.e., arms, legs, scalp, hands)
- What strength/dose of topical cream should I use and how often should I apply it?
- What are the potential side effects of this OTC product?
- What medicated ingredients are recommended for psoriasis and are they available without a prescription?
- Is this product safe for me to use?
- What benefits can I expect from this product?
- Will my insurance cover the cost of these treatments?
- Is there a brand name or generic version available?
What are some criteria to consider when purchasing an OTC product? (Fragrance, texture, application, cost)
Some things to consider when purchasing an OTC product include:
- Application Frequency
- Active ingredients
Fragrances are sometimes used to provide a positive sensory experience or to mask the smell of other ingredients in the formulation. The decision to select a product with or without fragrance is a personal one. For some, fragrances are preferred for the reasons mentioned. For others, fragrances can be irritating to the skin, migraine-inducing, or unpleasant to the senses. If you have sensitive skin or are prone to migraines triggered by strong smells, it may be a good idea to select fragrance-free formulations. This information is usually listed on the product packaging.
Formulation/Texture: Topical products can have many textures ranging from thick and oily to thin and dry. The choice of what texture is best for you can depend on what part of the body you will be applying the product to and the state of your skin on that area. For areas with hair, such as the scalp, thinner formulations such as lotions or gels may spread more easily and be more cosmetically appealing since they evaporate quickly and do not leave a greasy film. Lotions and other thin formulations such as foams and sprays are good for covering large areas of the body because they spread easily. Ointments are a lot thicker than lotions and can take longer to fully absorb. Ointments can be used for very dry areas of skin that may require more hydration. Thicker formulations, such as ointments, can protect the skin from losing moisture. Some people may also have a personal preference for one texture over another.
Cost: OTC skin care products are available at a variety of price points. No matter what you’re looking for, there is likely a product that will fit your budget. Brand name products tend to be more expensive than their generic alternatives. Your pharmacist can help you select a product that falls in your price range. When determining the cost of the treatment, it is important to consider how long the product will last you. This takes into consideration how much of the product you will need to cover the affected area and how often you will be applying it.
Active Ingredients: Talk to your doctor or pharmacist to learn what active ingredients are recommended for your skin. The Navigating the Skin Care Aisle Tool can also help you learn more about what ingredients to consider when selecting a skin care product to help you have informed discussions with your healthcare provider.
Dosage: Follow the instructions on the label to ensure you are applying the right dose of the product at the right frequency.
Safety: Read the product label and make note of any warnings or cautions indicated. The warnings section of the product label may contain information about product safety and may list certain populations that should avoid using the product. If you have any questions about the information provided in this section, talk with your doctor or pharmacist.
Application Frequency: Often once or twice per day is all you need. Some very dry, fissured areas may require more frequency application.
|Speed of absorption/ evaporation after application to the skin
|Useful for areas with hair
|Provides a protective layer when applied to skin
|Cooling sensation when applied to skin
|Non-greasy to mildly greasy
|Good for application to large areas of skin
|Cooling sensation when applied to skin
|Must be left in place for several minutes before rinsing (follow product instructions)
Can OTC products interact with my prescription medications?
The short answer is yes, OTC products can interact with your prescriptions. While most people know to check with their doctor or pharmacist when starting a new oral medication, many people don’t think to talk to their healthcare provider about drug interactions with OTC creams, lotions, ointments, and shampoos. While these products are available for self-selection without the guidance of a healthcare provider, some of them can interact with prescription medications. Your pharmacist or doctor can advise you on how to manage any drug interactions that arise. Common interactions may include duplication of therapy. This interaction occurs when an ingredient in an OTC product is the same as an ingredient that’s already in a prescription product. Taking both together can result in people getting a higher dose of the medication and having an increased risk for side effects. Some OTC ingredients, such as salicylic acid, can increase the absorption of other medicated creams that are applied over the same area, and lead to more side effects when not used appropriately. Talk with your doctor or pharmacist before starting any OTC products.