In this article, learn more about why psoriasis scales form, how to safely remove them, and what to avoid.
Psoriasis is an autoimmune condition that causes skin cells to multiply very quickly. This overgrowth can result in thick, scaly plaques that itch and cause discomfort.
There are many different types of psoriasis, with each type differing in appearance and the areas they affect. Research suggests that more than 8 million people in the United States have psoriasis and roughly 80-90% have plaque psoriasis, which is the type that presents with psoriasis scales.
Psoriasis patches form as a result of an overactive immune system response. The raised plaques on the skin are actually a build-up of skin cells.
Normally, it takes roughly a month for new skin cells to grow and old ones to flake off. In a person with psoriasis, this process happens much faster. The National Psoriasis Foundation notes that the skin cells of a person with psoriasis may shed in just 3-4 days, which is many times faster than usual.
The skin cannot shed away these extra cells fast enough, and they build up on top of each other. The build-up of these skin cells results in the characteristic plaques of psoriasis. As the skin cells build up, the old skin cells stay on top of the skin and begin to shed away in larger flakes, called scales.
Removing the silvery scales from plaques may improve the look and feel of the plaques and may reduce some symptoms or make them more tolerable. Removing dead skin may also make medications more effective, as they can absorb into active skin cells rather than old or dead skin cells. Some options may include:
Exfoliators
Some chemical exfoliators may be very helpful for psoriasis scales. OTC chemical exfoliators may be helpful in removing scale in mild to moderate cases. Doctors may prescribe stronger versions of these topical medications in some cases.
Common chemical exfoliators such as salicylic acid are widely available and may be effective for many people.
Salicylic acid is a keratolytic, meaning it helps break away the outermost layers of skin. A 2017 article notes that salicylic acid can help reduce the pH of the skin, which in turn increases the amount of moisture in the skin and softens the cells.
However, salicylic acid may cause side effects such as stinging, burning, or irritation. Other exfoliators may be similar to salicylic acid, but gentler on the skin. This includes alpha-hydroxy acids (AHAs) such as glycolic acid or lactic acid.
Moisturizers
Regular moisturizers are important for healthy skin. This may be more apparent in people with psoriasis. Applying moisturizers regularly may help reduce the visibility of scales on psoriasis patches. It may also help reduce some symptoms, such as itching caused by very dry skin.
Dermatologists may recommend using heavier creams to help lock in moisture and provide an additional barrier to the skin.
Coal tar
Coal tar is an anti-inflammatory that may help reduce redness and itching. A 2017 article notes that most chronic plaques treated with coal tar improve after 1 month of treatment and remain in remission longer than with other topical treatments.
Some OTC coal tar products such as soaps or creams contain less coal tar than prescription-strength treatments, and may be more suited for daily upkeep. However, coal tar products may cause side effects such as:
- odour
- irritation
- staining of skin
- stinging
OTC corticosteroids
A dermatologist may suggest using topical corticosteroids at varying strengths for treating all grades of psoriasis. OTC steroid creams are milder versions of prescription steroids and may help control mild symptoms of psoriasis.
Corticosteroids reduce inflammation in the plaques, slow down the growth of skin cells, and slightly suppress the immune system response behind these issues.
However, corticosteroids may cause side effects such as:
- thinning the skin
- changing skin colour
- easier bruising
- broken blood vessels
Baths
Soaking in the bath may help soften and slough away dead skin cells from psoriasis plaques.
The temperature of the bath should be lukewarm to warm. Avoid using hot water, as this may irritate the skin even more. Adding ingredients such as oils, Epsom salt, Dead Sea salts, or oatmeal to a bath may help remove psoriasis scales and soothe itching.
People should try to avoid harsh soaps or fragrances, which may irritate the skin. Soaking in a tub for about 15 minutes before using other methods may help soften and prepare the skin.
Medicated shampoo
Medicated shampoos containing salicylic acid, coal tar, or other acids may help control plaques on the scalp and surrounding skin. While other topical formulas may also work, these shampoos contain a special formulation to get the medicine through the hair and into the scalp.
In addition to the approaches above, a person may want to do the following:
Avoid triggers
While caring for mild psoriasis with OTC ingredients can help remove scales, it is also important to care for psoriasis in other ways, such as by avoiding personal triggers. Psoriasis triggers may make symptoms worse and make efforts to control or remove scales harder.
While each person’s triggers may vary, the National Psoriasis Foundation lists some common triggers to try to avoid, such as:
- stress
- injuries to the skin
- sunburns
- illnesses, including anything affecting the immune system
- allergies
- any possible food triggers
- alcohol
- environmental factors such as extreme heat or cold, dry weather
Avoid picking
Avoid picking at scales as a way to remove them. It is easy to pull too much of a scale off, leading to broken skin underneath. This could cause further irritation or bleeding that makes symptoms worse. Picking may also put the skin at an increased risk for infection.
If picking is a nervous habit, try finding something else to keep the hands occupied, such as holding a trinket or clicking a pen.
OTC ingredients and medications to remove psoriasis scales may help with cases of mild psoriasis. If these home remedies do not help control symptoms, a person should consult with a doctor.
Doctors can prescribe stronger medications that may be more effective in controlling plaques or eliminating scales in cases of moderate or severe psoriasis
Psoriasis may cause scales to form on the skin that can be uncomfortable and itchy. This is because psoriasis causes skin cells to multiply quickly. People can use various methods at home such as chemical exfoliators, moisturizers, and baths to help remove psoriasis scales and reduce symptoms.
It is also important to take other steps to help control psoriasis symptoms, such as avoiding personal triggers. Anyone having difficulty controlling their psoriasis symptoms or removing scales safely should see their doctor.
Last medically reviewed on June 7, 2021
https://www.medicalnewstoday.com/articles/psoriasis-scales-removal
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