From healthcentral.com
A new study found that hard water can increase the risk of psoriasis. Here’s what you should know about what’s coming out of your tap
If you have psoriasis, you’re probably careful about avoiding common triggers like fragrances, cigarette smoke, and alcohol-based products. But one unexpected irritant could be coming straight from your faucet: hard water.
Hard water is water that contains high levels of minerals like calcium and magnesium, which dissolve into the water as it moves through soil and rock, according to the U.S. Geological Survey (USGS). While it’s not considered dangerous, new research suggests it could increase the risk of developing psoriasis. The recent study found that for every 50 milligram-per-litre (mg/L) increase in water hardness, the risk of developing psoriasis rises by 3%. People exposed to very hard water (more than 180 mg/L) had a 20% higher risk of developing psoriasis than those who used softer water.
How Does Hard Water Affect the Skin?
To conduct their study, researchers followed 486,414 people in the UK for about 14 years to see if hard water increases the risk of psoriasis. They collected data from the UK Biobank, a large health study, which included information on participants’ genetics, lifestyle, and environment. Water hardness levels were recorded in 2005 from local water providers, and researchers tracked who developed psoriasis over time. They found that the harder the water, the higher the risk of psoriasis. This suggests that the minerals in hard water might help trigger psoriasis, and using softer water could help prevent it.
Hard water may contribute to psoriasis by irritating the outer layer of the skin, say researchers and study authors Ji Li, M.D., Ph.d. and Fang Wang, M.D. from the dermatology department of Xiangya Hospital in Changsha, China. “Calcium in hard water reacts with soap to form chalky particles that further irritate the skin,” says Dr. Li. Additionally, hard water may prevent the complete removal of detergent compounds, like sodium lauryl sulfate, from the skin, leading to further irritation and damage.
“Hard water can lead to soap deposits on the skin,” confirms Lauren Ploch, M.D., a board-certified dermatologist in Augusta, GA. For this reason, some dermatologists also believe that hard water can worsen psoriasis symptoms for those who already have the condition. “It can increase transepidermal water loss—the amount of water that evaporates from the skin—which can lead to dryness and worsen psoriasis symptoms.”
Do You Have Hard Water?
You may suspect your home has hard water if you notice spots or film on your glassware, or if you need extra soap or detergent to wash your hands, hair, or clothing. A quick at-home test: After washing your hands, see if your skin feels like it has a filmy residue (it will literally feel sticky or waxy when wet and chalky as it dries)—this could indicate a reaction between the soap and calcium in the water, forming soap scum.
City water hardness is often published online, says Dr. Ploch, and a map from the USGS can provide general information about different areas. Well water is more likely to be hard compared to city water, though it should be tested to confirm.
Some people don’t realize their water is affecting their skin until they move to a new location. “In some cases, people will notice a change after moving or traveling and realizing that their psoriasis has worsened,” says Marisa Garshick, M.D., an assistant clinical professor of dermatology at Weill Cornell Medical Centre in New York City. The good news? Soft water is unlikely to trigger a psoriasis flare. “Soft water doesn’t leave behind residue like hard water does, so it doesn’t tend to cause irritation or inflammation,” Dr. Garshick says.
What Can You Do About Hard Water?
It’s unclear whether using a water softener—a device that removes calcium and magnesium from water—can directly reduce psoriasis risk, say the study authors. “This hypothesis has not yet been rigorously tested in clinical studies,” they note. However, if you suspect hard water is exacerbating your psoriasis, switching to soft water may be worth trying, says Dr. Ploch.
There are two main types of water softeners:
Salt-based softeners, which remove hard minerals by exchanging them for sodium. These need to be recharged with salt, typically once a week.
Salt-free softeners, which don’t remove minerals but condition them to prevent build-up on surfaces.
The right choice depends on your budget, household size, and whether you prefer a salt-based or salt-free system. Water softeners are available online and at home improvement stores like Home Depot or Lowes.
If installing a water softener isn’t an option, you can still take steps to protect your skin. Jack Levy, M.D., a dermatologist at Weill Cornell Medicine, offers these tips:
Use a shower filter to reduce chlorine, minerals, and heavy metals that can contribute to skin irritation.
Avoid hot showers, which strip away natural skin oils. Instead, opt for lukewarm or cool water.
Switch to a gentle liquid cleanser rather than bar soap, and avoid washcloths, loofahs, or scrubbing beads.
Limit showers to under 10 minutes to minimize water exposure and skin dryness.
Pat skin dry with a towel instead of rubbing it and apply a moisturizer within five minutes of bathing to lock in hydration.
Use thick, petrolatum-based or ceramide-rich moisturizers in jars rather than pump bottles, as pump dispensers often contain more alcohol, which can dry out the skin.
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