A Few Self-Care Tips to Manage Psoriasis Itch and Scaling

From psoriasis.org

Pair these self-care tips with proper treatment to feel more in control of your skin 

If you’re reading this, chances are you know the relentless itch and the troublesome scaling of psoriasis. About 80% of people with psoriasis experience itching, and up to 90% say these symptoms affect their quality of life, from sleep to social activities, according to a study in the Journal of Dermatological Treatment.

The good news: When combined with proper treatment, a little self-care and self-love can go a long way toward managing psoriasis itch and scaling. Here, we’ll explain why these symptoms happen and steps to get some much-needed relief.

Why Does Psoriasis Itch and Scale?

Understanding what’s happening in your body can help make sense of these frustrating skin symptoms.

The science behind the itch

Itch is a major part of psoriasis. It’s even in the literal meaning of the word – “psora” means “itch” in Greek – and yet this symptom is often overlooked and underappreciated.

When it comes to psoriasis, itch – which is called pruritus in the medical community – is more than dry skin. According to a study in the International Journal of Molecular Sciences, the exact mechanisms that make skin affected by psoriasis so itchy are unknown, but we do know the process involves the activation of nerve fibres peripherally (on the outside of the body). The itch of psoriasis is most often associated with the area of the lesions, and often, the more a lesion is scratched, the more severe the itch becomes.

This itch-scratch cycle can also be psychological. Triggers like stress, anxiety, or even seeing someone else scratch can play a role. (Hopefully, reading this isn’t making you itch more!).

Why scaling happens

Scaling happens because psoriasis speeds up your skin’s natural renewal process, shortening the time it takes for skin cells to regenerate, causing them to pile up and form thick, dry, flaky scales that can crack and feel itchy.

How to Ease Psoriasis Itch and Manage Scaling

Pair these self-care strategies with your prescribed treatment plan to help ease your discomfort.

Don’t scratch, distract yourself

We know – it is so much easier said than done. Yet scratching never satisfies the itch, and it can lead to open wounds, raising your risk of infection.

Instead, try redirecting your attention by:

• Applying a cold compress for a few minutes.
• Going for a brisk walk.
• Doing some gentle stretching.
• Using a stress ball or fidget toy.
• Picking up a book or putting on a podcast.
• Practicing deep breathing.

If night-time itch is a problem, consider wearing cotton gloves to bed and always keep your nails trimmed and smooth.  

Moisturize when it counts

Moisturizing is a key part of any psoriasis self-care routine – and consistency matters. Use a fragrance-free cream, lotion, or ointment after hand-washing or bathing to lock in moisture. For added relief, you can gently pat it onto itchy areas to calm the urge to scratch, as recommended by the American Academy of Dermatology.

When choosing a product, check for the National Psoriasis Foundation’s Seal of Recognition to ensure it's safe for psoriasis skin.

Rethink your shower routine

If long, steamy showers are your go-to, it might be time to adjust your bathing routine. Hot water strips natural oils from your skin and can inflame the surface of the skin. The result? Potentially dry and flare-prone skin.

• Use warm (not hot) water.
• Choose unscented, soap-free cleansers.
• Lather using your hands, not a harsh loofah or washcloth.
• Shower for under 5 minutes and keep baths under 15 minutes
• Blot gently with a towel to dry off, rather than rubbing.
• Moisturize while skin is still slightly damp.

Pay attention to stress

Managing stress is a big part of psoriasis self-care, especially since it’s a known trigger, resulting in skin flare-ups for nearly 90% of people with psoriasis, according to a study in the International Journal of Dermatology. It can also intensify itch and make it harder to cope.

Work with your health care provider to find a stress-reducing technique that works for you:

• Meditation
• Breathing exercises
• Journaling
• Gentle movement like yoga or stretching
• Support groups (in person or online)

Focus on healthier habits

Like most, you probably aren’t eating a perfectly healthy diet and completely avoiding alcohol, vaping, or cigarettes; however, small, consistent choices do count when it comes to supporting your skin, so perhaps a bit of moderation or adjustment could help your symptoms? Try one of these to get started:

• Cut down on processed foods and go for a mostly Mediterranean-style diet with fruits, veggies, whole grains, and healthy fats.
• Limit alcohol, which can trigger and aggravate psoriasis flares, dry out skin, and even make some medications less effective. Some mixed studies even suggest alcohol can increase psoriasis itch.
• Skip smoking, tied to more severe disease (more itchy scales) and can worsen related conditions (or comorbidities) like cardiovascular disease and inflammatory bowel disease.

Focused, regular self-care might not stop every flare-up or completely eliminate the itch or scaling, but it can help reduce surface inflammation, soothe skin, and improve your overall well-being. Use these ideas as inspiration and find what works for you and your psoriasis.

https://www.psoriasis.org/advance/self-care-tips-for-psoriasis-itch-and-scaling/

Picking at Your Psoriasis Scales? Do This Instead

From everydayhealth.com

It’s tempting to peel and pick at those itchy scales, but if you can help it, there are better ways to cope

Psoriasis is more than just an outbreak of itchy skin rashes. It’s a systemic inflammatory disease that also affects internal organs, according to Anthony Fernandez, MD, PhD, director of medical and inpatient dermatology at Cleveland Clinic. More than 8 million Americans have the condition, according to the National Psoriasis Foundation.

Dr. Fernandez explains that while we don’t know the exact cause of psoriasis, the prevailing belief is that people have a genetic predisposition to it. 

“When exposed to the appropriate outside trigger — a viral or bacterial infection, a significant life stressor, or environmental exposure — it sparks the initiation of that chronic inflammation,” says Fernandez. “Unfortunately, once it begins, we don’t have a permanent way to turn it off.”

What’s Going on With Your Skin When You Have Psoriasis 

While the thick scales — combined with the sometimes-uncontrollable itchiness — make it very tempting to scratch and pick, Fernandez warns that this is not a good idea. To understand why, you’ll need to take a closer look at what’s happening with your skin.

"Psoriasis triggers the cells within the upper layer of the skin, called the epidermis, to reproduce more rapidly than they would normally,” Fernandez explains. “That’s what leads to the visible rash.”

In all people, as skin cells reproduce and move up toward the surface, they flatten out and form a thin layer of dead cells called the stratum corneum — the outermost layer of the skin — which has a protective function. For example, when bacteria and other organisms land on your skin and try to get inside your body, where they can cause infections, your skin sloughs off both the dead cells and foreign organisms as a defence mechanism.

People with psoriasis have cells that reproduce much more rapidly than they should, so the outer layer of skin becomes especially thick, eventually forming a scale: a bunch of dead skin cells that formed so rapidly that they don’t slough off. 

The formation of the scale, combined with the itchiness, can tempt you to pick at the skin. That, in turn, can cause more psoriasis flares — something called the Koebner Phenomenon.

 

Getting Picky: Can You Remove Psoriasis Scales?

There’s really no “safe” way to remove psoriasis scales, says Fernandez. “When you scratch, the scales are often dislodged and trigger bleeding,” he says, because scales can develop on areas of the body where there is a very thin barrier between the blood vessels underneath the epidermis and the epidermis itself. So, when a scale gets picked off, it often causes pinpoint dots of bleeding. There’s even a name for this: the Auspitz sign.

“I see patients with psoriasis who are frustrated, because all of their clothes and bedsheets have blood on them,” says Fernandez.

What’s more, the relief is short lived, he says. “That scale will re-form in a very short time.”

Using a pumice stone as an exfoliant doesn’t work well, either. “Think of the skin as a simple organ whose job is to protect all of the organs that are living inside of the body,” Fernandez explains. “When you use things like a pumice stone to rub the skin, it thinks that something is trying to get underneath and do damage to the organs within, so it will respond to that trauma by getting thicker. Using a pumice stone causes far more damage than good.” 

Ways to Treat Psoriasis

The best way to prevent scales from forming is by treating the psoriasis itself, he says. Here are a few treatments to try.

Salicylic acid moisturizer People who have mild psoriasis may want to stick to topical treatments, including salicylic acid (which is in a class called keratinolytics), Fernandez says, which can safely and gently remove scales. Over-the-counter moisturizers with salicylic acid can help dissolve and decrease the thickness of scales on psoriatic lesions.

Corticosteroid topicals Applying corticosteroids,another topical treatment, targets inflammation and itching and can help prevent you from scratching and exacerbating scales.

Fernandez recommends putting on all topical medications after showering and lightly towelling off, because they tend to penetrate moist skin better. (Steroids have to penetrate that top layer of skin to reach the inflammation they’re targeting.) He also recommends reapplying in the evening before bed, when you’re no longer active. “If you put it on first thing in the morning, the medicine tends to rub off before it can penetrate,” he says. “When you have downtime, the medicine can stay on the skin much longer.”

Phototherapy Light can be an effective way to control the inflammation and, as a result, decrease the amount of scaling. “Doctors don’t really know how it works, but the wavelengths of light will penetrate through the epidermis, and that light has immunosuppressive effects on the skin in the setting of an overactive immune system,” says Fernandez. He recommends getting five to 10 minutes of natural sunlight several times per week on areas that are affected by psoriasis to help control scaling and itching. 

Oral medication People with more widespread psoriasis may have systemic inflammation, says Fernandez. In this case, systemic medications, which come in the form of traditional medicines or newer biologic medications, may be able to help tamp down the inflammation.

Avoiding triggers Lifestyle habits can trigger or aggravate psoriasis. Smoking; drinking alcohol; eating a high-calorie, high-fat diet; leading an inactive lifestyle; lacking sleep; and not managing stress have all been found to trigger psoriasis flares, he says. 

https://www.everydayhealth.com/psoriasis/picking-at-your-psoriasis-scales-do-this-instead/ 

What to do and what to avoid to safely remove psoriasis scales

From medicalnewstoday.com

Psoriasis scales are a characteristic sign of psoriasis. They typically appear as patches of rough, red skin and silvery-white scales that may itch, cause discomfort, and flake away. There are a few methods people can try to manage their skin and remove psoriasis scales

A person who wants to safely remove psoriasis scales may need to try different methods to see what works best for them without damaging the skin or causing further irritation. While over-the-counter medications and home remedies can help reduce psoriasis scales, in severe cases people should see a doctor who can prescribe stronger treatments. People should also avoid personal triggers that could exacerbate any symptoms.

In this article, learn more about why psoriasis scales form, how to safely remove them, and what to avoid.

Psoriasis definition

Egor Kulinich/Getty Images

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.

Why do psoriasis patches form and skin flakes off?

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.

How to safely remove psoriasis patches

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.

Things to avoid

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.

When to see a doctor

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

Summary

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