From everydayhealth.com
Psoriasis is an autoimmune condition that usually involves patches of dry, itchy, painful skin, known as plaques. It occurs when the immune system mistakenly attacks healthy cells in the body, causing inflammation that leads to skin symptoms.
The skin involvement in psoriasis means it’s important to choose a soap, body, or face wash that doesn’t aggravate your symptoms or increase dryness. Harsh soaps can exacerbate psoriasis issues by disrupting the skin’s natural functions.
That’s why gentle, moisturizing cleansers are a good bet — they’re less likely to irritate and can even soothe. There are also medicated products available, which can help manage more severe symptoms.
The right cleanser can make you feel more comfortable in your skin every day. Here are our expert-backed picks.
Best Product Types and Ingredients to Look For
Gentle, moisturizing soaps, facial cleansers, and body washes can help you care for your skin barrier when you have psoriasis. Your skin’s barrier serves a crucial role — it protects you from environmental damage, infection from microbes, and helps regulate hydration, among other essential functions — so maintaining its integrity is key, especially when you have psoriasis.
“Psoriasis skin is characterized by impaired barrier function,” says Kseniya Kobets, MD, the director of cosmetic dermatology at Montefiore Einstein Advanced Care in Elmsford, New York. “It’s also more prone to water loss through the skin, which makes it more likely to become irritated, dry out, and crack.”
According to Dr. Kobets, the best cleansers for psoriasis are:
- Gentle
- Moisturizing
- Fragrance-free
These three qualities help support skin barrier function and prevent irritation due to dryness, Kobets says. With the right cleanser, you can help reduce flares, and keep your skin smoother and more comfortable.
Synthetic Detergent (Syndet) Bars and Liquid Cleansers
Synthetic detergent, or syndet, bars and liquid cleansers — both body and face washes — are commonly marketed as safe for sensitive skin, and they can typically be used with psoriasis. They have a lower pH than traditional alkaline soaps, which means they’re less likely to throw the skin’s naturally slightly acidic pH level out of balance. Keeping the skin’s pH stable helps preserve the skin barrier and may prevent irritation.
Kobets says using syndets can improve skin hydration, reduce flaking, and decrease itching.
Look for these cleanser ingredients when you’re dealing with psoriasis:
- Ceramides
- Glycerol (also called glycerine)
- Petrolatum (also called petroleum jelly)
- Paraffin
- Urea
- Hyaluronic acid
“Ceramides have been shown to improve the appearance of the skin as well as helping with itching and improving cracks in the skin,” says Kobets.
She says that ingredients like petrolatum, paraffin, glycerol, and urea will help with dryness, flaking, and itching as well.
Hyaluronic acid is often found in formulations made for psoriasis. This is because it may reduce symptoms by hydrating skin, repairing the skin barrier, and reducing inflammation.
Colloidal Oatmeal Cleansers
Colloidal oatmeal soaps, facial cleansers, and body washes are another option to soothe psoriasis. Colloidal oatmeal's anti-inflammatory and antioxidant properties can calm skin and prevent cellular damage.
“Oat-derived ingredients have also been shown to be helpful for mild to moderate psoriasis,” Kobets says. “Some of these components include oat flour, oat oil, and oat extract.” You can also look for natural oils, like olive or coconut. These soothing ingredients can ease dryness, itching, and scaling.
Coconut oil, however, is comedogenic — known to clog pores — so if you have acne-prone skin, ask your dermatologist before you try it.
Goat’s Milk Soap
Goat’s milk soap is another natural option to soothe skin that’s irritated from psoriasis. Kobets notes that evidence of its efficacy in psoriasis is limited, though.
Goat milk is rich in fatty acids and vitamins that can nourish the skin. Plus, it contains lactic acid, which provides mild, non-irritating exfoliation.
Kobets says that goat milk also naturally contains the bioactive compounds lactoferrin and lysozyme, which have antioxidant, antimicrobial, and anti-inflammatory effects. These compounds may even help regulate the immune response in people with psoriasis.
“We do not have good clinical trials that support the use of goat milk soaps in psoriasis at this time,” Kobets says.
She recommends goat milk over cow’s milk, as it’s less likely to contain allergens. “I [also] typically recommend avoiding fragrance and other additives in the products due to the risk of increased irritation,” Kobets says.
Medicated and Exfoliating Cleansers
If you have stubborn symptoms that don’t respond to other products, you may want to try a medicated option.
It’s important to speak to your doctor before using them, though. Medicated and exfoliating cleansers can be irritating, and shouldn’t be used on sensitive areas or broken skin.
Coal Tar Soap
Coal tar is approved by the U.S. Food and Drug Administration (FDA) as an over-the-counter treatment for psoriasis, in formulations that contain 0.5 percent to 5 percent of the active ingredient. “Coal tar soaps work by preventing both rapid skin cell growth as well as reducing inflammation,” says Kobets.
There are potential side effects, including:
- Irritation of the skin
- Folliculitis (a bumpy rash)
- Allergic reactions
- Staining of the skin, clothing, and countertops
- Worsened psoriasis symptoms
- Increased sensitivity to ultraviolet light, which can lead to sunburn
That means it’s important to follow proper dosing to avoid staining, burning, and irritation. Follow the package insert or your doctor’s instructions for use.
Kobets says that coal tar should be avoided during pregnancy because of safety concerns.
Salicylic Acid Cleansers
Cleansers with salicylic acid can help with absorption of topical psoriasis medications by removing flaky scales prior to application. “Salicylic acid can be helpful to soften the thick plaques and to reduce the amount of scaling,” says Kobets.
The acid helps soften, dissolve, and exfoliate thick plaques, which allows medications to penetrate the skin more deeply. It’s important to note that concentrated salicylic acid products can cause irritation if left on too long. Kobets says that salicylic acid cleansers may also cause allergic reactions.
“It should also not be used in children under 12 years old or in people who have impaired kidney or liver function,” she says. “It can also only be used sparingly in pregnant and breastfeeding women. In pregnancy we try to limit the use to small areas and for shorter durations to prevent significant absorption by the body.”
Sulfur or Zinc Pyrithione Soap
Sulfur and zinc pyrithione soaps can reduce the flaking and itching associated with scalp psoriasis. These ingredients also have antifungal and antibacterial properties.
“Sulfur soaps and shampoos can be helpful for people with psoriasis,” says Kobets. Sulfur “is a good anti-inflammatory agent and can help break down the dead skin seen in the scaling of the plaques of psoriasis.”
She says that zinc pyrithione may not do much for plaque psoriasis, or most other forms of the condition. “Zinc pyrithione has been shown to be helpful for scalp psoriasis but does not seem to be helpful for any psoriasis outside of the scalp,” Kobets says.
Cleanser Types and Ingredients to Avoid
Good psoriasis management means paying attention to how your skin responds to products and treatments and tweaking your routine as you go. It’s not one-size-fits-all.
“Choosing the wrong soap can make psoriasis worse,” says Kobets. “For example, harsh and alkaline soaps can further disrupt the skin barrier and create more dryness.” This skin irritation can potentially trigger a flare or cause itching.
Ingredients to avoid include:
- Fragrance and dyes
- Alcohols
- Sulfates, like sodium lauryl sulfate
- Physical exfoliants, like those in scrubs
Fragrances and dyes are common allergens and irritants that can cause redness and itching and may trigger new psoriasis plaques.
“Alcohol in [cleansers] significantly dries out the skin, leading to irritation and impaired barrier function,” says Kobets. “It strips away the natural oils from the skin layers that are important for keeping the moisture in the body and keeping the skin barrier intact. Alcohol topically can also make skin cells divide more rapidly (not what we want in psoriasis), and stimulate inflammation.”
Sulfates are strong detergents used to create a rich lather. They can be too harsh for sensitive skin. “Patients should avoid harsh detergents in their soaps like sodium lauryl sulfate because they can disrupt the skin barrier and cause irritation,” says Kobets.
Physical exfoliants irritate the skin. This includes abrasive exfoliants and scrubs that are sometimes added to cleansers. Any trauma to the skin, such as forceful scrubbing, can trigger the Koebner phenomenon, causing a new plaque to form at the site of the injury.
If you’re looking for specific products that might be helpful or you aren’t sure if something you want to try is safe, ask your dermatologist.
The Takeaway
- With psoriasis, gentle, mild cleansers without harsh ingredients are the best options for cleansing your skin.
- Soothing and moisturizing ingredients include oats, goat milk, hyaluronic acid, and ceramides; they can help ease symptoms and restore hydration.
- Medicated soaps with coal tar, salicylic acid, and sulfur can reduce scaling, but they may be irritating.
- Choose cleansers without fragrance, alcohols, sulfates, and rough exfoliants to avoid irritating your skin.
