Psoriasis responds well when you take good care of your skin with a hydrating anti-psoriasis skin care routine. Conversely, it gets worse if you don’t take good care of your skin. 

When I see a patient with psoriasis, I always start our discussion about treatment options with detailed information on hydrating skin care. It really is that important for psoriasis.

If you have psoriasis you need to know that the rash gets worse when your skin is dry, injured, and unhealthy. It means that maintaining well moisturized skin is the single most important step for psoriasis skin care.

This is part 3 of my 3-part article series on psoriasis.

In part one, titled Health Concerns Related to Psoriasis, I introduced the concept of how psoriasis is now considered one piece of a puzzle that makes up a person’s overall health; there are internal diseases that we now know are linked to psoriasis. If you or someone you love has psoriasis, you need to know this information.

In part 2, titled Lifestyle Changes to Help Heal Psoriasis, I summarized my lifestyle recommendations to help control these general health conditions and support healing of psoriatic skin.

In part 3, I’m going to summarize the skin care recommendation that I give to my psoriasis patients. I consider it foundational self care information for people with psoriasis.

What I’m not going to cover in this post, or in this psoriasis series, is prescription treatment. That’s a large and personal subject that needs to be discussed individually with your dermatologist. Prescription drugs for psoriasis come in topical and internal forms and they all have side effects meaning the risk/benefit analysis needs to be weighted personally by you and your treating physician relative to the extent of your skin disease.

Dermatologist’s Skin Care Recommendations to Help Heal Psoriasis

The key aspects of psoriasis skin care are:

1. To “lock and load” water into the skin 24/7.
2. To use skin care products that contain ingredients to slow skin cell turnover, like tar products.
3. To use skin care products that exfoliate excessive scale (BHAs like salicylic acid and AHAs like lactic and glycolic acid).
4. To address facial seborrhea (aka dandruff) because it often coexists with psoriasis in the crossover variant called sebopsoriasis.
5. To look for and treat foot fungus because it’s extremely common, can look like psoriasis, and it’s just one more rash that psoriasis patients don’t need to suffer from.

Here are the details…

Step 1: Hydrating Skin Care to “Lock and Load” Water into Your Skin

Adding water to your skin is what moisturizing is all about. You have to do it from the outside; drinking lots of water won’t moisturize your skin anymore than taking a bath will quench your thirst.

You need to know the two important rules for skin hydration. First, don’t dry out your skin by overusing soap. Second, do apply an effective moisturizer to all your skin within 3  minutes of toweling off after every bath or shower. The reason optimal skin hydration is so important to your psoriasis is because of the Koebner Phenomenon whereby the rash of psoriasis flares up on injured skin  and dry skin is injured skin.

• To avoid drying out your skin with soap:
• Limit soap exposure to only those areas that need it. On the average day, those are:
• The body odor areas including parts of your skin with body odor glands called apocrine glands. These sites are the armpits, groin, and buttocks.  Feet smell too so soap them up.
• The oily areas of your skin which are the face, back, and chest.
• Use a non-drying soap:
• Modern soap substitutes called Syndets (synthetic detergents) clean with mild cleansing ingredients. I like the hypoallergenic Vanicream Bar Soapfor my sensitive skin patients.
  

  Vanicream Soap

  My favorite creamy, liquid soap-less facial cleanser is Toleriane Cleanser.

  

  Toleriane Cleanser

• Old-fashioned natural soaps can be a great choice too if you have soft water (hard water reduces lathering with natural soaps). My Naturally Best Bar Soap is great for general bathing needs.
  

  Naturally Best Bar Soap

  For the face, back, and chest I like my Calming Zinc ® Bar which contains 2% medicated pyrithione zinc to help fight seborrheic dermatitis (aka dandruff) in these dandruff-prone areas.

  

  Calming Zinc Bar Soap

• To trap and hold moisture in your skin 24/7, apply a rich moisturizer right after toweling dry from your shower or bath. Your skin soaks in water when you bathe. Before this water evaporates, cover your skin with moisturizer to lock it in. My favorite moisturizers for psoriasis are Am Lactin Cream or Lotion (with the AHA lactic acid to help remove scale too). Am Lactin is available at most drug stores. Am Lactin can be irritating so I often have patients alternate it with a deeply hydrating, but soothing, product like my All Natural Face and Body Butter Cream or All Natural Face, Hand, and Body Lotion. Another option for a soothing moisturizer is Vanicream Moisturizing Cream.
  

  All Natural Face and Body Butter Cream

  

  All Natural Face, Hand and Body Lotion

Step 2:  Use skin care products with tar

Tar products are a time-honored treatment for psoriasis of the skin and scalp. The easiest way to add tar in a reasonably convenient way is to add a cap full of tar solution to the bath and soak for 15 minutes. I have my patients use Cutar Emulsion from Summers Laboratories. Scalp psoriasis can be treated with tar shampoos in exactly the same way we use them to treat scalp dandruff. To see more of my recommendations for scalp treatment click here. (As with all tar treatments, check with your doctor first to see if this ingredient is safe and right for you.)

Step 3: Use products with AHA and BHA ingredients

AHAs and BHAs help reduce the scale on psoriasis lesions. They also help bind water to the skin for extra skin hydration. The lactic acid in Am Lactin is my preferred moisturizer for psoriasis body because it has just the right combination of these two effects, yet is not as irritating as stronger products such as Glytone Body Lotion. Many of you know that Glytone Body Lotion is my favorite body AHA product for general anti-aging body skin care but psoriasis is the one exception.

Salicylic acid, a BHA, is best added to the skin care routine as a shampoo for thick psoriatic scalp plaques. I discuss that in my post on scalp dandruff noted above.

Step 4: Control facial sebopsoriasis

I have my psoriasis patients use my Redness Relief Kit. This kit includes the same soap mentioned above (Calming Zinc) plus my Green Tea Antioxidant Skin Therapy to help fight facial redness and boost the skin’s antioxidant reserve. I’ve used these products in my practice or years. They’re also what I use for my personal skin care because psoriasis runs in my family and I’m very prone to facial seborrhea.

Facial Redness Relief Kit

For stubborn facial seborrhea (aka dandruff), see my comprehensive skin care recommendations in my dandruff post series.

Step 5: Treat foot fungus

Athlete’s foot is so common and the scaling, fissured, and itchy rash looks so similar to psoriasis that I often treat it on principle when it looks like there is psoriasis foot involvement.  Here’s the advice I give my patients: Dermatologist’s Simple Tips to Treat Athlete’s Foot Fungus.