Psoriasis: Going Skin-Deep
The words “big” and “itches” come to mind.
Psoriasis: giving us the wrong kind of thick skin since forever. Trying to pinpoint the right approach to this complicated condition is no easy task, either - between failed treatments, unknown triggers, and a mysterious origin story, psoriasis can be a touchy subject for those experiencing it.
While there are still plenty of unanswered questions surrounding the diagnosis of psoriasis and how to successfully treat it, understanding the basics is often the first step to better skin health. Let’s discuss what we know (so far) and take a look at what effective care looks like according to experts.
As flare ups and frustration brews on the outside, a lot more is happening on the inside when psoriasis symptoms appear: the thick, scaly, discolored appearance is caused by the immune system attacking its own healthy T cells by mistake, triggering inflammation and rapid skin growth. As the skin reproduces, the fresh layers begin to pile on top of each other to create the dense exterior we see on our skin (1).
These rough patches frequently appear on elbows, knees, the scalp and genitals, and are often itchy, burning or otherwise painful (not to mention the inevitable dandruff 😠). The mental impact of psoriasis is also prevalent; many people describe a general lack of confidence - especially during shorts and bikini weather - and report suffering from anxious or depressed thoughts.
Even though over 8 million people in the U.S. have been diagnosed with psoriasis, scientists are still scratching their heads about where exactly it stems from.
Genetics and failed immune system function are both thought to be contributing factors; injuries, stress, illness (or, really anything affecting the immune system), and weather have all been known to exacerbate symptoms.
Less common psoriasis triggers are allergies and alcohol, although this is noted primarily by people with psoriasis rather than scientific studies (2). Researchers have recently suggested that high fat and sugar diets, which are already linked to inflammation (3), may also contribute to psoriasis development... ~pretends not to hear that & orders a side of fries like usual~.
Most people with psoriasis tend to fall under the same category, but there are actually several different types, each with their own unique symptoms:
About 80% of people who have psoriasis have plaque psoriasis. Raised, inflamed, discolored and scaly patches are found commonly on the elbows, knees, scalp, and the lower back (4).
If you’ve ever dealt with raw, discolored lesions between your thighs, in your armpits or under your breasts, you’ve already experienced inverse psoriasis. Unlike plaque psoriasis, inverse isn’t scaly, but rather shiny due to the top layer of skin being rubbed off by friction (making it common in skin folds).
Although rare, erythrodermic psoriasis is a particularly aggressive form of inflammation that causes a fiery sensation all over your skin barrier. Swelling from fluid retention and shivering are both side effects and major red flags - if you suspect you have this type of psoriasis, seek medical care right away to prevent a potentially severe, life-threatening illness from developing.
Small, discolored, individual patches that develop during childhood are a hallmark of guttate psoriasis. Upper respiratory infections, strep throat, tonsillitis, stress, or injury are all suspected triggers, and just like that date who ghosted you but still likes allllll your Instagram posts: it may go away on its own forever, or reappear later on.
Affecting a very small percentage of adults, pustular psoriasis causes white blisters of pus to appear on the hands, feet or body. Luckily, the blisters are noninfectious, but the effect is still unsettling for those dealing with it, especially since the blisters can scale and lead to discolored skin.
There is currently no known cure for psoriasis, but there are a variety of proven and unproven treatment options available for symptom relief. Here’s a few science and beauty-based tips:
Soak, don’t scrub
As with most health conditions, stress only worsens psoriasis symptoms; taking a warm bath can calm your nerves and your skin, making it a popular treatment choice. Here’s a start: add oatmeal or bentonite to a warm bath (like this fashion blogger) and soak for at least 20 minutes. Then, apply a scale softener, like salicylic acid, to the affected patches (5) and pat yourself dry with a towel - trust us, you don't want to rub your raw skin!
Why not make things fun? We suggest setting the mood by turning on some soothing music and tuning out while the product works its magic. Once complete, wear soft clothing with breathable material like cotton to prevent chafing.
Do a drugstore haul
OTC remedies: some great, some not so great. It’s always a risk to try a DIY, but when you’re in need of a quick fix for irritating psoriasis symptoms, OTC remedies are usually the most readily available option.
For itching: An ointment containing calamine, camphor, hydrocortisone, or menthol can help; mild corticosteroid, like hydrocortisone, helps eliminate itch while decreasing inflammation (6). For dry skin: A heavy cream or oil can lead your skin in the right direction and stop itchiness before it starts. Look for a ceramide cream to apply daily.
Eliminate fragrance and harsh chemicals
I know, I know - some of us started our adolescence dousing ourselves in B&BW “Sweet Pea” body spray, so why wouldn’t we continue to use fragrance in our everyday arsenal? One big reason: it contributes to worsening skin conditions (and is, unfortunately, pretty bad for you).
Fragrance, along with harsh chemicals like parabens, sulfates and phthalates, have a tendency to inflame irritated psoriasis patches, so avoiding them is key. You’ll have to stay vigilant: your favorite skincare brands may tout chemical-free formulas, but don’t always exclude fragrance as well (we’ve seen so ourselves). Double check your everyday products to make sure they’re fragrance and chemical-free, and if they’re not, consider switching ASAP to avoid excess irritation.
Seek professional care
So you’re over trying yet another “hack” just to be left suffering more - what now? If you’re stuck on what to do next, it’s time to make a doctor’s appointment to explore further treatment. Even a consultation is better than nothing, especially considering the complicated nature of psoriasis - an expert will be able to provide better insight on where your skin is at and what the best approach may be.
With medical assistance, you also have access to innovative treatments that have proven effects - things like light therapy (the use of UVA and UVB light to reduce inflammation), biologic medication, prescription retinoids, corticosteroids, and/or methotrexate are just a few of the options available to help you tackle your skin issues on a deeper level.
Most of the time, doctors end up prescribing several different treatment routes to effectively address your unique set of symptoms - something that’s hard to achieve without close expert supervision. Besides mild OTC remedies, avoid testing harsh treatments on your own to prevent any unwanted adverse reactions.
The bottom line
Understanding where psoriasis stems from is the first step to tackling unruly flare ups. It’s helpful to keep track of your body’s changes and only experiment with mild treatment options to hopefully achieve better skin health over time. Remember to be gentle on yourself through the process, too - like we said, psoriasis is complicated, and may take some extra patience before you find success with one or more solutions. In the meantime: love the skin you’re in (even/especially when it’s hard) and seek professional help - we’re here for you, mavens.
Got intel? Share your own psoriasis tips & tricks below!
Written by Adrianne Neal