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Treating Psoriasis

Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin.  It typically affects the outside of the elbows, knees or scalp, though it can appear anywhere on the body.  Psoriasis can cause itchy, burning and stinging sensations.

If you have psoriasis, it is particularly important to avoid certain ingredients in your skincare:

  • Fragrance and Perfumes Don’t trust that a product labeled ‘unscented’ doesn’t contain fragrance or perfumes.  Look for the term “fragrance-free.”  Same thing goes for products labeled ‘hypoallergenic’ or ‘dermatologist tested”– these terms are basically meaningless.  Look for products labeled “allergy tested.”
  • Alcohol and Witch Hazel are two of the worst offenders for those with sensitivities.
  • Preservatives and Parabens can cause skin sensitivities. Although methylparaben, ethylparaben and methylisothiazolinone have been found to be somewhat  problematic, paraben allergies are very uncommon, occurring in less than 5% of the population.
  • Sulfates (particularly Sodium Lauryl Sulfate, or SLS) have long been an enemy of sensitive skin types. Foaming agents in general disturb the natural moisture barrier of the skin.
  • Chemical Sunscreens, such as Oxybenzone and Octinoxate are particularly sensitizing. Physical sunblock such as zinc oxide and titanium dioxide are your best bets.
  • AHA’s (Alpha Hydroxy Acids), such as glycolic acid and lactic acid can be very irritating to sensitive skin.
  • Botanical Oils Clean and natural products can be just as irritating as products containing synthetic ingredients. Many contain highly irritating plant and citrus oils, as well as preservatives.  Some of the most common irritants are: linalool, limonene, peppermint, eucalyptus, cinnamon, ginger, lemon and lemon verbena to name a few.
  • Talc, Pigments, Dyes and Mica in makeup can trigger reactions. Some with extra sensitive skin can’t even use mineral makeup due to ingredients such as Bismuth Oxychloride.

In addition to the guidelines above, following a skincare regimen designed for sensitive skin can be very effective for psoriasis sufferers.

  1. Use a gentle, fragrance-free cleanser specifically recommended for sensitive skin. There are many excellent options available.  Avoid any type of abrasive cleanser or scrub, even if it claims to be formulated for sensitive skin.
  2. Always use a moisturizer with broad-spectrum sunscreen of SPF 30 or higher for your specific skin type. Sunscreens with zinc oxide and titanium dioxide are the best choices for psoriasis and sensitive skin types.
  3. In the evening, after cleansing and toning, follow with a hydrating, fragrance-free moisturizer formulated for your particular skin type.

Treatments that have proven effective in treating psoriasis include:

Salicylic Acid: A toner or liquid exfoliant containing salicylic acid will help exfoliate the red, scaly patches of psoriatic lesions. Removing these layers will allow other topical medications to better penetrate your skin.  Salicylic acid also has anti-inflammatory properties, which helps to reduce the redness associated with psoriasis.  Although there are many excellent over-the-counter options, a prescription-strength formula may be necessary to treat more severe cases of psoriasis.

Topical Steroid Creams: Over-the-counter cortisone cream and prescription-strength steroid creams are typically the first step in treating psoriasis.  Steroid creams help to reduce the itching, inflammation, and growth of the psoriatic skin cells in mild to moderate psoriasis.  More powerful prescription-grade topical steroids, called corticosteroids, can be very effective in treating more severe conditions.  However, they carry a higher risk of side effects, such as burning, thinning of the skin, and dilated blood vessels.  Always discuss possible side effects and proper application with your physician.

Topical retinoids: The combination of the prescription retinoid, Tazarotene, with corticosteroid creams has been shown to be especially effective on plaque psoriasis, the most prevalent form of psoriasis.  This combination is also proving to be particularly effective in providing longer periods of relief, as well as helping to reduce the thinning effects of corticosteroids.  Retinoids are not recommended for pregnant women and breastfeeding mothers.

As always, discuss any possible side effects and proper application techniques for these and any other prescription medications with your physician or dermatologist.

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