1. Health

Using Moisturizers Properly for Psoriasis

By Maureen Salamon

Updated July 03, 2008

(LifeWire) - Amid the dizzying array of treatments available for psoriasis, moisturizing is the only therapy that can help all patients regardless of the severity of their scaly skin lesions or where they are located.

A daily moisturizing regimen is simply essential for people with psoriasis who are also known as "psoriatics." These people want to not only keep their existing patches from worsening, but they want help to prevent further outbreaks. This help is needed because moisturizers -- whether in the form of lotions, creams, oils or ointments -- serve double duty in the fight against psoriasis, an immune-system condition that causes skin cells to reproduce far more rapidly than normal.

About 6 million Americans, or 2% of the population, suffer from psoriasis. It can strike at any age and it usually produces red, itchy, inflamed skin lesions anywhere on the body. Although it is not curable, many medications are available to psoriatics to help control symptoms, including topical creams, ultraviolet light therapy, several types of pills, and injectable medicines known as biologics.

However, no matter which therapy psoriatics use, regular moisturizing will also heighten all other benefits. First, consistently moisturized skin -- aside from simply feeling better -- is also stronger skin, better able to keep cracking and other damage at bay. For a significant number of psoriatics, even minor skin damage can lead to a flare-up in the same location, a trigger known as the Koebner phenomenon (So people are urged not to scrub or loofah their psoriasis too  vigorously).

Second, keeping already-inflamed psoriasis patches moist helps loosen scales, an effect enhanced by a process called occlusion, which involves covering affected areas with a thick cream or lotion, wrapping it in plastic wrap or fabric, and leaving overnight. Cosmetically, moisturized psoriasis also looks better, and scales that remain are partly hidden.

Which moisturizers work best? A general rule of thumb is that oils and ointments lock in skin moisture more effectively than creams, which in turn do this better than lotions. Here's a guide to terms you may see when reading over-the-counter moisturizer labels:

Emollients resemble lubricants the skin manufactures itself and include shea and cocoa butters; mink, emu and lanolin (animal-based) oils; and mineral oil and plant oil.

Water-binding agents help maintain skin water concentrations and include collagen, elastin, lecithin, amino acids, proteins, glucose, fructose, sucrose and phospholipids.

Anti-irritants help quiet the skin and are especially useful for psoriatics. These include aloe, vitamin C, licorice root, grape extract, green tea, chamomile extract and willow bark.

Antioxidants accelerate cell turnover, helping clear psoriatic scales away while moisturizing. These include selenium, vitamin A, coenzyme Q10, alpha lipoic acid, vitamin C, vitamin E and grape extract.

People with psoriasis who establish a daily bath and moisturizing routine will find it not only minimizes scaling but also helps alleviate itching and keep psoriasis patches looking as good as possible. According to Doris J. Day, MD, clinical assistant professor of dermatology at New York University Medical Center, this routine should include a 10- to 15-minute soak in warm bath water (not hot, because it saps moisture from the skin). The bath can include sloughing off scales with a loofah sponge or washcloth, if necessary.

After bathing, pat skin lightly to dry and then moisturize immediately, Day advises. Patients may want to use heavier creams, ointments or oils at night, and lighter lotions in the morning. Twice-daily moisturizing sessions are optimal.

Sources:

"Camouflage and Cover-ups." Psoriasis.org. Oct 2005. National Psoriasis Foundation. 11 Apr 2008 <http://www.psoriasis.org/about/living/social/camouflage.php>.

Doris J. Day, MD, clinical assistant professor of dermatology, NYU Medical Center. Phone interview. 16 May 2008.

"Dry Skin." University of Maryland Medical Center. 18 Jul 2007. University of Maryland Medical Center. 2 June 2008. <http://www.umm.edu/ency/article/003250trt.html>.

"Emollients and Moisturizers." Psoriasis.org. 2008. National Psoriasis Foundation. 29 May 2008. <http://www.psoriasis.org/treatment/guide/otc/?cat=aaabaf>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Maureen Salamon is a New Jersey-based freelance writer who has written for newspapers, websites and hospitals. She has suffered from psoriasis for nearly three decades.

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