Dermatologist's tips for the best skin care to help heal psoriasis.

The most important skin care tips to heal psoriasis are those that keep your skin deeply hydrated. Dry skin is damaged skin and psoriasis always gets worse when skin is dry and damaged. When I see a patient with psoriasis, I always start our discussion about treatment options with detailed information on hydrating skin care, because skin care really is that important for psoriasis.

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

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

In part one, Health Concerns Related to Psoriasis, I introduced the concept of how psoriasis is now considered one piece of a complex puzzle that makes-up a person's overall health; there are internal diseases that we know are linked to psoriasis - psoriasis is NOT JUST a skin problem! If you or someone you love has psoriasis, you need to know this information.

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

Here, in part 3 of this series, I’m going to summarize the key skin care tips to heal psoriasis that I give to my psoriasis patients.

Skin care information to help your skin fight and heal psoriasis is foundational self-care information for people with psoriasis.

Dermatologist Dr. Cynthia Bailey

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 5 Skin Care Tips to Help Heal Psoriasis

My 5 key goals for skin care that heals and prevents psoriasis are:

1. "Lock and load" water into the skin 24/7.
2. Use skin care products that contain ingredients that slow skin cell turnover. The best example of this are the products that contain tar.
3. Use skin care products that exfoliate excessive scale. Examples include BHAs (salicylic acid) and AHAs (lactic and glycolic acids).
4. Address facial seborrhea (a.k.a. dandruff) because it often coexists with psoriasis in the crossover variant called sebo-psoriasis.
5. Look for and treat foot fungus, because it's extremely common and can look like psoriasis, many psoriasis patients have it on their feet, and it's just one more rash that psoriasis patients don't need to suffer from.

Here are the details...

Skin Care Tip 1 to Heal Psoriasis: Use Hydrating Skin Care to "Lock and Load" Water into Your Skin.

Holding water in 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 any more 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. This phenomenon is the observation that the rash of psoriasis tends to flare up on injured skin. Because dry skin is injured skin, you need to prevent skin dryness. Thus, you need to:

To heal psoriasis, you need 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, ears, back, and chest.

Use only non-drying soap:

Modern soap substitutes called Syndets (synthetic detergents) clean with mild cleansing ingredients at a neutral pH. For general body cleansing I like the hypoallergenic Vanicream Cleansing Bar Soap.

Old-fashioned natural soaps can be a great choice too. Always use hypoallergenic cleansing products such as my Naturally Best Bar Soap which is great for general bathing needs for the entire family.

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), a rash that often coexists with psoriasis in the psoriasis variant called sebopsoriasis.

To heal your psoriasis, you need to apply moisturizer every day after your bath or shower to trap moisture.

Trap and hold moisture in your skin 24/7 by applying a rich moisturizer right after toweling dry from your bath or shower. Your skin soaks in water when you bathe. Before this water evaporates, you must cover your skin with a moisturizer to lock it in. My favorite moisturizers for psoriasis are Am Lactin Cream or Lotion (with the AHA lactic acid) or my Glycolic Acid Body Lotion (with the AHA glycolic acid). AHA's help to remove the thick scale of psoriasis.

These products also trap moisture to the skin. AHAs can be irritating of skin is sensitive or open. To avoid this alternate the AHA product with a deeply hydrating product such as my Natural Face and Body Butter or Natural Face and Body Lotion. These are hypoallergenic and very healing for psoriasis.

Skin Care Tip 2 to Heal Psoriasis:  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.)

Skin Care Tip 3 to Heal Psoriasis: 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. AHAs include lactic acid and glycolic acid. BHAs include salicylic acid.

Of the two AHA's lactic is a little better at hydrating skin. Glycolic is a little better than lactic acid at removing stubborn skin scale. Both work for psoriasis. I prefer glycolic acid to prevent psoriatic lesions from building up thick scale. My Glycolic Acid Face and Body Lotion has a light weight base that never feels greasy. It is made with the form of glycolic acid thought to be most effective. My Glycolic Acid Lotion or a product called Am Lactin are the best choices for maintenance hydrating skin care once psoriasis is controlled.

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.

Skin Care Tip 4 to Heal Psoriasis: Control facial sebo-psoriasis.

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.

For stubborn facial seborrhea (aka dandruff), see my comprehensive skin care recommendations for seborrhea treatment in the Advice Pages.

Skin Care Tip 5 to Heal Psoriasis: 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.