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Do Exfoliation Products Help or Hurt Psoriasis?

Medically reviewed by Kevin Berman, M.D., Ph.D.
Written by Anika Brahmbhatt
Updated on April 15, 2024

If you are living with psoriasis, finding the right exfoliation products can be a tricky task. The wrong choice could potentially trigger flare-ups and make your symptoms worse.

When experiencing the symptoms of psoriasis, some people turn to exfoliating products to help reduce the buildup of skin cells that cause plaques and scales. Exfoliating can reduce the thickness of the skin, making it easier for topical medications to penetrate psoriatic plaques.

“I used my sister’s exfoliant soap one time and had way better skin,” reported one MyPsoriasisTeam member. Another said, “Salt water is a great exfoliant — it helps my skin.”

Your dermatologist might prescribe treatments like biologic or corticosteroid drugs to help ease your symptoms and reduce inflammation. Or, they may recommend certain active ingredients in over-the-counter products like topical creams or oral supplements.

When it comes to products to exfoliate your skin, a variety of options could work for you. Before you try them, it’s important to know the risks and benefits.

Why MyPsoriasisTeam Members Exfoliate

Flaking scales can be not only painful and itchy, but they may also make you feel self-conscious. You may have changed the type of clothing you wear because of white skin flakes on your clothes. The symptoms of psoriasis, such as flaking scales and itchiness, can have an impact on your daily life at work and on personal relationships.

“I have white hair, so my scalp is bright pink and visible. My hair continues to thin, so I plan to wear a hat most places I go,” one MyPsoriasisTeam member wrote.

Another member shared their feelings of worry caused by psoriasis symptoms: “I can feel the buildup of plaques and sore spots on my scalp. I’m anxious about shedding scales.”

When it comes to treating and removing these scales, members have also shared their experiences as they learned. One member wrote, “I’m trying not to pick scales. They are covering most of my scalp. I’m using salicylic acid and tea tree oil shampoos. How do I remove these scales without them coming back? Underneath the scales, my skin is very dry.”

“I have amazingly cleared up a few patches over the last six months, although not sure how,” a member replied. “Gentle exfoliation and over-the-counter moisturizers, but constantly applied.”

What Is Exfoliation and How Does It Work?

Exfoliation is the process of removing dead skin cells. Typical exfoliation might include intensive scrubbing, which can irritate your skin. You’ll want to be extra careful to treat your skin gently when you have psoriasis.

The two types of exfoliation are mechanical and chemical. Mechanical exfoliation involves physically scrubbing off the dead skin, such as using a loofah sponge, which is a more intensive process that can pose a higher risk of irritating your skin when you have psoriasis. In some cases, dermatology professionals advise against exfoliating mechanically because it may only provide short-term gains and could actually promote more scales in the future.

Chemical exfoliation involves the controlled breakdown of the top layer of your skin, leading it to regenerate with healthy skin cells. This is often a good option for people with psoriasis because you do not have to risk irritating your skin by scrubbing or scratching sensitive areas.

Common Ingredients in Exfoliation Products

Exfoliation products may contain a variety of ingredients. The following are among the most common:

  • Salicylic acid
  • Alpha hydroxy acids
  • Polyhydroxy acids
  • Urea

Salicylic Acid

Salicylic acid has both exfoliating and anti-inflammatory properties, making it a good option to remove psoriasis scales. It is typically available as soap, gel, shampoo, or ointment.

By prompting your skin to self-exfoliate, salicylic acid can help remove debris and excess proteins, or keratins. In general, keratolytic agents work in this way to break down the outer layers of skin where the excess skin cells build up when you have psoriasis.

Alpha Hydroxy Acids (Glycolic and Lactic Acids)

Used as an ingredient in chemical peels, alpha hydroxy acids can help break down the outermost layer of your skin without slowing down or blocking its ability to function as a barrier. These acids work by increasing the space between the skin cells that produce keratin. This process helps loosen and break apart dead skin cells a bit, which can improve the overall texture and appearance of the skin.

One small study of 20 people with psoriasis found better results from treatment with glycolic acid lotion when used together with a steroid cream for scalp psoriasis. The combination of the two can be an effective way to treat severe skin conditions by using a corticosteroid and an exfoliating agent together.

Polyhydroxy Acids

Polyhydroxy acids have antioxidant and moisturizing properties. When included in an exfoliating product, these ingredients can help protect psoriatic skin when the natural barrier of your skin has been disrupted or irritated.

Urea

Urea is another ingredient used to exfoliate and rehydrate the skin. Lower concentrations are found in some over-the-counter moisturizers for psoriasis. Higher concentrations are used to thin out very thick areas of skin, such as on the feet. Urea is a compound found in the body, and it is used in many skin care products. It is a humectant, which means it helps to keep moisture in the skin and also has keratolytic properties.

Exfoliating Safely

Before you exfoliate any psoriasis plaques, talk to your dermatologist. If they give you the go-ahead to start exfoliating, ask them for best practices to follow. Here are some common tips that dermatology professionals advise:

  • Don’t rush — Allow the chemicals to do their job.
  • Use lukewarm water — Don’t dry out your skin.
  • Apply the product for 30 seconds at a time — Moisturize right afterward.

Instead of scrubbing to remove psoriasis scales, allow the chemicals in your skin care products to do the work for you. It can be tempting to speed up the process, but you should not rush. One way to loosen scales is to start with a 15-minute bath in lukewarm water using a bath solution that has a keratolytic agent.

Using lukewarm, rather than hot, water is important so as not to dry out or irritate your psoriasis lesions. Use a soft washcloth, pumice stone, or your hands to wash your skin and remove the scales while you are in the bath. These options are better than a more abrasive scrubber, like a loofah, which might cause a flare-up or bleeding as a result of skin injury.

Another option, if you are using a topical treatment, is to apply the product for about 30 seconds at a time, using small circular motions with your hand.

When you’re finished bathing, make sure to moisturize your skin well with a lotion, an oil, or a cream. Use a moisturizer or ointment with a keratolytic agent such as salicylic acid. You’ll likely notice scales lifting off of your skin, but do not pick at them. It’s important to moisturize immediately after exfoliating to prevent dry skin.

For scales from scalp psoriasis, frequent shampooing with a product that contains salicylic acid, coal tar, or another keratolytic can help reduce flaking. Some people use oil on their scalp and gently comb out scales. Putting olive oil on your scalp before shampooing may help loosen the scales in that area.

Potential Risks of Exfoliating

Exfoliation can be risky when done wrong or excessively, especially if you have sensitive skin. Be very careful not to scratch or pick at your psoriasis plaques or scales. Being too rough could injure your skin, cause bleeding, and possibly lead to future plaques.

Also, whenever you try a new product, you may risk side effects. Test your product on a small patch of skin first before applying it to a larger area.

Potential side effects of salicylic acid include skin irritation or a stinging sensation. Less common effects could include excessive dryness, peeling skin, hives and itching, unusually warm skin, swelling, and more. With alpha hydroxy acids, side effects to look out for include discoloration, burning, swelling, and severe itching.

If you are using skin care products with retinol (or other retinoids) or benzoyl peroxide, your skin might be extra sensitive to chemical exfoliation techniques. Talk to a dermatologist about the risks of mixing the different products you may be using, and never start an exfoliation routine without speaking with your doctor first.

Choosing the Best Exfoliator for Psoriasis

There’s no single exfoliator that’s best suited for all people with psoriasis, given that everyone’s skin is different. Following are some tips to guide you in your search for the best exfoliator.

Choose a Product That Suits Your Skin Type and Psoriasis Severity

The choice of exfoliator can depend on your skin type (oily, dry, combination) and the severity and location of your psoriasis. For instance, thicker plaques on elbows and knees may tolerate stronger exfoliants than more delicate areas like the face or skin folds​​​​.

Seek Gentle Ingredients

For individuals with psoriasis, gentle exfoliation is key. Harsh physical exfoliants (like those with large, gritty particles) can be too abrasive and may worsen psoriasis. Chemical exfoliants, such as alpha hydroxy acids like lactic acid or beta hydroxy acids like salicylic acid, can be effective. However, you should look for formulations with lower concentrations to avoid irritation.

Salicylic acid is particularly noted for its ability to soften and remove scales, and dermatologists often recommend it for psoriasis treatment​​.

Some MyPsoriasisTeam members caution against certain ingredients. “Avoid irritants such as added fragrance and acids, including salicylic, even though it’s touted for psoriasis, because it is drying and irritating,” one MyPsoriasisTeam member wrote. “Your skin will exfoliate without exfoliants, and those will just prolong the irritation.”

Consider Moisturizing Properties

Exfoliating products that also moisturize are beneficial. Ingredients like urea and lactic acid not only gently exfoliate but also help retain moisture in the skin. Moisturizing is particularly important because it helps counteract the dryness and scaling associated with psoriasis​​.

Look for the National Psoriasis Foundation Seal of Recognition

The National Psoriasis Foundation grants its seal of recognition to skin care and household products that the nonprofit deems safe and nonirritating for people living with psoriasis.

Several products in the directory are specifically noted as having exfoliating properties or as being able to remove scales and dead skin, including:

  • Antü Toning Radiance Mist
  • CeraVe Psoriasis Cleanser
  • CeraVe Psoriasis Cream
  • Codex Beauty Bia Exfoliating Wash
  • Prosoria Psoriasis Treatment System
  • Sphagnum Botanicals Psoriasis Shampoo

Test on a Small Area First

Given the variability in how psoriasis-affected skin can react to exfoliating products, it’s best to test any new exfoliator on a small area of your skin before applying it more broadly. This patch test can help determine if the product causes any adverse reaction.

Consult With a Dermatologist

Finally, it’s always a good idea to consult with a dermatologist before adding new products to your psoriasis care regimen. A health care professional can offer personalized advice based on the specific characteristics of your psoriasis and overall skin health.

Talk With Others Who Understand

On MyPsoriasisTeam, the social network for people with psoriasis and their loved ones, more than 127,000 members come together to ask questions, give advice, and share their stories with others who understand life with this skin condition.

Have you tried exfoliant products to treat your psoriasis symptoms? Have they been effective treatments for removing psoriasis scales or plaques? Share your tips and experiences in a comment below or post to your Activities feed.

    Updated on April 15, 2024
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    Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Anika Brahmbhatt is an undergraduate student at Boston University, where she is pursuing a dual degree in media science and psychology. Learn more about her here.

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