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Psoriasis and Itching: Managing the Itch

Posted on February 25, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Joan Grossman

  • Itching affects most people with psoriasis and negatively impacts quality of life.
  • Stick to your treatment plan to help manage itching with psoriasis.
  • Avoid scratching. Use a moisturizer or cool compress instead.
  • A healthy diet and lifestyle can help reduce disease activity that causes itching.

Itch is one of the most distressing symptoms of plaque psoriasis, the most common form of psoriasis. Some 60 percent to 90 percent of people with psoriasis report that itching — also known as pruritus — worsens quality of life. Itching can negatively impact daily functioning and psychological well-being.

MyPsoriasisTeam members often discuss their frustrations with itching. “Bad start to my morning. I’m very itchy today. I have to be at work and can't take any antihistamines. Fighting the itch!” one member posted. “So tired of my scalp being itchy,” another member wrote. “People look at me as if I had head lice. What can I use to stop this itch?”

“My face is killing me today, all red, tight, and itchy. I’m now into day four of barely sleeping. I feel so itchy and it’s 10 times worse at night,” a third member said. “No amount of moisturizer is helping. It just seems to aggravate the itch.”

In the past, itching in psoriasis was not always taken seriously by doctors. Researchers and health care professionals now recognize that itching is a crucial symptom to manage when treating psoriasis, due to the impact of itch on quality of life.

Stick With Your Treatment

Treating psoriasis lesions can require considerable time and effort with skin care at home. This is in addition to any other treatments, like phototherapy or medication, you may be using to control the condition. Daily adherence to a treatment plan is essential to manage itch and prevent flares.

Research shows that people with psoriasis fail to adhere to their treatment plans more than people with other chronic conditions. This is usually because they are dissatisfied with previous treatment outcomes. If you are not satisfied with your current psoriasis treatment plan, discuss it with your doctor, rather than stopping your treatment or changing it on your own. Your doctor can recommend different options that might be a better fit with your goals and lifestyle. Work with your health care team to establish realistic expectations and treatment goals, and adjust treatment plans as needed in consultation with your doctors.

Consider Topical Treatment for Itch

Topical treatment is often the first-line treatment for reducing symptoms like itching. Your dermatologist may prescribe you a topical corticosteroid or a nonsteroidal topical with ingredients like vitamin A and synthetic vitamin D. Your doctor may also recommend over-the-counter options. Setting aside time for an effective and regular skin care regimen is one of the most important ways to control itch. Choosing the right products is an important step to good skin health.

Moisturizers

Keeping skin clean and moist is essential in managing itchiness. Dry, scaly patches from plaque psoriasis are likely to itch. Plaques risk cracking and bleeding as well, which can exacerbate flare-ups. Your skin needs to be well hydrated throughout the day. Moisturizing has been shown to improve psoriasis symptoms, like itch, and to improve quality of life. Creams and ointments will be more emollient (softening) than lotions, but they may be more difficult to use.

Over-the-Counter Products

Along with any prescription topical agents you might be using, there are many over-the-counter cleansers, shampoos, and moisturizing products that are safe to use with psoriasis. The National Psoriasis Foundation has a directory of products that contain ingredients like coal tar, salicylic acid, and ceramides, which are known to help reduce itch and aid in the removal of scales. The directory also features laundry products to help you avoid detergents that may leave irritants on clothing or towels.

Skin Care Routine

Maintaining a topical treatment routine can be difficult among all the other demands of daily life, as MyPsoriasisTeam members frequently mention. “Doing my skin routine. Three hours and 45 minutes.😢” one member commented. “Some days it's hard to keep up with the cream routine,” another member wrote.

But for some MyPsoriasisTeam members, a topical skin care routine brings comfort. “A long moisturizing and gentle exfoliation routine is a good start to my day,” a member explained. Another member described part of her routine. “Using in-shower cream is really good. I save time doing my skin routine, and it makes me happy and looks great! No more itch!” she said.

Other Treatments

Prescription or over-the-counter topicals aren’t your only option for managing psoriasis symptoms like itching. Psoriasis treatment has advanced significantly in recent decades with drug therapies like biologics. Biologics act on specific cells or proteins in the immune system that cause inflammation. Biologics are generally used in cases of psoriasis that aren't controlled with topical medications. Talk to your doctor about alternative treatments if topicals are not relieving your itching.

Don’t Scratch

The urge to scratch can be hard to control. Scratching can make the condition worse and trigger the itch-scratch cycle, which can further damage skin. Scratching may feel good, but when you stop, your urge to scratch will be even greater. It is crucial to break this cycle. Keep nails short and rounded, in case of unconscious scratching. Work on developing habits that reduce itch without scratching the skin.

Many MyPsoriasisTeam members talk about their struggles with scratching. “My elbows are driving me mad today. Itch, itch, scratch, scratch, bleeding, 😢” one member lamented. Another member described troubles with scratching itchy skin: “I’m having a really bad day with my skin. It's been itching like no tomorrow. I've scratched it to the point of being sore and bleeding. I have had a bath, put my ointment on, and I’m trying not to scratch.”

Dermatologists generally recommend people with plaque psoriasis follow these recommendations to help with itch relief and avoid scratching:

  • Remove scales — which are a cause of itch — safely with careful techniques.
  • Take short showers or baths. Avoid hot water, which causes skin dryness.
  • Use gentle cleansers on your skin.
  • Moisturize right after bathing or washing hands, and reach for a moisturizer instead of scratching.
  • Try itch-reducing products that contain menthol or camphor.
  • Use cool compresses to relieve itch.

Sunlight has also been shown to improve skin condition in people with psoriasis. Extra care should be taken to avoid sunburn, which can damage skin and lead to skin cancer.

Make Lifestyle Adjustments

A healthy lifestyle can help reduce psoriasis flares and overall disease activity, which can ease symptoms like itching. MyPsoriasisTeam members frequently share their tips on lifestyle changes that have helped them reduce psoriasis symptoms.

“No booze really helps,” said one member. Another member offered these tips: “I am now gluten-free and have drastically cut down on my sugar intake, and eat very few processed foods. It has helped me tremendously.”

“I've improved my diet, and I’m still getting plenty of exercise. As a result, I've been condition-free for the best part of a year now,” a member wrote. Another member described some of the lifestyle factors that have helped reduce psoriasis: “I mainly owe it to diet, biologics, and an herbal remedy that I take. I’m keeping a simple life and keeping the stress reduced as much as possible. Being in the sun is also beneficial.”

Research shows that lifestyle choices, like diet, exercise, and stress reduction, can have a significant impact on psoriasis.

Smoking

Tobacco smoking contributes to a range of diseases, such as cardiovascular disease and diabetes, which occur in people with psoriasis at higher rates than the general public. Smoking is also believed to worsen psoriasis by creating inflammatory signals that affect the skin. Talk with your health care provider about smoking cessation programs.

Diet and Exercise

Obesity occurs at a higher rate in people with psoriasis. A pro-inflammatory condition, obesity is associated with an increase in psoriasis severity. A balanced diet and regular exercise can help maintain a healthy weight and may help reduce psoriasis symptoms.

Psychological Stress

Many people with psoriasis experience stress, anxiety, and depression due to the demands of living with this chronic autoimmune condition. Stress is also associated with an increase in psoriasis disease activity. Managing stress with mental health counseling or mindfulness practices, like yoga or meditation, can help reduce flares and symptoms like itching.

Alcohol

Excessive drinking of alcohol is associated with an increase in psoriasis inflammation and an increase in skin disturbances, such as itching.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 88,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Are you living with itching from plaque psoriasis? What has worked for you to ease itching? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
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.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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