How to Tame the Psoriasis Itch

Prescription and Home Remedies That Can Help

Woman with ice pack on elbow
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It is a perfectly normal to want to scratch an itch. However, the problem with psoriasis is that scratching can make the condition worse, leading to infection and scarring.

Unlike some rashes, which you may be able to tolerate for several days, psoriasis is a condition you have to live with. It can flare up at any time and lead to changes in the skin that can be uncomfortable, aggravating, and embarrassing.

In fact, people with psoriasis will often you tell you is that, as bad as the skin can get, the itching can sometimes be worse, interfering with sleep, sex, concentration, and the very quality of life.

Understanding Psoriasis

Most people think of psoriasis as just a skin condition. But it is actually an autoimmune disorder in which the immune system responds excessively, triggering inflammation that causes skin cells to be produced at an abnormal rate. While new skin cells normally develop and reach the surface of the skin in 28 to 30 days, psoriasis shortens the process to only three or four days.

What this causes is an accumulation of skin cells and the development of crusty, scaly lesions known as plaques. The inflammation can cause visible redness and pruritus (itch) which can get worse during periods of stress or in cold or hot weather.

While the exact mechanism for psoriatic pruritus is unclear, scratching the lesions only enhances the inflammation which, in turn, worsens the itch. It is an effect commonly referred to as the Koebner phenomenon in which psoriatic plaques appear along with lines of trauma.

How to Fight the Itch

The good news is that there is an increasing number of treatments available to reduce the inflammation and discomfort of psoriasis. Some of classified as antipruritics, meaning that they act the itch itself. Others address the dryness and flakiness that can exacerbate the itch.

Some of the options require a prescription, while others are available over the counter (OTC). In either case, make sure your doctor is aware of any and all medications you are taking, whether they are oral (taken by mouth) or topical (applied on the skin).

Among some more of the more common anti-itch remedies:

  • Antihistamines are medications used to treat allergies that target the nerve pathways linked to itching. Some versions have a sedative effect, which may help if the itching is keeping you up at night. Benadryl (diphenhydramine), purchase over the counter, is a popular choice.
  • Moisturiser creams rich in lanolin, glycerin, or petrolatum are able to alleviate dryness and lock moisture in for longer-lasting relief. For an added boost, keep your creams in the fridge for an extra-comforting, cooling effect.
  • Anti-itch creams are also available. OTC brands typically contain menthol or camphor, while benzocaine or hydrocortisone can be found in both OTC and prescription remedies. Check with your doctor before using an OTC product as some may contain ingredients that can irritate skin.
  • Topical corticosteroids, available both by prescription and over the counter, are effective in treating itch but need to be used sparingly to avoid skin atrophy (thinning). Never use a topical corticosteroid on your face unless instructed by your doctor to do so.
  • Oatmeal baths can be useful in treating widespread plaques, softening and soothing the skin with a gentle, moisturizing effect. Products containing ground colloidal oatmeal (such as Aveeno Soothing Bath Treatment) are especially popular. Immediately after drying apply a layer of moisturizing cream for longer-lasting relief.

Beyond store-bought products, there are a number of home remedies that may also help. Ice packs remain among the quickest and easiest solutions, numbing the nerve endings while cooling raw and inflamed skin.

Other people rely on a short-term occlusion therapy. This is a technique where you apply a layer of moisturizing or medicated cream to the skin and wraps it in cling film. The wrap can be worn for several hours or overnight, covered with a sock, glove, or loose elastic bandage.

Finally, while an oatmeal bath may be used occasionally if the skin is especially inflamed, it is best to avoid regular bathing or long, hot showers. Instead, cool showers can provide relief while doing little damage to the skin.

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Article Sources
  • Szepietowski, J. and Reich, A. "Pruritus in psoriasis: An update." Eur J Pain. 2016;20(1):41-6. DOI: 10.1002/ejp.768.