Understanding and Managing Skin Pain With Psoriasis

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People who have psoriasis pain use words such as, aching, burning, stabbing, throbbing, cramping, stinging, and more to describe skin pain. And when psoriasis flares become painful, you will want relief fast.

Having some remedies on hand can help you to soothe skin when you need relief. Here’s what you need to know about skin pain and how to best manage its effects.


6 Myths About Psoriasis

Understanding Skin Pain

Psoriasis is an inflammatory skin condition. It causes skin cells to grow too fast and build up into patches, called plaques. Inflammation—regardless of the body part it affects—can cause pain, discomfort, and distress. Inflammation causes pain because it pushes against sensitive nerve endings. This process sends signals to the brain and a person feels pain.

According to the National Psoriasis Foundation, skin pain is experienced by more than 40% of the people who have psoriasis. With psoriasis, sensitive nerve endings are in the skin. One study reported in 2014 in the journal Nature, suggests nociceptors, a type of nerve ending that promotes pain perception, help drive inflammatory responses leading to psoriasis flares. The study’s authors suggest these nociceptors affect the function of immune cells located in the skin.

Psoriasis plaques are also painful because they cause skin to be tight, red, and itchy. Plaques can also become cracked and dry, causing further pain. Additionally, you experience pain as a result of scratching. Scratching may lead to broken skin, bleeding, and infection.

One study reported in the international journal Acta Dermato-Venereologica assessed skin pain in 163 people with plaque psoriasis, the most common type of psoriasis. Of the study subjects, 43.6% reported skin pain in the past week describing it as “itchy, unpleasant, aching, sensitive, hot/burning, tender, and cramping,” this in comparison that skin areas that were unaffected. The researchers concluded on the importance of including pain management in psoriasis treatment.

Managing Triggers

The best way to manage skin pain from psoriasis is to works toward avoiding it altogether. This involves taking all the medications prescribed by your healthcare provider and avoiding psoriasis triggers.

The most common triggers that lead to disease flare-up—a period of high disease activity and severe symptoms—may include:

Cold and dry weather: Both types of weather can dry out skin and make flare-ups and skin pain worse. Researchers don’t know why cold and dry weather promotes flares, but some think it’s because cold, dark, and low-humidity conditions cause skin inflammation and thickening. Since you may not be able to move to a warmer city during the winter months, try covering up to reduce your skin’s exposure to cold, dry weather.

Some medications: If you are taking medications for other conditions, talk to your healthcare provider if you think they are contributing to psoriasis flare-ups. Medications such as lithium and beta-blockers are known for causing psoriasis flares.

Infections: Certain infections—such as strep throat—can cause psoriasis symptoms to worsen days or weeks after the infection.

Skin trauma: Any type of trauma to the skin­—including cuts, burns, vaccinations, tattoos, and other skin conditions—can cause psoriasis to flare up, especially at the injury site. This reaction is called the “Koebner phenomenon.”

Alcohol consumption: Excessive consumption of alcohol may increase the potential for a psoriasis flare. One study reported in 2015 in the journal Alcohol Research found alcohol can have a “detrimental effect” on psoriasis,” especially in males.

Smoking: Some experts believe smoking worsens psoriasis symptoms.

Diet: Because psoriasis is an inflammatory disease, your diet might play a part in triggering inflammation and triggers. Certain foods, including red meat, gluten, and processed foods can make psoriasis skin symptoms worse and promote inflammation. Try eating a diet high in anti-inflammatory foods to reduce frequency and severity of flare-ups. Examples of anti-inflammatory foods include various fruits and vegetables, fatty fish, and heart-healthy oils. You may also consider asking your healthcare provider if a nutritional supplement—such as fish oil, vitamin D, vitamin B-12, or selenium—is right for you.

Coping and Treating Skin Pain

Even when you can’t avoid flares, you can find ways to cope and treat skin pain. Here are some self-care tips to help you manage pain.

Keep skin lubricated: Keeping your skin lubricated can prevent dry, itching painful skin. It can also reduce redness and heal skin. The National Psoriasis Foundation recommends heavy creams that lock in water. Make sure you are using moisturizers that are fragrance-and alcohol-free, as fragrances and alcohol may dry out skin.

Refrigerate creams: Keep creams and moisturizers in your refrigerator. This helps keep them cold so they can soothe burning and itching.

Soften scales: You can soften scales with lotions containing lactic, salicylic, or glycolic acids. These substances can break up dead skin cells that have built up on psoriasis plaques. Generously apply to skin at night and cover up with a plastic wrap overnight. This way the lotion stays and absorbs into skin better. 

Try capsaicin: Check your drugstore for creams, lotions, and ointments containing capsaicin. Capsaicin is the ingredient in chili peppers that makes them hot. Products containing capsaicin block the nerve endings that cause pain. These products may also help reduce inflammation, redness, and scaling. However, there isn’t enough research to confirm these benefits in the long-term or on the safety of capsaicin.

Treat itch: You have many options for over-the-counter (OTC) options for control itching. Itching can often feel like burning or stinging when you have psoriasis. Ask your healthcare provider about recommendations for lotions that contain menthol or pramoxine. Hydrocortisone creams, which contain a mild steroid, are also helpful. 

Cold therapy: Using cold packs confuses the brain. Your brain cannot feel the itch if you are feeling cold at the same time.

Take a soak: Take a warm bath with some Epsom salt. Soak for about 15 minutes to smooth itchy skin and remove scales. Oatmeal baths can help with itch too. After the bath, pat skin dry and put on moisturizer right away.

Wash with vinegar: Apple cider vinegar can calm itchy scalp psoriasis. Massage the vinegar into your scalp a few times a week. If the vinegar causes burning, use a half water-half vinegar blend. Rinse your scalp after the vinegar dries to prevent irritation. You should see results in a couple weeks. Don’t use vinegar if the scales on your scalp are bleeding or cracked.

A Word From Verywell

Simply living with psoriasis is stressful enough, and many people with psoriasis report feeling more stressed during periods of flare-ups. Talk to your healthcare provider if you think psoriasis is causing you to feel stressed, anxious, or depressed. They may be able to offer some information on coping with stress or refer you to a mental health professional. It may also help to connect with others also living with psoriasis. Ask your healthcare provider’s office or search online for information on local and online support groups.

Exercise is another way to improve your mood. Even something as simple as a daily walk can help relax you and relieve stress.

Remember, self-care remedies don’t replace your healthcare provider’s advice or treatment plan. Call your healthcare provider if symptoms get worse, your skin feels red and inflamed all over, your joints hurt, or if you are feeling depressed.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Crane MW. National Psoriasis Foundation. Assessing skin pain in psoriasis patients.

  2. Riol-Blanco L, Ordovas-Montanes J, Perro M, et al. Nociceptive sensory neurons drive interleukin-23 mediated psoriasiform skin inflammation. Nature. 2014 Jun 5; 510(7503): 157–161. doi:10.1038/nature13199

  3. Patruno C, Napolitano, Balato N, et al. Psoriasis and skin pain: instrumental and biological evaluations. Acta Derm Venereol. 2015 Apr;95(4):432-8. doi:10.2340/00015555-1965

  4. American Academy of Dermatology. Are triggers causing your psoriasis flare-ups?

  5. Pascoe VL, Kimball AB. Seasonal variation of acne and psoriasis: A 3-year study using the Physician Global Assessment severity scale. J Am Acad Dermatol. 2015 Sep;73(3):523-5. doi:10.1016/j.jaad.2015.06.001

  6. Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to alcohol use. Alcohol Res.

  7. National Psoriasis Foundation. Anti-inflammatory diet.

  8. National Psoriasis Foundation. Over-the-counter (OTC) Topicals.

  9. National Psoriasis Foundation. Herbs and natural remedies.

By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.