Using Emollients for Psoriasis

What to Know About This Class of Moisturizers

An “emollient” is a type of moisturizer, a substance that can be used to hydrate and protect the skin. Emollients provide a cornerstone of treatment for people with psoriasis and other skin conditions.

It may take some experimentation to find the right emollient or combination of moisturizers for you. But finding the right ones will provide a helpful tool in managing your disease.

emollients for psoriasis
Illustration by Cindy Chung, Verywell

How Emollients Help

The outermost part of your skin is composed of a layer of dead skin cells called the stratum corneum. This layer forms a barrier that helps protect the tissue beneath from infection, dehydration, and other sorts of stress.

In psoriasis, the stratum corneum can’t protect the skin the way it normally would. Psoriasis causes abnormal reproduction of skin cells within the skin’s epidermis, the outer layer of skin (of which the stratum corneum is the very outermost part).

Inflammation and unusual growth of these cells lead to the symptoms of psoriasis, which include dry, cracked skin that can itch and bleed. A minor break in the skin’s integrity can cause a flare of acute psoriasis symptoms—something known as Koebner’s phenomenon.

Emollients form a film on the skin’s surface that helps the skin retain its moisture, limiting evaporation from the deeper layers. In addition, they can

  • Reduce skin scaling
  • Ease skin itching
  • Soften skin cracks
  • Reduce skin irritation
  • Improve the skin’s barrier function
  • Help infuse moisture into the skin
  • Provide anti-inflammatory effects
  • Improve the penetration of other topical drugs
  • Reduce abnormal death and proliferation of skin cells
  • Reduce psoriasis flares
  • Help prevent Koebner’s phenomenon (by making the skin less prone to injury)

Moisturizers vs. Emollients

An emollient can be considered a specific type of moisturizer. Emollients are better at softening the skin and protecting the skin compared to other types of moisturizers. Compared to other moisturizing products, emollients contain a greater percentage of oil relative to water. However, in practice, these terms are sometimes used interchangeably.

You may also hear about “humectants” and “occlusives.” These are other types of moisturizers that can be helpful in treating dry skin and psoriasis. Humectants like alpha hydroxy acids contain compounds that attract water into the stratum corneum. Occlusive moisturizes like mineral oil form an inert layer that physically helps block water loss. Practically speaking, you may sometimes hear all of these different types of moisturizers referred to as “emollients.”

Some products contain more than one type of moisturizer. You might use both an emollient and another type of moisturizer as part of your treatment, either separately or in a combined product. In fact, many people need to use more than one product to protect their skin.

Who They're For

Almost everyone with psoriasis can benefit from using some sort of emollient product, including people with mild, moderate, and severe psoriasis. This helps protect the skin and decreases skin dryness, overall lessening psoriasis symptoms.

However, emollients are always used as an adjunctive treatment for psoriasis. That means that they should always be used with other treatments.

For example, they might be used along with topical creams containing medications in someone with mild psoriasis or along with drugs in someone with severe psoriasis. Using emollients may enable you to use less of these other treatments (like steroid creams) than you otherwise would need.

Emollients can also be helpful for people with other kinds of skin conditions, like eczema.

Types of Emollients

There are many different forms of emollients. For example, they may be available as:

  • Creams
  • Ointments
  • Lotions
  • Gels
  • Bath oils
  • Spray
  • Soap substitutes

In general, creams and ointments tend to work better than lotions. Because they are thicker, they may protect the skin more effectively. You may want to use an ointment at night and a lighter cream or lotion during the day.

Best Options

We don’t have a lot of good scientific data about the best emollients to use for psoriasis. Many people may benefit from a number of different types. Some factors you might want to consider are the cost and the smell of the emollient.

Not everyone will have the same response to all emollients. You may need to experiment with a few before you find the combination of emollients and other moisturizers that work best for you. Ask your dermatologist about the best products to try.

How to Apply

Generally, doctors advise applying emollients one to three times a day. In order to work well, you need to use a generous amount on the affected area. This can help prevent the skin from drying out. It’s a good idea to apply more emollient if your skin is dry or itchy.

Ask your healthcare provider about how to combine your emollient with other treatments. Typically you should apply your emollient first and then apply your other topical treatment (such as a steroid cream) a little later. 

Don’t stop using your emollient once your skin improves. Because they are a preventative measure, it is important to keep using them, even if your skin dryness gets better.

Safety and Side Effects

Emollients that do not contain medication are generally safe for almost everyone. The large majority of these agents are also thought to be safe to use for women who are pregnant or breastfeeding. They are also generally safe for children. However, some people who use emollients might experience side effects from a particular product.

There are some possible side effects of emollients. Itchy, red skin can arise from irritant dermatitis or allergic contact dermatitis. Some other possible side effects include:

  • Stinging
  • Acne
  • Photosensitivity
  • Changes to skin color
  • Soreness from a blocked hair follicle

If you have any of these symptoms, you may need to switch to a different type of emollient. Don’t hesitate to contact your health care provider if you have questions. 

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