A good skin- and hair-care routine can improve—though not cure—your psoriasis. You don't need to stay away from any specific ingredients, but you should minimize the use of things that dry out the skin too much, says Mark Lebwohl, MD, chairman of the medical board of the National Psoriasis Foundation (NPF).
After cleansing, your goal should be to keep your skin moisturized, which will reduce redness and allow it to heal. On the scalp, special treatment shampoos can help clear lesions. Here's a cheat sheet to help you find the right products for you.
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Soaps and cleansers
Avoid harsh soaps (such as deodorant soaps) as well as scrubs, which can be very irritating, says Neil Korman, MD, PhD, clinical director of the Murdough Family Center for Psoriasis in Cleveland. Many people with psoriasis instead opt for gentle cleansers (such as Cetaphil) or soap with moisturizers (such as Dove). "I use a gentle Clinique foaming wash on my face, and Dove on my body because it’s most gentle," says Liz Salemme, 24, of Riverdale, N.J., who has lived with psoriasis for six years.
Devin Cirillo, 23, of New York City, has found that "wholesome cream-based products, like Aveeno Skin Relief Body Wash in the shower, are best."
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Doctors recommend that psoriasis patients keep their skin well moisturized to prevent scales and soothe dry skin. The most moisturizing formulas are ointments (Vaseline, Aquaphor), followed by creams (Cetaphil, Nivea, CeraVe) and lotions (Aveeno).
"The dilemma for patients with psoriasis is that while ointments are very moisturizing, they’re also very greasy," explains Dr. Lebwohl. Many people don’t want to walk around wearing a heavy product, especially during the day. Lotions dry quickly and are more comfortable to wear but aren't as moisturizing. As a compromise, many patients opt for a lighter lotion during the day and then apply an ointment at night.
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Many psoriasis patients have lesions on their scalps. Coal-tar shampoos slow the proliferation of skin cells and reduce inflammation. Unfortunately, those with high tar content (5% or more) smell and can stain light hair. But Neutrogena T/Gel (with only 0.5% or 1% percent tar) has a nice smell and doesn’t stain. Other brands include Denorex and MG217. Leave the shampoo on your head for 5 to 10 minutes.
You can also try salicylic acid shampoos including Neutrogena, Ionil, and Dermatologic Cosmetic Laboratories, and zinc shampoos, such as DHS Zinc. If none of these work, your doctor may prescribe something stronger.
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Conditioners can disguise the smell of tar shampoos and restore the moisture that shampoos take away. "A greasy conditioner will help the most," says Dr. Lebwohl. Popular choices among posters on the National Psoriasis Foundation's message boards include Paul Mitchell Tea Tree Special Conditioner, Aveda Scalp Benefits Balancing Conditioner, and Head & Shoulders Dry Scalp Care Conditioner.
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Though UV light can be therapeutic, you don’t want to get burned, says Dr. Lebwohl. He recommends staying in the sun for 10 to 15 minutes—long enough to get the benefit of the sun, but not long enough to get burned. (Even a mild sunburn can trigger a psoriasis outbreak.)
After that, apply sunscreen. Most psoriasis patients can use regular sunscreen—look for one with at least an SPF of 15—though you may want to choose a hypoallergenic one if your skin is sensitive. Also, many sunscreens are moisturizing.
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