Psoriasis scales result from an accelerated buildup of skin cells. Normally, skin cells shed over about a month, but with psoriasis, this process happens in just a few days, leading to thick, scaly patches. Managing these scales can alleviate discomfort and improve skin appearance. This guide offers practical, gentle methods for safely managing and removing psoriasis scales at home.
Softening Psoriasis Scales
Softening scales is an initial step before removal, making them less rigid and easier to manage. Applying fragrance-free emollients or moisturizers, such as petroleum jelly or mineral oil, creates a barrier that traps moisture. Consistent application improves the skin barrier and prevents water loss.
Warm baths or showers loosen scales. Soaking in warm, not hot, water for about 15 minutes softens thickened skin. Adding colloidal oatmeal provides soothing and moisturizing benefits, reducing inflammation and itching. Avoid harsh soaps during bathing, as they can further dry out the skin.
Wet wraps involve applying moisturizer to the affected area and covering it with a damp dressing. This technique enhances moisturizer absorption and aids in softening stubborn scales. The goal is to keep skin hydrated and pliable, preparing it for gentle removal.
Gentle Methods for Scale Removal
Once scales are softened, gentle methods can aid in their removal. Over-the-counter (OTC) keratolytic agents break down the protein holding scales together. Salicylic acid, commonly 2% to 10%, softens keratin, helping scales shed more easily. Higher concentrations may be more effective but can increase irritation.
Urea is another keratolytic agent, often 10% to 40%. Lower concentrations (2-12%) primarily moisturize, while higher concentrations (10-50%) soften and remove scales by dissolving excess keratin. These products can be applied safely and consistently, often making other topical treatments more effective by improving penetration.
Gentle physical exfoliation can be performed after scales are thoroughly softened, such as after a bath or emollient application. A soft cloth, brush, or sponge can remove loosened scales. Use very light pressure and avoid aggressive scrubbing, picking, or scratching, as this can irritate skin and worsen the condition. Tar-based products, including coal tar shampoos, creams, or lotions, slow skin cell growth and reduce scaling, making removal easier.
Important Considerations for Safe Removal
Adhering to safety guidelines prevents worsening psoriasis or causing harm. Aggressive picking or scraping of scales should be avoided. Such actions can lead to skin injury, increasing the risk of infection, scarring, and triggering the Koebner phenomenon, where new psoriasis lesions appear at sites of skin trauma.
Regular moisturizing keeps skin supple and hydrated, preventing scales from reforming quickly. Apply moisturizers to damp skin immediately after bathing to seal in moisture. Before using any new product, perform a patch test on a small, inconspicuous area, such as the inner arm or behind the ear, to check for allergic reactions or irritation.
Discontinue any method that causes pain, increased redness, burning, or heightened irritation. Maintaining good hygiene by keeping affected areas clean helps prevent secondary infections.
When to Consult a Healthcare Professional
Self-care methods are beneficial for managing psoriasis scales, but professional medical advice is sometimes necessary. Consult a healthcare provider if scales do not improve with home treatments or if the condition worsens.
Signs of infection, such as increased redness, swelling, pus, or fever, warrant immediate medical attention. Significant pain or discomfort impacting daily life also indicates a need for professional evaluation. If psoriasis covers a large body area or if joint pain, stiffness, or swelling occurs, seek medical advice. Joint symptoms may indicate psoriatic arthritis, requiring specific medical management.