When you’re in the middle of a psoriasis flare-up, you just want something that will relieve the itchiness that comes with those thick, red, scaly patches of skin—and you want it fast.
Maybe your psoriasis decided to flare after a period of stress or illness. But sometimes a flare arrives for no discernible reason at all. No matter what brought it on, a flare-up doesn’t have to be a catastrophe. With a little preparation, you can manage it (and mitigate the discomfort that comes with it) relatively easily.
Here, dermatologists share some of the best strategies for dealing with your next psoriasis flare.
- 1 1. Prevention is key.
- 2 2. Treat at the first sign of a flare.
- 3 3. Try a moisturizer with a keratolytic ingredient.
- 4 4. Or try one with vitamin A or D.
- 5 5. Apply a “wet wrap.”
- 6 6. Protect your flare.
- 7 8. Adjust your bathing habits.
- 8 9. Most importantly, be patient with yourself.
1. Prevention is key.
Your number one defense against flare-ups is preventing them from happening in the first place—even when your skin feels totally fine.
That means establishing (and sticking to) a good skin-care regimen, ideally one that features a gentle cleanser, a heavy moisturizer, and sunscreen, Linda Stein, M.D., a dermatologist with the Henry Ford Health System, tells SELF. Your dermatologist will likely have you on a maintenance therapy routine involving prescription topical medication, light therapy, or oral or injectable medication—even when your skin appears flare-free.
Similarly, Emily Newsom, M.D., a dermatologist at the Ronald Reagan UCLA Medical Center, recommends that people with psoriasis on their scalp use a dandruff shampoo that contains coal tar on a regular basis, as this active ingredient has been found to prevent against flares.
Beyond maintaining your skin’s health, practicing general self-care can reduce your risk of flares, too, Dr. Newsom says: “Make sure you’re sleeping enough [and] manage stress as best as you can.” Again, stress can be a major trigger for flare-ups.
2. Treat at the first sign of a flare.
Don’t wait until your symptoms are really affecting you to start treating a flare-up: As soon as you notice a change in your skin that could signal an oncoming flare (like redness or itchiness), it’s time to act, Dr. Stein says. Apply a topical steroid (or whatever medication your derm has prescribed) as directed and try to take it easy.
Also, it’s important not to stop treatment until you’re completely free of symptoms, Dr. Stein says, even if the flare appears to be going away. “In my opinion, it comes back faster if it’s not completely clear to begin with,” she explains.
3. Try a moisturizer with a keratolytic ingredient.
For particularly thick plaques, Dr. Newsom suggests applying a lotion that contains a keratolytic, or a softening and peeling agent, like salicylic acid, lactic acid, or urea. That will help dissolve some of the scales. For instance, check out CeraVe Psoriasis Moisturizing Cream, $19, or Gold Bond Ultimate Psoriasis Relief Cream, $8.
However, note these ingredients, particularly salicylic acid, can irritate the skin, exacerbate dryness, and in extreme cases be toxic. So be sure to use keratolytic moisturizers as directed and only on the thickest plaques rather than across large swaths of skin.
4. Or try one with vitamin A or D.
Meanwhile, products containing vitamins A or D—including their synthetic versions and derivatives—can also reduce the symptoms of a flare-up thanks to their anti-inflammatory effects, Dr. Stein says.
For example, your derm may recommend trying a prescription retinoid, a derivative of vitamin A, like tazarotene. Medications like this increase cell turnover while reducing the buildup of psoriasis scales, making retinoids a great option for those who deal with thick plaques during flares.
Synthetic forms of vitamin D (vitamin D analogs) can also be useful because they help regulate the cell turnover process and, therefore, help reduce scales.
5. Apply a “wet wrap.”
In addition to actually treating the flare, you’ll likely want to mitigate the discomfort that comes with it. This is when a “wet wrap,” as Dr. Stein calls it, comes in handy.
After applying your topical medication, run a washcloth under hot (but not scalding) water and wrap it around the affected area, letting it sit like that for about 30 minutes. “That actually has been shown to calm the skin down and help the medication penetrate a little bit better, Dr. Stein says, adding that you could cover the washcloth with plastic wrap for an even greater “sealing” effect.
6. Protect your flare.
People living with psoriasis are subject to the Koebner phenomenon, or flare-ups that arise due to trauma to the skin. “So if you pick at the plaques, it could actually make it worse,” Dr. Newsom says.
In addition to resisting the urge to pick, those with psoriasis on their hands, feet, or nails can prevent accidental damage with paraffin wax, a longstanding preventative measure against the Koebner phenomenon.
“You can buy an at-home kit where you dip your hand or foot in the wax and leave it for 10 to 15 minutes,” Dr. Newsom says. “It can really soothe those types of flare-ups.”
7. Get a little sun.
Phototherapy, which treats psoriasis using different types of light, is normally administered by a dermatologist in their office, but Dr. Stein says you can reap similar benefits from simply spending time outside.
Of course, if you’re at a greater risk for developing skin cancer due to genetics or another condition, you should avoid prolonged sun exposure. But as long as you touch base with your derm and they give you the go-ahead, 15 minutes of sun exposure a couple of times a week could very well help your flare improve, Dr. Stein says.
8. Adjust your bathing habits.
When your psoriasis is especially itchy, it’s crucial to avoid showering or bathing in water that is too hot because the heat can just make you itchier, the American Academy of Dermatology (AAD) explains.
You might also find it helpful to limit your time in the shower or bath because spending a long time in the water can actually make your skin drier. The AAD recommends keeping showers under 5 minutes and baths under 15 minutes.
9. Most importantly, be patient with yourself.
Don’t worry if you still haven’t found your flare-up “silver bullet”—psoriasis symptoms and triggers can vary immensely from person to person, so different treatments will work better for different people.
That said, if you find that your flares are becoming more frequent or increasingly difficult to treat, Dr. Newsom says it’s probably time to check in with your dermatologist for guidance around how best to treat your condition.