The itch of psoriasis may have a bigger impact on quality of life than the visible effect of the disease.
Itch is present in between 70 and 90 percent of psoriasis patients, yet it is only in the last decade that it has been recognized as a common symptom of the disease, said Dr. Gil Yosipovitch, a recognized itch expert and head of the Temple Itch Center at Temple University Hospital in Philadelphia.
Psoriatic itch is different than that of other skin disorders. Some people have described it as a burning, biting sensation. Others compare it to the feeling of being bitten by fire ants. Doctors were once taught that psoriatic patients couldn’t have both itch and pain, but scientists now know that itch and pain signals travel along different pathways in the spinal cord, Yosipovitch said.
Treating psoriasis also can profoundly improve these symptoms and your ability to cope with psoriasis on a day-to-day basis.
Read below for tips on how to handle the itch of psoriasis.
Stress and itch
Stress is a common trigger for a psoriasis flare. Stress also can make itch worse. This makes managing stress a particularly important life skill for people with psoriasis. Consider the following ways some people with psoriasis and psoriatic arthritis are effectively reducing stress in their lives.
- Meditation. Dr. Jon Kabat-Zinn is considered a leader in the "mindfulness" meditation movement. He describes mindfulness as "paying attention in a particular way on purpose, in the present moment and nonjudgmentally." Meditation has been described as a good way to clear the mind, slow down racing thoughts and relieve anxiety. You can give it try yourself: For 15 minutes, sit comfortably on the floor, with eyes closed or barely open and focus on your breathing. Read more about William Hayden, who credits meditation with relieving stress, improving his sleep and in time, improving his psoriasis.
- Exercise. Exercise increases production of endorphins, chemicals that improve mood and energy. Exercise also has been shown to improve sleep and decrease anxiety. A large U.S. study showed that women who regularly participate in vigorous exercise are less likely to get psoriasis than less-active women. If you haven’t been active for awhile, get tips on starting, or resuming, an exercise program.
- Get outside help. Consider taking a course in stress management or finding a therapist in your area who specializes in stress management. Connecting with others who know what you are going through can help, too. Connect with people living with psoriasis and psoriatic arthritis on TalkPsoriasis.org.
The following are ways people with psoriasis help relieve itch:
- Keep skin moisturized. This is the first step in controlling itch because it reduces redness and itching and helps the skin heal. Dermatologists recommend heavy creams and ointments to lock water into the skin. Cooking oils and even shortening can be inexpensive substitutes for commercial moisturizers.
- Remove scale and flaking. Apply a scale softening (keratolytic) product to reduce excess skin and prevent psoriasis plaques from cracking and flaking. Over-the-counter lotions that contain ingredients like salicylic acid, lactic acid, urea or phenol can help remove scale. Removing scale can reduce itch and make itch-relieving lotions and ointments more effective.
- Cold showers and cold packs also can offer relief. Avoid hot baths and try to limit showers to 10 minutes or less. Hot water can make skin irritation and dryness worse. Apply lotion after washing to lock in moisture. Store lotions in the refrigerator. The feeling of a cool lotion on itchy skin can help.
- Over-the-counter treatments can help. There are several ingredients that have been approved by the U.S. Food and Drug Administration (FDA) for treating itch. Some of these include calamine, hydrocortisone (a weak steroid), camphor, diphenhydramine hydrochloride (HCl), benzocaine and menthol. Beware that these ingredients may increase irritation and dryness.
Simply treating your psoriasis can help reduce itch. If your psoriasis is moderate or severe, or your itch is particularly bothersome, consider asking your doctor to put you on a more aggressive treatment.
Aspirin and noradrenergic and specific serotonergic (NaSSA) antidepressants also can relieve itch, Yosipovitch said. Gabapentin, a drug more commonly used to treat neurological pain, can help, too.
There also are prescription treatments that specifically help with itch, such as:
- Topical treatments that contain capsaicin
- Topical anesthetics like Pramoxine