Psoriasis: How to Tame the Itch (But Not Make the Rash Worse)

It's a normal cause and effect reaction that when you get an itch, you want to scratch it. But for individuals with psoriasis, that "itchy" feeling can be taken to truly excruciating levels where scratching doesn't stop the itch and can may it even worse.

An array of prescription and over-the-counter (OTC) remedies specifically target the itch of psoriasis. This disorder is from an immune system glitch that causes skin cells to turn over much faster than normal, producing red, scaly skin lesions.

To date, there is no cure for the disorder or for the itching — only treatments that can ease the itching and calm your skin.

The word psoriasis, in fact, is derived from the Greek word psora, meaning "itch," and alludes to one of the most troubling symptoms.

Psoriasis Itching May Be Worst Symptom

Although many people who have psoriasis (or "psoriatics") are disturbed by how the crusty lesions, or plaques, look — particularly when they appear on the face and hands — some are even more concerned with the itchiness.

For example, one study found that itching was the most frequent complaint among patients hospitalized for psoriasis, which can result in lesions on any area of the body, including the genitals, palms and soles of the feet.

Also, a survey of the National Psoriasis Foundation members indicated that only the scaling of lesions outranked the itch as the most vexing symptom of the condition.

Whenever a condition causes a chronic itch, it's likely to have an impact on quality of life. That's certainly the case with psoriasis, as evidenced by another scientific study. This study revealed that people with psoriasis reported various symptoms, including itchiness that disrupted their sleep, reduced their sex drive and interfered with their ability to concentrate.

How to Stop the Itch

There's good news: Many options are available to counter this uncomfortable symptom. Besides reducing discomfort, treatment can help avoid what's known as the "itch-scratch cycle," in which regular scratching can increase the inflammation, which leads to still more itching.

Moreover, scratching can actually trigger psoriasis flare-ups through what's known as the Koebner phenomenon, in which skin damage — such as cuts, insect bites or sunburn — makes the psoriasis worse. This occurs in a wide range of people with psoriasis — between 11% to 75%, depending on the study — as well as in several other skin conditions.

In no particular order, here are some of the most common itch-fighters for psoriasis, including prescription, over-the-counter and homemade remedies. Specific brand names may be mentioned because they're easy to find, but each of these remedies is sold under various labels. Consult a doctor if you have any unexpected reactions.

1) Antihistamines: These medications target the nerve pathways related to itching and can have a sedative effect, which may help those with psoriasis sleep through their itching.

Look for "non-drowsy" antihistamines for daytime usage, and be sure to follow dosage guidelines.

2) Creams and lotions: The simple act of smoothing on a rich layer of moisturizer can help keep itch away, because dry skin tends to be itchy skin — even in a person without psoriasis. Creams are more moisturizing than lotions. Certain anti-itch creams are particularly helpful for psoriasis, including Gold Bond Medicated Anti-Itch Cream and Aveeno Overnight Itch Relief (with oatmeal).

3) Topical corticosteroids: Whether in prescription or OTC strength, steroids — such as Cortaid or Lanacort — are widely used to treat various sorts of itching. However, you should take care in using these products, since over the long term, steroid creams can result in skin-thinning.

4) Capsaicin: An ingredient derived from hot peppers, capsaicin is proven to help itching, although for some it stings or burns at first. This product is available over-the-counter as Capzasin.

5) Topical anesthetics: An application of one of these nerve-deadening products can keep itch at bay for hours. Topical anesthetics include both prescription medications (such as benzocaine and lidocaine) and over-the-counter products (such as menthol and camphor) found in Sarna lotion, Bengay and Vicks VapoRub.

6) Oatmeal baths: Especially for those with widespread plaques, oatmeal baths soothe all affected areas in one step. Just pour in the recommended amount of ground colloidal oatmeal (such as Aveeno Soothing Bath Treatment) as you fill up the tub and soak in the milky smoothness for awhile. Immediately after drying off, follow with a thick layer of moisturizing cream for longer-lasting itch relief.

7) Ice packs: Among the quickest and easiest solutions, a frozen gel pack applied to your skin not only eases itch by numbing nerve endings, but cools the rawness of inflamed patches.

8) Plastic wrap over lotion: Covering psoriasis-covered areas with lotion and then plastic wrap, socks or gloves — known as occlusion — keeps medicated or non-medicated preparations airtight for hours, increasing their itch-fighting effect and helping to discourage scratching. Check with a doctor to determine which preparations may work best for your case, since there's a chance you'll absorb too much of the cream's ingredients.

Sources:

Thappa, D.M. The Isomorphic Phenomenon of Koebner. Indian Journal of Dermatology, Venereology and Leprology 70.32004 187-189. 23 Apr. 2008.

Yosipovitch, G. Clinical Characteristics of Pruritus in Chronic Idiopathic Urticaria. British Journal of Dermatology 147.1July 2002 32-36. 20 Apr. 2008.

Sampogna, F. Prevalence of Symptoms Exerienced by Patients with Different Clinical Types of Psoriasis. British Journal of Dermatology 151.3 Sep. 2004. 594-599. 20 Apr. 2008.

Dawn, Aerlyn. Treating Itch in Psoriasis. Dermatology Nursing 18.32006 227-233. 20 Apr. 2008.

National Psoriasis Foundation. Managing Itch fact sheet. Accessed Feb. 24, 2016.

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