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skin care in patients with psoriasis

Psoriasis is a common genetically determined disorder characterised by epidermal hyperproliferation (an increased rate of skin-cell turnover in the epidermis). Typical skin lesions include erythematous (reddened) scaly plaques that may crack and bleed. The sites most commonly affected include the elbows, knees, sacrum and the scalp. Palms and soles may also be affected, sometimes with pustular lesions, as well as the nails and the joints. Itching may be a problem in some of the patients.

Psoriasis requires medical / dermatological treatment. Several topical (creams, lotions etc. with pharmaceutical ingredients) and systemic (pills, tablets, infusions) medications are available.
Adequate cleansing and skin care can affect the course of the disease positively.

Skin cleansing
Mild soap-free skin cleansers without irritating ingredients should be employed. For dry skin, the use of shower and bath oils is recommended. Oil bathes soften the skin and are helpful in achieving scale removal.

Hair and scalp wash
Besides applying medical shampoos with pharmaceutical ingredients if necessary, mild shampoos should be used. In dry scalp and hair, moisturising shampoos are recommended. Often dandruff shampoos are employed which are too harsh.

Skin care
Basically, skin care products should be applied according to the skin type.
Psoriatic lesions are often dry and scaly, though, and require special soothing and softening skin care. In psoriatic dry plaques, water in oil-emulsions (mixtures with more oil/ lipids than water) with water-binding ingredients such as urea and lactic acid or rich ointments with urea should be applied. These skin care products are helpful with scale removal and soften thickened plaques.
If there is dry skin all over the body in psoriasis patients, a lipid-enriched water in oil-emulsion is recommended.
A new line of fragrance-free medical skin care products with urea and lactic acid has been developped (Dardia) which may also be used in psoriatic lesions.

In acute pustular psoriatic lesions, the use of light moisturisers (oil in water-emulsions) is recommended to prevent occlusion.



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