How to Control Psoriasis

Co-authored by Mohiba Tareen, MD and Hunter Rising

Last Updated: December 21, 2021 References

Psoriasis is an autoimmune disease that causes red, scaly patches on the skin. According to the CDC, these rashes typically occur on the elbows, knees, scalp, and lower back, among other places.^{[1]
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Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

Go to source} While there is no cure for psoriasis, its symptoms can be managed in a variety of ways. Many of these require a doctor's prescription, but there are several remedies you can try on your own.

Method 1

Method 1 of 3:

Applying Topical Treatments

1
Use a cold compress for immediate relief from itching skin. Even though it’s tempting, avoid scratching your skin since you could damage it more. Instead, hold an ice pack or cool, damp towel against your skin where it itches. Keep your skin covered for about 15 minutes at a time. The change in temperature will help soothe your skin so it doesn’t feel as irritated. Apply the compress as often as you need throughout the day.^{[2]
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American Academy of Dermatology
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- If you use an ice pack, wrap it in a towel first so you don’t damage your skin.
2
Rub moisturizer into your skin to keep it from drying out. Opt for a fragrance-free moisturizer so it doesn’t irritate your skin. Apply the moisturizer after you bathe while your skin is still moist. Put a large coin-sized amount of moisturizer on your skin and rub it in until it’s clear.^{[3]
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Research source} Apply the moisturizer 1–3 times throughout the day and before you go to bed until you see improvement.^{[4]
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Mayo Clinic
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- If your psoriasis is mild, keeping it moisturized might be all it takes to help it clear up.^{[5]
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  Expert Source
  
  Mohiba Tareen, MD
  FAAD Board Certified Dermatologist
  
  Expert Interview. 26 March 2020.}
- If you have cold and dry weather, you may need to moisturize more often when you feel your skin dry out.^{[6]
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  American Academy of Dermatology
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- Keep your lotion in the fridge since the cool feeling can help your skin itch less.^{[7]
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3
Use over-the-counter hydrocortisone when you feel itchy. Put a fingertip-sized amount of hydrocortisone on your skin and start rubbing it into the patch of skin that itches. Massage the ointment into your skin until it completely absorbs to start feeling relief.^{[8]
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Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} Apply the ointment 1–4 times every day around the same time to help keep your psoriasis under control.^{[9]
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- You can buy hydrocortisone from your local pharmacy.
- Hydrocortisone is a type of corticosteroid, which helps reduce redness, swelling, and itchiness.
- If you get a severe rash or your condition worsens, stop using hydrocortisone and contact your doctor.^{[10]
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4
Apply salicylic acid on scaly skin to prevent cracking and flaking. Look for an ointment or lotion that contains salicylic acid at your local drugstore. Rub a coin-sized amount of the lotion in your hands before spreading it over your affected patches of skin. Work the lotion until your skin absorbs it completely.^{[11]
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Research source} Use your salicylic acid ointment up to twice per day.^{[12]
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- Salicylic acid is a keratolytic, which means it reduces excess skin and softens hardened patches of psoriasis.
- Stop using salicylic acid if it irritates your skin.^{[13]
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5
Try applying aloe extract if you have inflamed and scaly skin. Aloe has natural soothing and healing properties, so it may work to alleviate your psoriasis. Buy either pure aloe gel or a moisturizing lotion that contains aloe extract. Rub the aloe into the irritated patch of skin and work it in until it’s clear. You can apply the aloe extract 3–4 times daily for up to 1 month, or until you see improvement.^{[14]
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Mayo Clinic
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- You can find aloe extract online or at your local drugstore.
6
Spread a coal tar product on your skin for scaling, itching, and inflammation. Coal tar is a type of oil that absorbs into your skin to treat irritation. Look for a coal tar shampoo, cream, or oil online or at your local pharmacy.^{[15]
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Mayo Clinic
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Go to source} Cover the affected area with the coal tar and rub it in gently. Leave the coal tar on your skin for 5 minutes before wiping the excess off with a clean paper towel.^{[16]
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- Coal tar has a strong odor, so it may not be the best treatment if you have a sensitive nose.
- Coal tar may irritate your skin and stain your clothes or bedding.
Tip: Coal tar can make your skin sensitive to light, so avoid exposing the area you treated to direct sunlight for 3 days.^{[17]
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Method 2

Method 2 of 3:

Avoiding Triggers

1
Try to protect yourself from skin injuries. When you get a cut, nick, or scrape, it may turn into an uncomfortable psoriasis flare-up. Use extra caution in your day-to-day life so you don’t get hurt or damage your skin. Be careful when working with rough or sharp materials. If you need to, wear long-sleeved shirts or gloves so you’re less likely to get injured.^{[18]
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- Avoid getting tattoos or body piercings since they’re also considered skin injuries. If you want to get body art, talk to a dermatologist to see if there’s a way to reduce flare-ups afterward.
- If you do get injured, treat it right away so you don’t get an infection. Even an infection could cause a flare-up.
2
Wear sunscreen when you go outside. While a little bit of sunlight can help your psoriasis, too much exposure can make your skin more sensitive and prone to flare-ups. Get a sunscreen that’s fragrance-free and has at least 30 SPF. Rub the sunscreen into any exposed skin that’s unaffected by your psoriasis. Be sure to reapply your sunscreen after 1–2 hours so you stay protected throughout the day.^{[19]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists

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- Avoid days where the sun feels intense since it may make your psoriasis worse.
- A little sunlight can actually help clear up your psoriasis. Apply sunscreen to your skin everywhere except the psoriasis patches, then spend about 20 minutes in the sun, 3 times a week.^{[20]
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  Expert Source
  
  Mohiba Tareen, MD
  FAAD Board Certified Dermatologist
  
  Expert Interview. 26 March 2020.}
3
Limit showers and baths to 15 minutes or less. Only bathe once a day, or else you may dry out your skin even more. Use water that’s warm but not steaming hot since it may irritate your skin more. Gently use your hands to wash your body with mild fragrance-free soap. When you’re finished with your shower or bath, pat yourself dry with a towel.^{[21]
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- Avoid scrubbing your skin with a washcloth or loofah since it could make your skin more irritated.
Tip: If your skin feels itchy or inflamed, try mixing colloidal oatmeal or Epsom salt into your bath before soaking in it.
4
Switch to an anti-inflammatory diet to prevent redness and swelling. Incorporate about 4 ½ cups (675 g) of vegetables into your daily diet, including things like beans, peas, spinach, broccoli, and cauliflower. You may also include 2–3 weekly servings of omega-3 fatty acids, like salmon and tuna. Try to limit the amount of red meat, saturated fat, and refined carbs, such as white bread and sugary processed foods.^{[22]
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Research source}
- Try following a Mediterranean diet that's rich in legumes, olive oil, and natural fatty acids.^{[23]
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  Expert Source
  
  Mohiba Tareen, MD
  FAAD Board Certified Dermatologist
  
  Expert Interview. 26 March 2020.}
- Extra-virgin olive oil can also help reduce inflammation, so use it while you’re cooking or try it as a simple salad dressing.^{[24]
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5
Maintain a healthy body weight to limit your flare-ups. Flare-ups occur more commonly if you’re overweight, so do your best to live a healthy lifestyle. Try to exercise at least 3–4 times per week and develop a routine that works your entire body. Also try to cut out any unhealthy, processed foods from your diet since they may lead to inflammation or weight gain.^{[25]
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American Academy of Dermatology
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- When you lose weight, sometimes treatments that weren’t effective before may start working for you.
6
Practice stress relief techniques. If you start feeling stressed, take a moment to close your eyes and relax. You can try reading a book, listening to music, practicing breathing exercises, or meditation to help you calm down. Everyone has a different way to relieve stress, so find the thing that works best for you.^{[26]
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American Academy of Dermatology
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- Try writing down things you’re grateful for before you go to sleep since it can make you feel happy and relaxed.
7
Stop drinking alcohol and smoking. If you have more than 2 drinks per day, other psoriasis treatments may not work as effectively. Either limit yourself to 1–2 drinks daily or stop drinking altogether. Smoking can also cause random flare-ups, so do your best to quit. Talk to a doctor if you have trouble quitting smoking on your own.^{[27]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists

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- Secondhand smoke can also trigger flare-ups, so limit your time around other smokers.
- While nicotine patches can make quitting smoking easier, they may cause psoriasis flare-ups where you put them on your skin. Talk to your doctor about other cessation options if you need to.
8
Run a humidifier when there’s cold, dry weather. Cold and dry weather makes your skin dry out faster, which can lead to uncomfortable patches of psoriasis. Put a humidifier in your home and run it throughout the day so the air stays moist. If the humidifier alone doesn’t keep your skin moisturized, put on lotion or ointment whenever your skin dries out.^{[28]
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American Academy of Dermatology
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- You can buy a humidifier from your local big box or appliance store.
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Method 3

Method 3 of 3:

Seeking Medical Treatment

1
Consult with your doctor to see if medications you take trigger your psoriasis. Medications like prednisone, lithium, and blood pressure prescriptions may cause your psoriasis to flare up. Continue taking the medication, but talk to your doctor as soon as you can to see if they think it’s causing the problem. Your doctor may switch your prescription to something that’s less inflammatory.^{[29]
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American Academy of Dermatology
Professional organization made of over 20,000 certified dermatologists

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- You’ll typically notice psoriasis flare-ups from medication within 2 weeks of starting it.
2
Get a prescription ointment to treat inflamed patches of psoriasis. There are many types of topical ointments your doctor may try depending on the severity of your condition. If you have itching and scaling, they may prescribe a moisturizing emollient to soften your skin. Otherwise, you may get corticosteroids, vitamin D analogues, or coal tar to bring down redness and inflammation. Use your prescription exactly how your doctor prescribes it.^{[30]
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- If you use corticosteroids more than prescribed, it may lead to skin thinning and further damage.
- Let your doctor know if you experience any side effects since they may try to switch your treatment.
3
Try phototherapy if you have moderate psoriasis. Phototherapy exposes your skin to natural and artificial lights to slow down the production of skin cells and make psoriasis patches shrink. Talk to your doctor or dermatologist to see if they recommend phototherapy for you. They UVA or UVB lights paired with topical and oral medications for a more effective treatment.^{[31]
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- You may need to go in 2–3 times per week for up to 2 months for phototherapy to be effective.
- Ask your doctor if there are any at-home options for phototherapy.
Warning: Avoid using tanning beds since they do not have the same effect as phototherapy lights and may irritate your skin more.
4
Ask about oral prescriptions for severe psoriasis. If you have large patches of psoriasis that haven’t responded well to other treatments, your doctor may prescribe a stronger oral medication. Let your doctor know about any other medications you’re taking to ensure they won’t interact with the psoriasis medication. Follow the directions your doctor gives you and never take more than the prescribed dose so you’re less likely to develop harmful side effects.^{[32]
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- Common oral medications include steroids, retinoids, methotrexate, and cyclosporine.
- Tell your doctor if you’re breastfeeding, pregnant, or trying to conceive since medications may have more negative side effects.
5
Consider biologics injections if other treatments haven’t worked. Biologics change your immune system to help improve your symptoms within a few weeks. Your doctor will inject the biologics directly into the patches of psoriasis to help soften them. Follow any aftercare instructions your doctor gives you to ensure the medication works properly.^{[33]
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- Biologics are not usually covered by health insurance and can be very expensive.
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Expert Q&A

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Question

How can I treat my psoriasis?

Mohiba Tareen, MD
FAAD Board Certified Dermatologist
Mohiba Tareen is a board certified Dermatologist and the founder of Tareen Dermatology located in Roseville, Maplewood and Faribault, Minnesota. Dr. Tareen completed medical school at the University of Michigan in Ann Arbor, where she was inducted into the prestigious Alpha Omega Alpha honor society. While a dermatology resident at Columbia University in New York City, she won the Conrad Stritzler award of the New York Dermatologic Society and was published in The New England Journal of Medicine. Dr. Tareen then completed a procedural fellowship which focused on dermatologic surgery, laser, and cosmetic dermatology.

Mohiba Tareen, MD

FAAD Board Certified Dermatologist

Expert Answer

Keep your body hydrated and your skin moisturized, and include fish oil and vitamin D in your diet. Salicylic acid-based shampoos and creams can help break down silvery scale on your skin that's caused by psoriasis. Getting 20 minutes of sun exposure 3 times a week can also help, because UV light helps reduce cells from forming too quickly, which leads to the thickened skin you see with psoriasis.

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Tips

While some treatments may work for others, they may not work for your psoriasis. Keep trying new treatments until you find one that works for you.

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Warnings

Talk to your doctor before starting any over-the-counter medications or supplements to make sure they don’t interact with anything you’re currently taking.

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If your psoriasis doesn’t improve or if it becomes more severe, contact your doctor.^{[34]
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