Alternative remedies for psoriasis – Managing skin psoriasis with moisturizers etc.

Immerse Yourself While you may think that a quick shower can help your body to wake up for the day or cleanse it free of the daily grind, your psoriasis affected body will love you if you allow it some time to soak. You can accomplish this feat in various ways. The first and simplest one is simply taking a long bath. Immerse your body completely under the water so that all of the affected parts are covered in water. The other method is to stand under the shower for a long period of time. If you will need to go somewhere or attend to something else take the time to have this immersing shower earlier in the day.

You can also go to the swimming pool and stay there for a while. Another good way to achieve this immersion can be with a wet compress. All of these methods will help to hydrate your skin and especially the areas which are affected by psoriasis. As these sections of your skin have become thickened, this softening process will help you in removing the scales without damaging your skin.

This is important as the thick scale act as a barrier which does not allow medications as well as ultraviolet light to penetrate the skin. Regular bouts of soaking may also reduce the itching and the redness of the lesions. There is one important thing that you need to keep in mind when you are soaking yourself. You should keep the water at a tepid level as hot water may increase the itching.

Smooth as Silk

Having soaked your skin you will need to prevent your skin from losing its protection in respect of moisture loss. This can be done by applying an emollient right after (within 3 minutes time) you have soaked, wetted or even washed your skin. By applying moisturizer after you have soaked, showered, or wetted your skin you are locking the moisturizer into your skin.

Don’t Injure Your Skin

We are all acquainted with various small injuries which come from our lifestyles. While these are irritating to people who don’t have psoriasis these problems may worsen your condition. You can get sunburn, tight clothing irritation, scratches from cats, dogs and other pets etc.

These may act as triggers to your condition.

Treat Your Infections on the Double While you may consider systemic infections to be rather annoying you do need to understand that these infections have the ability of causing flare ups in psoriasis for some people. It is for this reason why you should contact your physician at the slightest or earliest sign of an infection or fever. By doing this you can keep the infection and the psoriasis flare up down to the absolute minimum and help your immune system to recover as quickly as possible.

Moisturisers for psoriasis

Why should I use moisturisers?
Although there is little scientific research into the effects of moisturisers on psoriasis, our own experience shows that:

• moisturisers make the skin much more comfortable – they decrease the dryness, scaling, cracking and soreness, and itching;

• moisturisers allow the other active treatments that you use (e.g. tar or vitamin D) to work more effectively.

Which moisturiser is best to use?

There are so many to choose from that it is sometimes difficult to know which to choose. There are, however, two golden rules:

• Moisturising is absolutely vital for anyone with psoriasis. Although it does not get rid of the psoriasis, it makes it less scaly and much more comfortable.

• The best moisturiser is the one that you feel happiest with and that you feel you can use easily on a regular basis. Discuss this with your GP and ask her or him to prescribe one that you like and will use. You may find that you need two or three different moisturisers for different parts of your body or different times of day, so don’t be afraid to ask to try several varieties.

Consistency

Lotions are water based and tend to be very runny and easy to apply (e.g. E45 lotion). They are quite cooling but not very good at moisturising, particularly dry skin. They are useful for maintaining good skin once the psoriasis has gone.

Creams are thicker and a bit greasier than lotions but are still easy to use (e.g. Diprobase). They are less runny and tend to come in pots or pump dispensers. They are usually the best option for day-to-day use.

Ointments are very greasy and thick, and are oil rather than water based (e.g. Epaderm or 50/50 white soft paraffin/liquid paraffin mix). They are the best moisturisers but are less pleasant to use because they are greasy and quite sticky. If, however, your skin is very dry, they are the best option.

Doublebase is a relatively new gel-based emollient that many people find smoothes into the skin very easily.

Frequency

You should use your moisturiser at least twice a day and more often if possible. Try to make your treatment fit in with your lifestyle as best you can. Some suggestions are to use a lighter cream moisturiser in the morning before going to work or school and then use a greasier ointment before going to bed. Try taking a small pot of cream to work with you and applying it if a patch get particularly dry, itchy or uncomfortable. If you are applying a moisturiser all over, it is very easy to get through a 500 g pot in a week or so, so make sure that your doctor prescribes enough.

Method of application

When you apply the moisturiser, you should do this by gently stroking the cream/ointment on in a way that follows the lie of the little hairs on the skin. Try not to rub too aggressively as this will only serve to aggravate the plaques – a gentle repeated motion is best. A pump dispenser is best as it saves you having to keep putting your hand into the pot. If you have a moisturiser that does not come with a pump dispenser, scoop out what you need with a clean spoon – this stops dirt and skin scale getting into the pot.

In the bath or shower

Moisturising is not just about putting cream or ointments on: it starts in the bath or shower. As indicated in the answer to a later question, in the section ‘Practical aspects’, it is wise to wash with a soap substitute that does not dry your skin. If you choose to bathe, put a bath oil in the water; this helps to create a layer of oil over the skin, which prevents water being lost from the skin. Beware of the risk of slipping, though, when you get in and out of the bath or shower!
To summarise, moisturising should involve:
• using a soap substitute;
• putting an oil (e.g. Balneum, Oilatum or Diprobath) in the bath;
• using lots of cream or ointment moisturisers at least twice a day;
• choosing the moisturisers that suit you and your lifestyle best.

When should I apply moisturisers?

As mentioned in the answer above, moisturisers should be applied as often as possible. There are, however, two key times when moisturisers are a must:
• straight after a bath or shower as the skin is warm and well hydrated so will absorb the moisturiser better and the extra water will be sealed into the skin;
• before putting on a treatment. It is important that the moisturiser is absorbed into the skin because, if it is sitting on the surface of the skin, it may make the active treatment less effective.

A good routine to get into is to bathe or shower using a soap substitute, apply moisturiser and allow it to sink into the skin, and then apply the active treatment. (A lotion will be absorbed almost straight away, but it can take 10–15 minutes for a cream and 45–60 minutes for an ointment to be absorbed.)

Although there is a difference between creams and ointments, it can get a bit confusing because people refer to all the substances that go on the skin as creams. Strictly speaking, creams are water based, tend to be white in colour and are quickly absorbed into the skin. Although they are good moisturisers, they are not as effective as ointments, which are oil based. Ointments tend to be (although are not always) translucent, and they are very good moisturisers. So a moisturiser can be either a cream or an ointment. But, to make life more complicated, other treatments can come in cream or ointment form. Most steroid applications, for example, come in either an ointment or a cream, as do vitamin D applications. As mentioned in an earlier answer, ointments, although they have a better moisturising effect, tend to be less pleasant to use and can take much longer to be absorbed if you need to apply an active preparation on top. The choice is personal preference, and you

need to decide for yourself which preparations you like best. GPs often prescribe the ointment form of vitamin D and steroid treatments. If you find these too ‘tacky’ or sticky, ask your GP to prescribe you the cream form. If you are using moisturisers as well, it is less important to have the greasy form of the active treatment.

Should I be using moisturisers – my doctor has given me Dovonex?

Yes! Yes! Yes! No matter what other treatment your doctor gives you, you should always use moisturiser before applying the other treatment. The moisturiser (once it has sunk in) makes the other treatment more effective as well as easier to apply by reducing the scale and allowing a better absorption of the active creams.

Exorex is the brand name for a group of treatments for psoriasis. There is a lotion that is a weak tar solution (and has the characteristic tar smell), and also a moisturiser and a shampoo (which do not contain tar). Tar is a useful treatment for psoriasis and is helpful for many people. The amount of tar in Exorex is low, but the lotion is easy to put on, so some of its reported success may simply reflect the fact that people will keep using it. The cream contains an extract from the banana plant, which is what sparked a lot of media attention. It is a cream and is slightly greasy. It is really a matter of personal preference whether you like it more than any of the other emollients.

Tagged as: moisturizer, moisturizers