Moisturisers and emollients for treating psoriasis
Emollients and moisturisers can help in the management and treatment of psoriasis when used correctly and can be used liberally and frequently.
Emollients soften and moisturise the skin. They are used to improve dryness and scaling. They have two actions: an occlusive provides a layer of oil on the skin to slow water loss which in turn increases moisture, and humectants are substances introduced to the outer most part of the skin to help increase the capacity to seal in water. Some moisturisers contain both an occlusive and humectants.
Emollients can help:
- Clear scaling which in turn makes it easier to apply other topical treatments
- Lubricate and soften psoriasis patches preventing cracking
- Soothe and relieve itchiness/irritation
- Hydrate the skin
- Protect the skin from bacteria
- Prevent irritation
Emollients come in various formats such as lotions, creams, ointments, leave on products, sprays, bath oils, shower products and soap substitutes. Ointments are suitable for dry, thickened and or brittle skin and are more suitable for night time use. Creams/lotions tend to be less greasy and so are more suitable for day time use. By using both ointments and creams regularly the skin will not dry out. But what works for one person doesn’t necessarily work for another, so it is down to individual preference as to the type of emollient to use.
Leave on Products
There are several types of leave on emollients that can be used directly on the skin. Some create a protective barrier over the skin to lock in moisture and some have added ingredients to reduce itching or prevent infection. Your doctor or pharmacist will take to you about which type of emollient will work best for your skin condition. You may have to try a few different emollients to find the best one for your skin. Many of these leave on products can also be used as wash products.
There are so many moisturisers to choose from that sometimes it can be difficult to know which is best. However, the best moisturiser is the one that you feel happiest with and that you can use easily on a regular basis. You may find that a combination of moisturisers works best for you, and that different moisturisers are more appropriate at different times of the day. Even if you’ve been prescribed another treatment for your psoriasis, it is still recommended that you moisturise every day.
Bath oils will help hydrate the skin and will leave a film of oil on the skin surface preventing water loss, bacteria and irritation. The oil will keep the skin soft and help prevent cracking. The use of foaming shower gels and foam baths is not recommended as they can irritate and dry the skin out. It is advisable to have warm baths as opposed to hot baths because warm baths prepare your skin for an emollient. You might like to consider applying a bath oil directly on to your wet skin or on to a sponge but this isn’t as effective as soaking in the bath. However, a 10-minute soak may be more beneficial. Once out of the bath pat your skin dry with a towel. Using a bath additive leaves a protection of film of oil over the skin that helps it to stop losing moisture.
Soap substitutes, which do not foam, will not dry the skin or remove the skin’s natural oils – but it is essential that you avoid the use of soap at all times. Every day soaps, shampoos and shower gels usually dry out the skin and can make skin conditions worse. Using an emollient soap substitute instead of normal soap for hand washing and bathing can help to improve your skin.
How to Apply Emollients
Leave on emollient lotions, sprays, creams and ointments should be applied directly to the skin. They should be smoothed, not rubbed, into the skin gently and in the same direction that your hair grows, to help prevent hair follicles from getting blocked. They can be used to replace lost moisture whenever your skin feels dry or tight. They are very safe and you can’t overuse them. You may need to experiment with different emollients or try a combination for example, you may choose to use a cream during the day and an ointment at night.
Soap substitutes (emollient wash products) – mix a small amount (around a teaspoonful) of soap substitute in the palm of your hand with a little warm water and spread it over damp or dry skin. Rinse and pat the skin dry, being careful not to rub it. You can use soap substitutes for hand washing, showering or in the bath. They don’t foam like normal soap but are just as effective at cleaning the skin. If your skin stings after using an emollient wash product and doesn’t settle after rinsing, ask your GP or pharmacist to recommend a different soap substitute.
Emollients can complement other treatments such as topical steroids which can improve your psoriasis. If you’re using a steroid cream or other treatment for your skin condition, wait at least 30 minutes after putting on your emollient before applying it. This avoids diluting the effect of the treatment and spreading it to areas of skin that don’t need it.
When to Apply Emollients
Emollients can be applied as often as you like to keep the skin well moisturised and in good condition. Ideally, this should be done at least three or four times a day. It is especially important to regularly apply an emollient to your hands and face as they’re exposed to the elements more than any other part of your body.
Certain activities such as swimming or gardening can irritate the skin. It may help to apply an emollient before doing these activities.
Emollients are best applied after washing your hands, taking a bath or showering because this is when the skin most needs moisture. The emollient should be applied as soon as you have patted your skin dry to ensure it is properly absorbed.
Emollients can sometimes cause a skin reaction such as:
- an overheating, burning sensation or stinging that doesn’t settle after a few days of treatment – usually caused by a reaction to a certain ingredient contained in the emollient
- blocked or inflamed hair follicles (folliculitis) that may cause boils
- rashes on the face that can aggravate the skin
If you experience any of these symptoms, talk to your GP, nurse of pharmacist.
Safety Advice When Using Emollients
Follow this general safety advice when using emollients:
- keep away from fire, flames and cigarettes when using paraffin based emollients. Dressings and clothing soaked with the ointment can be easily ignited.
- Use a clean spoon or spatula to remove emollients from a pot or tub. This reduces the risk of infections from contaminated pots.
- Take care of slipping when using emollients in a bath or shower or on a tiled floor. Protect the floor with a non-slip mat, towel or sheet. Wearing protective gloves, washing your bath or shower after with hot water and washing up liquid, then dry with a kitchen towel.
- Never use more than the recommended amount of bath additive. It may cause skin irritation if the concentration is too high, particularly when used with antiseptic bath oils.
It is always advisable to seek advice from your doctor/dermatologist – he or she will be able to offer the best treatment for your symptoms.
Sources used in writing this article are available on request
Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence based articles are accredited by the PIF TICK, the only UK quality mark for trustworthy health information. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.
Information written by the talkhealth team
Last revised: 9 January 2018
Next review: 9 January 2021