Psoriasis: how to soothe the itching?

Psoriasis is a skin condition that is not contagious. It is characterised by red patches covered with whitish scales. Psoriasis presents in three forms: mild, moderate, and severe. In its severe form, it can lead to joint pain, known as psoriatic arthritis . Psoriasis evolves through flare-ups alternating with periods of remission. In other words, there are times when the symptoms disappear before reappearing later on.

Skininflammation is caused by a failure of the immune system. T lymphocytes produce inflammatory molecules (cytokines IL-17, IL-22, IL-23, TNF-alpha, among others). These molecules stimulate the proliferation of keratinocytes. When the skin cell renewal period, which is normally around four weeks, is accelerated to just three days, this leads to an accumulation of immature keratinocytes on the skin's surface. The consequences are an increase in the thickness of the skin's outer layer (hyperkeratosis).

Itching begins to be felt following the inflammation of flare-ups and skin dryness. It is exacerbated by the habit of scratching and stress. Here are some recommendations to alleviate the itching of psoriasis.

• Hydrating the skin: The hydration is the ally of skin diseases. In the case of psoriasis, it prevents and soothes itching. To hydrate the skin, it is recommended to apply an emollient care several times a day, and this, in a thin layer. It is also possible to use thermal waters. Simply perform prolonged sprays or apply compresses soaked in cool water. Moreover, it is advised to drink at least 1.5 litres of water per day.

• Applying cold: The cold is highly recommended in cases of psoriasis to numb the itching. Indeed, the cold has a vasoconstrictor effect, meaning it causes a narrowing of the blood vessels and can reduce the skin inflammation associated with itching. To do this, place a thermal water spray in the refrigerator. Once cool, spray it on the itchy skin surface.

• Avoid scratching: The urge to scratch is a constant presence throughout the day when dealing with psoriasis. The goal is to soothe the itchiness of psoriasis without damaging the skin. To achieve this, gently scratch using the palm of your hand or use your fingers folded to avoid nail contact. You can also use a cotton glove, a pebble, a massage roller or a wooden roller.

• Use gentle skincare: Avoid environmental factors that exacerbate symptoms, such as detergents and irritating substances. Choose gentle skincare that respects the health of your skin. In case of scalp psoriasis, it is recommended to select a very gentle shampoo, soap-free and with a physiological pH. Ideally, opt for a shampoo containing anti-itching active ingredients (thermal water, pre or postbiotics).

• Consulting a dermatologist: If itching persists or worsens despite self-care measures to alleviate discomfort, it is recommended to consult a dermatologist. They can assess the situation and recommend specific treatments, such as topical creams, oral medications or phototherapytreatments.

• FLUHR J. W. & al. Emollients, moisturizers, and keratolytic agents in psoriasis. Clinics in Dermatology (2008).

• Lutter contre les démangeaisons du psoriasis. Association France Psoriasis (2017).