Sunday, October 4, 2009

Moisturize, Moisturize, Moisturize: Psoriasis' First Line of Treatment

Psoriasis, which presents itself as dry skin mottled with red patches covered with off-white scales, is a condition that does not have any cure yet. That's the saddest thing about having, and the most common reason why we become frustrated over time when dealing with, this condition. Treatment for psoriasis varies differently among patients, but there is only one common goal: to rid our skin of the psoriasis lesions.

Often, doctors begin psoriasis treatment with a therapy which does not expose us to many side effects. If our response to the treatment using the least potent therapy is not promising, that's the time when doctors move up the scale, hoping to find the therapy that will clear the lesions. No matter what type of treatment (topical, light, systemic, or biologic) we use, we should not forget to moisturize our skin, including the lesions.

Aim of Emollient Therapy
While emollient therapy, or the use of moisturizers, does not make our psoriasis go away, it is an essential component in psoriasis care. Because it moisturizes and lubricates the skin, as well as helps remove scales from the psoriasis-affected patches, overall skin condition is enhanced. It is very useful in preparing our skin for application of active topical (e.g. creams or ointments containing steroids) or light therapies (natural sunlight, or UVB). Once the psoriatic skin is moisturized regularly, we feel more comfortable as we go about our everyday life because skin becomes less itchy, inflamed and scaly.

How to Apply Moisturizer on Skin
Moisturizers may come in the form of soap substitutes, lotions, steroid-free creams or ointments, and oil. Make sure you use the moisturizer that you are most comfortable with and have no qualms about using regularly, day in day out. Moisturizing the skin starts not after but during the bath or shower itself. If you are taking a shower, it is best to use a soap substitute (e.g. Cetaphil) to avoid drying the skin. For those who prefer using the bath tub, it helps to put some bath oil in the water; a thin film of oil will deposit on your skin, keeping moisture in.

Once you finish bath or shower, you can proceed to apply the lotion, or the steroid-free cream/ointment. You would not want to develop an infection on your hair follicles (called folliculitis), hence, make sure that in applying moisturizer you use long strokes in line with the natural direction of the hair. Avoid rubbing in too aggressive a fashion, as the friction provokes more plaque-formation. Instead, use a gentle, circular motion to work the liquid into the skin.

While it is best to apply moisturizers as often as possible during the day, it may not be practical in your work and lifestyle. You may want to make it a routine to apply the moisturizer before you go to work and then apply again before you sleep. Any application in between should be a great plus.

One final point about moisturizers: actually, they don't add water to your skin; instead, they minimize the amount of water lost via evaporation. If there is little water in your skin in the first place, then moisturizers will not help at all.

Make sure you do not become dehydrated by drinking plenty of fluids during the day. Then, moisturizers can do their job.

Photo credit: shawncampbell (

Hughes, E. and Van Onselen, J. (2000). Dermatology Nursing. (New York: Churchill Livingstone).

Mitchell, T. and Penzer, R. (2005). Psoriasis At Your Fingertips Guide. (London: Class Publishing).

Rees, A. (1997). Consumer Health USA. (Phoenix: Oryx Press).