If you’re one of the 7.5 million Americans suffering from psoriasis, then you’re all too familiar with the dry, cracked, red, itchy, scaly skin that comes courtesy of the condition. And with sensitive skin like that, you’re also aware that using products with the wrong ingredients can be a fast pass to even more irritation. “Psoriasis is characterized by a compromised barrier function,” says dermatologist Rachel Maiman, M.D., of Marmur Medical in New York. “Although the skin may appear thickened, the inflammation and flaking from psoriasis render it more sensitive to ingredients that might otherwise be easily tolerated.”
Not to mention, some products can even worsen your symptoms, which is the last thing you need. You can navigate some of this by looking at the packaging for the skincare items you buy at the store. If you see the National Psoriasis Foundation Seal of Recognition on your brand of moisturizer, cleanser, shampoo, and laundry detergent, you’re good—the Foundation gives this seal to products tested and shown to be non-irritating and safe for people living with psoriasis.
But just because a product doesn’t have this seal doesn’t necessarily mean it’s bad: More like, do your own homework. By educating yourself on the ingredients to swipe left on, you’ll be able to better protect your skin. Take a look at some of the top psoriasis offenders, then sleuth every label like a true detective to make sure it’s safe for your skin.
Alcohol is all kinds of sneaky. While you wouldn’t pour it directly onto your skin, certain types, such as ethanol, isopropyl, and methanol, are often used in products as preservatives or to make a lotion feel lighter, Dr. Maiman says. The problem is, alcohol strips already dry, sensitive skin of essential moisture (yes, even when it’s used in a moisturizer). “During the process of evaporation, alcohol dries out the skin barrier,” Dr. Maiman says. It can also lead to inflammation, making it an ingredient to avoid.
The job of sulfates is to produce that foamy lather often synonymous with squeaky-clean skin and hair, but the way they achieve this is no bueno for sensitive skin. “Sulfates are detergents that dry out your skin and hair, and should be avoided,” says Jennifer MacGregor, M.D., of Union Square Laser Dermatology in Manhattan. Dryness is one of the prime triggers for itching, which can make psoriasis worse. To protect your skin, look for products labeled “sulfate-free.” Also, make sure to scan for sulfates’ lesser-known names: “Sulfates may be listed under ingredient names such as sodium laureth or sodium lauryl sulfate or ammonium lauryl sulfate,” Dr. Maiman says.
For some people, moisturizing with a fragranced product can exacerbate their psoriasis, Dr. Maiman says. The reason: Artificial fragrances usually contain a laundry list of chemicals or botanical additives, all of which can trigger a reaction in your already-sensitive skin. It’s best to go simple and look for fragrance-free skincare products and shampoos. If you’re not sure about a product, it’s always a good idea to sample it first. “When you’re trying out a new product, apply it on a small area of affected skin and assess it for a reaction before using it more broadly,” says Dr. Maiman.
“Oils are fatty acid sources and included in moisturizers, but while they may balance the product and are generally soothing and hydrating to skin, they aren’t specifically designed to help with psoriasis,” says Dr. MacGregor. More importantly, essential oils—often used in perfumes as well as lotions with “relaxation” or “stress-relieving” claims—may make your psoriasis worse. “If you’re considering adding an essential oil to your psoriasis regimen, speak with your doctor first to ensure it’s an appropriate choice and that the oil in question does not interact with any of your other medications,” Dr. Maiman says. “Essential oils can be quite potent and can cause allergic reactions and irritation.” Because psoriasis compromises your skin barrier, she adds, there is an even greater susceptibility to contact dermatitis—the inflammation of your skin that results when it’s exposed to an external irritant.
While it may be tempting to reach for a product to slough away scaly skin, you should steer clear of harsh scrubs containing mechanical exfoliants. These can cause tiny tears on the top layer of your skin, allowing bacteria to seep in. Mechanical exfoliants include scrubs with microbeads or grainy ingredients, loofahs with rough surfaces, or dry brushes—all of which are just too abrasive for psoriasis-prone skin. “Any trauma, even mild trauma caused by sloughing the skin, can worsen psoriasis and induce new psoriasis plaques to form on unaffected skin when injury occurs,” Dr. Maiman says.
It can feel like a lot to keep track of when you’re dealing with psoriasis, and if you find yourself growing weary of all the things you constantly have to monitor and avoid, we feel you. The positive spin is that in doing these things, you are gaining control over your condition, not vice-versa. Simplifying and streamlining your skincare routine, with a focus on natural products bearing the NPF Seal, will go a long way to keeping your skin healthy and psoriasis at bay.