How to Sleep Better With Psoriasis

by Jennifer Tzeses Health Writer

It’s the season for flannel pajamas, wool blankets, and cozy, billowy bedding. But if you’re dealing with psoriasis, feeling comfortable in your own skin is a challenge—let alone sleeping between winter’s warmest fabrics. “Psoriasis is a chronic autoimmune condition that causes the rapid buildup of skin cells,” says Manhattan dermatologist Ellen Marmur, M.D., founder of MMSkincare. This buildup of cells can form scaling on the skin’s surface, as well as inflammation and redness, Dr. Marmur says. “Choosing bedding wisely is important because certain fabrics and detergents can make the condition worse,” she says.

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Not only can the wrong fabrics irritate your skin, but all that discomfort and itching may be keeping you up at night. A 2018 report in Reumatologia found that 57.7% of psoriasis patients in the study suffered from poor sleep, which affected their overall quality of life. Other studies have shown that impaired sleep quality may be associated with disease severity. The bottom line: Improved snoozing is important. To help you ease the itch and sleep more soundly, here’s the sensitive skin-approved sleep scene you need to set, stat.

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Give Your Skin Breathing Room

Dress yourself (and your bed) in fabrics made from natural fibers, such as 100% cotton. It’s more breathable and less likely to stick to the skin than other materials, such as polyester or synthetic blends, Dr. Marmur says. “The skin is already cracked and sensitive, and the wrong fabric—such as polyester, rayon, nylon, or spandex—may not be breathable, which will cause you to sweat more and irritate your psoriasis, which can lead to infection,” she says.

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Forgo Anything Tight-Fitting

Wool long johns may sound like super-cozy bedwear, but experts urge against anything that's slim-cut, which can trap heat and be irksome when you have sensitive skin. “Wearing loose-fitted clothing causes less friction between your skin and the fabric you wear,” Dr. Marmur says. Slip on an oversized tee or baggy bottoms in cotton or silk, your most skin-friendly choices. “Many people are also allergic to synthetic fabrics and wool, which are more likely to irritate psoriasis,” she adds.

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Ditch Warm Fabrics

Flannel sheets are super-snuggly, but along with wool and polyester they are the most irritating to sensitive skin, says Orit Markowitz, M.D., associate professor of dermatology at the Icahn School of Medicine at Mount Sinai. “Any bedding that has dyes, synthetic material, and even a low thread count can scratch or scrape the skin,” she says. “This can cause new plaques to form in scraped areas, a phenomenon called keoberization.” (Translation: Don’t.)

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Perfect Your Pillowcase

If ever you needed a reason to splurge on a silk pillowcase (or sheets and lingerie), this is it. Silk looks and feels decadent, and it’s also breathable and smooth, Dr. Marmur says. What’s inside the pillow matters, too: Make sure yours isn’t stuffed with polyester or feathers—both inhibit breathability. “Cotton filling doesn’t retain as much heat, which is good,” Dr. Marmur says. (PS: If you don’t want to splurge on a silk case, a 100% cotton works, too.)

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Get Steamy

A good night’s sleep requires more than awesome bedding. Psoriasis can flare when the air is too dry, a frequent situation with home heating in the winter months. Protect your skin by using a humidifier in your bedroom. “The more moist you can keep your skin, the less itchy it will feel,” says Dr. Markowitz.

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Wash, Rinse, Repeat

Washing your bedding at least once or twice a week will help keep infections and irritation at bay, Dr. Marmur says. How you wash it matters, though. The most important takeaway: “Use a fragrance-free detergent, as fragrance tends to irritate the skin and can worsen psoriasis,” she says. Look for one that’s dye- and additive-free, too. Wash your bedding in hot water and skip the fabric softener. If you dry clean any bedding, it’s worth asking if they can use a solution for sensitive skin.

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Nip the Nightly Itch

Getting ahead of the itch is everything with psoriasis—especially before bed. Try this expert trick: Slather your skin with a thick creamy product, such as Vaseline, Cetaphil, or Eucerin. Go all in—head to toe—so your skin won’t feel flaky and dry. “Scratching makes the condition a hundred times worse,” Dr. Marmur says. If you don’t like the feeling of a thick lotion try a lighter-weight serum (like Dr. Marmur's MMRevive Serum). It helps calm redness and dryness and creates a strong barrier for your skin, she says.

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Take a Pre-Bed Bath

Soaking in a lukewarm (read: not hot) bath before bed can lock and load moisturizers and medications more effectively, Dr. Marmur says. Adding oil, colloidal oatmeal, Epsom salts, or Dead Sea salts in the bath have been proven effective for some people for removing psoriasis scales and soothing itch. Just don’t soak for any longer than 15 minutes (too long and your skin will dry out) and apply a moisturizer or oil to the skin immediately after getting out of the bath for optimum hydration.

  • Sleep Study: Reumatologia. (2018). “Sleep Disorders in Patients with Psoriatic Arthritis and Psoriasis.” pubmed.ncbi.nlm.nih.gov/30505012/
  • Sleep & Psoriasis: The Eurasian Journal of Medicine. (2017). “Sleep Quality and Its Association with Disease Severity in Psoriasis.” ncbi.nlm.nih.gov/pmc/articles/PMC5469838/
  • Dead Sea Salt & Psoriasis: International Journal of Dermatology. (2005). “Bathing in a Magnesium-Rich Dead Sea Salt Solution Improves Skin Barrier Function, Enhances Skin Hydration, and Reduces Inflammation in Atopic Dry Skin.” pubmed.ncbi.nlm.nih.gov/15689218/
Jennifer Tzeses
Meet Our Writer
Jennifer Tzeses

Jennifer Tzeses is a writer and content strategist specializing in health, beauty, psychology and lifestyle. She's written for The Wall Street Journal, Mind Body Green, CNN, Architectural Digest, Barron's, Cosmopolitan, Harper's Bazaar, Psycom, Elle, Marie Claire, and more. Follow her on Instagram @jtzeses.