Tips From Doctors On Managing Psoriasis Pain Effectively

Psoriasis is a chronic autoimmune condition that causes skin cells to multiply too fast, leaving behind itchy, scaly patches. But there are a number of ways the estimated 125 million people worldwide who have psoriasis experience it. Studies show anywhere from 17 to 83 percent of patients say pain is one of the unwelcome side effects. 

Sometimes, psoriasis pain can get so severe that it even messes with the ability to sleep. “Psoriasis pain can feel different for each person, but it is often described as aching, burning, stabbing, throbbing, cramping, or stinging skin,” says board-certified dermatologist Ife J. Rodney, MD, founding director of Eternal Dermatology Aesthetics in Maryland. For patients with painful psoriasis, she says those sensations can range from mild to severe, and affect all different parts of the body.

In about 30 percent of cases, psoriasis also causes a condition known as psoriatic arthritis, which affects the joints. “This can lead to stiffness or pain as well,” says Joshua Zeichner, MD, the director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital in New York City.

If you have psoriasis pain, what you likely want are answers: Why you’re in pain to begin with and what, exactly, you’re supposed to do to get relief. Here, doctors break it all down.

What causes psoriasis and the pain it can bring?

It’s not entirely understood why psoriasis can be so uncomfortable. “The medical community sometimes struggles to find the exact cause of psoriasis or psoriasis pain, but [the pain] is thought to be caused by inflammation that irritates nerves in the skin,” Dr. Rodney explains.

What we do know happens is that the immune system sends signals to the skin cells that cause them to grow too quickly, she says. “This process results in a buildup of skin cells,” Dr. Rodney explains. “When these skin cells die and fall off the skin, they cause red, scaly patches that can be itchy and painful.”

In the case of psoriatic arthritis, your body’s immune system mistakes joints and tendons as foreign objects and attacks those healthy cells, according to the American Academy of Dermatology Association. “When it comes to psoriatic arthritis, no two patients are alike,” says Naomi Schlesinger, MD, chief of the rheumatology division at Rutgers Robert Wood Johnson Medical School in New Jersey. “Some individuals may have only peripheral joint disease—in which the hands, wrists, and knees are affected—while others may have only spine involvement. Still, other people may have both.”

How to manage the psoriasis pain during flares

Doctors say there are several things you can do at home to help relieve your pain during psoriasis flares.

1. Keep your skin moisturized

Don’t skimp on that soothing lotion. “This can help to reduce dryness and scaling, which can make the pain worse,” Dr. Rodney says. Dr. Zeichner also suggests using a cream with salicylic acid to “help remove excess scale.”

2. Apply cold compresses or take warm baths

Both the cold and the heat can help to reduce inflammation and pain, Dr. Rodney says.

3. Use over-the-counter pain relievers

Ibuprofen or acetaminophen can help, Dr. Rodney says. Both medications work by temporarily increasing your body’s pain threshold so that you feel less pain.

4. Avoid scratching the affected skin

It’s tempting to scratch or pick at skin during a flare, but doctors stress that this will only make the pain and inflammation worse. Dr. Rodney adds that it could even lead to infection.

5. Pay attention to what you’re putting on your skin

“Avoid using harsh soaps or other products that can irritate the skin,” Dr. Rodney says. Instead, try to stick with unscented products.

6. Manage stress

Dr. Rodney suggests regularly working out to keep your stress in check, and doing calming activities like yoga, meditation, or deep breathing. Managing stress is, of course, easier said than done, but she says it’s important to prioritize because stress can trigger psoriasis flares.

7. Avoid alcohol and cigarettes

Both alcohol and cigarettes may impact flares—and your pain. It’s best to avoid them if you’re able, Dr. Rodney says.

8. Ask your doctor about medications

There are topical creams or ointments, oral medications, and injections that can be used to manage psoriasis pain, Dr. Rodney says. “These come in different strengths and sometimes, the doctor or dermatologist may suggest different options based on their effectiveness,” she says, noting that it’s important to talk to your personal physician since psoriasis treatment can impact everyone differently.

However, don’t give up hope. Dr. Zeichner stresses that “psoriasis can be managed.”

When to see your doctor about psoriasis pain

If you suspect you may have psoriasis but haven’t been given a diagnosis:

Dr. Rodney recommends contacting your dermatologist for an evaluation. “We can recommend treatment options and help manage the pain and inflammation associated with psoriasis,” she says.

If you’ve already been diagnosed with psoriasis and you’re uncomfortable but it’s manageable:

Dr. Zeichner recommends starting with at-home strategies like those mentioned above and seeing where that gets you. “If over-the-counter products are not helping after two to four weeks, visit a board-certified dermatologist for prescription treatments,” he says. “Your dermatologist can talk to you about higher-strength cortisone creams as well as medications that address the inflammation from the inside out, including those you can take by mouth or injectables.”

If your psoriasis pain is severe enough that it’s impacting your quality of life:

Dr. Rodney recommends contacting your dermatologist right away. There’s no reason to needlessly suffer.