Psoriasis and Cosmetics — Which Ingredients Help in Skincare?

Psoriasis — a disease cosmetics can't cure, but can help manage

Psoriasis is a chronic autoimmune disease in which the skin's renewal cycle is dramatically accelerated — from the normal 28 days to just 3-5 days. The result is hyperkeratosis — excessive keratinisation, visible as silvery-white, thick scales on reddened, inflamed skin.

It's essential to understand this: cosmetics do not treat psoriasis. It is a systemic disease that requires dermatological care — from topical treatments (corticosteroids, vitamin D analogues) through phototherapy to biologic drugs. That said, the right cosmetic skincare is an essential complement to medical therapy, improving the comfort and appearance of the skin.

Please note: This article deals solely with the role of cosmetic ingredients as supportive skincare. It does not replace a dermatological consultation or pharmacological treatment.

Hyperkeratosis — the main skincare challenge

Psoriatic plaques are clusters of excessively keratinised skin cells, beneath which an inflammatory process is taking place. The two main goals of cosmetic skincare are:

1. Keratolysis — exfoliating excess keratinised cells to reduce the thickness of the plaques
2. Moisturising and softening — improving skin elasticity, reducing itching and cracking

Both goals are achieved using specific cosmetic ingredients with well-documented effects.

Keratolytic ingredients — exfoliating plaques

Salicylic acid (2-3%)

Salicylic acid is a keratolytic — it dissolves the intercellular bonds in the stratum corneum, making it easier to exfoliate excessively keratinised skin. At a concentration of 2-3%, it effectively reduces the thickness of psoriatic plaques, improves the penetration of other active ingredients and gives the skin a smoother appearance.

In the context of psoriasis, salicylic acid is applied locally to the plaques, not over the entire body surface. It works best in the form of ointments or creams, which ensure longer contact with the skin's surface.

Urea 10-30%

At higher concentrations, urea combines moisturising and keratolytic properties. Within the 10-30% range, it effectively softens psoriatic plaques:

• 10% — intensive moisturising + gentle exfoliation
• 20% — a clear exfoliating effect, softens thick plaques
• 30% — strong keratolysis, applied locally to particularly thick lesions

Urea is safe for long-term use and well tolerated. However, it should not be applied to cracked skin — it causes stinging.

Ichthammol (ichthyol) — an ingredient with heritage

Ichthammol (sulfonated shale oil) is an ingredient with a long tradition in dermatology, used for over 100 years. In cosmetics, it acts as an ingredient with exfoliating and irritation-soothing properties. It has a characteristic dark colour and a distinctive smell.

In the European Union, the use of ichthammol in cosmetics is regulated — it is subject to limits on concentration and form of use. Products containing ichthammol should be used in accordance with the manufacturer's recommendations.

It's worth noting that ichthammol in cosmetics is not a substitute for prescription formulations containing coal tar, which requires a prescription at higher concentrations.

Emollients — the foundation of daily care

Emollients are the cornerstone of psoriasis care — used regularly, even during periods of remission. Their role is to:

• Replenish lipids in the stratum corneum
• Reduce transepidermal water loss (TEWL)
• Reduce itching and a feeling of tightness
• Improve skin elasticity and reduce the risk of cracking

The most effective emollients for psoriatic skin contain ceramides, shea butter, paraffin oil or petrolatum. Apply them at least twice a day — morning and evening — and after every bath.

Emollients support pharmacological treatment, but they do not replace it. Treat them as an essential complement to the therapy prescribed by your dermatologist, not as an alternative.

Therapeutic baths

Baths with the addition of bath oils (emollient ones) can soothe the symptoms of psoriasis over larger areas of the body. The rules:

• Water temperature: lukewarm (around 33-36°C) — hot water intensifies itching
• Duration: 15-20 minutes — longer baths dry out the skin
• After bathing: gently pat dry with a towel (do not rub) and apply an emollient immediately

What to avoid in cosmetics when you have psoriasis?

• Harsh surfactants (SLS, SLES) — they damage an already weakened skin barrier
• Fragrances — potential irritants and allergens
• Alcohol denat. — dries out and irritates
• Retinol at high concentrations — may intensify irritation (although prescription retinoids are used in psoriasis therapy under medical supervision)

Emollients and medications — order matters

If you use emollients and medicinal preparations (e.g. corticosteroid ointments) at the same time, leave a minimum 30-minute gap between applications. The order depends on your dermatologist's recommendations — do not change it on your own.

Summary — the role of cosmetics in psoriasis

Cosmetics containing salicylic acid, urea, ichthammol and ceramides can significantly improve the comfort of psoriatic skin. Remember, however, that they are a complement, not a replacement for dermatological treatment. Discuss your skincare routine with a dermatologist, who will tailor it to the current condition of your skin and the therapy you are using.

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