Interview with Dr. AMODE: "Psoriasis in Everyday Life."

"Psoriasis is not a skin barrier abnormality like eczema. However, the presence of scaling can impair quality of life and skin comfort. For the daily cleansing routine, we generally opt for a gentle superfatted cleansing bar, preferably soap-free (no detergents) and fragrance-free to avoid irritating the skin.

The frequency of washing varies according to daily demands and individual needs. Moreover, it can be tempting to use “aggressive” cleansing methods to remove the scaly lesions of psoriasis. However, skin trauma can trigger new psoriasis lesions (Koebner phenomenon). Therefore, it is advisable to adopt gentle hygiene practices.

For example, wash yourself in lukewarm water. Indeed, hot, frequent baths or showers can dry out the skin and worsen psoriasis. Similarly, you might be tempted to use a washcloth or any other bathing accessory to remove psoriatic scales. However, excessive or vigorous exfoliation or rubbing can inflame the skin, potentially causing minor wounds or skin infections that trigger psoriasis flare-ups. Instead, use your hands to wash.

"For a gentler bath, it is often recommended to add oat flour or starch. Starch has been used for a long time in dermatology for all inflammatory dermatoses. Yes, it can be used in one’s bath. They have anti-inflammatory, soothing, softening, and emollient properties, thus providing comfort to the patient."

For your baths, it is preferable to use a colloidal oatmeal powder. This is finely milled oatmeal that forms a uniform suspension in water, thus helping to prevent your plumbing from clogging.

"Also, both during and outside of flare-ups, thedaily use of an emollient after bathing is recommended over your entire body at least twice a day using a moisturizing treatment such as a balm or thick cream to strengthen the skin barrier, maintain skin hydration, reduce uncomfortable scaling, and lengthen the intervals between flare-ups. This moisturizer can be enriched with keratolytic agents like urea, which help to gently remove scales."

The over-the-counter bathing and skincare regimen cannot heal skin lesions because psoriasis is an autoimmune inflammatory disease.

"Makeup is not contraindicated. In cases of facial involvement, priority should be given to administering treatments. Camouflage is permitted provided certain principles are observed. Before applying makeup, thoroughly prepare your skin in advance for makeup application. Consider using a moisturizing treatment."

First applying a hydrating treatment helps soften the skin. This prevents makeup from clumping on dry, flaky patches and from further irritating the skin.

"Then use fluid makeup products that are non-irritating, non-occlusive, and non-allergenic. Opt for hydrating formulations, and avoid those that could dry out your skin and exacerbate psoriasis symptoms, such as products containing essential oils, fragrances, or alcohols."

Some clothing and textiles can exacerbate psoriasis symptoms. Wool, mohair, and synthetic fabrics tend to retain heat, triggering psoriasis or worsening existing scaly plaques.

"It seems that natural fibers provide better skin comfort: cotton, linen, silk, and other plant-based fibers." says Dr. AMODE.

Moreover, it is recommended toavoid tight-fitting clothing and to favor garments that are loose. Beyond clothing, the bedding you choose should also be selected carefully. Use sheets, pillowcases, and duvets made from cotton, bamboo fiber, silk, or linen.

"Yes, poor lifestyle habits or overexertion can contribute to the onset of a psoriasis flare-up or exacerbate an existing one. Moreover, the itching (pruritus) associated with psoriasis, as well as potential comorbidities (depression, anxiety, etc.), can make it difficult to fall asleep, impair sleep quality, and lead to sleep disturbances (insomnia, sleep apnea, restless legs syndrome)."

"Thermal spa treatments can deliver improvements in symptoms, well-being, self-esteem, and quality of life. The observed benefit is multifactorial: stress reduction, regulation of diet and lifestyle, and the soothing effects of treatments and thermal waters. This is a medical treatment requiring a prescription, used in addition to drug therapies," according to Dr. AMODE.

It is possible to observe a benefit of thermal spa treatments on psoriasis through an indirect effect, by taking a break and experiencing less stress Because we know that environmental factors can impact and trigger flare-ups (chronic stress, psychological trauma, etc.). Although psoriasis is not a psychosomatic disease, it does involve psychological risk factors and life events that can precipitate flare-ups.

Laser hair removal is not contraindicated; however, it is logical to avoid affected areas and flare-up periods. As a reminder, any trauma can trigger a psoriasis flare-up (Koebner phenomenon).