Psoriasis

Psoriasis treatments: bath oils/emollient, soap substitutes and medicated shampoos

Some shower gels, soaps and shampoos can irritate psoriasis. Damini finds 'normal' soaps or shampoos make her skin itchy. Megan’s “never been able to use bubble baths or bath bombs”, but can use ‘normal’ shower gel now that her psoriasis is less severe. As an alternative to ‘normal’ versions, some of the young people we talked to had tried:
  • bath oils and emollients (added to a bath)
  • soap and shower gel substitutes
  • medicated shampoos (prescribed and shop-bought)
Others found shop-bought brands of soap, shower gel and shampoo were fine for them. Zara likes fragranced shower gels and doesn’t notice a difference in her skin. Others opt for shop-bought versions which are “gentle”, “natural” and plain (less fragrance). Abbie and Louie use “dermatologically tested” bathing products in the hope these are less likely to cause a flare-up.

Bath oils/emollients and soap substitutes

Many people used a prescribed soap/shower gel substitute. Sometimes this substitute was the same as their leave-on emollient. These don’t tend to lather up or make bubbles as much as other soaps and shower gels.

Some people found using soap substitutes helped their skin. Louis’ shower gel substitute soothed and calmed his skin. Ella described the look of her soap substitute as “slightly thickened milk”. She likes the smell and finds it works well. Although Carys disliked things about her bath/shower gel substitute, she found it useful having a soap substitute for washing her hands at work.
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Others didn’t like using bath oils or soap/shower gel substitutes. Abbie’s skin felt oily when she moisturised afterwards. She didn’t like that she can’t wash her hair in the bath when using the bath oil/emollient “because it’s so oily”. Steven finds soap substitutes make the shower floor greasy. Megan finds having a bath emollient adds to the confusion of having so many different prescribed treatments.
Steven’s doctors told him to be careful drying off after a shower and to avoid rubbing the skin with a towel which can also remove the emollient shower gel – instead he has “a bath robe that I now hide in for like half an hour afterwards, just to gently dry off”.

A few people talked about using exfoliating bath/shower products. They wanted to use something which would reduce skin flaking without irritating the skin. Abbie likes products containing sea salt (see also section on home remedies) but can’t use these if her psoriasis is severe: “[when] my skin was in a worse state, it stung quite a lot because you were pulling all that skin away”.
Medicated shampoos

Many people had used medicated shampoos for scalp psoriasis (see also about: body parts and types of psoriasis). Some medicated shampoos can be prescribed by a doctor and be bought from a shop. Others found ‘normal’ shampoos were fine – Louis said it was okay using a ‘normal’ shampoo as long as it didn’t get on the rest of his skin too much. Hannah and Lisa said they only use medicated shampoos if the psoriasis on their scalp was severe.
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Those who had used special shampoos for psoriasis had often tried ones containing coal-tar, an ingredient also available as a topical treatment. There are various types of coal-tar shampoos. As Hannah explained, most have “a really specific smell” which Abbie found “horrific” and made some people feel self-conscious. Hannah used perfume and Adam added hair products to mask the coal-tar smell.
Medicated psoriasis shampoos worked well for some people, but were disappointing for others. Lucy didn’t find coal-tar shampoos helped and one “burned” her scalp when she used it. Lucy and Louie prefer using a menthol shampoo, like Head & Shoulders. Lucy says it “soothes the scalp”. Simon’s GP gave him a coal-tar shampoo as his first treatment when diagnosed with psoriasis on his scalp. Simon hoped it would completely “clear up” the psoriasis but found “if anything, it made my scalp a lot more irritable” and his psoriasis “spread”. Simon thinks he should have been given a topical steroid instead or in addition. Other issues include medicated shampoos being expensive/an added cost and time-consuming.

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