When you’re dealing with a painful skin sitch, you want to find relief ASAP. Psoriasis typically causes itching and redness, but psoriasis can also be painful. We’re breaking down the factors behind painful psoriasis flare-ups and how to prevent and manage them.

Is psoriasis painful?

The primary symptoms of psoriasis are itching, redness, and dry flaky skin, but pain can definitely be part of the picture. People with psoriasis may experience skin pain from scratching or irritation.

Psoriasis is also associated with joint and musculoskeletal pain caused by psoriatic arthritis. If painful psoriasis is interfering with your quality of life, talk with your doctor about your treatment options ASAP.

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More than 7.5 million adults in the U.S. have psoriasis, but scientists still aren’t sure what causes it. It does seem to be related to your genetic background and an overactive immune system, though.

For folks with psoriasis, their body creates skin cells faster than is typical, especially when their skin is damaged. This skin cell buildup creates thick, red, scaly patches (aka plaques) that can be itchy and sometimes painful.

In a 2015 study, researchers assessed the skin pain of 163 people with plaque psoriasis. About 44 percent of participants said they had experienced skin pain in the last week. They used these words to describe their pain:

  • itchy
  • unpleasant
  • aching
  • sensitive
  • hot or burning
  • tender
  • cramping

Painful psoriasis can interfere with your daily activities, sleep, and general well-being.

Psoriasis isn’t contagious, but genetics and the immune system do play a role. A variety of factors can set off a psoriasis flare-up.

  • Cold, dry weather. People with psoriasis tend to do better in warm, sunny climates.
  • Stress. What health problem isn’t aggravated by omnipresent stress?
  • Illness. A strep infection, ear infection, bronchitis, tonsillitis, or a respiratory infection could kick your psoriasis into high gear.
  • Skin injury. Scratches, sunburn, bug bites, and vaccinations may irritate skin and set off a psoriasis flare.
  • Some medications. Drugs like beta blockers, lithium, and anti-malaria medication have been linked to psoriasis.
  • Smoking or drinking alcohol. Need another reason to quit smoking? Tobacco and alcohol are both potential psoriasis triggers.

Psoriasis triggers are very personal and individual. By tracking your symptoms, you may uncover patterns of flare-ups when you have allergies, eat certain foods, drink alcohol, or when the weather changes. Get to know your own triggers for the best chance at preventing flare-ups.

Prescription treatments

The first form of treatment depends on which areas and how much surface area are affected. Most commonly, though, your doc will recommend a topical steroid medication.

If your psoriasis is moderate or severe, or it doesn’t get better with topical medication, your doctor may recommend oral medications or injections. If you’re dealing with a large, affected area or your joint pain, there are other options including:

  • methotrexate (brand names: Lantarel, Metex, MTX Hexal, Methotrexat AL)
  • fumaric acid esters (brand name: Fumaderm)
  • ciclosporin (brand names: Ciclosporin Pro, Ciqorin, Sandimmun)
  • biologics (like Humira, Enbrel, Taltz, Cosentyx, Stelara)

These medications do have side effects and tend to require regular bloodwork. They can also increase your risk of certain health probs, so talk with your doctor to make sure you understand all of the factors.

Home remedies

In addition to taking prescription medications, you can also take steps at home to manage psoriasis.

The psychological distress of an illness like psoriasis can make physical pain worse. (Remember, stress is a known flare-up trigger). Getting enough sleep can also be hard for people with psoriasis. In a 2018 study of 100 people with psoriasis, 62 percent had insomnia, mainly due to itching.

Try these techniques for reducing stress to help manage the itching and pain:

  • meditation
  • regular exercise
  • psychotherapy

Good skin care is one of the most impactful things you can do to live better with psoriasis. Gentle cleansing and adequate moisturizing are the keys to keeping your skin comfortable.

Dry skin is never your friend, especially if you have psoriasis. Bathing has a big impact on moisture and irritation, so the American Academy of Dermatology recommends these tips for doing it right:

  1. Limit baths and showers to 1 per day. More than that puts you at risk for dryness and irritation.
  2. Keep showers under 5 minutes and baths under 15 minutes.
  3. Warm water only! Hot water is really not your pal if you have psoriasis.
  4. Use gentle soap for sensitive skin.
  5. Skip exfoliation — even a washcloth! Use your hands to soap up instead.
  6. Rinse thoroughly, but not roughly.
  7. Blot gently with a soft towel to dry, but keep your skin a little damp.
  8. Put on a gentle moisturizer right away. Thick creams and ointments are your best bet.

When it comes to psoriasis symptoms, you may hear more about itching and redness, but pain is definitely a factor. In a 2020 study of 859 people with psoriasis, 92.9 percent said they had skin pain. However, 63.4 percent of respondents with psoriasis said their doctor never asked about skin pain.

FYI: The researchers do point out, however, that because this was a web-based survey, it was not possible to verify respondents’ diagnosis and symptoms. Also, people with severe skin pain may have been more motivated to fill out the questionnaire.

Just because your doctor doesn’t bring it up, it doesn’t mean your pain isn’t important! Any symptom that interferes with your quality of life is worth mentioning.

There are a few other reasons to talk with your doctor about skin pain if you have psoriasis.

  • If your pain is caused by damage to the skin, you may be at risk for infection. Your doctor can help you heal and prevent complications.
  • Joint and body pain could be a sign of psoriatic arthritis. Early diagnosis and treatment helps delay joint damage.
  • Your psoriasis becomes worse very quickly. It could be a sign of an infection or other issue.

You know psoriasis can leave you red, itchy, and scaly, but it can also be a real pain. You may experience skin pain from irritation or joint pain if you have psoriatic arthritis. Talk with your doctor about skin pain and find the right topical, oral, or injectable medication to treat your psoriasis. With good skin care, you can prevent flare-ups and live with less psoriasis-related stress and pain.