Psoriasis Australia

Emollients and Moisturisers

Emollients and moisturisers are essential components of the skincare regimen for individuals with psoriasis. They help to maintain skin hydration, reduce scaling, alleviate itching, and improve the overall appearance of the skin.

Overview of Emollients and Moisturisers

Emollients are substances that soften and soothe the skin, while moisturisers primarily work to hydrate the skin by trapping water in the outermost layer. Both play a critical role in managing the symptoms of psoriasis by restoring the skin’s natural barrier function and preventing dryness, which can exacerbate psoriatic lesions.

How Emollients and Moisturisers Work

Emollients and moisturisers work by addressing the dryness and scaling associated with psoriasis:

  1. Skin Barrier Repair: Psoriasis is often accompanied by a compromised skin barrier, leading to increased transepidermal water loss (TEWL). Emollients help to restore the lipid barrier of the skin, reducing TEWL and improving skin hydration.

  2. Soothing and Softening: Emollients contain lipids and oils that fill the gaps between skin cells, smoothing and softening rough, scaly skin. This helps to reduce the physical discomfort associated with psoriasis, such as itching and tightness.

  3. Hydration Maintenance: Moisturisers contain humectants, such as glycerin and hyaluronic acid, which attract and retain moisture in the skin. This helps to keep the skin hydrated, reducing the severity of scaling and flaking.

  4. Reduction of Inflammation: By maintaining skin hydration and integrity, emollients and moisturisers can help reduce the inflammatory response that drives psoriasis, leading to milder symptoms.

Forms of Corticosteroids

There are various types of emollients and moisturisers available, each suited to different needs:

  • Creams: These are thicker than lotions and provide a good balance between hydration and ease of application. They are suitable for most areas of the body and for daytime use.

  • Ointments: Ointments are the most occlusive, forming a protective barrier on the skin that traps moisture. They are ideal for extremely dry or thickened areas of skin and are often used at night due to their greasy texture.

  • Lotions: Lotions are lighter and less greasy than creams or ointments, making them ideal for use on large areas of the body or in warmer climates. However, they may need to be applied more frequently to maintain hydration.

  • Bath Oils and Additives: These are added to bathwater to provide a whole-body treatment that soothes and hydrates the skin. They are especially useful for individuals with widespread psoriasis.

  • Emollient Washes and Soap Substitutes: These are designed to cleanse the skin without stripping away its natural oils, which is important for individuals with psoriasis, as regular soaps can exacerbate dryness.

Usage Guidelines

Proper use of emollients and moisturisers can enhance their effectiveness in managing psoriasis:

  • Frequency of Application: Emollients and moisturisers should be applied multiple times a day, especially after bathing or washing, to maintain skin hydration. For best results, they should be applied to slightly damp skin to lock in moisture.

  • Amount and Coverage: A generous amount should be applied to cover the affected areas completely. Regular and consistent application is key to preventing dryness and flaking.

  • Layering with Other Treatments: Emollients can be used in combination with other topical treatments, such as corticosteroids or calcineurin inhibitors. In such cases, it is usually recommended to apply the emollient first and allow it to absorb before applying the other treatments.

  • Tailored to Skin Type: The choice of emollient or moisturiser should be tailored to the individual’s skin type and the severity of their psoriasis. For instance, ointments may be more suitable for very dry skin, while lighter creams or lotions may be preferred for less affected areas.

Benefits of Emollients and Moisturisers

Emollients and moisturisers offer several benefits in the management of psoriasis:

  1. Improved Skin Hydration: By maintaining adequate hydration, emollients help to reduce the scaling and dryness that characterize psoriasis, leading to smoother and more comfortable skin.

  2. Prevention of Flare-Ups: Regular use of emollients can help prevent psoriasis flare-ups by maintaining skin barrier function and reducing the risk of environmental triggers, such as cold weather or irritants.

  3. Enhanced Treatment Efficacy: When used in combination with other topical treatments, emollients can enhance the penetration and effectiveness of these medications, improving overall treatment outcomes.

  4. Symptom Relief: Emollients provide immediate relief from itching, tightness, and discomfort, improving the quality of life for individuals with psoriasis.

Potential Side Effects

Emollients and moisturisers are generally safe and well-tolerated, but some potential side effects include:

  1. Skin Irritation: Some individuals may experience irritation or allergic reactions to certain ingredients in emollients, such as fragrances or preservatives. It’s important to choose products that are free from these potential irritants, especially for sensitive skin.

  2. Acne or Folliculitis: Ointments, particularly those that are greasy, may cause blocked pores or folliculitis in some individuals, especially if used on acne-prone areas.

  3. Greasy or Sticky Residue: Ointments and heavy creams can leave a greasy residue on the skin, which some people may find uncomfortable, particularly during the day.

Scientific Evidence Supporting Emollients and Moisturisers Use

Numerous studies have underscored the importance of emollients and moisturisers in psoriasis management:

  1. Barrier Repair and Hydration: A study published in The Journal of Clinical and Aesthetic Dermatology highlighted that regular use of emollients significantly improves skin hydration and barrier function, reducing the severity of psoriasis symptoms .

  2. Reduction in Treatment Reliance: Research in The American Journal of Clinical Dermatology found that consistent use of emollients can reduce the need for more aggressive treatments, such as topical corticosteroids, by maintaining skin hydration and preventing flare-ups .

  3. Enhanced Efficacy of Topical Treatments: A review in Dermatologic Therapy demonstrated that emollients enhance the efficacy of other topical treatments by improving their absorption and reducing skin irritation, making them a crucial part of the therapeutic regimen for psoriasis .

Special Considerations

  • Children: Emollients are safe and effective for use in children with psoriasis. It is important to choose gentle, fragrance-free products to avoid irritation.

  • Pregnancy and Breastfeeding: Most emollients and moisturisers are safe for use during pregnancy and breastfeeding. However, it’s advisable to choose products with minimal ingredients to reduce the risk of skin irritation.

  • Cost and Accessibility: Emollients and moisturisers are available over the counter in Australia, making them accessible and affordable options for daily psoriasis management. However, it is important to select products that are both effective and suited to the individual’s specific needs.

Accessing Corticosteroids in Australia

In Australia, a wide range of emollients and moisturisers are available over the counter. These products come in various formulations to suit different skin types and needs. Some may be eligible for subsidies under the Pharmaceutical Benefits Scheme (PBS) for individuals with chronic skin conditions like psoriasis.

Summary

Emollients and moisturisers play a foundational role in the management of psoriasis. By maintaining skin hydration, supporting barrier function, and enhancing the effectiveness of other treatments, they help to reduce the severity of symptoms and improve the quality of life for those affected by this chronic condition.