The Invisible Symptom Affecting up to 97% with Psoriasis

Common symptoms

Some of the most common and recognisable symptoms of psoriasis, include raised red patches of skin, covered with silvery white scaling, called plaques. Itch is also reported to be a common symptom of psoriasis. However, it can sometimes be underappreciated as it is not a visible indicator.

Psoriasis is a chronic immune-mediated inflammatory skin disorder involving the skin and nails, affecting at least 100 million people worldwide; a 2015 report on the Burden of Psoriasis in Ireland estimated a prevalence of close to 2% of the Irish population. Psoriasis can appear at any age, and affects males and females equally. There are different types, but the most common form is plaque psoriasis which affects approximately 90% of people with this skin condition.

What is itch?

The medical term for itch is ‘pruritus’ and refers to the sensation in the skin, which may provoke the desire to scratch. Symptoms of itch are identified in many skin conditions with the incidence ranging between 62-97% in people with psoriasis, reported in various studies.

Why do we get itchy in the first place?

The exact mechanisms involved in psoriasis itch are still unknown, but it does involve a complex interaction between cells in the skin and the nervous system. Chemicals released in the skin send signals to the spine via nerves and then onto the areas of the brain responsible for creating the sensation of an itch.

Effects on quality of life

Itch can have a negative impact on physical, social and psychological wellbeing. It can vary in severity and affect the whole body, but more commonly affects the scalp, hands, legs, and back. Some descriptions that people with psoriasis use to describe their itch include, stinging, tickling, pinching, crawling and burning sensation, which can persist throughout the day or only become more severe in the evening. For some, this bothersome symptom can affect their psychosocial well-being, mood, concentration and also interrupt sleep.

What can aggravate itch in psoriasis?

There are several reported potential factors that can exacerbate itch in psoriasis which may include: skin dryness, stress, sweating, hot water, and contact with woollen or synthetic clothing. Changes in the seasons may also influence the severity of itching, as it has been reported in a study that some patients reported worse itching in the winter compared to the summer months.

Self-help tips to address the itch

  • Apply psoriasis treatments as prescribed.
  • Moisturise regularly or at least twice a day, which can alleviate dryness, scaling, soreness and soothe itch. Moisturisers should be applied in a smooth, downward motion, in the direction of the hair growth.
  • Placing a cool flannel soaked in moisturising cream on the skin can reduce the feeling of itch for some. A cooled moisturiser that has been stored in the refrigerator may also help.
  • Take shorter showers/baths with lukewarm water and wash with a soap substitute (emollient/moisturiser) instead of soap or shower gel.
  • Speak to your pharmacist about over-the-counter, itch-relieving creams or lotions, which contain ingredients that may soothe the itch, in addition to moisturising.
  • Moisturise instead of scratching; if you feel the urge to scratch, gently apply moisturiser to itchy skin.
  • Keep fingernails short with no sharp edges.
  • If possible, select cotton daywear/sleepwear as cotton is a breathable fabric, and is less irritating on the skin.
  • Find a comfortable temperature for your bedroom, also a dark quiet room may be more conducive to sleep.
  • To reduce stress, mindfulness-based stress reduction through yoga or meditation may help alleviating stress and also help with the symptoms if itch.

Learn more from our information booklet, What you need to know about psoriasis and our Managing Scalp Psoriasis leaflet.

If itch is affecting your life negatively, be sure to talk to your doctor about your symptoms as alternative treatment options may be required.

For more information about psoriasis, visit our Psoriasis Section to download our booklet, What you need to know about Psoriasis or contact the ISF Helpline for one-to-one information and support.