Best Lotions for Psoriatic Skin
Emollients (moisturizers) are the essential foundation of psoriatic skin care and should be applied 1-3 times daily to all affected areas, with the American Academy of Dermatology recommending them as standard adjunctive therapy for all psoriasis patients. 1, 2
Primary Role of Emollients
Emollients work by retaining moisture in the stratum corneum, improving skin hydration and barrier function, which directly addresses the fundamental skin barrier dysfunction present in psoriasis. 2 They provide several critical benefits:
- Reduce itching and scaling (desquamation), which are particularly problematic in excoriated plaque psoriasis 2
- Prevent quick relapse when topical corticosteroids are discontinued 2
- Enhance efficacy of active treatments - when combined with topical corticosteroids for 4-8 weeks, emollients improve outcomes by reducing itching, desquamation, and total body surface area involvement 2, 3
- Steroid-sparing effect - one study demonstrated that water-in-oil cream or lotion combined with betamethasone dipropionate cream increased efficacy while achieving control with fewer steroid applications 1
Specific Evidence for Emollient Efficacy
An RCT showed that mometasone plus emollient improved the area of palmoplantar skin affected, desquamation, and symptoms compared with mometasone alone after 4 weeks of treatment. 2 This demonstrates that emollients provide measurable clinical benefit beyond active medications alone.
Practical Application Guidelines
- Apply 1-3 times daily to affected areas 1, 2
- Apply after bathing - a thin coat of petrolatum applied to psoriatic areas after bathing may be particularly beneficial 1
- Use in conjunction with active treatments for 4-8 weeks 2, 3
- Apply after active medications - when using calcipotriene/corticosteroid combinations, apply emollients afterward to avoid washing off active medication 3
Specialized Moisturizer Formulations
Ceramide-containing moisturizers show particular promise, with studies demonstrating overall improvement in skin appearance and providing relief for psoriasis. 4 Ceramides help restore the epidermal barrier function that is compromised in psoriatic skin.
Salicylic acid-containing moisturizers (typically 2-6%) soften plaques and enhance absorption of topical treatments such as corticosteroids. 5, 4 However, never combine salicylic acid with calcipotriene, as the acidic pH inactivates calcipotriene. 3
Safety Profile
- No known contraindications unless hypersensitivity to ingredients exists 1, 2
- Small risk of contact dermatitis with some formulations 2
- Safe during pregnancy and lactation 1, 2, 3
- Safe for pediatric use 1
Integration with Active Treatments
Emollients should be used as part of a rotational therapy approach with topical vitamin D analogues, topical calcineurin inhibitors, and topical corticosteroids as steroid-sparing regimens. 2 When used with topical calcipotriene, emollients may reduce irritation and enhance efficacy. 2
Common Pitfall to Avoid
The most significant error is viewing emollients as optional or secondary. Emollients represent an internationally accepted standard adjunctive therapeutic approach 1 and should be prescribed to every psoriasis patient regardless of disease severity or other treatments being used. Their barrier-restoring properties address fundamental pathophysiology, not just symptoms. 1, 4