Treating Psoriasis Scars

By

Erin Azuse

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As a psoriasis patient, you likely feel a sense of relief when your body starts to respond to treatment and the thick, itchy scales begin to disappear from your skin. But that happiness may be short-lived if you notice you’re now left with discolored patches of skin where the psoriasis plaques used to be. For many patients, this can be almost as upsetting as the disease itself.

Try not to despair. There are things you can do to help improve the appearance of your skin.

Give It Time

The good news is that psoriasis rarely causes true scars. More frequently, the pigmentation of the underlying skin is temporarily affected. Researchers have discovered that during a psoriasis flare up, parts of the immune system disrupt the production of melanocytes, the cells responsible for giving your skin color. When the psoriasis clears, you may see areas of hypopigmentation, where your skin is lighter, or areas of hyperpigmentation, where your skin is darker than what is surrounding it.

It is normal to want a quick fix, but be patient- this will generally improve with time. It may take several weeks to months, but you should notice that your skin color will begin to even out.   

Protect and Nourish Your Skin

As your skin is healing, it can be sensitive, and you’ll want to do what you can to promote skin health.

  • When going outside, be sure to apply sunscreen or cover up. Sun is known to worsen areas of hyperpigmentation.

  • Keep your skin well moisturized.

  • Eat a healthy, nutrient-rich diet. For example, vitamin C may help with skin pigmentation and omega-3 fatty acids may help with skin repair.

  • Try to avoid scratching or picking at itchy or irritated skin.

  • Notify your doctor if you notice any signs of skin infection, such as redness, swelling, or drainage.

Continue Your Treatments

Taking good care of your skin during psoriasis flares will help limit scarring. But under your doctor’s supervision, some psoriasis treatments may also continue to help your skin after-the-fact.

  • Topical retinoids can help lighten skin.

  • Corticosteroids fight inflammation and promote healing.

Smooth It Out

Removing the outer layers of skin may help even out your skin tone and make small scars less visible. For mild cases, this may be done at home using a gentle exfoliant. For more severe scarring, other skin resurfacing techniques such as dermabrasion may be performed in a doctor’s office, but make sure to discuss the risks with your doctor. Techniques that are too aggressive and cause trauma to the skin can lead to the development of the Koebner phenomenon, where psoriasis develops in areas of injury, or actually make hyperpigmentation worse.

Psoriasis manifests itself physically, but those suffering can also feel emotional distress regarding its appearance. If you are concerned about your psoriasis scars or pigmentation issues, talk to you doctor about what treatment options are right for you.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Feb 21, 2017

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Medical References

  1. Dermabrasion Treatment and Management. Medscape. http://emedicine.medscape.com/article/1297069-treatment
  2. Mcdaniel JC, Belury M, Ahijevych K, Blakely W. Omega-3 fatty acids effect on wound healing. Wound Repair and Regeneration. 2008;16(3):337-345. doi:10.1111/j.1524-475x.2008.00388.x.
  3. Michaels B, Rosso JD. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: Case-based presentations and evidence-based conclusions. Yearbook of Dermatology and Dermatologic Surgery. 2012;2012:115-116. doi:10.1016/j.yder.2012.02.093.
  4. Postinflammatory Hyperpigmentation Treatment & Management. Medscape. http://emedicine.medscape.com/article/1069191-treatment
  5. Psoriasis. Medscape. http://emedicine.medscape.com/article/1943419-overview
  6. Researchers discover reason for skin discoloration in psoriasis. National Psoriasis Foundation. https://www.psoriasis.org/advance/psoriasis-skin-discoloration

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