MANAGING psoriasis

Psoriasis presents a range of problems for those who have it – and for their beauty therapists. Ellen Cummings speaks to the experts to find out their strategies for helping clients to manage the condition

Psoriasis is a chronic autoimmune skin condition that affects around two in every 100 people in the UK.

As a beauty professional, having an understanding of the condition, its triggers and the treatments that can help manage symptoms can make a significant difference to your clients’ skin health and overall wellbeing.

Psoriasis is an inflammatory skin disorder characterised by the rapid production of skin cells. Dr Ahmed El Muntasar, a GP and aesthetic doctor, explains, “Psoriasis results in dry skin, particularly dry raised patches with some inflammation, redness and flakiness. The skin can also be very itchy as a result of the dryness.”

These patches, known as plaques, can be painful, and they are often found on the scalp, elbows, knees and lower back – although they can appear anywhere on the body, with a range of severity.

Dr Sonia Khorana, a GP with a special interest in dermatology, says, “Psoriasis is thought to be related to immune system function. Genetics play a big part and, if one of your family members has it, chances are you might too.”

One of the key challenges in managing psoriasis is its cyclical nature, with symptoms often alternating between acute flare-ups and more manageable chronic phases.

During a flare-up, plaques can become inflamed, red and extremely sensitive. In contrast, during the chronic phases the skin might still be dry and flaky, but symptoms tend to be less intense.

How to manage psoriasis

While psoriasis is a chronic condition, it can be managed through a combination of medical treatment, skincare and lifestyle adjustments. Beauty professionals can support clients with treatments that can alleviate their symptoms and improve their skin health.

One of the most promising treatments for psoriasis is light therapy. Red light therapy has been shown to reduce inflammation and promote skin healing, making it an excellent option for clients with psoriasis.

Katie White, owner of Relax skin school and the Relax Skin Studios in London, and a trained facialist and nutritionist, explains, “Red light therapy can help reduce the appearance of psoriasis plaques and calm irritated skin. It’s gentle, safe and clients can see results with regular use over time.”

Another option is blue light therapy, particularly for mild psoriasis. “There are FDA-approved blue light devices that can be used at home between treatments, and they offer a convenient way for clients to manage their symptoms outside of the clinic,” says Dr Khorana.

While beauty professionals can offer red light therapy in their salons, it’s important to recommend clients consult their dermatologist before undergoing any form of light therapy, especially if they are on medications or topical treatments for psoriasis.

The role of skincare

A key aspect of managing psoriasis is maintaining skin hydration. Psoriasis causes the skin to lose moisture quickly, leading to dryness, itching and scaling. Beauty professionals can incorporate hydrating treatments into their services, focusing on deeply nourishing the skin.

White advises, “Hydration is vital for psoriasis sufferers, and incorporating deeply hydrating products into beauty treatments can make a huge difference. Use moisturisers and serums rich in glycerin, hyaluronic acid, panthenol, ceramides and shea butter, as these ingredients help maintain the skin’s moisture barrier and soothe irritation.”

During facials or body treatments, beauty therapists can apply hydrating masks or serums that are designed to lock in moisture. These products should be fragrance-free and hypoallergenic, as psoriasis-prone skin is often sensitive and reactive to strong ingredients.

Humectants like glycerin and hyaluronic acid work by drawing moisture from the air into the skin, making them essential in skincare treatments for psoriasis.

Occlusives, such as shea butter and petrolatum, help to seal moisture into the skin, preventing water loss and maintaining hydration for longer periods.

Dr Khorana adds, “One of the most effective strategies for clients is to layer products. Start with lighter serums and end with heavier emollients to trap moisture and protect the skin barrier.”

Beauty professionals can also recommend thermal water sprays or hydrating mists during treatments to provide instant relief from itchiness and dryness. These can be used throughout the day by clients to soothe their skin in between professional treatments.

Exfoliation can be beneficial for clients with psoriasis, but it requires a delicate touch. “Exfoliation helps remove the build-up of dead skin cells, which can improve the appearance of plaques and allow moisturisers to penetrate deeper,” explains White. “However, the key is to use gentle exfoliation methods that don’t cause trauma to the skin.”

Beauty therapists should avoid mechanical exfoliants, such as scrubs with large particles, as these can cause micro-tears in the skin and trigger a psoriasis flare-up. Instead, opt for enzyme-based exfoliants or mild alpha hydroxy acids (AHAs) like lactic acid, which are gentle enough for sensitive skin. These ingredients work by breaking down the bonds between dead skin cells, allowing them to slough off without damaging the skin barrier.

White recommends incorporating exfoliation only during chronic phases when the skin is not inflamed or broken. “For those with mild psoriasis, gentle exfoliation once or twice a week can help reduce scaling and improve the texture of the skin,” she adds.

After exfoliation, it’s crucial to immediately follow with a hydrating serum or moisturiser to replenish the skin barrier.

Body treatments for psoriasis

Body wraps and moisturising masks can be soothing treatments for clients with psoriasis, provided that the ingredients are chosen carefully.

“Look for body wraps that incorporate healing and hydrating ingredients like aloe vera, colloidal oatmeal and shea butter,” says White.

Aloe vera is known for its soothing, anti-inflammatory properties, making it a great choice for clients with psoriasis. Colloidal oatmeal helps to calm irritated skin and reduce itching, while shea butter offers deep hydration and nourishment.

While essential oils are often used in beauty treatments, caution should be taken when using them on clients with psoriasis. Some essential oils can be irritating to sensitive skin, particularly during flare-ups. However, when used properly, certain oils can provide anti-inflammatory and calming effects.

White suggests, “If you want to use essential oils, go for lavender, chamomile or tea tree oil in diluted forms, as they have calming and antibacterial properties.”

Essential oils should always be mixed with a carrier oil, such as jojoba or sweet almond oil, to avoid irritation. However, essential oils are not recommended during active flare-ups when the skin is broken or severely inflamed.

Homecare for psoriasis clients

In addition to in-salon treatments, it’s important to guide clients on how to manage their psoriasis at home. White advises that clients with psoriasis should focus on keeping their skincare routine minimal and avoiding potentially irritating ingredients.

“I recommend a gentle cleanser, followed by a hydrating serum and a thick, occlusive moisturiser,” she says.

Dr Khorana recommends beauty professionals encourage clients to use fragrance-free, hypoallergenic products. “Avoiding fragrance and harsh chemicals is key for managing psoriasis, as the skin is highly sensitive to irritants. Stick to proven ingredients like ceramides, glycerin and colloidal oatmeal,” she comments.

Treatments to avoid

While some treatments can soothe the symptoms of psoriasis, there are others to avoid, especially during active flare-ups. Dr El Muntasar advises against microneedling and microdermabrasion during flare-ups, as these treatments can cause skin trauma and worsen the condition. Similarly, Dr Khorana cautions against the use of tanning beds, which, although once considered a psoriasis treatment, are now known to increase the risk of skin cancer.

Dr Khorana adds that beauty professionals should also avoid using overly aggressive exfoliating treatments or chemical peels, which could trigger the Koebner phenomenon, where trauma to the skin can lead to new psoriasis lesions.

Gut health and nutrition

An emerging area of psoriasis management is the role of gut health. The connection between the gut and skin, often referred to as the gut-skin axis, suggests that gut inflammation can play a role in the development and severity of psoriasis symptoms.

Emma Gould, a registered nutritional therapist specialising in psoriasis, explains, “Nutritional therapy is about finding out where imbalances may be in the body and correcting them with nutrition and lifestyle measures. In the case of psoriasis, supporting the gut and liver is key. These organs are heavily involved in skin health, and by improving gut bacteria, digestion and decreasing potential pathogens, we can help alleviate symptoms.” White adds, “The gut plays a role in all inflammatory skin conditions, including psoriasis. Dysbiosis of the gut may increase the risk of psoriasis occurrence and development by influencing the immune system.”

Diet can have an impact on psoriasis. Foods that trigger inflammation, such as processed foods, sugar and alcohol, can worsen symptoms, while anti-inflammatory foods can help manage them.

White advises clients to eat a diet rich in lean protein, whole grains, nutrient-dense vegetables and healthy fats. She suggests that a diet high in omega-3 fatty acids (found in oily fish, like salmon and mackerel) can be particularly beneficial due to their anti-inflammatory properties.

Gould emphasises the importance of eating a varied diet rich in plant-based foods. “I recommend aiming for around 30 different plants per week,” she says, because a diverse diet helps maintain a healthy gut microbiome. Leafy greens, berries and seeds are particularly beneficial for reducing inflammation.

Both Gould and White agree that while supplements such as omega-3 or multivitamins can be helpful, they should be taken under the guidance of a qualified practitioner. Some supplements can interact with medications or exacerbate symptoms if not used correctly.