Symptoms-Itching & Burning
Most people with psoriasis experience the symptoms of itching and burning on the skin. In fact, the word psoriasis actually comes from the Greek word meaning “to itch.” Itching that is due to psoriasis is also called psoriatic itch1.
The itching caused by psoriasis is different than that of other inflammatory skin conditions. It tends to happen more frequently, and the sensation can be more severe, with a burning quality. Some patients compare this burning feeling to the intensity of fire ant bites. The severity of your psoriasis is not necessarily connected to the amount of itching you feel, and itching can even occur in areas that do not have visible plaques or patches2.
Itching can have a large impact on a patient’s quality of life. For example, itching can be worse at night and make it difficult to sleep well and cause people to scratch in their sleep and injure the affected skin.
Itching due to psoriasis plaques on the scalp can be particularly bad, as can itching on buttocks, in the groin area, the palms of the hands, and the soles of the feet. Many people find that itching tends to be worse during a flare-up of psoriasis symptoms3.
How common is psoriasis itching and burning?
Itching is a very common symptom of psoriasis, affecting between 70% and 90% of people with the condition1. Studies have found that itching was the symptom most frequently complained about by psoriasis patients, with around 77% of patients experiencing itching every day4. Many patients report that itching was the first or second most bothersome symptom of the condition (other than scaling).
What causes psoriasis to itch and burn?
Itching happens when something irritating comes into contact with the skin and activates what are called itch receptors3. The receptors send a signal up the spinal cord to the brain, which triggers the need to scratch.
Scratching feels good at first because it temporarily interrupts the signal sent from the itch receptor to the brain. However, scratching can actually make the itching sensation worse and more intense. This is called the itch-scratch cycle5.
How is the psoriasis itching and burning treated?
The aim of treating itch caused by psoriasis is to break the cycle of itching and scratching. In people with psoriasis that causes frequent itching, scratching is a particular problem because it can damage the skin and cause new plaques to form in healthy areas of skin (called the Koebner phenomenon)1.
For people with milder psoriasis, itching can often be relieved by treating the underlying condition with the usual range of treatments (topical medicines and phototherapy, for example). Other treatments that can help with itching and burning, include2:
- Over-the-counter antihistamines
- Moisturizers that contain colloidal oatmeal
- Coal tar products
Some prescription medicines can be used specifically to treat itch. A medicine made with capsaicin (Zostrix) is an ointment that can help with psoriatic itch when applied three or four times a day. Certain types of antidepressants can also have an itch-relieving effect, as can a medicine called gabapentin3.
Patients with moderate or severe psoriasis may need to treat the condition with medicines called biologic therapies, such as etanercept, adalimumab, infliximab, ustekinumab, secukinumab, and ixekizumab.
These are very powerful drugs that affect the immune system, unlike topical treatments that are applied directly to the skin. Biologic drugs can have the effect of disrupting the signal sent from the itch receptor to the brain4.
Researchers are currently developing new types of drugs specially designed to treat itching at its source in the brain.
Tips for managing psoriasis itching and burning
Stress can trigger a psoriasis flare-up, as well as worsening the itching and burning. Finding ways to reduce and manage stress can help1. For example, meditation, relaxation techniques, and/or exercise can be helpful ways to deal with stress.
Some people find that a lukewarm or warm bath (with added oils, salts, or colloidal oatmeal) followed by a salicylic acid preparation and then the application of a thick lubricant is helpful in relieving the itch, at least temporarily. Hot baths can dry the skin and make itching worse7. Brief, cold showers can also provide some relief. Keeping lotion in the refrigerator so it is cold when used may have a soothing effect.