People often use clothing to mask symptoms such as red, dry, and itchy skin, but certain types of clothing can aggravate skin irritation and trigger flare-ups related to psoriasis. It can become a vicious cycle if you aren’t careful. “Patients with psoriasis have very itchy, irritated, cracked dry plaques or areas of skin. As a consequence, the skin will readily bleed,” says Erin Boh, MD, PhD, professor and chairman of dermatology at the Tulane University School of Medicine in New Orleans. “Because the skin is dry, cracked, and oozing at times, clothes will stick to the open areas, further contributing to the bleeding.” Making Smart Clothing Choices The good news is that there are simple changes you can make in your clothing choices and routines to help manage the pain, bleeding, and discomfort associated with psoriasis. Consider these steps: Go loose. Tight clothing can worsen the symptoms of psoriasis. “As dermatologists, we often see plaques arise on the hands, elbows, knees, and torso of people with psoriasis, so the more that a patient can cut back on tight-fitting or constricting clothes, the better,” says Daniel R. Opel, MD, a dermatologist with Aurora Health in Sheboygan, Wisconsin. So choose looser clothing and undergarments (for example, boxers over briefs) when possible. Choose cotton. Compared to other fabrics, cotton is less likely to irritate the skin or cause overheating. So try wearing lightweight cotton clothing next to your skin when possible, and avoid materials such as wool and synthetic fabrics. “Synthetic clothes don’t breathe as much as cottons,” says Dr. Boh. “Synthetic fabrics are a bit worse in part because they cause heat retention and also because they stick to the open areas.” Launder fragrance-free. Laundry detergent can also affect your psoriasis. “In general, my recommendations for laundry detergents are consistent, whether a person has psoriasis or not,” notes Dr. Opel. “Too often, I see issues arise when detergents contain too much dye or fragrance, chemicals that are harsh for our skin. People with psoriasis have an impaired skin barrier and they will be more susceptible to these chemicals. So ‘free and clear’ brands will be important for them.” Liquid detergents may be preferable to solid ones, adds Opel, as they dissolve better, and detergent particles may be less likely to stick to clothing. Wear light colors to minimize the look of flakes. If you’re concerned about skin flakes appearing on your clothing, remember that light colors and patterns typically hide flakes better than dark colors. Dress to hide your psoriasis. A National Psoriasis Foundation survey found that approximately 40 percent of people with the condition choose their clothing to hide their psoriasis. For days when you don’t want to deal with strangers’ reactions, wearing a long-sleeved shirt, full-length pants, and a strategically placed scarf will reduce the number of unwanted stares. But be aware that covering up may contribute to heat retention, so choose fabrics wisely. Also keep in mind that as you’re treating your skin condition, your comfort level with wearing different types of clothing may increase. Moisturize regularly. Keeping your skin moisturized can help ease symptoms such as itching and flaking, which can help you feel more comfortable in your clothes. Moisturize regularly with an unscented lotion, ointment, or cream. Boh also recommends rock salt baths. “These are beneficial for relieving itching and helping with skin hydration,” she says. “To prepare, add two cups of rock salt to a tub of really warm water. Soak for 10 to 15 minutes, and rinse. Do not use soap. Before patting dry, apply moisturizer or a prescription topical.” Treat your psoriasis. “There are a number of therapies available now to treat psoriasis, so that people with this disorder can have normal-appearing skin, relief of pain in the joints and the skin, and also look good — all of which then will allow patients to wear any kind of clothing they like including bathing suits, shorts, or none at all,” says Boh. “There are many studies that have looked at the psychological impact that psoriasis has on those with the condition,” Opel adds. “Since it can be very visible, patients may suffer from lack of confidence or embarrassment based on their perception of their own skin. Depending on the stage of the psoriasis plaque, the scale on top may have a ‘silvery’ or whitish hue, so light-colored clothes would definitely help mask it, similar to how a light-colored top would help mask dandruff compared to a dark top. However, no patient should have to suffer with psoriasis to this degree. We have many different types of medications in our toolbox to really help alleviate many of these plaques, ultimately clearing the skin and helping our patients feel much more confident.” Treatment options for psoriasis include light therapy, prescription and over-the-counter topicals, and biologic therapies. Work with your dermatologist to find the right treatment or combination of treatments for you. Additional reporting by Brian Dunleavy
