Psoriasis Flares: Which Beauty Products and Treatments to Avoid

Psoriasis doesn’t require you to abandon your entire skincare routine, but certain products and treatments can trigger flare-ups. The condition stems from immune system dysfunction rather than external irritants, which means many topical products are safe to use as long as they don’t damage the skin’s barrier.

However, anything with potential to cause skin trauma—potent acids, strong cleansers, physical scrubbing—can spell trouble, particularly through a mechanism called the Koebner phenomenon. When local trauma stimulates the immune system, new psoriasis plaques can develop on previously clear skin. This response affects about 25 to 30 percent of patients, according to research frequently cited by dermatologists. “If you’ve ever watched a plaque appear at a cut, a scratch, or a sunburn, assume you’re someone who does,” says Omar Noor, MD, a New York City-based board-certified dermatologist.

Risk varies significantly depending on whether your psoriasis is controlled with medication. “If you haven’t found a treatment that controls your psoriasis yet, your skin is already primed to react, and a product that causes even mild trauma can seed a new plaque,” Dr. Noor explains. Conversely, controlled psoriasis—especially on systemic treatments like biologics—carries substantially lower risk, though not zero. The key is understanding what irritates your skin during flares and what might cause problems day-to-day.

Hydration should anchor any psoriasis skincare routine, as it can soften plaques and ease discomfort. Beyond that foundation, dermatologists offer specific guidance on ingredients and treatments to approach carefully.

Exfoliating Acids Require Careful Concentrations

Every dermatologist consulted by Allure emphasized caution with alpha-hydroxy acids and beta-hydroxy acids, which include glycolic, lactic, mandelic, and L-ascorbic acids. These ingredients work by breaking down the bonds holding dead skin cells together, a process that can penetrate deeper on already-inflamed skin and cause genuine injury.

Recommended Safe Concentrations

For leave-on products, dermatologists generally recommend patients with psoriasis stick to 5 percent or less glycolic acid, about 8 percent or less lactic acid, or up to 10 percent mandelic acid. For L-ascorbic acid, the purest and most potent form of vitamin C, concentrations of 15 percent or higher can be very irritating and should be avoided.

Salicylic Acid Is Different

One acid breaks the pattern: salicylic acid can actually help treat psoriasis symptoms, provided it’s paired with moisturizing ingredients. “Salicylic acid will get rid of all the scale,” says Shira Y. Wieder, MD, a board-certified dermatologist at Montefiore Einstein Advanced Care in New York City. Dermatologists use many moisturizers formulated with salicylic acid specifically for psoriasis patients. At low concentrations, salicylic acid can even improve how well topical psoriasis treatments penetrate the skin. “Salicylic acid allows for gentle exfoliation of the top layer to allow better penetration of ingredients like steroids, vitamin D, and analogues such as calcipotriene,” explains Divya Shokeen, MD, a board-certified dermatologist and founder of OSVI Dermatology and Surgical Institute in California. In over-the-counter products, 2 percent salicylic acid is generally safe for most patients.

Chemical Peels and Physical Exfoliants Damage the Barrier

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The caution around exfoliating acids extends to chemical peels, which typically combine multiple acids in high concentrations. “By definition a chemical peel impairs the skin barrier,” Dr. Wieder notes. “That’s the whole point of it.” Medium-depth and deep peels should raise red flags for psoriasis patients, though those with well-controlled psoriasis on biologic medication face lower risk. Physical exfoliants pose similar problems. “Psoriasis patients come in thinking they have to scrub off the scales,” Dr. Noor says. While walnut shells, apricot scrubs, and loofahs might temporarily remove visible scaling, they can exacerbate psoriasis or trigger new patches by causing tiny cuts and scratches.

In-Office Procedures Require Disease Control

Stronger in-office treatments like microneedling and certain lasers carry comparable risks. “You don’t want to sandblast your skin with all these exfoliants or some of these devices,” Dr. Noor explains. If psoriasis is flaring, avoiding these treatments altogether is advisable. However, some laser treatments can successfully treat psoriasis when used carefully. Excimer treatments for redness, in particular, have proven very effective in psoriasis patients.

Cleansers and Moisturizers Are Foundation

Hydration takes priority for psoriasis skincare, making intense cleansers potentially problematic. “You may want to be a little more cautious around harsh chemicals like surfactants that really strip the skin of oils,” Dr. Wieder advises. Cleansers that “lather like dish soap” often contain heavy amounts of sodium lauryl sulfate, which strips away the lipids, ceramides, and natural moisturizing factors the skin needs. Dr. Noor recommends gentle cleansers with hydrating ingredients, such as Cetaphil Gentle Skin Cleanser.

Rich Moisturizers Over Lightweight Formulas

Any moisturizer beats none for psoriasis, but richness matters. Companies often thin creams by adding alcohol, which can further dry psoriatic skin. Dermatologists recommend looking for richer formulas with multiple lipids and specifically avoiding products dispensed from pumps, which require thinning agents to function.

Fragrance Labeling and Natural Ingredients Matter

Fragrance sensitivity varies among psoriasis patients. Some tolerate scented products fine; others find fragrance triggers flares. What seems counterintuitive: unscented products can be worse. “Unscented usually means companies are using chemicals to hide the scents, and those chemicals can make products worse for psoriasis,” Dr. Noor explains. Look instead for “fragrance-free” on labels. Natural ingredients require equal caution. “Botanical doesn’t always mean benign,” Dr. Noor notes. Tea tree oil, peppermint oil, menthol, and witch hazel, all plant-based, can trigger inflammation and immune responses. Patients sometimes apply cooling menthol creams to plaques hoping to calm flare-ups, but this approach can backfire. “Tingling is not good with psoriasis,” Dr. Noor says, referring to the sensation peppermint oil creates.

Hair Dye and Tattoos Demand Consideration

Para-phenylenediamine, a common hair-dye ingredient, causes allergic reactions in some patients. For someone without psoriasis, this means a few weeks of irritation. For a psoriasis patient, “the allergic reaction creates an inflammatory mess. The immune system is already edgy when you have psoriasis,” Dr. Noor says, potentially causing additional plaques and making the condition harder to control. Tattoos present a different challenge. The physical trauma from repeated needle punctures can trigger Koebnerization in susceptible patients, creating microtrauma that sparks psoriasis flares. “I’ve seen people develop psoriasis in the shape of their tattoo,” Dr. Wieder notes. However, modern injectable and oral medications that suppress the immune system can substantially reduce this risk, allowing patients to pursue tattoos without fear of psoriasis developing in tattooed areas.

The First Step: Get Your Condition Controlled

Beyond avoiding specific triggers, dermatologists emphasize one foundational step. “When you have psoriasis you should see a dermatologist,” says Tracy Evans, MD, medical director of Pacific Skin and Cosmetic Dermatology in California. A dermatologist will help you settle on an effective treatment plan and identify personal sensitivities, regardless of how well-controlled your psoriasis is. “Once your disease is under control, you pretty much can use what you want,” Dr. Evans says. Before introducing any new product, whether an acid serum or a rich cream, patch test it first to see if it triggers a reaction. This simple precaution, combined with a dermatology-guided treatment plan, opens up far more skincare options than you might expect.

Source: Allure