Psoriasis outbreaks may be itchy or painful. Particularly itchy outbreaks or painful areas of psoriasis may lead to psoriasis scars. However, scarring can be prevented if the right steps are taken.
How do psoriasis scars form?
Discoloration of the skin after a psoriasis flare is quite common.
No matter what type of psoriasis a person has, there is always a risk of developing scars after the psoriasis flare is over.
Most people with psoriasis can expect skin discoloration, at least for a little while after the flare is over. However, a few people will develop scarring after a psoriasis flare has occurred.
Scarring is most likely to occur in people who have an extreme case of psoriasis and those who have scratched at the affected skin a lot.
Scarring can also affect people who have done things to the patches that formed during a flare. They may have scratched or rubbed the affected area to ease itching and discomfort. These actions are likely to cause injury to the skin that leads to scarring.
With proper treatment and care, however, most people with psoriasis will see their skin eventually return to its normal state.
Do different types of psoriasis lead to different forms of scarring?
Most people familiar with psoriasis know there are several types of psoriasis. Though each type is treated differently from person to person, the resulting scars all end up looking similar.
Treatment and prevention for scars does not really vary between the forms of psoriasis. The person's doctor will ultimately determine which treatment is right for them.
Scarring does not tend to lead to other medical issues. However, when psoriasis scarring occurs on the scalp or hairline, it can lead to alopecia.
Alopecia occurs as the body starts to attack the hair follicles, which causes the hair to start falling out. Alopecia can result in patchy or full baldness.
A topical cream may help to treat psoriasis scar tissue.
If scarring has already formed, there are options to treat the scar tissue. These options include topical or surgical approaches.
A topical treatment is a cream or gel or other medication that is applied directly to the affected area.
A doctor will choose a treatment method based on the extent of the scarring that the psoriasis has left behind. They will also consider how well a person has taken care of their psoriasis.
Medical treatments include a number of creams, ointments, shampoos, and therapies that may help both prevent and reduce a person's scarring. These therapies may include a combination of the following:
- Sunscreen is as much of a preventive measure as it is a treatment. However, if a person applies sunscreen to an area that is healing, the effect of blocking the sun's harmful rays helps prevent color changes.
- Tretinoin cream is actually designed to help treat pimples. It is often available in over-the-counter creams and ointments that target acne. However, a doctor may prescribe it to help begin the healing of the scarred area.
- Salicylic acid helps the skin remove dead skin cells and reduce scaling. It is available over the counter and on prescription. People may use salicylic acid alongside corticosteroids or coal tar to increase its effectiveness. Salicylic acid is available in solutions, creams, washes, and shampoos.
- Coal tar is one of the oldest forms of psoriasis treatment. It helps reduce the itching, swelling, and scaling that cause scarring due to scratching. It is available in pharmacies or by prescription. Pregnant women should not use it.
- Clobetasol cream is an extremely potent corticosteroid used to treat a number of skin conditions, including psoriasis. The cream is available only with a prescription and would likely be prescribed during a flare.
Clobetasol cream works by preventing the areas affected by psoriasis from swelling and becoming red and itchy. This cream is prescribed most often for more mild cases of psoriasis. Clobetasol also comes in a spray making it easy to use on the scalp.
Surgical treatments and laser therapies are not typically a doctor's first option. People are most likely to receive these more advanced treatments if topical creams and ointments are not working or their psoriasis is more advanced.
Some of these treatment options include the following:
Excimer laser therapy
Laser therapy slowly removes layers of the skin by directing concentrated ultraviolet light lasers to specific areas of the skin.
Unlike traditional light therapies, it only takes a few sessions for people to see the effectiveness of excimer lasers on mild to moderate psoriasis scarring. This is because the strength of the light goes deeper than other light therapies.
Dermabrasion is a process used to remove the top layer of skin. This treatment is likely to be recommended for people who have more advanced scarring from psoriasis.
It works by removing the scaly patches from areas of the skin affected by psoriasis, allowing new skin to form in its place. Dermabrasion can potentially remove previous scar tissue as well.
Studies suggest that people who were treated with dermabrasion saw good results, with limited recurrence and scarring of the psoriasis.
Punch-graft (MPG) surgery
MPG surgery can be used to remove deep scarring from areas that are worst affected by psoriasis.
However, this form of surgery will not be used as a treatment option for most psoriasis scars. The treatment seeks to repair highly damaged areas that most patients with psoriasis are not likely to have.
How to prevent scarring
Scarring may be prevented by resisting the urge to scratch psoriasis and applying a cream instead.
There are many ways to prevent scarring from happening for most people with psoriasis. The best methods to prevent psoriasis scarring include:
- Treating the psoriasis outbreak. One of the best methods of preventing scarring is keeping psoriasis under control. This includes following doctors' instructions and not skipping treatments.
- Avoiding scratching the psoriasis patches. Scratching psoriasis patches can lead to damage that turns into scar tissue. It is best to apply approved creams and ointments to help reduce the uncomfortable feeling.
- Protecting the skin from sun. Sunscreen should always be applied when outside. Also, many psoriasis medications leave a person at greater risk of sun damage.
- Moisturizing. Moisturizers can help reduce dryness on patches of psoriasis. Moisturizers can also help prevent itchiness from the dryness, and the reduced need to itch can help prevent scarring.
Fortunately, psoriasis patients can usually avoid permanent or long-lasting scars through proper care and treatment of their psoriasis. Taking proper care of the skin both during and after psoriasis flares helps significantly to reduce scarring.
If more action is needed, treatments are available, ranging from simple creams and therapies to surgical procedures.