Come wintertime, everyone's skin looks a little drier and flakier. You might get dry patches on your face, or dry, itchy hands and legs. But is that weird patch of rough skin that won't go away due to dryness..or the chronic condition known as psoriasis?
You're not the only one asking this question. That's why we turned to New York City dermatologist Gary Goldenberg, M.D., for advice on how to distinguish between dry skin and psoriasis, and what you should do in either case.
What's The Difference Between Dry Skin And Psoriasis?
Dry skin happens when skin cells don't have enough lipids and oils to stay self-hydrated. Skin can become flaky, rough, and cracked. When you get really dry, the skin may stubbornly retain these characteristics, and fail to improve with just your regular moisturizer or hydrating treatments. That's because the barrier function of the skin (its ability to keep hydration in and dryness out) has likely been compromised.
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Dry skin is often caused by cold temperatures, low humidity, over-washing, overly harsh skin-care ingredients, long and hot showers or baths, and environmental factors like blustery, windy weather. Poor nutrition, not drinking enough liquids, and medical conditions like thyroid disease can also cause dry skin.
So what is psoriasis? Psoriasis, unlike dry skin, isn't generally caused by external factors. It's actually a chronic inflammatory disease of the immune system, and often co-exists with other conditions, including diabetes, arthritis, and depression, per the American Academy of Dermatology (AAD). If you have psoriasis, your immune system is sending faulty signals to your skin, telling it to produce more cells at an accelerated rate. According to the National Institutes of Health, psoriasis has a strong genetic link, and about one-third of patients have a first-degree relative with the condition.
Speaking of skin conditions, here's why your feet are peeling:
The most common form of psoriasis is made up of raised lesions known as plaques, says Goldenberg. They're caused by a buildup of excess skin cells. Plaques can appear virtually anywhere, but are very commonly found on the scalp, elbows, knees, and feet, he says. Eighty to 90 percent of psoriasis patients have plaques, according to the AAD. While flaky, dry skin might at first glance look like psoriasis, plaques have a distinctive raised, silvery-white appearance similar to scales that sets them apart. Goldenberg says they come with incessant itching, which is the most common complaint he gets from psoriasis patients. Here's a picture of what plaques typically look like:
In short, they're two totally different skin conditions. So here's what to do about them:
How To Treat Dry Skin
You'll need equal parts prevention and treatment, says Goldenberg. Look for a moisturizer that contains ceramides and lipids to help build back the skin barrier, so that skin can better retain hydration on its own. Apply moisturizer to damp skin for optimal absorption (or use a wet-skin moisturizer specifically designed for this purpose). Try to take lukewarm showers (since super-hot temperatures can dry out skin), and keep your bathing time under seven minutes.
You'll also want to cut potentially irritating products from your routine, like those containing retinol, glycolic acid, astringent, and heavy fragrance. These can cause extra drying—exactly what you don't want! And sleep with a humidifier on to add moisture back into the air to help skin heal.
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How To Treat Psoriasis
Although there is no cure for psoriasis, Goldenberg says enough progress has been made with treatment that most patients can be almost completely cleared of their symptoms. He says the key to addressing psoriasis is decreasing inflammation. Usually, this is accomplished by seeing your dermatologist for a steroid cream. More severe psoriasis may require oral pills or biologic injections—consult with your dermatologist to help work out the best course of treatment for your condition.
Many psoriasis patients also see improvement in their skin from anti-inflammatory diet changes—like eating gluten-free— and by taking supplements, says Goldenberg. The National Psoriasis Foundation recommends omega-3 fatty acids (found in nuts, seeds, and fatty fish) to help decrease inflammation in the body. Eating more vitamin D (which you can find in fortified milk, supplements, orange juice, egg yolks, and yogurt) can also help slow the skin cell growth associated with plaque build up, according to The National Psoriasis Foundation.
