Inverse psoriasis is a strange beast — it lacks the raised lesions and dry, scaly skin that are hallmarks of psoriasis — which can make it difficult to diagnose. When I first saw my doctor about the itchy patches of skin I couldn’t seem to get rid of and the discoloration of my nail beds, they misdiagnosed me with a fungal infection. A dermatologist finally diagnosed me with inverse psoriasis. And through his advice and my own trial and error, I’ve been able to keep the condition to a minimum for the last several years. Here are some of my top recommendations for keeping your inverse psoriasis under control.
Anything that rubs against your skin and creates friction can cause irritation and create a pathway for inverse psoriasis. Similarly, tight clothing can trap sweat and bacteria, which can also trigger flares. Avoid skinny jeans, spandex, corset tops, and similar clothing items as much as possible.
Keep cool when you sleep. Consider swapping silky or polyester materials for light, loose-fitting pajamas and night shirts made with natural fibers. Keep bedding lightweight, too, to avoid getting overheated while you sleep. Remember, breathability is key.
Good hygiene is always important, but even more so when you’re dealing with inverse psoriasis. Aim to keep your skin clean and dry at all times. Try to avoid soaps or body washes that leave a film on your skin, and use perfumes and body sprays with caution. Keep the water warm, not hot. Dry off well with a clean towel each time.
If you live with psoriasis of any kind, you understand how uncomfortable dry skin can be. When it comes to inverse psoriasis, how you select your moisturizer is key. Try to avoid products with fragrances or additives you struggle to pronounce. When it comes to products, seek out an ingredient list that is as short and natural as possible.
You can use petroleum jelly-based products like Vaseline or Aquaphor as a protective barrier on your skin after a shower, before bed, or whenever you’re a little irritated. This can help with friction and trap the “good kind” of moisture on your skin without causing additional irritation.
Inverse psoriasis loves skin folds. Gross, I know. There are places you can’t help (like your underarms), but there are also some that can be alleviated by weight loss if you have extra skin folds.
This can be tricky if you have psoriasis, as sweating can also cause a flare. If you plan to make any significant diet or lifestyle changes, be sure to do so under the supervision of a medical professional. Major dietary changes can also trigger a flare, so be sure to keep a close eye on your symptoms as you make changes.
Each time you work up a sweat, it’s essential to clean your skin. If you aren’t able to hop in the shower right away, be sure to clean off your trouble spots with a clean washcloth, or bring body wipes in your bag to give a quick refresher.
If you are someone who typically exercises in spandex or sports bras, be sure to dry off and change immediately after you finish. While sweat-wicking materials may keep you cool during a workout, those materials can also be sneaky traps for moisture and bacteria.
If you get irritation between your breasts, try to let that area breathe as much as possible: Don’t trap it with a bra that covers your cleavage. Go for plunging bras that don’t squish your breasts together too much. You can also put a barrier between your breasts (like thick tissues or thin cotton material) when they’re irritated so they don’t rub into each other and cause more friction.
My dermatologist told me to only use cortisone creams when my symptoms become severe because regular use can thin the skin and make it more prone to infections. So, on a normal day, I’ll just use Vaseline and follow my best skin care routine, but sometimes during a particularly uncomfortable flare, I’ll supplement with a topical steroid cream.
If you get inverse psoriasis under your arms, on your thighs, or in other sensitive areas where you normally shave, consider using an electric razor to reduce the chance of bumps, nicks, and ingrown hairs. This will also reduce the pain of dragging a razor over already tender skin.
Avoid any hair removal creams or scented shaving creams. They tend to contain harsh chemicals and irritants that can exacerbate symptoms. If you want to soothe your skin after shaving, go the more natural route. Coconut oil can be a great, natural alternative and can actually help keep your psoriasis under control.
Bacteria in the groin area can cause inverse psoriasis flares. Rinse off with a bidet to be sure you’re more thoroughly clean after using the bathroom or after sex, and use soft toilet paper to dry yourself without pulling on your skin.
Stress can trigger and worsen psoriasis, so do what you can to reduce it in your life. There are lots of ways to practice calming yourself and mitigating the inevitable effects of stress.
Some common ways to relax include:
Minimizing stress looks different for everyone. My recommendation is to determine what brings you joy and do whatever you can to do it as often as possible!
When the itch gets to be just too much, an oral antihistamine can take the edge off and break the cycle of scratching. Benadryl is likely to make you sleepy, so it’s best used at night.
Inverse psoriasis doesn’t have a cure yet, but it can be managed through proper care and a consistent routine. If you still find yourself struggling to manage symptoms despite your best efforts, ask your doctor if the medication route is necessary for you.
Like all psoriatic conditions, consistency and patience are key when it comes to management. It may take some time, but through trial and error, I have found what works for me and my inverse psoriasis, and I hope you are able to do the same.
Medically reviewed on January 20, 2023
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