Emollient Therapy in Psoriasis Management

Benefits of Emollients

Emollients exert their action by retaining moisture in the stratum corneum, improving skin hydration and barrier function, and are recommended by the American Academy of Dermatology as an adjunctive therapy for itchy and excoriated plaque psoriasis 1, 2
They help reduce itching and desquamation (scaling), which are particularly problematic in excoriated plaque psoriasis, with a strength of evidence supported by the American Academy of Dermatology 1, 3
Emollients can prevent quick relapse of psoriasis when topical corticosteroids are discontinued, as suggested by the American Academy of Dermatology 2, 4

An RCT showed that the combination of mometasone plus emollient improved the area of palmoplantar skin affected, desquamation, and symptoms compared with mometasone alone after 4 weeks of treatment, with a moderate strength of evidence 1, 2

Apply emollients once to three times daily to affected areas, as recommended by the American Academy of Dermatology 5
Use emollients in conjunction with topical corticosteroids for 4 to 8 weeks to help reduce itching, desquamation, and total body surface area, with a high strength of evidence supported by the American Academy of Dermatology 2, 4
Consider emollients particularly valuable for itchy psoriasis, with a moderate strength of evidence 2
Consider emollients for psoriasis of the folds, as suggested by the American Academy of Dermatology 6

Emollients have no known contraindications unless there is hypersensitivity to their ingredients, as stated by the American Academy of Dermatology 1, 2
There is a small risk of contact dermatitis with some emollients, with a low strength of evidence 2
Emollients are considered safe during pregnancy and lactation, with a high strength of evidence supported by the American Academy of Dermatology 2

Emollients can be used as part of a rotational therapy approach with topical vitamin D analogues, topical calcineurin inhibitors, and topical corticosteroids as steroid-sparing regimens, with a moderate strength of evidence supported by the American Academy of Dermatology 7, 8
The use of emollients with topical calcipotriene may reduce irritation and enhance the efficacy of calcipotriene, with a moderate strength of evidence 7, 8
A thin coat of an emollient such as petrolatum applied to areas of psoriasis after bathing may be particularly beneficial, as suggested by the American Academy of Dermatology 6