Cosmetic Procedures for Psoriasis: Are They Safe?
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Are Cosmetic Procedures Safe if You Have Psoriasis?

If you have psoriasis under control, you may be a candidate for certain cosmetic procedures — in the right hands, of course.
Are Cosmetic Procedures Safe if You Have Psoriasis?
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Published on April 5, 2024
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Are Cosmetic Procedures Safe if You Have Psoriasis?

Dermatologist Andrew Alexis, MD, speaks about cosmetic procedure safety when you have psoriasis.
Are Cosmetic Procedures Safe if You Have Psoriasis?

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If you’re used to buying fragrance- and chemical-free makeup and moisturizers, you might have assumed that facials, fillers, and other cosmetic procedures are also off the table.

But, as it turns out, people with psoriasis don’t necessarily have to avoid beauty treatments — as long as the psoriasis is under control. “Active disease states are very inflammatory, and inflammation increases the likelihood of things not going well,” says Sonya Kenkare, MD, a dermatologist at the Illinois Dermatology Institute in Hinsdale.

That’s not all you need to keep in mind. “Psoriasis is known to be aggravated by skin trauma,” says Joel M. Gelfand, MD, director of the Psoriasis and Phototherapy Treatment Center at Penn Medicine in Philadelphia. Psoriasis lesions can form after your skin has been injured by a burn, for example, or a cut, which is called the Koebner phenomenon. 

This is why many people who have psoriasis assume they’ll never be candidates for any type of beauty treatment: They believe lasers, peels, and needles will cause trauma to the skin. But if you have psoriasis under control, you likely won’t experience a flare-up of symptoms after getting a cosmetic procedure, says Dr. Kenkare.

In one study, about nine out of 10 of people with moderate-to-severe psoriasis who’d undergone a cosmetic procedure said they were able to do so because they started taking a treatment that alleviated most of their lesions. The majority of the study’s participants said psoriasis had prevented them from these types of procedures previously.

Still, if you want to try a treatment, it’s better to talk to a dermatologist first to find out if you’re a candidate, says Dr. Gelfand.

Here’s what you should know about some of the more common cosmetic procedures.

Botulinum Toxin Injections (aka Botox)

What they are: These neurotoxin injections block the nerve signals to the muscles, which temporarily prevents them from tensing.

 The injections are used to smooth fine lines and wrinkles, often in the face and neck.

Risks: You may experience some swelling, redness, or bruising at the injection sites, but this is usually mild and improves in a day or so.

How to do it safely: Your doctor may recommend avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) for a day or two before the procedure, because they can increase the risk of bruising, according to Cleveland Clinic. So can alcohol, meaning you may want to abstain from drinking for 24 hours before your appointment.

Facials

What they are: Treatments depend on the type of facial you get and the skin-care specialist doing it. But in general, they include a facial cleanser, exfoliation to remove dead skin cells, moisturizer, and a gentle massage.

Risks: Sometimes, facials can cause “skin purging” — an acceleration of your skin’s natural cell turnover, which can cause breakouts.

How to do it safely: Ask your aesthetician to use gentle moisturizers and other skin-care products that won’t irritate your skin, especially if you know certain ingredients trigger your symptoms.

Laser Hair Removal

What it is: This procedure uses a beam of light to vaporize the hair within the follicle.

 When done correctly, it shouldn’t cause trauma to the skin itself, says Kenkare. Lasers can remove hair from any part of your body, but it’s most commonly used on the bikini line, face, legs, and underarms.

Risks: If you don’t go to a pro, such as a dermatologist, it’s possible to experience side effects such as blistering and scarring.

How to do it safely: In the days after treatment, you’ll want to stay out of the sun, since ultraviolet (UV) rays can further damage your already sensitive skin.

Microneedling

What it is: Thin needles are used to make tiny holes in the skin in this procedure. This stimulates the production of collagen, a protein that helps keep skin smooth.

 It’s often done on the face, but microneedling can also be done on the back, legs, neck, and other areas of the body.
Risks: There can be some redness and discomfort after microneedling.

How to do it safely: Avoid using at-home microneedling products, which could pierce the skin and cause scarring or infection, according to the AAD. Before you have microneedling, you may need to avoid alcohol, NSAIDs, and products that contain salicylic acid for a day or so.

Microdermabrasion

What it is: This treatment uses a device to gently remove the top layer of skin, which gives the skin a smoother appearance.

 It may feel as if someone is “sanding” your skin, but it isn’t painful. Microdermabrasion is performed to lessen age spots, fine lines or wrinkles, and mild scars. It’s often done on the face, but you can get microdermabrasion on other areas of the body, such as the back, chest, hands, and neck, as well.

Risks: After microdermabrasion, there can be some redness or swelling, similar to a sunburn.

How to do it safely: You may need to avoid taking NSAIDs and using products that contain salicylic acid for a few days before your scheduled microdermabrasion. If you use products that contain other irritating ingredients, such as glycolic acid or retinols, you may need to stop taking them for at least a week before the procedure.

Before You Book

Before you undergo a cosmetic procedure, talk to a dermatologist who has experience working with people who have psoriasis, and ask whether the procedure is right for you.

“The best time for psoriasis patients to do cosmetic procedures is when the psoriasis is under good control,” says Kenkare. “If a person’s overall inflammation is otherwise well controlled … it should be well tolerated.”

Whether you go to a dermatologist or another professional — like an aesthetician or cosmetologist — be sure to let them know you have psoriasis. That way, they can take any extra precautions to avoid irritating your skin.

The Takeaway

If you have psoriasis under control, you may be able to undergo certain cosmetic procedures safely. But they do come with some risks, so it’s important to take the right precautions. If you’re thinking of getting a procedure done, consider getting the green light from your dermatologist first.

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Ross Radusky, MD

Medical Reviewer
Castle Connolly Top Doctor

Ross Radusky, MD, is a practicing board-certified dermatologist at the Dermatology Treatment and Research Center in Dallas. Originally from New York City, he graduated summa cum laude from the City University of New York and then received his MD from the New York University School of Medicine. There, he was inducted into the Alpha Omega Alpha Honor Medical Society and served as chapter president for two years. He completed his residency in dermatology at NewYork-Presbyterian Hospital and Weill Cornell Medical Center, and at Memorial Sloan Kettering Cancer Center.

Dr. Radusky practices general and cosmetic dermatology with a focus on the early detection of skin cancer, and provides patients with a personalized approach to looking their best at any age. He has authored articles and textbook chapters on the clues that our finger- and toenails may provide us about internal disease, as well as on comprehensive therapies for cosmetic dermatology and reversing the signs of skin aging.

Complementing his medical practice, Radusky has a strong passion for the cultural arts, particularly in expanding access to youths and seniors. He previously served as an artist instructor for the Rockaway Artists Alliance, a New York City nonprofit arts and education organization, and then served as both a board director and treasurer of the organization throughout his medical school training.

Radusky enjoys spending time outdoors with his wife Robyn, son Oliver, and poodle Lucy, where he can usually be found preventing photoaging and reducing the risk of skin cancer beneath an umbrella in a wide-brimmed hat. He is also the proud inventor of Sunshotz, the world’s only sunscreen measuring cup, designed to help patients of all ages apply the proper amount of sunscreen needed to enjoy all the sun without the burn.

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Maria Masters

Maria Masters

Author

Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and she has held positions at Men's Health and Family Circle. Her work has appeared in Health, on Prevention.com, on MensJournal.com, and in HGTV Magazine, among numerous other print and digital publications.

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Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Sanchez DP et al. Koebner Phenomenon. StatPearls. November 14, 2022.
  2. Walters ME et al. Increased Trend of Cosmetic Procedures in Patients With Psoriasis Who Attain 75% or Greater Improvement. Journal of Drugs in Dermatology. August 1, 2020.
  3. Botox (Botulinum Toxin). Cleveland Clinic. April 6, 2022.
  4. Facials: What Are They, and What Do They Really Do? Cleveland Clinic. August 28, 2023.
  5. Laser Hair Removal: FAQS. American Academy of Dermatology Association.
  6. Microneedling. Cleveland Clinic. May, 23, 2022.
  7. Microneedling Can Fade Scars, Uneven Skin Tone, And More. American Academy of Dermatology Association. July 17, 2023.
  8. Microdermabrasion: FAQS. American Academy of Dermatology Association.
  9. Dermabrasion & Microdermabrasion. Cleveland Clinic.