What causes psoriasis scars?

One of the most troubling things about psoriasis is dealing with the physical scars it leaves behind. Fortunately, treatments are available which can minimize their appearance and help smooth out the skin.

Psoriasis is a chronic autoimmune disorder that causes rapid skin cell turnover. Skin cell turnover is the process of skin cells rising to the skin’s surface. This rapid turnover causes inflammation and thick patches of scaling skin. Scarring may then occur as a result. Infection and excessive scratching may also cause scars.

Treatments for psoriasis scars

It may be impossible to remove every psoriasis scar entirely, but treatments are available to lessen their severity. In some cases, treatment may focus on treating the plaque lesions to help reduce your risk of scarring.

Every treatment has pros and cons. Costs can vary widely, depending on the severity and size of your scars, length of treatment, your dermatologist, and your insurance plan.

Clobetasol (Temovate, Embeline) cream

Clobetasol cream (Temovate, Embeline) is a prescription topical corticosteroid cream. It may help to reduce skin redness and swelling. Using this cream will not remove any previous scarring, but it will lower the likelihood of new scars developing by reducing the inflammation of the psoriasis plaque. The cream is typically applied in a thin layer to the affected area twice daily for up to four weeks at a time.

Side effects may include:

  • irritation
  • stinging
  • burning
  • mild to severe allergic reaction

The generic version is around $29 for 15 grams. You will pay more for the brand name. For example, Temovate cream costs about $180 for 30 grams.

Tretinoin (Renova, Avita, Retin-A, Atralin) cream

Tretinoin (Renova, Avita, Retin-A, Atralin) is a prescription retinoid cream used to smooth skin, increase skin cell turnover, improve skin discoloration, and reduce the appearance of wrinkles. It’s commonly prescribed to treat acne and acne scars, but may also help improve the appearance of psoriasis scars.

Tretinoin cream may cause side effects such as:

  • burning
  • stinging
  • redness
  • abnormal dryness of the skin
  • skin irritation
  • skin peeling
  • blistering
  • changes in skin color (especially to a lighter or whitish color)
  • allergic reaction

Tretinoin cream may also increase your sensitivity to the sun, so it’s important to use sunscreen whenever heading outdoors.

You should not use tretinoin cream if you’re pregnant, thinking of becoming pregnant, or breastfeeding. You should also not use if you have a sunburn or take another medication that causes sun sensitivity.

Tretinoin costs around $93 for 20 grams.

Excimer laser therapy

Excimer laser therapy is a painless procedure that delivers a beam of UVB light to psoriasis lesions. It targets only damaged skin and does not impact healthy surrounding tissue.

A study published in Archives of Dermatology concluded excimer laser therapy is safe and effective in treating hypo-pigmented (lighter colored) scars and striae alba, or stretch marks.

Excimer laser therapy may cause redness, skin discoloration, and sores, though these side effects are generally mild.

Depending on the size of the lesion or scar, treatments are typically done twice a week for four to six weeks. The procedure may be covered by insurance after other treatment options have been exhausted.

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Dermabrasion

Dermabrasion may be used for the treatment of scars. The procedure uses a wire brush to remove the top layer of skin. This allows new skin to develop.

Dermabrasion may be painful, so numbing agents or general anesthesia is often used. It may take several weeks to see results.

Potential side effects include:

  • additional scarring
  • skin darkening
  • infection
  • swelling
  • uneven skin

Dermabrasion costs on average $143 per session, but this varies widely by region of the country, and does not include anesthesia or facility charges.

Punch-graft surgery

If you have deep, depressed scars, punch-graft surgery may help. During the procedure, a hole is punched in the skin. The scar is removed and replaced with new skin. The new skin is usually taken from behind the earlobe.

Risks include excessive bleeding and infection. The healing process takes about a week.

Punch-graft surgery costs about $1,300 and is not usually covered by insurance.

Why treating scars matters

Psoriasis plaque and scarring may lead to feelings of insecurity. Minimizing the appearance of psoriasis scars may help to lessen the “psoriasis stigma” and help boost your confidence. Speak with your doctor to learn more about your treatment options.