Cosmetic procedures focus on your physical appearance but have a variety of effects on your skin. Not all cosmetic procedures may be appropriate when you live with psoriasis, and even those that cause minor irritation could cause new lesions or symptom flare-ups.

Psoriasis is an immune-mediated skin disorder. It’s caused by dysfunction in your immune system that triggers inflammation and stimulates rapid growth of skin cells.

Excessive cell growth leads to patches of scaly, thickened skin, often on the scalp, knees, elbows, and other parts of the body.

When you live with psoriasis, cosmetic procedures may feel daunting. It’s natural to be self-conscious about your skin or to be wary of new routines that might aggravate your symptoms.

Many people can still enjoy cosmetic procedures when they live with psoriasis. But because skin injury (even minor injury such as a cut or mild sunburn) can be a potential trigger of psoriasis, choosing cosmetic procedures with caution is always recommended.

When you live with psoriasis, injury to your skin — of any severity — can produce what’s known as the Koebner phenomenon. In the Koebner phenomenon, damage to areas of your skin unaffected by psoriasis may cause new psoriasis lesions.

The exact reasons behind this experience aren’t clear, and there’s no way to reliably predict who might have this type of reaction or what types of skin trauma might lead to it.

How will I know if I can have a cosmetic procedure with psoriasis?

Psoriasis can affect everyone differently. What may act as a trigger for you might not affect someone else.

Consulting with your dermatologist before committing to a cosmetic procedure can help you decide whether it’s the right decision based on your unique symptoms, triggers, and overall health.

Cosmetic injections use needles to insert substances into the layers of your skin for different effects, such as wrinkle reduction, firming, or attribute enhancement.

Botox and dermal fillers are examples of common cosmetic injections.

Botox injections

Botulinum toxin, commonly known as Botox, is both a cosmetic and therapeutic tool. It’s used to enhance appearance but can also help treat certain medical conditions.

If you’re living with a type of psoriasis known as plaque psoriasis, Botox may improve your skin symptoms.

In a 2020 study, botulinum toxin injections were injected into two psoriatic plaques. Symptoms improved over a 4-week treatment regime with no significant side effects, but this improvement may be injection-site based. More research is needed.

That doesn’t mean Botox is for everyone or that Botox used in a cosmetic procedure will improve your psoriasis, however. It’s still possible to experience the Koebner phenomenon even with a therapeutic agent.

Dermal fillers

Dermal fillers use substances such as hyaluronic acid to add volume to your face or enhance features such as your lips.

While they’re generally considered safe for most people, they may not be appropriate for people with immune-mediated conditions, such as psoriasis. Introducing foreign bodies into the skin can activate T cells in the immune response.

T cells are specifically involved in the pathology of psoriasis. They’re a critical component in inflammation and release chemicals that directly contribute to the rapid growth of skin cells.

What about needle-free fillers?

Needle-free fillers sound like they’d be less traumatizing to your skin, but that’s not necessarily true. Needle-free fillers are placed into your skin using pressure rather than a needle.

The American Academy of Dermatology Association (AADA) indicates that the risks of needle-free fillers greatly outweigh the benefits.

Was this helpful?

According to a 2022 clinical trial, skin disease-oriented spa therapy is considered a safe complementary treatment for psoriasis.

Cosmetic spa procedures that have a lower risk of skin trauma, such as facial masks, deep cleansing, and thermal treatments, may be better suited for psoriasis skin. Many of these focus on soothing your skin, adding nutrients or moisture through topical applications and massage.

Because they’re less likely to cause damage to your skin, they may be a safer choice compared to more abrasive procedures. Even with gentle spa treatments, though, it’s possible to have a reaction that flares your psoriasis.

Exfoliating when you have psoriasis is tricky. Exfoliating can help reduce the appearance of psoriasis patches, but friction can make symptoms worse.

When a mechanical exfoliant is used on your skin, it can damage healthy skin tissue, causing inflammation. For this reason, dermatologists typically prescribe chemical exfoliants, such as salicylic acid, in the form of gels or creams.

Skin resurfacing techniques — such as chemical peels, microneedling, dermabrasion, or dermaplaning — may be too harsh on psoriasis skin, though some have been investigated as potential treatments.

However, investigative treatments performed by researchers aren’t the same as cosmetic procedures available to the general public.

When you have scalp psoriasis, paying attention to the products you use on your hair can matter. Coloring, perming, and relaxing your hair involves the use of chemicals that can potentially aggravate symptoms.

Also factored in is the quality of the products and services used. Having your hair done in a professional setting decreases the chances of skin irritation. Your stylist is a professional trained in how to apply chemicals to your hair while sparing your scalp as much as possible.

Even if you regularly visit the salon without issues, coloring, perming, and relaxing aren’t recommended during an active psoriasis flare.

Living with psoriasis doesn’t mean you can’t put anything on your skin or need to avoid all makeup — but ingredients are important. Certain dyes, fragrances, and preservatives can cause aggravation, even for people without a chronic skin condition.

If you’re wondering what makeup might be suitable for you, the National Psoriasis Foundation (NPF) maintains a compendium of products that carry their Seal of Recognition.

Having the seal on a product label means the NPF recognizes that product as safe for people living with psoriatic disease, which includes psoriasis and psoriatic arthritis.

Psoriasis is a chronic inflammatory skin disorder that features thickened, scaly patches of skin. Because skin injury can trigger psoriasis flares or create new psoriasis lesions, all cosmetic procedures should be considered carefully and with the guidance of your dermatologist.