“One of the things that triggers and activates psoriasis is trauma to the skin — anything that causes inflammation,” says Stephen P. Stone, MD, a professor of dermatology at Southern Illinois University School of Medicine in Springfield. Psoriasis lesions can often form after an injury, such as a cut or a burn — due to a process called the Koebner phenomenon — which is why people with psoriasis have to be careful to avoid skin damage. “The issue with hair removal is that it’s causing trauma,” explains Neelam Vashi, MD, an assistant professor of dermatology at Boston University School of Medicine and a dermatologist at Boston Medical Center. Whether you’re shaving, waxing, or using another form of hair removal, it will involve some level of irritation or injury to the skin, she notes. That said, whether or not psoriasis is triggered and how severe the flare is depends largely on the individual and how well their disease is managed. Psoriasis may not always flare after hair removal, and it does not happen in every patient, says Rosalyn George, MD, a board-certified dermatologist, a fellow of the American Academy of Dermatology, and the owner of Wilmington Dermatology Center in North Carolina. “It depends on the person. Some people have no problem shaving or waxing,” says Dr. George. Regardless of how well your psoriasis is managed, if you wish to use a hair removal method, be sure that it’s gentle, no matter which process you choose, advises Dr. Vashi. If you’re in the middle of a flare, wait until it’s over before removing hair in that area. “If someone is flaring, the Koebner phenomenon may be more inclined to happen,” says Vashi. She notes that treatment can usually help a patient through a flare and calm the skin within a week or two. “I would advise against any type of traumatizing treatments, such as hair removal, while you’re experiencing a flare,” she says.
Shaving With Psoriasis
Shaving is one of the most commonly used methods of hair removal. It involves using a razor to cut the hairs on the surface of the skin. Unlike waxing or laser hair removal, this method doesn’t cause pain (unless you cut yourself). The trade-off is that the hairs will grow back relatively quickly, and you may need to shave every few days — or even daily — to keep your skin smooth. For people with psoriasis, the main downside of shaving frequently is that it can irritate the skin, thus increasing your risk for a flare. To minimize your risk, follow these tips. Shower first. Whether you’re shaving your face, legs, or armpits, shower first, recommends Dr. Stone. “Let the skin and hair get saturated with water, which makes it easier to cut,” he says. Use a razor that is sharp and has multiple blades. Change out your blade frequently, don’t use old blades, and opt for razors that have multiple blades, which are easier on the skin, advises Vashi. Go with the grain. If you use a razor, be sure to shave in the same direction your hair grows, rather than against it, to minimize irritation. “That’s true for anyone with irritated skin, not just those with psoriasis,” says Dr. Green. Never shave dry skin. Always use shaving cream to protect your skin, says George. Moisturize after shaving. According to the National Psoriasis Foundation, keeping your skin moisturized is an important part of stopping it from becoming dry, inflamed, or itchy and helping it heal.
Other Methods of Hair Removal
Here are some other common techniques for removing unwanted hair, according to the American Academy of Dermatology Association (AAD). Waxing This method uses hot or cold wax that’s applied to the skin and then quickly removed to pull out the hairs. The results can last a few weeks or longer, and it can be used in delicate areas, such as the skin above your upper lip or your bikini area. But the removal of the wax can be painful and irritating, which could be problematic for some people with psoriasis. And if the wax is too hot, it can potentially burn your skin. Depilatories This method involves applying a specially formulated cream, lotion, or gel that dissolves unwanted hair. Some people prefer this method because it’s easy and convenient: You simply put the product on the skin where you want to remove hair, wait a set amount of time, and then rinse it off with water. “Depilatories are irritating enough that they can cause problems,” though, says Stone. “We don’t recommend them for people with psoriasis.” Laser hair removal This procedure uses a beam of light to destroy the hair follicle so it can’t grow back. While home devices are available, the AAD notes that you should have this done by a trained dermatologist to achieve the best results. And if you have a condition that affects your skin, such as psoriasis, it’s especially important that you see your doctor to find out if this procedure might be right for you. “I usually recommend laser hair removal for my psoriasis patients,” says George. She notes that it is a less irritating way to get rid of hair than shaving, waxing, or using a depilatory, particularly if you repeatedly remove hair from sensitive areas, such as the underarms and bikini area. “If you’re constantly shaving and waxing those areas, it can cause psoriasis flares,” says George. One drawback is that laser hair removal can take six or more treatments to work, but it is permanent in most cases — except for women’s facial hair, according to the AAD. Also, laser hair removal isn’t as effective on blonde, white, gray, or red hair, and you’ll need to keep the treatment area covered and avoid the sun until your skin heals completely. Electrolysis In this procedure, electrical currents are sent through hair follicles to damage them and prevent hair from growing. It can take several sessions and is time consuming, but you can eventually achieve permanent hair removal, according to the AAD. It can also work on people with light-colored hair. As with laser hair removal, there are home kits, but the AAD notes that you’ll achieve best results if a board-certified dermatologist or electrologist performs the procedure. It’s also important to keep some precautions in mind. For instance, probes that are not sterilized well can lead to skin or blood infections, and electrolysis performed by someone who isn’t properly trained can cause burns and scarring, according to the AAD. Some people also report experiencing pain and discomfort during the procedure. “I would only suggest it for very small areas like the upper lip or chin. It’s mostly useful on the face, so typically I wouldn’t see a lot of psoriasis patients having electrolysis in active psoriasis flare areas,” says George. “I think laser hair removal would be preferable for psoriasis patients since there is less manual disruption of the skin.”
