Psoriasis: How to Deal With Cracked, Bleeding Skin

Take these steps to heal your skin and avoid future fissures.

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If not well-treated, psoriasis plaques can become itchy and flaky and sometimes crack and bleed.Shutterstock

Psoriasis is a chronic skin condition that causes patches of red, dry, itchy skin, called plaques. When these plaques are not well treated, they can get itchy and flaky and then sometimes crack and bleed, according to the Cleveland Clinic.

People with psoriasis tend to notice bleeding if they scratch plaques too much, rub cracked skin against their clothes, or put pressure on their skin while sitting or bending their limbs.

The more parched your skin, the more likely it is to develop cracks, or fissures, and open sores on the skin. “The dryness is what causes the plaques to crack and subsequently bleed,” says Saakshi Khattri, MD, an associate professor of dermatology at Mount Sinai Hospital in New York City.

Unfortunately, cracks in your skin are uncomfortable and could increase your risk of infection. Here’s how to prevent and manage skin cracking and bleeding.

First-Aid Care for Cracked Skin

If you develop cracks or fissures in your skin, it’s important to take steps to treat the wound and reduce your risk of infection. Follow these tips, advises Dr. Khattri.

Wash your hands. Use warm, soapy water to wash your hands before touching your skin.

Stop the bleeding. Apply gentle pressure to the fissure with a clean bandage or cloth until the bleeding stops.

Clean the cut. Rinse the wound under running tap water and clean the surrounding area with soap. Gently remove any dirt, lint, or other debris from the wound.

Apply a protective ointment. The best over-the-counter first aid is petroleum jelly, says Khattri, “but eventually the goal should be to treat underlying psoriasis.” Petroleum jelly can help injured skin heal and ease dryness, according to the American Academy of Dermatology.

Watch for infection. Generally, psoriasis plaques don’t get infected, but if they’re cracked or open, they could, says Khattri. Watch for pus or yellow discharge, tenderness to the touch, worsening redness on or around the lesion, or any systemic problems such as fevers or muscle pain, as these can be signs of infection, she adds. Talk to your doctor if you notice any of these or if the wound isn’t healing.

How to Prevent Skin Cracks and Bleeding

Following your psoriasis management and treatment plan can help reduce your risk of developing fissures, as can practicing self-care habits to protect your skin, says Khattri.

Keep your skin moisturized. As noted, dry skin is more likely to crack and bleed. Avoid long showers or baths, which can dry out skin, and apply cream or ointment after you shower, take a bath, or wash your hands to help lock in moisture.

Remove scales. Over-the-counter lotions and creams with salicylic acid can help decrease the buildup of scales, according to Khattri. Plain old moisturizer has its place, too. “A good moisturizer that helps with dryness and skin healing can be a helpful [addition],” she adds.

Be gentle on your skin. If you use an abrasive product, such as a pumice stone, to remove scaly skin, you could be doing more harm than good. “There is a possibility that such aggressive measures could result in bleeding,” notes Khattri.

Avoid your triggers. Knowing your psoriasis triggers and taking steps to avoid them can help prevent plaques from developing in the first place. Common triggers include stress, smoking, cold weather, and injuries to the skin, according to the National Psoriasis Foundation.

Talk to Your Doctor About Your Psoriasis Treatment Plan

Look at your psoriasis symptoms as part of the bigger picture, says Khattri. If your skin is frequently cracking and bleeding, it may be a sign that your condition isn’t well controlled and you need to discuss options with your doctor to better manage it. See a dermatologist if your skin continues to bleed and crack, is breaking over a large area of your body, or impairs your quality of life, she advises.

There are many treatment options for psoriasis, including medicated topical treatments that are mostly available by prescription, as well as 1 percent hydrocortisone, which is available over the counter, says Khattri.

Your doctor may recommend a variety of treatments of differing potencies, depending on the severity of your psoriasis, your preferences, your age, and the location of your plaques, according to a study review published in February 2021 in the Journal of the American Academy of Dermatology. For example, people with chronically dry, thick plaques might need the strongest class of steroids, the researchers say.

While topical treatments come in many forms, in an April 2023 study published in the Journal of Drugs in Dermatology, nearly 76 percent of participants with moderate psoriasis said they preferred water-based creams; almost 71 percent also like oil-based foam. Less-popular options included gel, solution, lotion, and ointment.

If topical treatments aren’t enough to manage your psoriasis, your doctor may recommend systemic therapies, such as biologics, says Khattri. Unlike topicals, which are applied directly to the skin, systemic medications are taken orally or injected and alter the immune system to help control the underlying inflammation that causes psoriasis.

Work with your doctor to find a treatment plan that will help keep your psoriasis symptoms under control.

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