TABLE 5.
Prevention and treatment methods for itchiness in patients with psoriasis
| Category | Results | Quotes |
| Prevention | Moisturizing skin | You want to keep your skin as hydrated as possible.” IT4 P 66–67* |
| Relaxing (nonmedical) | “Mindfulness of the present moment and just trying to chill out. It can definitely help.” FG2 P7 390–391 | |
| Relaxing (medical) | “Doctors just tell me to be less stressed [...] [or] to meditate, and I know I should but it’s so hard. [...] I started using cannabis, which is not necessarily helpful in the sense that you can have allergic reactions, but in a larger sense, it has been a blessing to keep it at bay. Anything to keep my stress and anxiety down. [...] that’s what I do when I’m trying to fix it on my own, and I’ll do anything to see if it works.” FG3 P2 159–160, 195–198 | |
| Diet change | “I've cut a lot of things out of our diets just to try to see what will help keep it mellow or what will trigger an even worse flare-up than normal—you never know.” FG2 P5 427–429 | |
| Coping strategies | Alternative treatments (oats, coconut oil, hemp seed oil, quaking aspen) | “I just put oats in a bag like Grandma used to and put that in a [...] fill a tub, start it with hot water.” FG2 P2 625–626 “Coconut cream—so far, that’s what is she is carrying.” IT10 FM 27–28 “Hemp seed oil, yeah. I'll rub it on my skin, and it helps sometimes [...] a little bit.” FG2 P4 166–167 “The one other thing that kind of helped me a little bit too was quaking aspen trees. When you rub your hands on the outside of the bark, there is a white fine powder, and I used to put that on there when I was out in the field. […] It kind of helped with the itching.” FG2 P3 484–486, 488 |
| Inflicting pain | “But I would much rather hurt than itch, and so I do scratch until it hurts and then it doesn't itch anymore. [...] it's easier to deal with the pain.” FG1 P1 508–509 | |
| Self-control | “There's never a moment my scalp doesn't itch. I just control myself not to itch it.” FG1 P5 294 | |
| Showering (hot or cold water), overwhelming the neural response | “But you just start with a long, hot shower and then you turn it to ice cold, and then you deal with the dry skin from the shower.” FG2 P2 331–332 | |
| Keeping oneself busy | “I actually crochet so I don't itch [laugh].” FG2 P4 100–101 | |
| Medication to control itch | Antihistamines (hydroxyzine, diphenhydramine) (oral) | “I take Benadryl. Knocks me out. I don't itch for a little while [laughs]. That's what the doctor told me to do.” FG2 P4 246–247 |
| Antihistamines (hydroxyzine, diphenhydramine) (topical) | “I do have a little bottle of spray Benadryl on my nightstand, and I will use that if it really gets intolerable.” FG1 P7 513–514 | |
| Steroid creams | “Some of the eczema lotions work pretty well. There is a psoriasis cream that they have over the counter now that works pretty well to take away the itchiness. It does not take [the rash] away completely, but it will take the itchiness away. Cortisone stuff works pretty well.” IT4 P 48–51 | |
| Systemic treatment (oral immunomodulators) | “But there's never a time my scalp doesn't itch [throughout the day], [...] which is why I'm doing the methotrexate. I do not want to be on that medicine.” FG1 P5 296–297, 299–300 | |
| Systemic treatment (biologics) | “I've had it really super bad, but I was going through a [biologic] study here. And the second time the study came, that's the one that was really good. I don't know what it was called. [...] Now I'm on Humira. But the second one was the one that really changed me. I didn't itch at all.” FG1 P1 30–34 | |
| Light therapy | “I am on light therapy now. I do it [twice] a week, and I take methotrexate. I am a different person now. It used to be so much pain and itching; it was really bad. [...] I am so happy. [...] I am 98% clear now.” FG3 P3 23–27 | |
| Coal tar shampoo | “[Coal tar shampoo]—it smells bad, [but] it stopped the itch.” FG1 P2 326–327 | |
| Enlisting loved ones’ help | Applying topical treatments | “I was putting creams on her, because she could not get her back mainly. She will close her eyes and start crying, saying, ‘Just do it.’ She stands up naked, and I am trying to be as fast as I can, just slathering her, you now, with these creams and stuff.” IT9 FM 62–64 |
| Scratching | “She’ll say, ‘Itch me, scratch my back, scratch me.’ I do not like that because there are skin cells all over me [laugh]. So I would find something to scratch her, because I do not like skin cells on me, so when she would say, ‘Scratch me, scratch me,’ I go find something like a brush.” IT9 FM 43–45 | |
| Restraint | “When I'm asleep, my husband will grab my hands [...] [to] stop me from itching when we’re sleeping.” FG2 P4 537–538 | |
| Encourage adherence/offer support | “I feel so bad. If I could take it away, I would, but I can’t. So all I can do is make sure she goes to appointments and she takes the medicine, you know, doing what I can do in a supporting role. With her going to college for the first time [...], I had to let her step up to the plate, be her own advocate, and be responsible for things that mom normally does. I feel my role is more supportive at this point. She calls me a nagger, but you know what, if it involves a medicine, I don’t care; I will be a nagger. That’s what moms do [laugh].” IT9 FM 76-81 | |
| Advice from others | Internet searches | I’ll let her research it before she does it, you know, because researching is all about [...] because some treatment might work and sometimes might not work. Some bodies take it and some bodies won’t.” IT10 FM 103–105 |
| Soliciting advice from others with psoriasis | “So, these things you're talking about, the topical things you're putting on—is it just like a really thick Eucerin lotion or does it have steroids in it?” FG1 P3 540 |
FG: focus group; FM: family member; P: participant with psoriasis; IT: interview
*Study nomenclature: Interview type, person speaking, transcript lines