What to Wear When You Have Psoriasis

For most people, getting dressed every day is usually about comfort, functionality, and personal style. But for people with psoriasis, there’s another consideration: how your clothes interact with your skin.

That’s why what you wear matters. Paying attention to softness, fit, breathability, and how a garment feels against your skin can help you stay comfortable — and avoid exacerbating symptoms.

When you’re clothes shopping or getting dressed, focus on how a fabric feels against the skin, says Jody A. Levine, MD, a dermatologist in New York City.

Feel how coarse the fabric is, and make sure it has a soft finish, especially with textiles like bamboo, Levine says.

Natural fibers aren’t your only option, says Chris Adigun, MD, a dermatologist in private practice in Chapel Hill, North Carolina. “You can still wear synthetics, but [opt for] the newer kinds of silkier fabrics that are less likely to chafe,” Dr. Adigun says.

Keep this rule of thumb even as a preventive measure. “If you have a lot of active plaques on your body, you’re going to want to wear soft clothing because it’ll be more comfortable. But if you’re trying to avoid a flare, you also want to decrease any risk of potential trauma,” Adigun says.

Some materials are more likely than others to feel scratchy, trap heat and sweat, or create friction against the skin. Levine says these often include:

• Wool
• Heavy denim
• Polyester
• Nylon

“Wool is one of the fabrics I would be most cautious about, because its texture can be very irritating to already sensitive or inflamed skin,” Levine says. Denim may be uncomfortable if it’s stiff, tight, and rubbing against an active plaque, she says.

Tightly woven synthetics, like polyester and nylon, tend to be “very occlusive,” trapping moisture and heat. These, too, can lead to friction against the skin, Adigun says.

Instead, she recommends wearing workout gear as needed — as long as it feels comfortable — then changing out of sweaty clothing, rinsing your skin, and moisturizing.

The best clothing style is ultimately one that doesn’t repeatedly irritate your skin through rubbing, snagging, or scratching, Adigun says.

Try Looser, More Relaxed Fits

Maxi dresses, oversize tops, wide-leg trousers — styles with a relaxed fit allow for air circulation and create less friction than fitted tops and tight jeans. “Loose-fitting, flowing clothing is often more comfortable because it minimizes rubbing and pressure against the skin,” Levine says.

That doesn’t mean everything in your closet needs to be oversize. Leggings, waistbands, or bra straps aren’t problematic unless they’re chafing your skin, Adigun says.

Pay Attention to Seams, Tags, and Hardware

Sometimes the fabric itself is perfectly comfortable, but one tiny part of a garment isn’t: tags, raised seams, stiff collars, zippers, buttons, and other details may rub or pull on the same area of skin, raising the risk of the Koebner effect, Adigun says.

“[They] aren’t inherently a problem, but their placement matters. If something repeatedly rubs against an area where a patient has active psoriasis, I’d recommend choosing another style,” Levine says.

Use Color and Patterns Strategically (if You Want To)

This is more of a personal preference, not a medical one. “Dark clothing itself does not worsen psoriasis,” Levine says. “Some patients feel more comfortable in lighter colors or prints because flaking may be less noticeable than it is against black.”

But if black is your favorite color — or navy is part of your work or school uniform — there’s no medical reason to stop wearing it. You may just notice flakes more readily on the fabric.

Dress in Layers

Where possible, layer up instead of wearing a thick, heavy sweater. Lightweight layers can make it easier to regulate your temperature, Levine says.

“If you notice that overheating tends to make your psoriasis worse, being able to remove a layer before you become very warm can make a significant difference,” she says.

When you’re getting dressed, Adigun suggests asking yourself: What is the garment doing to my skin?

Skinny jeans, compression leggings, tight bra straps, snug waistbands, or fitted cuffs don’t automatically trigger psoriasis. But if it digs in, traps sweat, repeatedly rubs the same area, or aggravates an already sensitive area, consider changing the fit, she says.

If a garment normally feels comfortable and doesn’t chafe, there may be no reason to avoid it.

She says the same rule applies to rough embroidery, sequins, heavy zippers, or other embellishments. If they’re rubbing, scratching, chafing, itching, or digging into your skin, it’s worth reconsidering.

What happens to your clothes before and after you wear them can matter, too.

• Consider washing new clothes before wearing them. If your skin is highly sensitive or you’re managing an active flare, Levine recommends washing new clothing before the first wear. “Washing can help remove excess dyes, finishes, or other residues left from manufacturing,” she says. It isn’t an essential step, Adigun says, but if your skin is especially reactive, it’s an easy precaution to try.
• Choose simple laundry products. When you’re shopping for laundry detergent, look for fragrance- and dye-free options, and avoid heavily scented ones.

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   More detergent isn’t necessarily better, either. “Detergent residue left in fabric can itself become irritating,” Levine says. She cautions against conventional scented fabric softeners and dryer sheets, too. If softness is an issue, fragrance-free dryer balls or using a low dryer setting are alternatives.
• Wash clothes that sit against your skin regularly. Clothes worn directly against your body should generally be washed after each wear, Levine says. This helps to clean sweat, body oils, skin-care products, and shedding skin cells from your clothing. This becomes especially important after exercise or anytime clothes become damp with sweat.