If you have psoriasis -- or know someone who does -- you've probably spotted the telltale flakes on your carpets, couches, car seats, and clothes.
“The outer layers of the skin grow much faster than normal,” says David Pariser, MD, professor of dermatology at Eastern Virginia Medical School. “As the layers peel off, that's what makes all the scale."
Psoriasis flakes look a lot like dandruff. Because they come from your scalp and body, they can get everywhere.
The flakes can be very embarrassing. It's a part of the disease you can't hide.
Over more than 4 decades of living with psoriasis, John Latella estimates he’s lost more than 300 pounds of scale. The flakes were a big issue when he had to travel for work.
"If I went out to dinner with somebody and reached across the table and brushed something, I always worried the scales would fall off," he says.
At hotels, he'd wake up in the morning to find the bed full of flakes.
"I was embarrassed to leave it like that because I didn't want the maid to have to clean it up." He says using a moisturizer regularly in both the summer and winter helps keep his skin soft, supple, and less scaly.
Heavy flaking isn't as common as it once was. Treatments like biologic drugs are available to control psoriasis.
"If you have so much flaking that it's lying around the house, you should go back to your dermatologist," says Carolyn Jacob, MD, founder and director of Chicago Cosmetic Surgery and Dermatology. "Biologic medications can free your skin of the inflammation, which causes the flaking in the first place. They've completely changed the entire way of treating the disease, and they allow people to have normal lives so they're not vacuuming every day."
It's important to get inflammation under control, she says, not just to improve your skin, but also to prevent damage to your joints and blood vessels.
Latella says biologics worked for him, helping to reduce his scaling "to practically nothing."
If you're on a treatment but still dealing with flakes, there are some easy ways to tidy up.
1. Fire Up the Hoover
"Vacuum every other day," Jacob suggests.
It’s the easiest way to clean up psoriasis flakes. It’s important, too, because scales can build up in carpets and attract bugs.
"Dry, flaking skin that comes off ends up being food for dust mites," she says.
A hose with a rubber edge will pick up the smallest flakes. Buy a portable hand-held model for your car and travel. And if you get tired of pushing the vacuum, a robotic one can do the work for you.
2. Go Deep
Psoriasis flakes can go deeper into your carpets than your vacuum can reach. When Latella tore up the wall-to-wall carpeting in his home, he was surprised by what he found.
"The scales had worked their way down through the fibers of the carpet. It was just powder underneath," he says.
Have your carpets deep cleaned every 6 months to pick up the scales your vacuum cleaner misses.
3. Sweep Them Away
Hardwood or linoleum floors make it easier to clean up flakes. You simply sweep them up with a broom or brush. A broom with softer bristles may make it easier to pick up the scales, Latella says.
4. Scrape Them Off
Latella found his own solution for flakes that covered the bed while he slept.
"I made a hard card out of plastic. In the morning, I'd scrape the scales into a pile and throw it out." Any hard-edged surface will help you collect the flakes more easily.
5. Roll Them Off
Scalp psoriasis can dust the shoulders of your shirt, much like dandruff. A lint roller or brush is an easy way to remove flakes that fall on your clothes.
"These scales are not sticky," Jacob says. "They're not going to stick to your clothing."
She also suggests wearing light-colored clothes to hide any flakes that do fall.
6. Go Long
If your arms and legs shed a lot, wear long pants and long-sleeved shirts with buttoned cuffs when you go out. Your clothes will catch the flakes before they fall.
7. Wash Them Off
Wash your sheets and clothes more often to get rid of the scale buildup, Jacob suggests. Use a gentle detergent that won't irritate your skin.
8. Filter Them Out
Install an air filter in your home to trap psoriasis particles. This will keep the flakes from floating in the air. Or use a vacuum cleaner with a built-in filter.
David Pariser, MD, professor of dermatology, Eastern Virginia Medical School.
National Psoriasis Foundation: "Life With Psoriasis."
John Latella, patient, Windsor, CT.
Carolyn Jacob, MD, founder and director, Chicago Cosmetic Surgery and Dermatology, Chicago.