The psoriasis itch I cannot scratch - when injury strikes

The psoriasis itch I cannot scratch

Recently, I managed to break a few bones, which resulted in one of my hands being out of action. I thought I'd share my experience of how my skin reacted and what it's like to have psoriasis whilst in a cast. Hopefully it will be useful should anyone else find themselves in the same unfortunate situation.


While I was having my arm put in some kind of medieval torture device and as two nurses (one 6'5") and Doctor Dan were all pulling in three different directions to put my bones as close to back into place as possible, all I could think about was how exposed I felt with my patchy elbows on show. It was then that I realised I'll be digging out the old t-shirts for a fair while to come.

The senior nurse in the manipulation room of orthopaedics told me how some psoriasis patients are in there every week having their plaster off to allow some form of brief topical treatment to their skin and then to have a new plaster put on. Bear in mind the area must be completely dry before a new plaster can be applied and it's not uncommon for the nurse setting the plaster to rub the area quite vigorously with a paper towel.

A chance to moisturise is great but once a week or once every two weeks in my experience really isn't enough to make a real difference to your skin or comfort. For me the trip to the hospital, long wait, the discomfort of having a plaster removed and a new one put on really doesn't justify the half hour of brief relief. However, I can see the psychological benefit of getting the chance to free your skin once or twice from its cocoon.

Matt arm in plaster with psoriasis

The itch you cannot scratch

Did it itch? Yup, like crazy but at the beginning I couldn't tell you if that was psychosomatic or not as the more I distracted myself from it the less it appeared to itch.

I decided quite early on to go for a treat-what-you-can plan. The idea being to try to pretend the skin under the plaster didn't exist until it appeared from it. You can't get near the covered skin and trying to force thin objects under your cast is a definite no no. You could damage your skin which could become infected and you wouldn't know. So try to take your mind off it as much as possible.

Sadly, the longer the damaged area was encased the more the itch began to drive me slightly crazy and almost felt like a burning sensation. What I did find was that the cooler I managed to keep the area, the better it felt. It felt like there was less inflammation, itching and the burning sensation disappeared.

Here are a few photos and X-rays of my injury.

Xrays with psoriasis

Keep cool

Keeping the area cool is key. I went through splints, casts and surgical dressings covered by a restrictively tight bandage and metal support. Ensuring the area was kept as cool as possible throughout was the key to keeping the dreaded itch to a minimum.

One important thing I did learn along the way is to ask or in some cases beg, plead or insist on a synthetic cast. Normally synthetic is a bad word in the psoriasis community but in this case a synthetic cast is a God send. A Plaster of Paris cast, or POP, is a heavy non-breathable plaster cast which doesn't allow for any skin inflammation and becomes incredibly hot and uncomfortable. Whereas a synthetic cast is usually made from polyester or fibreglass and is much lighter with more chance to let your skin breathe.

Do not be afraid to tell the fracture clinic if the plaster is too tight, rubbing your skin too much or that your skin is too painful to cope with. They will understand and they will remove it and try their best to replace it in a slightly more comfortable way (generally, slightly looser). This may also give you a chance to moisturise your skin.

An ice pack or, the old favourite, a bag of frozen peas at each end of the cast is not to be underestimated. It provides an amazing amount of itch and pain relief albeit only temporarily. Reapply when the itch strikes. Warning - it can be very addictive!

It is not unheard of for people to use fans or even a vacuum or vacuum aided cooling device to try to cool the area under the cast. I personally wouldn't recommend these methods as whilst they may provide a small amount of brief relief, in the long run they are only aiding in drying your skin further which may lead to more itching and irritation.

I split a bag of frozen peas and put a small amount in multiple food bags so I always had some ready to use. Small is cool. Two small amounts of frozen peas at each end of the cast worked wonders for me, wrapped in a tea towel to ensure there were no freezer burns.

Frozen peas cool psoriasis itch

Flare Trauma

The trauma of the injury and for me the subsequent surgery did make my psoriasis flare quite badly. For the first time, I could no longer moisturise or treat my skin completely by myself. Asking my partner to help felt uncomfortable but I soon realised that it was only me that felt that way. It may feel like a big step asking someone to help you but short of filling a bath with emollient it's sometimes a step you need to take. I'm sure like in my case they will want to help. Once again, for me the biggest step is the one that takes me over my own psychological psoriasis barrier.

Try your best to keep cool in body and mind.

You can get in touch with Matt via Twitter or via his blog.

This content is not intended to advise you about your health. Always seek advice from your doctor or other qualified healthcare professionals.

UK/IE MAT-06964. Date of Prep: January 2017

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