Treatment of Psoriasis
There is no cure for psoriasis at this time, but there are various treatments that can, in most cases, temporarily clear the skin of psoriasis. Occasionally, psoriasis will go into spontaneous remission without treatment. If the psoriasis does not clear up, the following is a list of available treatment methods:
- Topical Therapy (used to treat mild to moderate psoriasis):
- Emollients (moisturizers) help soften scales and reduce discomfort
- Steroid creams and ointments help reduce inflammation. They range in strength from very potent to mild. (View list of topical steroids).
- Tazarotene (Tazorac) is a topical retinoid for treating mild to moderate plaque psoriasis
- Anthralin helps slow skin cell reproduction
- Coal tar preparations
- Vitamin D3 or calcipotriene (brand name Dovonex)
- Bath solutions, such as mineral salts or oatmeal additives, assist in soothing skin and encouraging healing
- Sunbathing. Exposure helps about 95 percent of all people who tan easily. This must be practiced cautiously by those who sunburn easily.
- Phototherapy(used alone or in combination with topical therapy to treat moderate to severe psoriasis):
- Lasers, pulsed dye and excimer, are used to treat a small, localized area of psoriasis. They work by destroying the tiny blood vessels that contribute to the formation of psoriasis lesions.
- Ultraviolet Light B (UVB), either outdoors or from a light box in a physician's office, helps to heal lesions.
- Day Treatment Program helps heal lesions.
Psoralen and Ultraviolet Light A (PUVA) - PUVA involves the combined use of a photosensitizing medication, called psoralen and a long-wave ultraviolet light (UVA).
Combination therapies can also help.
Internal Medications (used for severe psoriasis):
Biologic drugs are taken from living material (human, plant, animal, or microorganism). They act on parts of the body's immune system to prevent inflammatory disorders, including psoriasis. Unlike drugs that suppress the entire immune system, biologics can fight more selectively and target only those chemicals involved in causing psoriasis. Only recently have biologics targeted toward psoriasis begun to emerge as potentially promising new treatment options. Etanercept (Enbrel), and infliximab (Remicade) belong to the class of biologic medicines called tumor necrosis factor (TNF) blockers. These work by blocking the activity of TNF, the primary cytokine involved in psoriasis. Alefacept (Amevive), and efalizumab (Raptiva) are T-cell blockers and block the overactive T-cells.
Methotrexate (MTX) helps to slow down cell reproduction.
Retinoid Therapy, including etretinate (Tegison), isotretinoin (Accutane), and acitretin (Soriatane), helps to reduce inflammation
Hydroxyurea (Hydrea)
Sulfasalazine helps reduce inflammation.
Cyclosporin A
Trial and error will tell which treatments are effective for each individual. Healing can take as little as a few weeks or as long as several months. Dermatologists may rotate patients through many different therapies to avoid long-term side effects and to determine which ones work best for that individual.
Self Care
Keep skin lubricated. Oils, creams and petroleum jelly preparations are suggested.
Use a humidifier in the home.
Get out in the sun.
Bathing in hot water may help reduce scaling.
Use mild soaps or soap-free cleaners. Mild soaps such as Nivea Cream, Neutrogena Dry Skin, Phisoderm, Gentle Cleansing Bar, Dove, Dial or Lever 2000 are recommended.
Minimize stress.
Protect against skin injuries and skin infections.
Questions To Ask Your Doctor About Psoriasis
What form of psoriasis is this?
How severe is the psoriasis?
Can it increase in severity or spread?
What are the chances that another rheumatic disease may develop?
What type of treatment will you be recommending?
What measures can be taken to help prevent reoccurrence?
If over-the-counter lotions are recommended, which ones seem to be most effective?
If a biopsy is recommended, what will the result tell you?