Treating Psoriasis

For people with psoriasis, there are a number of traditional as well as newer treatments available. Finding the right treatment may involve a period of trial and error, since symptoms may vary by frequency or intensity. Talk to your doctor about which treatment is most appropriate for you.

Topical therapy

Topical treatments such as ointments and creams are often used to treat mild to moderate psoriasis. Topical treatments include corticosteroids, which are anti-inflammatory ointments often applied to sensitive areas such as the face. They vary in strength and can quickly relieve symptoms. However, resistance to corticosteroids may develop quickly, and symptoms often become more severe once treatment stops.

Other topical treatments include:

• Anthralin – An anti-inflammatory cream that goes on the skin briefly and is then washed off. Anthralin is often used in combination with light therapy.
• Coal tar – Perhaps the oldest treatment for psoriasis, coal tar is made from the manufacture of gas and coke. Coal tar is used to treat all types of skin lesions.
• Moisturizers – Moisturizers cannot treat psoriasis, but they may help reduce itching and scaling, as well as combat dryness that may result from the use of topical or oral therapies. Heavier, oil-based moisturizers that are unscented are recommended over lighter, perfumed lotions.
• Salicylic acid – An ingredient that is used to remove scales. It is often used in combination with topical steroids, anthralin, or tar to increase its effectiveness. Salicylic acid is available both over-the-counter and by prescription from a doctor.
• Topical retinoids – These topicals are derivative of vitamin A and vitamin D, delivering powerful doses of vitamin-like chemicals directly to the skin in the form of a cream. Retinoids produce minor side effects such as skin irritation. They are also available as oral medications.

Light therapy

Light therapy, also called phototherapy, can either involve the use of natural or artificial light.

The easiest way to employ light therapy is to expose the skin to the sun. Research has shown that moderate amounts of sunlight can improve symptoms of plaque psoriasis. The key is moderation, however, since sunburn can actually worsen psoriasis symptoms and put you at greater risk for skin cancer.

Psoralen UVA (PUVA) therapy is a more aggressive treatment that a physician will administer. Psoralen is an oral and topical medication taken before exposure to ultraviolet A (UVA) light. This therapy helps to suppress the growth of skin cells in severe psoriasis. However, long-term treatment is not recommended since increased exposure to ultraviolet light can increase the risk of skin cancer.

Often physicians will use different types of combination light therapy. This therapy combines ultraviolet light treatments with other medications such as retinoids, coal tar, or anthralin.

Oral medication

• Retinoids – The oral version of the vitamin D/vitamin A formulation.
• Methotrexate – An anti-inflammatory medicine that helps to treat psoriatic arthritis symptoms and helps to suppress skin cell production in people with psoriasis.
• Cyclosporine – This anti-inflammatory helps to suppress the immune system and is used to treat both skin and joint symptoms. Side effects include increased risk for infection, high blood pressure, and kidney disease.

Biologics

Some biologics have been approved for the treatment of psoriasis. Biologics selectively interact with processes in your body to treat a number of diseases and their symptoms. They can be effective in treating moderate to severe psoriasis.

Alternative therapies and self-care

In addition to prescription medications, there are many ways people with psoriasis can help to manage symptoms, such as use of moisturizers, baths, and ointments and sun exposure.

Balneotherapy refers to water treatments such as hot springs, mineral water, or sea water. These treatments help soothe and exfoliate the skin and relieve symptoms such as itching and irritation.

People may also combine sun exposure and water therapy to treat symptoms. This is called climatotherapy.

Other natural substances such as aloe, oats, Evening primrose oil, and tea tree oil can help to keep the skin moisturized and reduce itching and inflammation among people with mild to moderate psoriasis. Apple cider vinegar may be added to baths as a disinfectant or can be used as a cleansing agent for fingernails and toenails affected by psoriasis.

Next: Living with Psoriasis