Psoriasis Treatment

Psoriasis is a chronic and unpredictable skin condition. It is estimated that 7 million Americans suffer from the condition, with countless others all over the world making effective psoriasis treatments of vital importance to many people world wide.

New psoriasis treatments are making the management of this condition easier as many recently developed treatments are offering a greater chance of remission with less side effects. A long term psoriasis treatment that best suits the individuals life style is required.

Psoriasis treatments are many and varied. They range from topical (applied to the skin), systemic (taken internally) and phototherapy (ultraviolet light applied to the skin). Whilst some psoriasis treatments are used individually the possibility of combining the treatments offers greater hope for those who struggle to find therapies to assist with the chronic condition.

Below is a brief outline of the psoriasis treatments in use today.

TOPICAL TREATMENTS

These are the treatments that are applied directly to the affected skin. It is the first form of treatment for the psoriasis sufferer and is often sufficient for effective relief of mild psoriasis. A topical treatment will be used in conjunction with other treatments when the psoriasis is more severe.

Moisturizers: The easiest and least expensive form of treatment which will soften the skin and help relieve the itching. For some the use of moisturizers alone will be sufficient to offer long term relief of the psoriasis. Ensuring the skin is kept moist will also help to prevent new lesions being triggered.

Corticosteroids: Corticosteroids are available in a variety of forms including creams, gels, sprays, ointments and lotions. They come in varying strengths and may reduce skin inflammation. Ideally steroids should be used for limited periods of time as misuse or over use can result in thinning of the treated skin or even in making the psoriasis worse.

Coal Tars: A very old form of treatment for psoriasis, coal tars are still popular today. Although less effective than topical steroids they have few side effects and are safe to use. For increased effectiveness they are often used in combination with phototherapy treatment.

Anthralin: Another old treatment. Anthralin is a synthetic chemical that is believed to act on psoriatic lesions by normalising the DNA activity and reducing inflammation. It is often used in combination with UVL therapy.

Vitamin D Derivatives: A relatively new form of treatment, calcipotriene is a synthetic form of vitamin D. It is thought to slow down the turnover rate of diseased skin cells. It is used only in the treatment of mild psoriasis and is often combined with other forms of treatment.

Vitamin A Derivatives: Tazorac is a fast drying, odourless, non staining gel. It is also a new synthetic form of vitamin A, which is proving effective in the treatment of psoriasis of the scalp and nails.

SYSTEMIC TREATMENTS

These are medications which enter the body either orally or by injection. They are used primarily to treat moderate to severe psoriasis and can produce remarkable clearing of the disease. They are given under close medical supervision and monitoring as they are strong medications.

Methotrexate: This as an antimetabolite which means it interferes with skin cell growth, thus reducing psoriatic skin cell production and suppressing inflammation. Methotrexate is often called for when more conservative forms of treatment have proved ineffective. It is especially useful in the treatment of generalized pustular psoriasis, psoriatic arthritis and disabling psoriasis of the palms and soles.

Corticosteroids: Systemic corticosteroids are rarely used in the treatment of psoriasis anymore due to the possibility of them causing a severe outbreak of psoriasis. On rare occasions they are used in conjunction with methotrexate in acute psoriasis for a short period and under close monitoring.

Oral Retinoids: These are synthetic derivatives of Vitamin A and directly affect the growth and differentiation of skin cells. The drug can clear the disease and help the skin stay clear for up to a year. However this form of treatment is only suitable for some people.

Cyclosporine: This drug is typically used to put the disease in remission when people have severe, disabling and uncontrollable psoriasis or psoriatic arthritis. The drug is derived from fungi and found in soil and is a potent immunosuppressant. For the psoriasis sufferer the drug will slow down the abnormally rapid skin cell turnover and reduce the number of activated white blood cells in the skin. Studies show the drug will benefit about ½ the patients who use it and can result in remission in about 16 weeks. It is reserved for treatment of psoriasis that does not respond to other therapy.

ULTRAVIOLET LIGHT THERAPY

It is unknown why but most people suffering from psoriasis respond well to ultraviolet light (UVL) which occurs naturally in sunshine. UVL works best when used in conjunction with topical medications.

Natural Sunlight Therapy: Many can achieve a temporary remission when natural sunlight is used as a part of their treatment regimen. It is important to seek medical advice prior to using the sun to help clear up your skin simply to determine how much sun your skin can safely take. Natural sunlight therapy requires a regular schedule, persistence and care to prevent over exposure.

Photochemotherapy: This is a very reliable and frequently used form of treatment for people with severe to moderate psoriasis covering 1/3 or more of their body. It combines the use of the drug psoralen with UVA light and is more commonly called PUVA Therapy. PUVA Therapy is often used in rotation with other forms of treatment like methotrexate and cyclosporine.

Mel Sinclair, RN