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Psoriasis Treatment

Psoriasis treatment is aimed at accomplishing 2 main objectives:

Psoriasis

– Treat psoriasis symptoms by removing scales and plaques
– Treat the underlying causes of psoriasis thus reducing inflammation and symptom appearance and severity

Generally, psoriasis treatment methods can be subdivided into 4 categories:

1. Topical Applications
2. Light Therapy
3. Systemic Applications
4. Dietary/Exercise Interventions

1. Topical Applications

Various topical drugs exist in the form of creams and lotions for psoriasis treatment of milder cases. As a case of psoriasis worsens it becomes increasingly difficult to manage plaques and scales through topical medications alone, particularly when they appear on a large percentage of the body.

However, there are several topical psoriasis treatment options worth learning about.

Moisturizing Creams: These creams and ointments can be useful in reducing dryness, peeling and flaking of psoriasis plaques although they don’t treat the plaques themselves.

Salicylic Acid: This common over-the-counter cream is used widely as an acne medication due to its property of promoting sloughing of the skin. This medication is available in creams and shampoos for those with scalp psoriasis.

Calcineurin Inhibitors: This class of drugs is so far only approved for treating atopic dermatitis. However, they show promise as a psoriasis treatment option by virtue of their presumed ability to interfere with T-cell activation, which counters inflammation and plaque formation. Calcineurin inhibitors show particular promise in treating areas of fine skin such as those near the eyes, where other treatments are considered too risky to be used. This requires specific doctor approval and is not intended for long term use due to its carcinogenic potential.

Coal Tar: This is a very old psoriasis treatment whose mechanisms of action have not yet been completely elucidated. Coal tar curbs itching, scaling and inflammation and has few noted side effects. However, it creates quite the mess, stains clothing and has a powerful odor.

Corticosteroids: This class of immunosuppressant drugs is widely prescribed for psoriasis treatment in mild and moderate instances. Corticosteroids act to slow down the skin cell renewal cycle which helps curtail inflammation and itching. These drugs diminish in efficaciousness with prolonged use and so are generally used during a flare-up. Corticosteroids vary in potency and are prescribed on a case-by-case basis.

Anthralin: This psoriasis treatment is thought to work by normalizing DNA activity in the skin cells. It can be used for scale removal and skin smoothening although it stains everything it comes into contact with including skin. It can be found under the name Dritho-Scalp.

Vitamin D Analogues: These synthesized compounds are similar to vitamin D in chemical structure. They are usually applied as a topical psoriasis treatment and are often used in combination with other therapies to treat mild to moderate psoriasis cases.

Retinoids: These are Vitamin A-derived compounds that are thought to exert a normalizing effect on skin cell DNA and reduce inflammation. However, they commonly cause skin irritation.

2. Phototherapy (Light Therapy)

Phototherapy is a psoriasis treatment that uses measured quantities of light, natural or artificial, to mitigate scales, plaque formation and inflammation.

Natural sunlight exposes the patient to UV (ultraviolet) radiation but must be taken in piecemeal or symptoms can worsen rather than improve.

There are several auxiliary light treatments available as well.

UVB Light Therapy: Also called broadband UVB phototherapy, this procedure involves exposure to UVB rays from an artificial light source to treat psoriasis plaques

Narrowband UVB Therapy: A fairly novel psoriasis treatment, narrowband UVB therapy may be more efficacious than broadband UVB therapy but also carries the risk of more severe impact on the skin.

Excimer Laser: This psoriasis treatment is similar to narrowband UVB therapy and utilizes UVB light of a particular wavelength. The treatment is effective but blistering may result.

Pulsed-Dye Laser: This psoriasis treatment uses a different type of light to cauterize small blood vessels that contribute to psoriasis plaques. Skin may be bruised after treatment and scars are a potential complication.

Goeckerman Therapy: A combination of UVB and coal tar. The coal tar renders the skin more receptive to UVB light thus making for a more powerful therapy than either of the two alone.

Photochemotherapy: This psoriasis treatment entails taking medicine which sensitizes the skin to light and then exposing it to UVA rays. This treatment is often used for rather severe and intransigent cases of psoriasis. The treatment does, however, carry some serious potential complications such as increased risk for melanoma.

3. Systemic Psoriasis Treatment – Oral And Injected Therapies

There are several oral and injectable psoriasis treatment options available. These treatments are typically reserved for extremely stubborn and severe cases of psoriasis due to their severe side effect potential. As such, they are typically prescribed for one-off use or short courses.

Cyclosporine: An immunosuppressant drug used to alleviate inflammation and plaque formation. As with all immunosuppressants, rather serious side effects are a possibility.

Methotrexate: Reduced skin cell production and mitigates inflammatory response. Used for prolonged periods, methotrexate can cause severe side effects.

Hydroxyurea: A less efficacious drug than the first two. Unlike them, this one can be used in combination with phototherapy. Possible side effects include anemia and depletion of red and white blood cells.

Retinoid Drugs: These compounds related to Vitamin A may help to slow the skin cell production cycle. Significant birth defects may result in women using this therapy.

Thioguanine: About as efficacious as the first two oral drugs listed, this psoriasis treatment may also cause anemic status and result in birth defects.

4. Dietary And Exercise Interventions

Diet is a big part of psoriasis treatment so see psoriasis diet for information on adopting an anti-inflammatory diet and exercise regime that can exert significant influence on symptom reduction and elevating quality of life.