Psoriasis is a chronic skin condition and every approach to the treatment of psoriasis must be considered for the long term. Any treatment regimens must be adjusted for each individual. The adjustment should take into consideration age, occupation, gender, health benefits, available resources, and personal motivation.
The severity of the disease is also defined by the patient’s acceptance and perception of the disease, and not only by the number and extent of plaques present. Rather than just focusing on the extent of body surface area involved, the treatment must be designed with the patient’s specific expectations in mind.
Several treatments exist for this skin condition. However, an effective therapeutic regimen is not hard to construct and necessarily complicated. There are three basic types of treatments for psoriasis: Topic therapy, light therapy (phototherapy), and systemic therapy (oral therapy). All of these treatments can be used in combination or alone.
Topical treatments for psoriasis
Topical treatments are directly rubbed into the skin which is affected in order to bring local relief without the system side effects of medicines taken orally. Topical treatment for psoriasis includes salicylic acid which is recommended by many doctors. Salicylic acid smoothes the skin by promoting the shedding of psoriatic scales.
However, using salicylic acid over large skin areas may cause the body to absorb too much of the medication, which can lead to side effects. Also, salicylic acid may weaken hair shafts and cause skin irritation. Weaken hair shafts can cause temporary hair loss. The effectiveness of these medications is modest at best.
Light therapy for psoriasis
Regular doses of sunlight, which are not enough to cause sunburn, can help psoriasis lesions in a lot of people. Many doctors recommend light therapy for difficult-to-treat, persistent cases of psoriasis. PUVA (the drug psoralen in combination with ultraviolet A light) is one of the most effective treatments.
However, this form of therapy is less often used today, because it can increase the risk of developing skin cancer, even after several decades after stopping this therapy. In addition, some doctors may prescribe UVB (Ultraviolet B-light) treatment using just a lightbox or with other therapies like coal tar. Narrow-band UVB therapy, which is more targeted ultraviolet light treatment, is less carcinogenic than PUVA but almost as effective.
Systemic therapy for psoriasis
When topical and phototherapy treatments fail, some doctors prescribe oral drugs to treat psoriasis, which is known as systemic therapy for psoriasis. Some of these medications may affect your immune system. Methotrexate is one such medication, and it can produce dramatic clearing of the psoriasis lesions.
However, methotrexate can cause side effects, so the doctor who prescribed it should perform regular blood tests. Cyclosporine is also another medication of this type. Oral retinoids, which have vitamin-A-like properties, might be mildly helpful to people who have severe psoriasis. This may be followed by PUVA treatment.
For chronic and milder forms of pustular psoriasis, light treatment or topical treatment may be a better solution. For very active psoriatic arthritis systemic agents may be considered. People whose disease is disabling because of psychological, physical, economic, or social reasons may also be considered for systemic treatment.
In addition, women at childbearing age should use birth control with this medication and for three years more afterward, because it is associated with increased risk for birth defects. Today, newer treatments are available for people with psoriatic arthritis and severe psoriasis.
Some “biologic” drugs made from animal or human proteins focus on controlling the immune response of your body. These drugs are extremely expensive but quite effective. Some of them are ustekinumab (Stelara), etanercept (Enbrel), and adalimumab (Humira).