Psoriasis treatments
Psoriasis is incurable, but it responds to topical and systemic treatments
Although psoriasis is incurable, it responds to topical and systemic treatments. Topical treatments that may be effective to treat mild psoriasis include creams, lotions, and sprays. Moderate-to-severe psoriasis may require treatment with ultraviolet light treatments or medications.
Topical treatments for psoriasis are applied directly on the affected parts without the risk of side effects. They include:
Topical corticosteroids: Topical corticosteroids such as hydrocortisone are often the first-line treatment for psoriasis. Hydrocortisone treats psoriasis in the following ways:
- Reduce inflammation
- Relieve itching
- Block the production of cells that are overproduced in psoriasis
However, there may be few side effects associated with a stronger dose such as follows:
- Burning sensation
- Dryness
- Irritation of the skin
- Thinning of the skin
Coal tar: Coal tar is often the first-line treatment for psoriasis, and it reduces:
- itching and flaking.
- redness, swelling, and scaling.
- rapidly growing cells.
It is available in shampoos, bath solutions, and creams. The major advantage of coal tar is the lack of skin thinning.
Calcipotriene- and Calcitriol-containing topical ointment: It mainly affects calcium metabolism. Combining calcipotriene and a topical steroid may be more effective in treating psoriasis than using calcipotriene alone. Prolonged use of calcipotriene on more than 20% of the skin surface can lead to an abnormal increase in body calcium levels.
Salicylic acid: Salicylic acid cures psoriasis by
- removing and softening the scale.
- reducing swelling.
Salicylic acid is mainly found in products used for treating scalp psoriasis; however, using it beyond the instructions may worsen the symptoms of psoriasis. Other ingredients that are equally effective as salicylic acid include:
- Urea
- Lactic acid
Moisturizers: Moisturizers relieve dryness and help in skin healing. Applying moisturizer once a day helps to treat psoriasis. Moisturizer should be fragrance-free and should be greasy and oily.
Prescription retinoids: Synthetic form of vitamin A can improve psoriasis. These do not provide a quick response as steroids.
Phototherapy or light therapy may also improve psoriasis. Getting a daily dose of sunlight can help manage psoriasis lesions in many people. Physicians may also use artificial light sources to heal psoriasis. Artificial light sources include PUVA, UVB, and narrow-band UVB. PUVA (a combination of the drug psoralen with ultraviolet A, or UVA, light) is one of the most effective treatments. It has a risk of skin cancer. The physician may prescribe ultraviolet B light and narrow-band UVB therapy as an alternative and effective treatment. Newer therapy such as lasers and photodynamic therapy help in improving psoriasis. Photodynamic therapy utilizes a light-activating medication and a special light source to treat psoriasis.
Natural therapy for psoriasis may be useful when all other therapies fail. The most commonly used natural remedies include:
- Aloe vera: It soothes the symptoms of psoriasis.
- Fish oil: It must be taken through an intravenous (IV) route that may help to improve psoriasis symptoms.
- Cayenne pepper: It contains capsaicin, which may relieve itching and skin lesions.
- Dead sea salts, Epsom salts, oatmeal: They may remove scales and ease itching.
- Mediterranean diet or anti-inflammatory diet: It may help to curb the symptoms of psoriasis.
Oral medications and injections may include:
- Trexall (methotrexate)
- Soriatane (acitretin)
- Neoral (cyclosporine)
- Otezla (apremilast)
- Humira (adalimumab)
- Remicade (infliximab)
- Orencia (abatacept)
- Cosentyx (secukinumab)