Psoriasis Treatments

Although there is no cure for psoriasis there are several treatments that can effectively manage the symptoms and help to clear up plaques. Psoriasis can be a life-long condition that comes and goes so it is important to establish a treatment routine for when symptoms occur.

First line treatments for psoriasis are usually enough to manage the symptoms, particularly in milder cases. First line treatments are topical which means they are applied to the skin.

If your psoriasis does not respond to first line treatments, or is severe, your doctor may recommend second line treatments.

First Line Treatments

Emollients and Moisturisers. Emollients and moisturizers form the mainstay of psoriasis management. These help to keep the skin moist and supple, reducing redness, scaling, dryness and cracking. Choosing the right moisturizer or emollient will depend on your psoriasis and your preferences. The general rule is the more greasy and thick an emollient is, the more effective it will be, but these can also be unpleasant to use. Choose one that you are most likely to use on a regular basis. Try to moisturize at least twice a day and always after a bath or shower as this helps to keep moisture in the skin. It’s worth using a soap substitute when bathing or showering.

Coal Tar: Coal Tar is effective but can leave an unpleasant smell and stain clothing and bed linen. Coal tar can relieve the itching as it has mild antiseptic and anti-inflammatory properties. Coal tar is thought to inhibit DNA replication which can slow down new cell production. This helps to reduce the thickening of the skin that is common in psoriasis.

Topical Steroids: Topical steroids may be used sparingly and for a short time. Topical steroids damp down activity of the immune cells through anti-inflammatory and immunosuppressive properties.  The problem with steroids is the potential for side-effects when used for long periods of time.

Vitamin D Derivatives. Alternatively your doctor may prescribe a topical preparation containing a Vitamin D derivative. This is usually applied twice a day. It has no smell, does not stain clothing and is usually effective in about four weeks. You should follow the advice of your doctor as this treatment should not be used on the face or in the folds of the skin. As they are not steroids these treatments may be safer for longer term use.

Other Treatments

Light Therapy: For widespread psoriasis that does not respond to topical treatments, therapeutic exposure to ultra-violet light can be very effective.

PUVA therapy: Involves using UV light therapy together with psoralen, an oral drug that makes the skin more sensitive to the effects of light.

Sunlight: Regular short doses of sunlight can help. Moderate exposure to the affected areas can be very beneficial during the summer months.

Oral and intravenous medication: In very severe cases of pustular psoriasis for which topical preparations may not be effective, treatment with oral or intravenous drugs may be recommended. The drugs for this treatment include Retinoids, the anti cancer drug methotraxate and the immunosuppressant drug cyclosporin.

Chinese herbs: Chinese herbs in tablet, infusion and cream can be very successful and are always worth trying.

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