Psoriasis 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)
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