Getting the right treatments

Psoriasis is a condition where your symptoms may come and go. You may have severe symptoms for a few days or weeks, known as a 'flare-up'. Then periods where your symptoms are mild or have gone completely. There is no cure for psoriasis.¹ However, from mild to severe, there are many different treatment options to help relieve your psoriasis symptoms.^1,2 You can talk to your healthcare professional and together find the right treatment for you.² Using your treatments as discussed with your healthcare professional is the best way to manage your psoriasis.³ This will allow you to focus on feeling confident and getting the most out of your life.

What you need to know about psoriasis treatments

If you have psoriasis, keeping your skin moisturised every day is an important part of caring for your skin. You should use moisturising soaps and apply emollient cream straight after washing to help lock the moisture into your skin. This can reduce the redness and itching and help your skin to heal.⁴

Psoriasis treatments range from topical treatments to tablets, injectable medication, and light therapy.^2,5 Your treatment will depend on many factors, such as the severity of your disease and what will best fit with your lifestyle and personal needs.^2how

All medicines have side effects and precautions that must be followed. Always read the patient information leaflet for any medicine you are buy from you pharmacist or are prescribed by your doctor. Always follow your pharmacist's or doctor's advice when taking a medicine.

Over-the-counter topical treatments

There are topical treatment options available for you to buy from your pharmacist.⁴ If you think you have psoriasis, or have been diagnosed, you should make an appointment to talk to your healthcare professional about what treatments they can prescribe that are appropriate for you. If you have not been diagnosed with psoriasis and are worried that you may have the condition, seek the advice of a healthcare professional.

Prescription topical treatments

Topical treatments are usually the first treatment your healthcare professional will prescribe. They are applied to your skin’s surface and include creams, gels and ointments.² Discuss with your healthcare professional about which formulation will be right for you,² the correct way to apply it^2,6 and what to expect. After the first 4 weeks of starting a new topical treatment you should have a review so your doctor can see how you are getting on.²

Corticosteroids (steroids) help reduce swelling, itching and irritation.⁷ You should only apply steroids to the affected areas of your skin.⁸

Vitamin D formulations can be used alongside steroids,² combined in the same formulation as a steroid,⁹ or on their own.² They may be used during rest periods from steroids.² They stop the skin cells being replaced so quickly⁶ (reducing the thickness of plaques). Vitamin D formulations can be used if you have scalp psoriasis and are intolerant to steroids.²

Coal tar preparations may also be prescribed.² They may be used during rest periods from steroids.² Coal tar might stain your clothes and bed sheets.⁴

Dithranol stops your skin cells being replaced so quickly.⁶ It is usually applied in short contact therapy.² So it is applied and then washed off after an hour, which can be done in the bath or shower.¹⁰ Dithranol cream comes in different strengths. Your doctor should try the lowest strength first and gradually build up until the best dose for you has been found.¹⁰

Salicylic acid-containing products can be prescribed to help remove scales in scalp psoriasis.^2,4,6

Tazarotene ointment contains vitamin A. It stops skin cells being replaced so quickly.⁶

Light therapy

Light therapy (phototherapy) may be recommended if you have plaque psoriasis or guttate-pattern psoriasis that cannot be controlled with topical treatments.² It involves your skin being exposed to ultraviolet light 2 to 3 times a week.^2,6 This will be carried out by a healthcare professional. Phototherapy is not the same as indoor tanning. The use of sunbeds is not recommended to treat psoriasis.⁶

Systemic drugs

If you have severe psoriasis and other types of treatment don’t deliver the desired results, systemic drugs can be an option.^1,2 Systemic treatments are usually given as a pill or an injection.⁶

Systemic drugs may be recommended if:²

• Your psoriasis can’t be controlled with topical treatments and
• It is having a significant impact on your physical, psychological or social wellbeing and
  - It covers more than 10% of your body or
  - It is localised and is causing you significant impairment or distress or
  - Phototherapy has been ineffective or can’t be used

Systemic drugs include:

Immunosuppressants for example methotrexate and cyclosporine.² They work by suppressing your body's immune response.¹

Oral retinoids for example acitretin, a form of vitamin A,¹¹ reduce the rate that skin cells grow.¹¹ Acitretin works slowly. Your symptoms may get worse before they get better. It may take 2 to 4 months for symptoms to improve.¹¹

Apremilast may be used for severe psoriasis.^2,12

Biologics are a type of medication that targets specific parts of the immune system. They are given by an injection or infusion.¹ There a number of different biologics. If one is unsuccessful another can be tried.²

Natural remedies

Natural remedies can complement conventional treatments. They are not backed up by scientific evidence, but many people are convinced that they have benefits. They include: applying aloe vera gel on your skin,¹³ apple cider vinegar on your scalp,¹ using shampoos with tea tree oil,¹⁴ taking a warm bath in Dead Sea salts,⁴ or consuming turmeric.¹⁵ Please always speak to a healthcare professional before trying any natural remedies, as they may have dangerous interactions with other medications.

Coping with psoriasis

Everyone copes with psoriasis differently. A treatment which works well for one person may not work for you.⁵ Work with your doctor. Once they have a clear picture of your preferences and lifestyle, they will be able to create a treatment plan that works for you.^2,5 They will review your treatments,² to help you overcome any issues and keep you on track.