Getting the right treatment
Once you develop psoriasis, the skin condition is likely to come and go in various different forms on your body. However, if you use a medication specifically prescribed for your psoriasis in the correct way, it is possible to manage your condition. This will allow you to focus on feeling confident and getting the most out of your life.
From mild to severe, there are many different treatment options to help control and alleviate psoriasis symptoms. You can discuss your options with your doctor and together find the treatment that is best for you.
What exactly is psoriasis?
Psoriasis is a chronic disease that appears on the skin. It occurs when the immune system sends out faulty signals that make new skin cells grow too quickly. With psoriasis, the normal cycle of skin cells, which usually takes about a month, is sped up to a cycle that is completed in just a matter of a few days. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and ‘plaques’ form.
There are seven types of psoriasis. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white build-up of dead skin cells. Psoriasis can occur on any part of the body and may, in some cases, be associated with other serious health conditions, such as diabetes, heart disease and depression.
Who is affected by psoriasis?
Anyone can develop psoriasis. It is equally common in men and women, and affects approximately 100 million people, about 2-3% of the global population.
Psoriasis can start at any age, but most people develop psoriasis in between the ages of 15-35. Each person’s experience is completely different; similarly, the emotional and psychological impact of psoriasis can affect individuals in different ways.
Everything you need to know about psoriasis treatment
There are many different treatment options to help manage and alleviate psoriasis symptoms. You can discuss your options with your doctor and together find the treatment that is best for you. Treatments range from creams and gels to tablets and injectable medication, and even light therapy. The treatment prescribed will depend on many factors, such as the physical severity of the disease and what will best fit with your lifestyle and personal needs. The following information about treatment options will help you find the most effective way to manage your psoriasis.
Over-the-counter topical treatmentsThere are many topical treatment options available to you. Topical medications – typically a cream, gel or an ointment applied directly to the skin – are commonly prescribed by your doctor as first-choice, also known as first-line treatments, to manage mild to moderate cases of psoriasis. You may also want to mention to your doctor if you are finding your medication too time-consuming or greasy to apply, as there may be a preferable alternative. The following over-the-counter (without prescription) medications are available:
- Steroids (also called corticosteroids) – facilitate slowing down cell growth and reduce inflammation. It is advised that this treatment is only applied to the affected area and used for a short period of time due to the possibility of various side effects, such as thinning of skin. Alternatively, milder options such as hydrocortisone, which can be purchased at your local pharmacist may be a more suitable option.
- Moisturisers – moisturising creams and lotions soften and rehydrate the skin and provide a protective barrier, helping to keep the skin comfortable, reducing itching and scaling.
- Coal tar – has been used for decades to treat psoriasis due to its anti-inflammatory and anti-scaling properties. Available as lotion, cream, solution and shampoo for scalp psoriasis, as well as oil for use in the bath or shower. Coal tar products should be carefully considered, as they may irritate the skin, making the skin more sensitive to sunlight and even promote skin cancer; It is important to therefore attend regular check-ups and monitor for any changes to the skin when using the substance.
- Salicylic acid ointments – used for a variety of different skin conditions, salicylic acid ointments work as a peeling agent to shed the outer layer of the skin. The ointment can benefit patients with psoriasis by softening the skin and reducing the appearance of silvery scales. It is important to note that the ointment can cause skin irritation and may also lead to temporary hair thinning or hair loss.
Prescription topical treatments
More potent topical treatments for psoriasis are available on prescription and include:
- Dithranol: a topical treatment that comes in a cream, gel, ointment or paste and is good for chronic scaly psoriasis.
- Topical retinoids: these are derived from vitamin A and can reduce the thickness of psoriasis plaques by slowing skin cell growth.
- Topical steroids: often come in a cream, gel or ointment formulation, and are measured in strengths of 'mild,' 'moderate,' 'potent' and 'very potent'. They are used to reduce inflammation and may be useful to use on thickened plaques of psoriasis which appear on the palms and soles.
- Vitamin D3: topical forms of synthetic chemically produced vitamin D analogue to help slow down the growth of skin cells and remove scales.
- Combination fixed-dose products: combine a topical steroid and topical form of vitamin D, coal tar or salicylic acid in one treatment to slow down the development of skin cells as well as to suppress inflammation.
- Biologics: a type of medication that targets specific parts of the immune system that play a major role in developing psoriasis and psoriatic arthritis.
- Immunosuppressants: used to treat severe psoriasis and also works to suppress or reduce the body's immune response.
- Cytotoxic drugs: work by binding to and inhibiting an enzyme involved in the rapid growth of cells. They also slow the rate of skin cell growth.
- Oral retinoids: these are synthetic (chemically-produced) forms of vitamin A that work to re-establish a more normal pattern of cell growth. This can help decrease the scale and thickness of psoriasis plaques, as well as decrease inflammation. Oral retinoids are often used to treat severe psoriasis – including plaque, guttate, erythrodermic and pustular psoriasis.
The process can be conducted at home or at a dermatologist’s office, however it is imported to note that an indoor tanning machine is not a suitable substitute for a phototherapy unit. Beneficial effects can also stem from exposure to natural sunlight; however, you should take care to protect yourself from sunburn, which can make your psoriasis worse and increase your risk of skin damage and skin cancer.
While there remains little evidence to prove the effectiveness of natural skin remedies, many individuals chose to use them to help reduce the appearance of psoriasis plaques. The range of natural medicines available to purchase include aloe vera, tree oil shampoo or apple cider vinegar (applied to the scalp), Dead Sea bath salts and consuming turmeric. When incorporating any of the above in a psoriasis treatment plan, it is important to work in partnership with your dermatologist to ensure they are safe to use alongside other medication.
Coping with psoriasis
Everyone copes with psoriasis differently and the choice of therapy should be based on conversations between you and your doctor. A treatment which works well for one person may not work for another. And in some cases, a treatment that has previously worked well for someone may not be the right choice for them in the future. So work with your doctor to find the right treatment for you. Once he has a clear picture of your preferences and lifestyle, he will be able to create a treatment plan that works for you. Your doctor will also be able to help you overcome any issues with the treatment, to keep you on track.
UK/IE MAT-09232 Date of prep: May 2017