Psoriasis treatment has come a long way in the past 10 years. That's welcome news for the 7.5 million people with this complex skin disease.
"Every year, we've had either a new medication or a new use for one of these medications," says Michael P. Heffernan, MD, a dermatologist with Central Dermatology in St. Louis. These medications have resulted in "a marked improvement in successful treatments."
Could one of the newer medications -- or a drug in the research pipeline -- benefit you? That may depend on how severe your psoriasis is. Many people can control this disease with treatment applied to the skin (topicals) or light treatment (phototherapy). Others need more powerful medicine. Doctors tend to use a stepwise approach to treatment: They start with milder creams and light therapy. If those don't work, they move on to systemic medications.
"You'll often be asked to try older, less expensive medications before getting access to newer ones," said Heffernan, spokesman for the National Psoriasis Foundation. As a result, he says, many people are undertreated. "So you have to be your own best advocate with your physician and the insurance company."
Keep that in mind as you learn more about psoriasis treatment advances and new medications in the research pipeline.
Developments in Topical Treatments and Phototherapy
In recent years, advances with topical therapies have produced new ways to deliver these creams and ointments. This includes sprays and foams and shampoos, as well as more advanced gels and ointments. Many of these treat larger or more sensitive areas more easily, effectively, and safely.
Phototherapy is now available in a more focused form called narrow-band ultraviolet B (UVB) therapy. This lessens the risk of skin cancer.
"People with localized disease can receive treatment to the localized plaque only," Heffernan says. Another newer approach involves combining ultraviolet A (UVA) light with a photosensitizer (psoralen).
State-of-the-Art Biologic Medications
Some of the biggest advances in psoriasis treatment in recent years have come with biologic medications. While older psoriasis drugs suppress the entire immune system, the new biologics mount a targeted attack on the immune system, resulting in fewer side effects. Biologics are created from living cells, and they block proteins (cytokines) or a type of immune cell (T cells).
Heffernan says biologics are helpful for people with disease that covers a large area or that greatly affects their day-to-day life. "Biologics have offered a new long-lasting form of treatment that has been life-changing for many patients," he says.
Biologic agents are exciting not only because they offer good control, but also because they've also filled certain voids, Heffernan says. For example, they are safer than the old drugs for women who want to get pregnant. And many biologics treat psoriatic arthritis as well as the skin disease, he says.