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Understanding Psoriasis -- Treatment

What Are the Treatments for Psoriasis?

Despite the fact that psoriasis is incurable, it responds well to many topical and systemic treatments. Even people with severe psoriasis can get relief during flare-ups in about 85% to 90% of cases.

Topical Treatments for Psoriasis

Topical treatments are rubbed directly into the affected skin to bring local relief without the system-wide side effects of medicines taken by mouth. Topical treatments for psoriasis include:

Salicylic acid. Some doctors recommend salicylic acid ointment, which smoothes the skin by promoting the shedding of psoriatic scales. Using salicylic acid over large areas of skin, however, may cause the body to absorb too much of the medication, leading to side effects. Salicylic acid may also cause skin irritation and weaken hair shafts, which can cause breakage and temporary hair loss. The effectiveness of these preparations are modest at best.

Steroid-based creams. The mainstay of psoriasis treatment, steroid creams decrease inflammation, relieve itching, and block the production of cells that are overproduced in psoriasis. Stronger preparations, which are more effective than milder ones, can cause side effects that include burning, dryness, irritation, and thinning of the skin. Be especially careful to follow your doctor's instructions on their use. 

Calcipotriene-containing topical ointment. Calcipotriene, which is related to vitamin D, has proven to be effective for treating psoriasis, especially when combined with a topical corticosteroid cream. It's best to use only limited amounts to avoid side effects. 

Coal-tar ointments and shampoos. These products can help slow the rapid growth of skin cells and alleviate symptoms, but some people are vulnerable to the side effects, especially folliculitis, a pimple-like rash affecting the hair follicles. These medicines should be used only under a doctor's supervision. 

Prescription retinoids. These topical preparations containing a synthetic form of vitamin A can help improve psoriasis. These preparations don't work as quickly as steroids. Topical retinoids can sometimes cause dryness and irritation of the skin.

Light Therapy for Psoriasis

Even regular doses of sunlight -- not enough to produce sunburn -- can help psoriasis lesions in many people. For persistent, difficult-to-treat cases of psoriasis, many doctors recommend light therapy. One of the most effective treatments is PUVA (the drug psoralen combined with ultraviolet A, or UVA, light). However, this form of therapy is used far less often today, because it has been shown to increase the risk of developing skin cancer -- even decades after stopping this therapy. 

Some doctors may prescribe ultraviolet B light (UVB) treatment using a light box alone or with other therapies such as coal tar. A more targeted ultraviolet light treatment, called narrow-band UVB therapy, is less carcinogenic than PUVA but almost as effective.

 

WebMD Medical Reference

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