How is psoriasis treated?

Although there is no cure for psoriasis, treatments can reduce the skin inflammation it causes. Topical steroid medications are frequently prescribed, but the condition often returns quickly once treatment ends. UVB light therapy, sunlight, oral and topical vitamin A derivatives, coal tar, salicylic acid, hydroxyurea (which can be combined with light therapy), anthralin and topical vitamin D derivatives often help.

Anthralin (Dritho-Scalp), a medication believed to normalize DNA activity in cells, can help improve smoothness of the skin. The oral medication tacrolimus (Prograf) and new injectable medications used for treating arthritis, such as etanercept (Enbrel) or infliximab (Remicade), seem to be very effective for some individuals with psoriasis.

For more severe forms of psoriasis, methotrexate (Trexall), an immunosuppressant drug used to treat rheumatoid arthritis and other conditions, is sometimes prescribed. This medication, which can be taken by pill or injection, slows cell production by suppressing the immune system. People taking methotrexate must be closely monitored to avoid possible liver damage and/or decreased cell counts. Pregnant women or those who are planning to become pregnant should not use methotrexate.

Cyclosporine, another immunosuppressant drug, is also sometimes prescribed. This medication increases risk for high blood pressure and kidney problems.

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Erik O. Gilbertson, MD
There are several different ways to treat psoriasis, an autoimmune disorder that can cause inflammation on the skin. Psoriasis is caused by skin cells multiplying too rapidly, resulting in a scaly growth plaque that grows on the skin and other areas.

Some treatments are applied directly to the skin while others are injected or taken as pills. Topical treatments include corticosteroid creams or lotions that help calm immune system inflammation. These treatments, however, may lose their effectiveness over time. Topical Vitamin D treatments can also help slow skin cell growth.

Another treatment choice for psoriasis involves phototherapy, or light therapy. The sun's UV light rays can actually destroy the cells that cause psoriasis. But too much UV exposure can also make things worse. Many dermatologists use more controlled versions of phototherapy, such as narrowband UVB light.

Finally, there are systemic drug therapies called biologics. These medications target a protein in the body that is largely responsible for the inflammation and rapid cell growth associated with psoriasis.

Biologic drugs like Enbrel and Humira, given by injection every week or two, can be very effective. However, it’s important to note that these medications can include side effects, some of them severe.

Psoriasis increases the risk for other serious conditions, including cancer, cardiovascular disease, arthritis, diabetes and depression. Doctors take these risks into consideration as they treat the whole person.
Treatment for psoriasis usually starts with topical drugs. Corticosteroid creams or ointments can be very effective at minimizing your symptoms and providing relief from itching. They come in several different strengths. Which one is right for you depends on the severity of your psoriasis and what part of your body is being affected. Other effective topical treatments include vitamin D, salicylic acid, anthralin, and even coal tar. All of these medications can be used in conjunction with phototherapy. You may have already noticed that natural sunlight helps improve your psoriasis. Doctors can take advantage of this by harnessing ultraviolet light and using it to help your condition. If these treatments aren't effective you may be directed to use an oral drug or an injection. Immunomodulators, cyclosporine and methotrexate are all drugs that may be used to suppress your immune system and diminish your psoriasis symptoms.
Yogi Cameron Alborzian
Alternative & Complementary Medicine
Ayurvedic tradition typically considers psoriasis to be a buildup of excessive heat in the body. This is a heat that may also lead to indigestion, acid reflux, acne, irritable bowel syndrome, and other indications of irritation in the body. When the heat that is supposed to be contained within the digestive system (i.e. the digestive fire) becomes excessive, it spreads to other parts of the body and may create a toxic reaction on the skin. This is what happens when someone gets psoriasis.

To resolve this condition, an Ayurvedic practitioner will help the patient to lessen this heat and allow the digestive fire to once again be contained. This will happen through the taking of herbs, a diet that cools the body off, cooling breathing practices, and the application of topical herbal remedies as well as other treatments.
While there's no cure for psoriasis, a good treatment plan will reduce its symptoms, improve your appearance, and enhance the quality of your life. Initial treatment usually focuses on clearing your skin. After that, a maintenance plan will aim to keep the lesions from returning. It may take trial and error to develop, because there are many treatments, and they're often most effective used in combination. They may include creams and other topical (external) medications, light therapy, and, sometimes, powerful systemic (internal) medications.

What doctors start with generally depends on the size of the affected area, the type of psoriasis, and is the severity. This is sometimes called the 1-2-3 approach.
  • In step 1, medications are applied to the skin (topical treatment).
  • Step 2 uses light-based treatments (phototherapy).
  • Step 3 brings in the big guns: medicines that treat the immune system (systemic therapy).

Adam J. Mamelak, MD

There are literally numerous therapies that exist for psoriasis, including creams and lotions, topical agents, oral medication, light therapies and biologic drugs. The type of therapy selected often depends on the extent of your disease, the symptoms and how it affects your life. Your dermatologist can advise you by examining your skin and devising a treatment plan that suits all your needs.

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Treating psoriasis is hit or miss, so docs typically try a number of approaches to see what works. Some common treatments include using moisturizers, mineral oil, or petroleum jelly to help reduce the dryness that comes with the buildup of skin cells. Docs may also use medicated topical agents to help not only minimize the appearance but also quell the immune reaction, reduce the inflammation, and stop the overproduction of skin cells.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.