Psoriasis: Treatment Options to Manage Your Symptoms
Psoriasis Uncovered: Myths Versus Truths
- Myth:Psoriasis is just "dry" skin. Truth:Psoriasis is an immune disorder with often embarrassing effects.
- Myth: Psoriasis is contagious. Truth: You cannot "catch" psoriasis from someone else, even if you come into contact with their skin. It is not an infection.
- Myth:Psoriasis can be cured. Truth:Psoriasis is a chronic condition that has no cure; however, there are many effective treatments. Consult with your doctor for the right treatment for you.
What is Psoriasis? It's More Than Skin Deep
There is no cure for psoriasis, but advanced treatments and medications allow rough 80 to 90 percent of patients to have successful treatment to lessen symptoms and appearance of the plaques.
What Does Psoriasis Look Like?
Psoriasis can affect small areas of the body or be very widespread. For many people, psoriasis can lead to embarrassment, self-consciousness, or stress; some people may require treatment for depression or anxiety. Family doctors, dermatologists, or rheumatologists may treat your psoriasis depending upon site and severity.
What Causes the Heartbreak of Psoriasis?
In psoriasis, new skins cells are formed too quickly and result in a layer of dead, scaly skin and white blood cells that remain on the top layer of skin, insteading of sloughing off. These patches of skin and lesions are known as psoriatic lesions or plaque psoriasis.
Who Gets Psoriasis? It's Not All in the Family.
About 30 percent of people that develop psoriasis may also develop psoriatic arthritis, a type of rheumatoid arthritis that tends to affect the hands and feet. Some, but not all, patients will have a family history of psoriasis. Psoriasis is not contagious; you cannot catch it from someone else. Psoriasis is an immune disorder - not an infectious disease.
Is There More Than One Type of Psoriasis?
- Plaque Psoriasis: Most common form that causes raised, red skins areas that may be itchy or flaky.
- Guttate Psoriasis: May be a past history of streptococcal infection; may occur in children or younger adults. Small plaques form on the midsection of the body.
- Pustular Psoriasis: Painful and severe form of psoriasis, with pus-filled sacs in the psoriasis plaques that can break. Fever may occur.
Other Types of Psoriasis, Continued
- Inverse Psoriasis: This psoriasis may affect skin fold areas such as the genital area, under the breast or arms, or around the groin area. The lesions are flat, red, and often without scales.
- Nail Psoriasis: Nails may become yellow-brown, pitted, flake away or detach from the nail bed.
- Psoriatic Arthritis: May occur in up to 30 percent of patients with psoriasis; symptoms include swelling of the knee, ankles, hands and toe joints, pain, and nail psoriasis.
Flare Ups: Common Psoriasis Triggers
- Illnesses or infections
- Skin injuries or burns
- Stressful situations or anxiety
- Cold weather, smoke or smoking
- Heavy alcohol use
- Certain medications such as lithium, high blood pressure medications (beta blockers), drugs to prevent malaria, and iodide products
Treatments for Psoriasis: Where Do I Begin?
Treatment can lessen the formation of the excessive cells and help to return your skin to a smoother appearance. Treatments may include topical creams or lotions, phototherapy (light therapy) with or without certain medications, or prescription drugs that may be taken by mouth or injected. Some injectable medications can be used by the patient at home, too.
The First Line of Therapy - Topical Corticosteroids
Topical Corticosteriods - Safety and Side Effects
Combined Use of OTC Emollients and Creams
These preparations are available over-the-counter (OTC) without a prescription - common examples include Aquaphor, Lac-Hydrin Five, Nivea, or Eucerin. Ask your pharmacist for more information on how to best use these products for psoriasis.
Vitamin D Analogues: How They Help
Topical Retinoids: Vitamin A to the Rescue
Phototherapy: Lighten Your Symptoms
Topical Coal Tar: An Old Stand-By
The exact way that coal tar treats psoriasis is not known. Coal tar can be found over-the-counter in shampoos, creams and lotions and can be used in combination with corticosteroids and emollients to soften the skin. Coal tar is also combined with UVB light in a treatment known as Goeckerman treatment. Coal tar increases the skin's absorption of UVB light for an added effect.
Heads Up: Anthralin for Scalp Psoriasis
Like coal tar, anthralin may be used in combination with UV light to help with skin symptoms of psoriasis, including dryness, redness, flaking, scaling, and itching.
Salicylic Acid: A Keratolytic
Salicylic acid is available in both over-the-counter and prescription strengths and loosens dead skin from the psoriasis plaque to reduce scaling (keratolytic). Salicylic acid (Dermarest, Psoriasin) is available in many different OTC formulations to treat both skin and scalp psoriasis.
Salicylic acid can be used in combination with other treatments, like corticosteroid creams, anthralin, or coal tar to increase effectiveness. It may take up to several days before your symptoms improve. Common side effects of salicylic acid may include skin irritation, peeling, rash, or blanching of the skin area.
Methotrexate: A Longer-Term Option
Cyclosporine: A Short-Term Option
Some healthcare professionals will suggest that patients take a "holiday" from cyclosporine, use other treatments in the interim, and then return to cyclosporine therapy again later. This may help to lessen severe side effects like kidney damage or high blood pressure. Cyclosporine can be used in combination with emollients.
The Latest Treatments: Biologics Agents
Finished: Psoriasis: Treatment Options to Manage Your Symptoms
- American Academy of Dermatology. Clinical Guidelines. Psoriasis. Guidelines of care for the management of psoriasis and psoriatic arthritis. Accessed August 12, 2013. http://www.aad.org/education/clinical-guidelines
- National Psoriasis Foundation. Psoriasis. Topical steroids potency chart. Accessed August 15, 2013. http://www.psoriasis.org/about-psoriasis/treatments/topicals/steroids/potency-chart
- National Psoriasis Foundation. Topical treatments for psoriasis, including steroids. Accessed August 15, 2013. http://www.psoriasis.org/Document.Doc?id=164
- Mayo Clinic. Psoriasis. Accessed August 15, 2013. http://www.mayoclinic.com/health/psoriasis/DS00193
- UpToDate. Wolters Kluwer Health. Patient Information: Psoriasis (Beyond the Basics). Accessed August 14, 2013. http://www.uptodate.com/contents/psoriasis-beyond-the-basics