moderate to severe psoriasis

Psoriasis is a chronic autoimmune disorder. The most common symptoms of this condition include thick, inflamed patches of red skin that often burn or itch. Those patches are also frequently covered with silvery scales called plaques.

Psoriasis is fairly common. It affects more than 2 percent of Americans. Psoriasis goes in cycles of activity: It’s often more active before it falls dormant. Many treatments are very effective at reducing symptoms during these times. Find out which treatments are worth your time and which ones you can just skip.

What causes psoriasis

A healthy immune system is designed to protect itself from invading infections and diseases. When a foreign cell enters your body, your immune system springs into action to defend your healthy cells. It puts up a fight to prevent an infection by releasing protective T cells. These T cells seek out and destroy invading cells.

If you have an autoimmune disease, your immune system doesn’t work this way. Instead, it falsely sets off a response when there’s nothing to attack. The T cells as a result attack your body’s healthy cells. When that happens, you may develop signs or symptoms of a problem.

In the case of psoriasis, your immune system falsely attacks skin cells. Your skin cells then spring into overdrive, producing more skin cells than needed. Those skin cells pile up on your skin’s surface, creating inflamed spots and plaques.

The aims of psoriasis treatments fall into three main categories:

  • Stop rapid skin growth and reduce plaque growth and development.
  • Eliminate existing scales and soothe affected skin.
  • Reduce likelihood of future flare-ups.

What’s worth considering

Psoriasis treatments are quite successful at easing symptoms. Here are the treatments and lifestyle remedies shown to be most effective:

Topical medicines: Medicated topical ointments, creams, and lotions are highly effective for mild to moderate cases of psoriasis. These topical medicines are quite potent, but they’re not often used over large sections of the body. This reduces the likelihood of side effects.

For people with more severe cases of this skin condition, topical medicines may be used with other treatments to achieve the best results. Examples of these medications include:

  • topical corticosteroids
  • vitamin D analogues
  • topical retinoids
  • salicylic acid
  • moisturizers

Injected or oral medicines: Systemic psoriasis treatments are used for people with severe or widespread symptoms. Because of possible side effects, these medicines are often only used for brief periods of time. Examples of these medicines include:

  • oral corticosteroids
  • retinoids
  • methotrexate
  • cyclosporine
  • biologics

Light therapy: This type of treatment, also called phototherapy, uses natural or artificial light to reduce symptoms. Whether it’s supervised exposure to natural sunlight, artificial ultraviolet light, or lasers, this type of treatment can kill errant immune cells.

However, exposing yourself to too much light could make symptoms worse. That’s why it’s important this type of treatment is conducted only with supervision from your doctor.

Proper skin care: Some people with psoriasis find that daily baths with warm water help ease symptoms. Hot water may dry and aggravate delicate skin. In addition, routine use of moisturizers and humidifiers may ease symptoms. While these remedies won’t cure psoriasis, they can make day-to-day life during a psoriasis flare-up more tolerable.

Avoid triggers: The most common psoriasis triggers include illness, skin injury, stress, prolonged exposure to sunlight, and smoking. If you know what causes a psoriasis flare-up for you, avoid those triggers.

Which psoriasis treatments you should discuss with your doctor

Some psoriasis treatments hold promise, but research doesn’t fully support their use. Before you begin any of these treatments, talk with your doctor. Better, more effective alternatives may be available.

Dietary supplements: Supplements like fish oil and Oregon grape probably won’t have an influence on your psoriasis. While they’re frequently touted as complementary treatments for psoriasis, research doesn’t support their use. However, these supplements are considered safe for regular consumption, so taking them likely won’t make your condition worse. Just don’t have unrealistic expectations for any changes in your symptoms.

Aloe vera: If this magical plant can soothe so many other skin ailments, why not psoriasis? There’s just no science to support it. Extracts of aloe vera are frequently combined with lotions and ointments to help ease itching and burning. Like dietary supplements, aloe vera won’t hurt. But it’s unlikely to be very helpful at treating plaques.

An anti-inflammatory diet: Superfoods and specific diets get a lot of praise for curing symptoms. However, the studies that back up many of these claims are quite small and not entirely reliable. These foods may not be helpful, but they’re very rarely harmful. Plus, eating a balanced diet that includes fruits, vegetables, lean meats, low-fat dairy, and whole grains is always healthful. Include touted foods if you wish, but don’t expect major changes to your skin’s health.

The bottom line

Psoriasis treatments are very personal. What works for a friend might not work for you. On top of this, what worked for you at one time may not always work for you. As the disease changes, you may find it necessary to try more than one type of psoriasis treatment. Work with your doctor to find a treatment or a collection of treatments that work best to ease your symptoms.