Psoriasis is a chronic disease that waxes and wanes. Symptoms of psoriasis include red scaly patches on the skin, dry cracked skin, and itching; and it sometimes affects the nails, causing discoloration, pitting, and crumbling. It is believed to be an autoimmune disease that causes skin cells to grow too fast and accumulate in abnormal structures. Although there is no cure for psoriasis, it can be treated and managed. Here are some of the psoriasis treatment options.
Psoriasis tends to occur in bursts and then remit for weeks to months in between outbreaks. Many patients experience significant relief simply by avoiding common triggers of outbreaks of psoriasis:
- Heavy drinking
- Certain medications
In addition to these factors, other factors that are less easy to control, such as minor upper respiratory infections and cuts and minor injuries to the skin may induce outbreaks. Losing weight and taking vitamin D supplements may also reduce the frequency and severity of outbreaks.
Topical Psoriasis Treatment
During an outbreak, various creams and ointments can be applied to the affected skin to shorten the duration of the outbreak and relieve symptoms. The most common such ointments include corticosteroids, vitamin D analogues, retinoids, salicylic acid, coal tar, and moisturizers. In addition, a drug called anthralin can be applied to slow the growth of skin cells. In cases of lesions around the eyes, calcineurin inhibitors may be prescribed.
Exposure of the affected skin to either natural sunlight or artificially delivered UV light can significantly improve the appearance of lesions. However, excessive exposure to sunlight can make them worse. Generally, a 10 to 15 minute period of sun exposure in the middle of the day is recommended. UV light treatment is usually delivered for short periods of time two to three times per week. Light therapy can be combined with topical psoriasis treatment.
For severe cases, the lesions can be treated with lasers that deliver UV light. The psoriasis treatment may sometimes be enhanced by the patient taking an oral light-sensitizing drug called psoralen before the treatment. Both of these treatments can cause side effects such as redness, burning, itching, and blistering. Psoralen can cause nausea and headaches, and its use can cause wrinkling of the skin and increase the risk of skin cancers.
In some recalcitrant cases, medications may be recommended. Oral retinoids may be helpful for some cases, but they can cause hair loss and pregnancy needs to be avoided for up to three years after its use. Drugs that suppress the immune system, such as methotrexate and cyclosporine, may be used to treat severe cases. These drugs increase the risk of infections and should only be used for short periods. More recently, biologics that alter the function of the immune system have been approved for treatment of psoriasis, but they also increase the risk of infections and most need to be injected.