Psoriasis Treatment Options

There are a variety of psoriasis treatments available, ranging from topical treatments, to light therapy treatment, dietary treatments, and oral medications.

Topical treatments

Topical treatments are treatments applied to body surfaces such as the skin or mucous membranes to treat various ailments. Most topical medications are epicutaneous, meaning they are applied directly to the skin.

In many cases creams and ointments applied to your skin can effectively treat mild to moderate cases of psoriasis. When the disease is more severe, creams may or may not be as effective. Many doctors recommend oral medications or light therapy for advanced cases. Topical psoriasis treatments can include both natural herbs and drug treatments:

Vitamin D and Vitamin D analogues. Vitamin D treatments are available in natural forms (dietary and topical forms) as well as synthetic treatments. The synthetic forms of vitamin D are designed to slow down the growth of skin cells. Calcipotriene (Dovonex) is a prescription cream that contains a vitamin D analogue. In some cases it is effective to treat mild to moderate cases of psoriasis. However, the treatment in some cases may irritate the skin. Calcitriol (Rocaltrol) is another alternative that is synthetic. In some cases it may be less irritating to the skin than calcipotriene. Vitamin D may also be obtained through natural sunlight. Exposure to sunlight may also be helpful insofar as it contains UVB (Ultra violet B).

Topical corticosteroids. Another group of synthetics consiste of the topical corticosteroids. These powerful anti-inflammatory drugs are often prescribed by allopathic doctors to treat mild to moderate psoriasis. They act by slowing cell turnover by suppressing the immune system, which in turn helps to reduce inflamation in some cases. Topical corticosteroids range in strength, from mild to very strong. One downside of this method is that it can suppress the immune system, comprimising the body's ability to fight other disease.

If you do choose to use corticosteroids, it is recommended often by doctors to use a low-potency corticosteroid ointment for sensitive areas, such as your face.

Bear in mind that Long-term use or overuse of strong corticosteroids can cause thinning of the skin. It can also cause resistance to the treatment's benefits. To minimize side effects topical corticosteroids are generally only used on active outbreaks.

Anthralin. This form of medication is thought by some to normalize DNA activity in the body's skin cells. Anthralin (Dritho-Scalp) can be effective in removing scale. Anthralin can also irritate the skin, however, and it stains skin, clothing, and almost anything it touches. Accordingly, this form of treatment should only be used for short periods of time, according to many doctors.

Topical retinoids. Tazarotene topical solutions (Tazorac, Avage) was developed for the treatment of psoriasis. As a vitamin A derivative, Tazarotene normalizes DNA activity in skin cells. It is thought to be helpful in decreasing inflammation. Common side effects include some skin irritation and increased sensitivity to sun-light. Tazarotene isn't recommended when you're pregnant or breast-feeding.

Salicylic acid. Unlike many of the other topical solutions discussed, salicylic acid is available over the counter in low dosages. As an acid, it is helpful at times in removing dead skin cells and therefore is helpful in some cases to reduce scaling. Available over-the-counter (nonprescription) and by prescription, salicylic acid promotes sloughing of dead skin cells and reduces scaling.

Moisturizers. Moisturizing creams can be used to help reduce itching and scaling and they can help combat the dryness resulting from other topical therapies. Natural moisturizers such as aloe vera and other topical herb solutions can be safer to apply in some cases then chemical based moisturizers. Always read the labels before applying moisturizers and research the ingredients and talk to a physician to determine the appropriate moisturizer in your particular case.

Light therapy

Unlike topical solutions, light therapy uses natural or artificial ultraviolet light to help fight or treat psoriasis. The natural and easy and inexpensive form of phototherapy involves simply in exposing your skin to natural sunlight. Other forms of light therapy include the use of artificial light, which is applied to the skin by professionals in order to apply ultraviolet A (UVA) or ultraviolet B (UVB) light in a more controlled environment.

Sunlight. Ultraviolet (UV) light is a unique wavelength of light. It is contained in sunlight. When exposed to sunlight, UV rays can activate cells in the skin die. This process is known to slow skin cell turnover and helps to reduce inflamation, itching, and scaling. Controlled exposure to sunlight may help improve psoriasis. But long term intense exposure can worsen symptoms and irritate and inflame skin cells, causing more skin damage.

UVB phototherapy. Broadband UVB, or UVB therapy is a form of treatment intended to provide doses of UVB light from articifiial light sources in a more controlled manner. Talk to a doctor to determine whether this form of light may be beneficial in your unique case.

Narrow band UVB therapy. Narrow band UVB therapy may also be effective and perhaps even more effective than broadband UVB treatment in treating psoriasis symptoms. Narrow band UVB therapy may in some case severe and longer lasting burns, however, and, therefore, may be much more dangerous than sunlight therapy.

Goeckerman therapy. In some cases, doctors recommend a combination of UVB treatment and coal tar treatment. This combination is known as Goeckerman treatment.

Photochemotherapy or psoralen plus ultraviolet A (PUVA). Photochemotherapy involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more responsive to UVA exposure. This more aggressive treatment consistently improves skin and is often used for more-severe cases of psoriasis. PUVA involves two or three treatments a week for a prescribed number of weeks. Short-term side effects include nausea, headache, burning and itching. Long-term side effects include dry and wrinkled skin, freckles, and increased risk of skin cancer, including melanoma, the most serious form of skin cancer. Because this treatment makes you more sensitive to sunlight, it's important to avoid sun exposure when possible and to wear a broad-spectrum sunscreen with an SPF of at least 30. To protect your eyes, wear UVA-protective sunglasses.

Oral medications

In some cases, where symptoms are persistent and severe, doctors may recommend an oral prescription or injected drug. These drugs can often involve serious side effects, and, therefore, should only be used in severe cases for brief periods of time.

Methotrexate. Methotrexate helps psoriasis, in theory, by decreasing the production of skin cells. This may help in reducing inflammation. Taken orally, methotrexate is generally administered in low doses. In some cases it may cause upset stomach, fatique, loss of appetite, and a variety of other symptoms. Make sure to read and understand all of the possible side effects before taking this drug.

Retinoids. Another class of orally administered drugs that may be effective in some cases in short term treatment of psoriasis are called retinoids. This group of drugs is related to vitamin A and may be used to reduce the production of skin cells. It may be used in some cases under careful doctor supervision in cases where other forms of treatment are ineffective. One down side of this class of drugs is that the symptoms often re-emerge after treatment ceases.

Other drugs that may be useful in the treatment of psoriasis may include: Cyclosporine, Thioguanine, hydroxyurea, and biologics (drugs that alter the immune system). Any oral administered drug should be used only under careful supervision by a trained physician.

Dietary Treatments

Some naturopaths, herbalists, and dieticians suggest using diet to combat and fight and treat psoriasis.

There is at least some evidence, according to many dermatologists, that certain foods can cause inflammation and other foods can reduce inflammation. Foods to avoid include: processed foods, gluten, alcohol, red meat, condiments, dairy products, genetically modified organisms, and citrus fruits.

Although few scientifically conducted studies have been employed to explore the relationship between diet and psoriasis, that may in part be explained by the fact that there are few if any financial benefits to conducting such research. Therefore, it is worth investigating possible dietary causes and links to psoriasis. If you are interested in learning more about the possible link between diet and psoriasis, consult a naturopath, dietician, or a doctor knowledgeable about such things. As always, take responsibility for your own health and understand that diet and health are in many cases related.

Choosing a Treatment

The traditional approach to treating psoriasis is often to start with the mildest form of treatment from the options above, then to progress to treatments with more harmful potential side effects only if necessary. Talk to a doctor about your options, and be sure to discuss with your physician any treatments thoroughly, including side effects, before beginning any treatment plan.

This article is not intended to provide medical advice. It is only offered to present some of the types of treatment normally offered to help you navigate the psoriasis landscape. You should always consult with your doctor before beginning any treatment plan.