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Treatments for Psoriasis

Treatments for Psoriasis:

Psoriasis is a chronic condition that is not curable. However, with a well integrated, medically monitored plan of care, symptoms can be controlled, and people with psoriasis can lead active, comfortable lives. A good treatment plan is individualized to a person's medical history, severity of psoriasis and other factors.

A combination of treatments that include lifestyle changes with medications and other treatments as appropriate is the most effective way to best control psoriasis.

Treatment of psoriasis includes prevention of flare-ups by avoiding exposure to triggers, such as stress, sunburn, skin injury and excessive alcohol consumption. A variety of topical and oral medications may also be prescribed. These include a topical Vitamin D cream and corticosteroid medications. Another type of treatment that may be effective for psoriasis is phototherapy.

Antibiotics may be prescribed to treat secondary bacterial infections.

Treatment List for Psoriasis

The list of treatments mentioned in various sources for Psoriasis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

  • Topical skin care
  • Phototherapy
    • Sunlight - in mild doses, but taking care to avoid sunburn.
    • UVB phototherapy
    • Ingram regime - combined coal tar and UVB therapy, and anthralin-salicylic acid paste
    • Goeckerman treatment - combined coal tar and UVB therapy
    • PUVA - Psoralen and UVA light combination
  • Medications
  • Hospitalization - for severe cases
  • Steroid creams and ointments
  • Antifungal agents
  • Tacrolimus, pimecrolimus
  • Castellani's Paint
  • Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy
  • Photochemotherapy
  • Systemic therapy
  • The main topical treatments are corticosteroids, vitamin D-3 derivatives, coal tar, anthralin, or retinoids
  • Hospitalisation for supportive care including intravenous fluids and temperature regulation
  • Bland emollients and cooling wet dressings
  • Bed rest
  • Low-dose methotrexate, ciclosporin or acitretin
  • Treatment of complications (for example antibiotics, diuretics (water tablets), nutritional support)
  • Oral corticosteroids should be avoided
  • Topical tar preparations and phototherapy should also be avoided in the early treatment of erythrodermic psoriasis as they may worsen the condition
  • There are a large number of treatment options with varying degrees of success in different patients - often combinations of various therapies are required. The type of treatment varies depending on the type and severity of symptoms and individual response to treatments already tried. Initially, the mildest treatments are used in order to avoid the side effects of stronger treatments.
  • Treatment options include:
  • Avoid triggers and exacerbating factors e.g. smoking, alcohol, obesity, stress, cold weather, hot showers, harsh soaps and other personal products
  • Regular moisturizing and baths containing bath oil, Epsom salts, dead sea salts and colloidal oatmeal can alleviate symptoms
  • Topical therapies:
  • Medicated solutions - for scalp psoriasis
  • Topical corticosteroids
  • Topical Vitamin D analogues
  • Topical retinoids e.g. Avage
  • Calcineurin Inhibitors e.g. pimecrolimus, tacrolimus
  • Salicylic acid products - often included in scalp products
  • Light therapy (phototherapy):
  • Exposure to natural sunlight
  • Excimer laser
  • Combination light therapy
  • Oral retinoids - may cause significant side effects so its use must be closely monitored
  • Cyclosporine - works by suppressing the immune system
  • Hydroxyurea - often used in combination with phototherapy
  • Immunomodulator drugs - e.g. Remicade, Enbrel - tends to be used for more severe psoriasis
  • Alternative therapies:
  • Alternative therapies may help alleviate symptoms in some patients
  • Capsaicin cream
  • Aloe vera
  • Fish oil supplements
  • Arthritis Treatments:
  • Anti-inflammatory drugs (NSAID's) - alleviates arthritic and psoriasis symptoms.
  • Anti-malarial drugs - alleviates arthritic and psoriasis symptoms.
  • Retinoic acid derivatives - alleviates arthritic and psoriasis symptoms.
  • Psoralen with UV-A light - alleviates arthritic and psoriasis symptoms.
  • Sulfasalazine - alleviates arthritic symptoms.
  • Cyclosprin A - alleviates arthritic and psoriasis symptoms but carries a significant risk of hypertension and kidney toxicity.
  • Tumor necrosis factor inhibitors - alleviates arthritic and psoriasis symptoms.
  • Physical therapy
  • Topical skin care - should be the treatment of choice for stable plaque psoriasis
  • Phototherapy - used for more severe, resistant, or widespread forms of psoriasis
    • Sunlight - in mild doses, but taking care to avoid sunburn
    • UVB phototherapy
    • Ingram regime - combined coal tar and UVB therapy, and anthralin-salicylic acid paste
    • Goeckerman treatment - combined coal tar and UVB therapy
    • PUVA - Psoralen and UVA light combination, for severe psoriasis unresponsive to other tretament
  • Medications - used for more severe, resistant, or widespread forms of psoriasis
  • Combination therapy - used when single agent treatment has failed, and allows lower dosages to be used
  • Rotational therapy - limits toxicity and facilitates long term treatment
  • Hospitalization - for severe cases

Alternative Treatments for Psoriasis

Alternative treatments or home remedies that have been listed as possibly helpful for Psoriasis may include:

Psoriasis: Is the Diagnosis Correct?

The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Psoriasis may include:

Hidden causes of Psoriasis may be incorrectly diagnosed:

  • Genetic predisposition
  • Factors that may aggravate psoriasis include stress, excessive alcohol consumption, and smoking
  • Withdrawal of systemic steroids
  • Drugs, including salicylates, iodine, lithium, phenylbutazone, oxyphenbutazone, trazodone, penicillin, hydroxychloroquine, calcipotriol, interferon-alpha, and recombinant interferon-beta injection
  • Strong, irritating topicals, including tar, anthralin, steroids under occlusion, and zinc pyrithione in shampoo
  • Infections
  • more causes...»

Psoriasis: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Psoriasis:

Curable Types of Psoriasis

Possibly curable types of Psoriasis may include:

Psoriasis: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Drugs and Medications used to treat Psoriasis:

Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.

Some of the different medications used in the treatment of Psoriasis include:

  • Dexamethasone
  • Fluticasone
  • Advair
  • Advair Diskus
  • Cutivate
  • Methotrexate
  • Abitrexate
  • Folex
  • Folex PFS
  • Mexate
  • Mexate AQ
  • Rheumatrex Dose Pack
  • Trexall
  • Prednisone
  • Apo-Prednisone
  • Aspred-C
  • Deltasone
  • Liquid Pred
  • Meticorten
  • Metreton
  • Novoprednisone
  • Orasone
  • Panasol-S
  • Paracort
  • Prednicen-M
  • Prednisone Intensol
  • SK-Prednisone
  • Sterapred
  • Sterapred-DS
  • Winpred
  • Acitretin
  • Soriatane
  • Alefacept
  • Amevive
  • Anthralin
  • Drithocreme
  • Dritho-Scalp
  • Psoriatec
  • Anthraforte
  • Anthranol
  • Anthrascalp
  • Micanol
  • Betamethasone (systemic)
  • Celestone
  • Celstone Soluspan
  • Betaject
  • Betnesol
  • Soluspan
  • Betamethasone (topical)
  • Beta-Val
  • Diprolene
  • Diprolene AF
  • Luxiq
  • Maxivate
  • Betaderm
  • Betnovate
  • Celestoderm-EV/2
  • Celestoderm-V
  • Glycol
  • Diprosone
  • Ectosone
  • Prevex B
  • Taro-Sone
  • Topilene
  • Topisone
  • Valisone Scalp Lotion
  • Clobetasol
  • Clobevate
  • Clobex
  • Cormax
  • Embeline
  • Embeline E
  • Dermovate
  • Gen-Clobetasol
  • Novo-Clobetasol
  • Clocortolone
  • Cloderm
  • Cutar
  • DHS Tar
  • DHS Targel
  • Doak Tar
  • Estar
  • Exorex
  • Ionil T
  • Ionil T Plus
  • MG 217
  • MG 217 Medicated Tar
  • Neutrogena T/Gel
  • Neutrogena T/Gel Extra Strength
  • Oxipor VHC
  • Pentrax
  • Polytar
  • PsoriGel
  • Reme-t
  • Tegrin
  • Zetar
  • SpectroTar Skin Wash
  • Targel
  • Coal tar and salicylic acid
  • Sebcur/T
  • Lidex
  • Lidex-E
  • Fluocinonide
  • Lidemol
  • Lyderm
  • Lydonide
  • Tiamol
  • Topsyn
  • Flurandrenolide
  • Cordran
  • Cordran SP
  • Rheumatrex
  • Trexal
  • Apo-Methotrexate
  • Ratio-Methotrexate
  • Ledertrexate
  • Texate
  • Trixilem
  • Methoxsalen
  • Dermox
  • Meladinina
  • Oxsoralen
  • 8-MOP
  • Oxsoralen-Ultra
  • Uvadex
  • Tiseb
  • Salicylic Acid
  • Ionil
  • Ionil Plus
  • LupiCare II Psoriasis
  • LupiCare Psoriasis
  • Neutrogena Body Clear
  • Stri-dex
  • Stri-dex Body Focus
  • Sebcur
  • DHS Sal
  • MG217 Sal-Acid
  • Salicylic Acid and Propylene Glycol
  • Keralyt Gel
  • Allantoin
  • Alphosyl
  • Calcipotriol
  • Daivonex
  • Resorcinol

Unlabeled Drugs and Medications to treat Psoriasis:

Unlabelled alternative drug treatments for Psoriasis include:

  • Sulfasalazine
  • Alti-Sulfasalazine
  • Azaline
  • Azulfidine
  • Azulfidine EN-Tabs
  • PMS Sulfasalazine
  • PMS Sulfasalazine E.C
  • Salazopyrin
  • Salazopyrin EN
  • SAS-Enema
  • SAS Enteric-500
  • SAS-500
  • Sulfazine EC
  • Triamcinolone
  • Aristocort R
  • Aristoform D
  • Aurecort
  • Kenalog H
  • Flutex
  • Triacet
  • Triaderm Mild
  • Triaderm Regular
  • Kenacort
  • Mytrex
  • Mytriacet II
  • Triderm
  • Mycogen II
  • Kenacomb
  • Mycolog
  • Mycomar
  • SK-Triamcinolone
  • Viaderm-K.C
  • Mycophenolate
  • CellCept
  • Myfortic

Hospital statistics for Psoriasis:

These medical statistics relate to hospitals, hospitalization and Psoriasis:

  • 0.09% (12,060) of hospital episodes were for papulosquamous disorders including psoriasis in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 97% of hospital consultations for papulosquamous disorders including psoriasis required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 51% of hospital episodes for papulosquamous disorders including psoriasis were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 49% of hospital episodes for papulosquamous disorders including psoriasis were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 12% of hospital admissions for papulosquamous disorders including psoriasis required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • more hospital information...»

Medical news summaries about treatments for Psoriasis:

The following medical news items are relevant to treatment of Psoriasis:

Discussion of treatments for Psoriasis:

Questions and Answers About Psoriasis: NIAMS (Excerpt)

Doctors generally treat psoriasis in steps based on the severity of the disease, the extent of the areas involved, the type of psoriasis, or the patient’s responsiveness to initial treatments. This is sometimes called the “1-2-3” approach. In step 1, medicines are applied to the skin (topical treatment). Step 2 focuses on light treatments (phototherapy). Step 3 involves taking medicines internally, usually by mouth (systemic treatment).

Over time, affected skin can become resistant to treatment, especially when topical corticosteroids are used. Also, a treatment that works very well in one person may have little effect in another. Thus, doctors commonly use a trial-and-error approach to find a treatment that works, and they may switch treatments periodically (for example, every 12 to 24 months) if resistance or adverse reactions occur. Treatment depends on the location of lesions, their size, the amount of the skin affected, previous response to treatment, and patients’ perceptions about their skin condition and preferences for treatment. In addition, treatment is often tailored to the specific form of the disorder.

Topical Treatment

Treatments applied directly to the skin are sometimes effective in clearing psoriasis. Doctors find that some patients respond well to sunlight, corticosteroid ointments, medicines derived from vitamin D3, vitamin A (retinoids), coal tar, or anthralin. Other topical measures, such as bath solutions and moisturizers, may be soothing but are seldom strong enough to clear lesions over the long term and may need to be combined with more potent remedies.
  • Sunlight--Daily, regular, short doses of sunlight that do not produce a sunburn clear psoriasis in many people.

  • Corticosteroids--Available in different strengths, corticosteroids (cortisone) are usually applied twice a day. Short-term treatment is often effective in improving but not completely clearing psoriasis. If less than 10 percent of the skin is involved, some doctors will begin treatment with a high-potency corticosteroid ointment (for example, Diprolene®,* Temovate®, Ultravate®, or Psorcon®). High-potency steroids may also be used for treatment-resistant plaques, particularly those on the hands or feet. Long-term use or overuse of high-potency steroids can lead to worsening of the psoriasis, thinning of the skin, internal side effects, and resistance to the treatment’s benefits. Medium-potency corticosteroids may be used on the torso or limbs; low-potency preparations are used on delicate skin areas.

    *Brand names included in this fact sheet begin with a capital letter and are provided as examples only. Their inclusion does not mean that these products are endorsed by the National Institutes of Health or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

  • Calcipotriene--This drug is a synthetic form of vitamin D3. (It is not the same as vitamin D supplements.) Applying calcipotriene ointment (for example, Dovonex®) twice a day controls excessive production of skin cells. Because calcipotriene can irritate the skin, however, it is not recommended for the face or genitals. After 4 months of treatment, about 60 percent of patients have a good to excellent response. The safety of using the drug for cases affecting more than 20 percent of the skin is unknown, and using it on widespread areas of the skin may raise the amount of calcium in the body to unhealthy levels.

  • Coal tar--Coal tar may be applied directly to the skin, used in a bath solution, or used on the scalp as a shampoo. It is available in different strengths, but the most potent form may be irritating. It is sometimes combined with ultraviolet B (UVB) phototherapy. Compared with steroids, coal tar has fewer side effects, but it is messy and less effective and thus is not popular with many patients. Other drawbacks include its failure to provide long-term help for most patients, its strong odor, and its tendency to stain skin or clothing.

  • Anthralin--Doctors sometimes use a 15- to 30-minute application of anthralin ointment, cream, or paste to treat chronic psoriasis lesions. However, this treatment often fails to adequately clear lesions, it may irritate the skin, and it stains skin and clothing brown or purple. In addition, anthralin is unsuitable for acute or actively inflamed eruptions.

  • Topical retinoid--The retinoid tazarotene (Tazorac) is a fast-drying, clear gel that is applied to the surface of the skin. Although this preparation does not act as quickly as topical corticosteroids, it has fewer side effects. Because it is irritating to normal skin, it should be used with caution in skin folds. Women of childbearing age should use birth control when using tazarotene.

  • Salicylic acid--Salicylic acid is used to remove scales, and is most effective when combined with topical steroids, anthralin, or coal tar.

  • Bath solutions--People with psoriasis may find that bathing in water with an oil added, then applying a moisturizer, can soothe their skin. Scales can be removed and itching reduced by soaking for 15 minutes in water containing a tar solution, oiled oatmeal, Epsom salts, or Dead Sea salts.

  • Moisturizers--When applied regularly over a long period, moisturizers have a cosmetic and soothing effect. Preparations that are thick and greasy usually work best because they hold water in the skin, reducing the scales and the itching.

Phototherapy

Ultraviolet (UV) light from the sun causes the activated T cells in the skin to die, a process called apoptosis. Apoptosis reduces inflammation and slows the overproduction of skin cells that causes scaling. Daily, short, nonburning exposure to sunlight clears or improves psoriasis in many people. Therefore, sunlight may be included among initial treatments for the disease. A more controlled form of artificial light treatment may be used in mild psoriasis (UVB phototherapy) or in more severe or extensive psoriasis (psoralen and ultraviolet A [PUVA] therapy).

UVB phototherapy--Some artificial sources of UVB light are similar to sunlight. Newer sources, called narrow-band UVB, emit the part of the ultraviolet spectrum band that is most helpful for psoriasis. Some physicians will start with UVB treatments instead of topical agents. UVB phototherapy is also used to treat widespread psoriasis and lesions that resist topical treatment. This type of phototherapy is normally administered in a doctor’s office by using a light panel or light box, although some patients can use UVB light boxes at home with a doctor’s guidance. Generally at least three treatments a week for 2 or 3 months are needed. UVB phototherapy may be combined with other treatments as well. One combined therapy program, referred to as the Ingram regime, involves a coal tar bath, UVB phototherapy, and application of an anthralin-salicylic acid paste, which is left on the skin for 6 to 24 hours. A similar regime, the Goeckerman treatment, involves application of coal tar ointment and UVB phototherapy.

PUVA--This treatment combines oral or topical administration of a medicine called psoralen with exposure to ultraviolet A (UVA) light. Psoralen makes the body more sensitive to this light. PUVA is normally used when more than 10 percent of the skin is affected or when rapid clearing is required because the disease interferes with a person’s occupation (for example, when a model’s face or a carpenter’s hands are involved). Compared with UVB treatment, PUVA treatment taken two to three times a week clears psoriasis more consistently and in fewer treatments. However, it is associated with more short-term side effects, including nausea, headache, fatigue, burning, and itching. Long-term treatment is associated with an increased risk of squamous cell and melanoma skin cancers. PUVA can be combined with some oral medications (retinoids and hydroxyurea) to increase its effectiveness. Simultaneous use of drugs that suppress the immune system, such as cyclosporine, have little beneficial effect and increase the risk of cancer. In very rare cases, patients who must travel long distances for PUVA treatments may, with a physician’s close supervision, be taught to administer this treatment at home.

Systemic Treatment

For more severe forms of psoriasis, doctors sometimes prescribe medicines that are taken internally:

  • Methotrexate--This treatment, which can be taken by pill or injection, slows cell production by suppressing the immune system. Patients taking methotrexate must be closely monitored because it can cause liver damage and/or decrease the production of oxygen-carrying red blood cells, infection-fighting white blood cells, and clot-enhancing platelets. As a precaution, doctors do not prescribe the drug for people with long-term liver disease or anemia. Methotrexate should not be used by pregnant women, by women who are planning to get pregnant, or by their male partners.

  • Cyclosporine--Taken orally, cyclosporine (Neoral®) acts by suppressing the immune system in a way that slows the rapid turnover of skin cells. It may provide quick relief of symptoms, but it is usually effective only during the course of treatment. The best candidates for this therapy are those with severe psoriasis who have not responded to or cannot tolerate other systemic therapies. Cyclosporine may impair kidney function or cause high blood pressure (hypertension), so patients must be carefully monitored by a doctor. Also, cyclosporine is not recommended for patients who have a weak immune system, those who have had substantial exposure to UVB or PUVA in the past, or those who are pregnant or breast-feeding.

  • Hydroxyurea (Hydrea®)--Compared with methotrexate and cyclosporine, hydroxyurea is less toxic but also less effective. It is sometimes combined with PUVA or UVB. Possible side effects include anemia and a decrease in white blood cells and platelets. Like methotrexate and cyclosporine, hydroxyurea must be avoided by pregnant women or those who are planning to become pregnant.

  • Retinoids--A retinoid, such as acitretin (Soriatane®), is a compound with vitamin A-like properties that may be prescribed for severe cases of psoriasis that do not respond to other therapies. Because this treatment also may cause birth defects, women must protect themselves from pregnancy beginning 1 month before through 3 years after treatment. Most patients experience a recurrence of psoriasis after acitretin is discontinued.

  • Antibiotics--Although not indicated in routine treatment, antibiotics may be employed when an infection, such as Streptococcus, triggers the outbreak of psoriasis, as in certain cases of guttate psoriasis.

(Source: excerpt from Questions and Answers About Psoriasis: NIAMS)

Understanding Autoimmune Disease: NIAID (Excerpt)

Most treatments focus on topical skin care to relieve the inflammation, itching, and scaling. For more severe cases, oral medications are used. (Source: excerpt from Understanding Autoimmune Disease: NIAID)

Psoriasis: NWHIC (Excerpt)

Doctors generally treat psoriasis in steps according to the severity of the disease or responsiveness to initial treatments. This is sometimes called the "1-2-3" approach. In step 1, medicines are applied to the skin (topical treatment). Step 2 involves treatments with light (phototherapy). Step 3 involves taking medicines internally, usually by mouth (systemic treatment).

Over time, affected skin tends to resist some treatments. Also, a treatment that works like magic in one person may have little effect in another. Thus, doctors commonly use a trial and error approach to find a treatment that works, then switch treatments every 12 to 24 months to reduce resistance and adverse reactions. Selection of treatment depends on the location of lesions, their size, the amount of the skin affected, previous response to treatment, and a patient's perceptions about their skin condition and patient preferences for treatment. In addition, treatment is often tailored to the specific form of the disorder.

Treatments can include:

Topical Treatment:sunlight, steroid ointments, medicines made from vitamin D3, coal tar, or anthralin. Other topical measures, such as bath solutions and moisturizers, may be soothing but are seldom strong enough to clear lesions for a sustained length of time and may need to be combined with more potent remedies.

Phototherapy: UVB Phototherapy, PUVA -

Systemic Treatment: Doctors sometimes prescribe medicines that are taken internally for more severe forms of psoriasis, particularly when more than 10 percent of the body is involved. (Source: excerpt from Psoriasis: NWHIC)

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