Psoriasis treatment

psoriasis_treatment

Are you living with psoriasis? If you’re regularly experiencing symptoms, this is a sign that your condition is not well managed. Read on to learn about the psoriasis treatments that could bring your symptoms under control.

About psoriasis treatment

Most people who have psoriasis are treated effectively by their GP, using a mixture of prescription and over-the-counter products. In severe cases, a referral to a dermatologist may be necessary.

If your psoriasis symptoms are fairly mild you may only need to use topical treatments; if it is more severe you may need a different kind of treatment such as light therapy, which should be administered by a dermatologist.

Types of psoriasis treatment

There are three broad categories of psoriasis treatment in the UK, each of which can be broken down further. These categories are:

  • Topical treatments – moisturisers, lotions and medicated ointments and creams that are applied directly to the skin
  • Phototherapy – where affected areas of skin are exposed to ultraviolet light
  • Systemic treatments – tablets, capsules and injections which work throughout the body, rather than just affecting the skin

Topical treatments

Everybody who has psoriasis will use topical treatments, and for some people this type of treatment will be sufficient to keep symptoms under control. Topical treatments for psoriasis fall into two groups:

  • Emollients
  • Medicated treatments

Emollients are moisturisers and cleansers designed for very dry and sensitive skin. They are beneficial for people with psoriasis as they reduce dryness, scaling, cracking and itching. In addition, they can make it easier for the skin to absorb medicated creams.

Emollients come in a variety of forms. Some are designed as soap substitutes and bath oils for cleansing the skin when you’re bathing. Others are moisturisers, which should be applied to dry skin several times a day. Moisturising emollients come as ointments, creams and lotions – with ointments being thick and greasy, and lotions being watery and light.

Your GP may prescribe emollients, but you don’t need a prescription to buy them in a pharmacy. If you’re choosing your own emollient you should ideally look for a product that is non-fragranced and hypoallergenic, such as Dermalex psoriasis or Grahams natural psoriasis cream – this will reduce the chances of skin irritation. If your skin is extremely dry, opt for ointments, as these contain a high quantity of fats and are very effective at moisturising the skin.

Emollient moisturisers should be applied at least twice a day – and ideally more if you can manage it. With effective emollient treatment, it’s sometimes possible to keep psoriasis symptoms under control.

Medicated topical treatments for psoriasis tend to contain the following:

  • Vitamin D analogues
  • Steroids
  • Coal tar
  • Dithranol
  • Calcineurin inhibitors

These ingredients mostly work by slowing down skin cell production and reducing inflammation. Some can be found in over-the-counter products, while others are only available with a prescription. Dithranol is usually only administered in a hospital environment.

If emollient therapy is not sufficient in treating your psoriasis, your doctor will probably prescribe topical treatments containing vitamin D and or steroids. If these prove ineffective, other topical treatments might be necessary.

Some medicated treatments suitable for psoriasis such as hydrocortisone are available over the counter in your local pharmacy or online. However it’s best to speak to your doctor before you start using this kind of topical treatment.

Phototherapy

If emollients and medicated creams haven’t worked to bring your psoriasis symptoms under control, you may need to be referred to a dermatologist for phototherapy. This is where ultraviolet light is directed at affected areas of skin.

Phototherapy typically falls into three categories:

  • UVB therapy – This utilises ultraviolet B light, which is known to slow down skin cell production. You will need to have two or three short sessions each week for six to eight weeks.
  • PUVA therapy – This utilises a combination of ultraviolet A light, which penetrates the skin more deeply than UVB, and psoralen, which makes your skin more sensitive to light. You will take tablets containing psoralen, or have it applied to your skin. After this, UVA light will be directed at your skin.
  • Combination therapy – This is where phototherapy is combined with topical treatments such as coal tar or dithranol.

If you have psoriasis you should not self-medicate by using a sunbed, as this can put you at risk of skin cancer. Instead, speak to your doctor about safely receiving phototherapy from a dermatologist.

Systemic treatments

Systemic treatments are only recommended for people with very severe psoriasis that is not responding to other treatments. Systemic treatments can be biological or non-biological, and work throughout the entire body. They can be effective in treating severe psoriasis but can have serious side effects which you’ll have to talk through with your doctor.

Typically non-biological treatments are given as tablets and capsules, and biological treatments are given as injections.

Scalp psoriasis treatment

If you have psoriasis on your scalp, your doctor will probably recommend or prescribe a medicated shampoo. These are not designed to wash your hair – rather, they should be thought of as a treatment, applied to your hair for five to 10 minutes before being rinsed out.

Psoriasis shampoos typically contain coal tar and can be bought over the counter (two popular brands are Polytar and Neutrogena T/Gel). In addition you may need to apply a medicated application, ointment or gel to the scalp containing steroids, vitamin D analogues, or salicylic acid (this is effective in removing built up plaques). Find out more about scalp psorasis in our guide here.

Guttate psoriasis treatment

Guttate psoriasis is often triggered by a streptococcal throat infection, and its symptoms can often clear up on their own within a matter of weeks or months. In the meantime, symptoms (a rash of small, dry red spots on the skin that may be itchy and sore) can be treated with emollients and topical medicated ointments and creams.

If guttate psoriasis does not clear up, ultraviolet light therapy may be recommended.

Psoriatic arthritis treatment

Psoriatic arthritis is a condition that causes stiffness and soreness in the joints. It can be treated by your GP using painkillers and anti-inflammatories, but usually requires referral to a physiotherapist and a rheumatologist. Find out more about the symptoms and causes of psoriatic arthritis here.

What is the best psoriasis treatment?

There is no single psoriasis treatment that is better than the rest. This is because psoriasis affects everybody in different ways. If you only have mild psoriasis you might find that the best treatment for your condition is emollient therapy. If your psoriasis is more severe you might find that phototherapy combined with topical treatments keeps your symptoms under control.

To find the best treatment for your condition you should speak to a doctor.

Sources:

www.nhs.uk/conditions/psoriasis/treatment

www.psoriasis-association.org.uk/media/InformationSheets/SCALP_2016.pdf

www.psoriasis-association.org.uk/media/InformationSheets/Guttate.pdf

www.psoriasis-association.org.uk/media/InformationSheets/Steroids.pdf

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