What Are Common Treatments for Psoriasis?

Psoriasis occurs when an overactive immune system targets healthy skin cells and speeds up the production cycle of skin cells. The rapid buildup of these cells on the skin causes psoriasis lesions. The condition is not contagious and tends to come and go in cycles. It can get worse for a short time, then get better for a while.

Psoriasis can increase the risk of heart disease, high blood pressure and diabetes. People with the condition should see their primary care doctors regularly to prevent problems, Dr. Gilbertson says.

Psoriasis can affect anyone, but it is more common in adults. If a family member has psoriasis, you may have a higher risk because of genetic factors.

Psoriasis symptoms differ from person to person but can include red patches with silvery scales, dry skin, itching, thick nails and swollen joints. Severity of these symptoms can fluctuate, with periods of remission and flare-ups.

Certain things may trigger a flare, including:

• Infections
• Stress
• Weather changes that dry out your skin
• Certain medications
• Cuts, scratches and sunburns

Symptoms of psoriasis depend on which type you have. The main types are:

This is the most common type of psoriasis. It appears as raised patches of inflamed, itchy and painful, scaly skin. In some, the skin may be red with silvery white scales. It often appears on the scalp, knees, elbows, belly button area and lower back.

This type causes smooth, red patches in skin folds, including the underarms, under the breasts and in the genital and buttocks areas.

This type usually begins in childhood or early adulthood. It causes small, raised scaly red spots on the skin after an infection. It often appears on the arms, legs and torso. An outbreak is usually triggered by a bacterial infection, such as strep throat, that sets off an immune system reaction.

This is a rare form of psoriasis. It is marked by white, pus-filled painful blisters and inflamed or reddened skin. It may appear only in certain parts of the body, such as the hands and feet, or it may cover most of the body.

This is a rare and aggressive form of psoriasis. It causes red and scaly skin over much of your body and can be life-threatening.

About 30% of people with psoriasis get psoriatic arthritis which causes pain, stiffness and swelling in and around the joints, including the shins.

Treatment for psoriasis varies depending on the type and severity of the condition. It also depends on how much of the body is affected.

Topical treatments are usually the first step in treating mild to moderate psoriasis. They help reduce swelling, slow skin cell growth and remove scales. These include corticosteroids and numerous nonsteroidal anti-inflammatory drugs.

“These are treatments that you apply directly onto your skin,” Dr. Gilbertson says. “They come in many different forms, such as creams or ointments, lotions, or sprays. They come in different strengths, from over the counter to prescription strength.”

Also known as light therapy, this treatment uses natural (sunlight) or artificial ultraviolet light to help reduce scaling and inflammation. “Your doctor may prescribe phototherapy, which is also known as light therapy, either alone or in combination with other treatments,” Dr. Gilbertson says.

“UV rays from the sun may improve psoriasis,” he adds. “However, too much sun can also worsen the condition. It’s important to consult with your doctor about the safest way to use sunlight as treatment.”

Your doctor may prescribe systemic medications — which are drugs that work throughout the body — if you have moderate to severe psoriasis. These include:

Drugs like retinoids, methotrexate, and mycophenolate mofetil (CellCept) — may be prescribed for severe psoriasis that does not respond to other treatments. These drugs target the immune system to reduce overactivity.

Biologics come in oral and injectable forms that can be self-administered or done in an outpatient setting.

These are strong medicines that inhibit the different mechanisms of the immune system that cause inflammation. “They have revolutionized the treatment for psoriasis and psoriatic arthritis,” Dr. Gilbertson says.

Every psoriasis treatment has potential side effects. Talk to your doctor about this and keep track of how the treatment affects your health.

“While these drugs can help make you feel better, they can cause serious side effects,” Dr. Gilbertson says. “As with any medication, they should be used with caution. The goal should always be to find the right treatments with the fewest possible side effects.”

Living with psoriasis can be difficult. However, it is now easier to find the right treatment.

“There are now over ten medications that for my patients have been life changing with almost complete clearance of their disease,” says Dr. Gilbertson. “The most important thing is to work with your doctor to find the best treatment.”

To manage psoriasis over time, it’s not enough to just rely on medicine. Lifestyle changes can greatly affect how the condition progresses and how the patient feels. It’s important to reduce stress, eat well, avoid triggers and see your doctor regularly.