Psoriasis Treatments

Psoriasis is a very common condition that can occur at any stage of life. Psoriasis has many different varieties and can morph into different subsets with varying appearance. Psoriasis can affect the scalp, nails, skin folds, palms and soles, as well as the more typical locations such as the elbows, knees and lower back. In some cases joints can become inflamed in association with psoriasis leading to joint pain and stiffness (called psoriatic arthritis). Treatments include creams, light therapy (phototherapy, UVB), tablets and injections.

Psoriasis is not an infection and is not contagious in any way. Various causes have been identified for psoriasis, the most important being your genetic makeup. Factors which can worsen or cause a flare of psoriasis include stress, some medications and infections. Severe psoriasis can be related to other health problems.

Psoriasis

Psoriasis is a chronic skin condition caused by an overactive immune system, leading to the rapid growth of skin cells and the formation of red, scaly patches on the skin. While the exact cause of psoriasis is unknown, it is believed to be a combination of genetic and environmental factors.

 

Common symptoms of psoriasis include;

  • Red and salmon-pink coloured, raised, inflamed patches of skin
  • Silvery-white scales or plaques on the skin
  • Dry, cracked skin that may bleed
  • Itching, burning, or soreness
  • Thickened, pitted, or ridged nails
  • Swollen and stiff joints

General Lifestyle Measures for Psoriasis

Taking care of your skin and overall health can have a significant impact on managing psoriasis. Here are some general lifestyle measures that can help;

 

Keep your skin moisturised

Apply a fragrance-free moisturiser regularly, particularly after bathing, to lock in moisture and protect your skin.

 

Avoid triggers

Identify and avoid common psoriasis triggers, such as stress, infections, injuries to the skin, and certain medications.

 

Maintain a healthy diet

Eating a well-balanced diet rich in fruits, vegetables, and whole grains can help support your skin and immune system.

 

Manage stress

Stress can exacerbate psoriasis symptoms, so practice stress-reducing techniques.

 

Limit alcohol consumption

Excessive alcohol intake may worsen psoriasis symptoms, so it’s essential to drink responsibly.

 

Skincare for Psoriasis

Suitable skincare is crucial for managing psoriasis symptoms. Here are some tips to help you maintain healthy skin;

  • Choose gentle, fragrance-free cleansers and moisturisers designed for sensitive skin.
  • Avoid hot showers or baths, as they can strip your skin of natural oils.
  • Pat your skin dry after bathing or showering instead of rubbing.
  • Use a humidifier in your home to maintain a healthy humidity level.

 

Specialised Treatments for Psoriasis

For more severe cases of psoriasis, specialised treatments may be necessary. Your dermatologist may recommend one or more of the following treatments;

  • Topical corticosteroids
  • Topical Vitamin D analogues
  • Topical retinoids
  • Calcineurin inhibitors

 

Phototherapy for Psoriasis Treatment

Phototherapy, or light therapy, has proven to be an effective treatment option for managing psoriasis, particularly when other treatments like topical medications have not provided sufficient relief. Phototherapy harnesses the power of ultraviolet (UV) light to help reduce inflammation, slow down the rapid growth of skin cells, and alleviate psoriasis symptoms such as itch.

 

There are several types of phototherapy used to treat psoriasis:

  • Narrowband UVB (NB-UVB): A widely used form of phototherapy for psoriasis, NB-UVB emits a specific wavelength of UVB light that effectively treats psoriasis symptoms with a lower risk of sunburn.
  • Broadband UVB (BB-UVB): A less commonly used form of phototherapy that employs a broader range of UVB wavelengths, BB-UVB may be somewhat less effective and carry a higher risk of side effects compared to NB-UVB.
  • PUVA (psoralen plus UVA): This treatment involves a combination of a photosensitising drug called psoralen, administered orally or topically, with UVA light exposure. PUVA is rarely used anymore and generally reserved for more severe cases of psoriasis or when other treatment options have been ineffective.

 

Phototherapy treatment plans typically consist of multiple sessions per week over several weeks, with the frequency and duration determined by your dermatologist based on your specific condition and treatment response. Although phototherapy is generally considered safe, potential side effects may include skin redness, burning sensations, and an increased risk of skin aging and skin cancer with long-term use. It is essential to discuss the risks and benefits with your dermatologist before initiating phototherapy treatment.

Other Treatments for Psoriasis – Oral Medications and Biologics

In some cases, advanced treatments may be necessary to manage moderate-to-severe psoriasis that has not responded to traditional therapies. These treatments include:

 

  • Oral medications: Systemic drugs like methotrexate, acitretin, and cyclosporine can help manage psoriasis symptoms by targeting the immune system and reducing inflammation. These medications may have side effects, so it’s essential to discuss the risks and benefits with your dermatologist before starting treatment.
  • Biologics: These medications are designed to target specific parts of the immune system involved in the development of psoriasis. Biologics are typically administered via injection and are usually reserved for severe cases of psoriasis that have not responded to other treatments. Certain criteria need to be met for PBS subsidised access to biologic medications.

As with any medication, there may be side effects, and it’s essential to discuss the risks and benefits with your dermatologist before starting treatment.

 

When to See a Dermatologist

If you’re struggling with psoriasis symptoms despite following lifestyle measures and skincare tips, it’s important to consult a dermatologist. They can evaluate your condition, identify potential triggers, and recommend appropriate treatments, including specialised and advanced options if necessary.

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