Health Conditions

Many safe and effective treatments are available for improving the condition of the skin by reducing the swelling, redness, flaking, and itching associated with plaque psoriasis. However, since psoriasis is a chronic (long-lasting) disease, it may be a challenge to treat. Generally, treatment is started with the least powerful treatment option. If this option fails, a stronger medication may be used. This cycle will continue until an acceptable combination is found.

Psoriasis Treatment Steps:

Step 1

Topical treatments are used first in treating plaque psoriasis because they tend to have the fewest side effects. These medications are commonly used in combination with phototherapy for the more severe cases of psoriasis. The following are the most common topical medications:

• Anthralin: may slow down the rapid growth of skin cells.

• Coal Tar: works by slowing skin cell growth.

• Calcipotriene (Dovonex): helps to regulate skin cell production and may be used in combination with topical steroids. This product should not be used in combination with products containing salicylic acid because this combination will make the medication ineffective.

• Moisturizers/Emollients: help keep the skin moist and prevent the cracking and itching associated with psoriasis.

• Salicylic acid: helps to loosen and remove the build-up of skin cells or scales.

• Steroids: may slow down the rapid growth of skin cells and decrease the swelling associated with the rashes.

• Tazarotene (Tazorac): is available as a cream or gel and is applied once a day. This medication is thought to inhibit increased skin cell growth.

Step 2

Phototherapy (UV light therapy) is used for individuals with moderate to severe psoriasis who do not respond to topical treatments or whose condition is too severe for topical therapy.

• Many people with psoriasis use sunlight to help heal lesions. Short, multiple sunbathing sessions can prove helpful in treating psoriasis. However, caution must be exercised because sunburn could actually worsen psoriasis.

• PUVA (psoralen plus ultraviolet light A) is also called "photochemotherapy." Psoralen is a medication that can be taken orally or applied topically to increase sensitivity to ultraviolet light A. PUVA therapy slows the growth of psoriasis.

• Ultraviolet Light B (UVB) is used to reduce the number of skin cells that grow at a faster rate in people with psoriasis and can reduce inflammation in the skin lesions.

• Lasers represent the newest type of phototherapy for psoriasis. They work by destroying the tiny blood vessels in the skin that contribute to the formation of psoriasis lesions.

Natural sunlight and artificial ultraviolet light slow the rapid growth of skin cells. Although ultraviolet light or sunlight can cause skin wrinkling, eye damage, and skin cancer, light treatment is safe and effective under a doctor's supervision. People with psoriasis all over their entire body may require treatment in a medically approved center, equipped with special light boxes for full body exposure. Psoriasis patients who live in warm climates may be directed to carefully sunbathe. Seek the advice of a doctor before self-treating with natural or artificial sunlight.

Step 3

Systemic drugs (oral or injectable medications) are usually reserved for individuals with moderate to severe psoriasis or disabling psoriatic arthritis. The following systemic medications are the most commonly used:

• Alefacept (Amevive) or efalizumab (Raptiva) works by blocking certain cells in the body's defense system (immune system) believed to trigger the start of increased skin cell growth.

• Methotrexate works by halting the production of skin cells.

• Cyclosporine (Neoral, Sandimmune) is believed to slow down the production of skin cells.

• Acitretin (Soriatane) is thought to inhibit skin cell growth.

Other medications are sometimes used to treat psoriasis, although they do not have FDA-approval for treating psoriasis. These medications include hydroxyurea (Hydrea), mycophenolate (CellCept), sulfasalazine (Azulfidine), isotretinoin (Accutane), and 6-thioguanine (6-TG).

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.