Psoriasis Treatment

About Psoriasis

Psoriasis appears as scaly, reddened patches of skin. It can appear anywhere on the body, but it's most common in the following locations:

• Elbows
• Knees and Legs
• Face and Scalp
• Palms and Soles
• Lower Back

The patches may itch or hurt.

Doctors think that psoriasis is caused by a problem with the immune system. For some reason, a faulty signal in the immune system tells the skin to shed cells too quickly. The dead cells build up into the characteristic silvery scales. The skin underneath is usually inflamed and appears pink or red.

Types of Treatment

Making psoriasis go away is a matter of treating both the skin rash and the underlying problem. There are three categories of treatment:

• Topical treatments are applied directly to the skin.
• Phototherapy involves the use of special lights.
• Systemic therapy refers to pills and injections that treat the immune system.

One of the frustrations of psoriasis treatment is that something that works well for one person might not help someone else. Also, treatments can work for a while and then stop. It may take a process of trial-and-error to find the right regimen.

Home Remedies

Psoriasis must be diagnosed by a doctor. It can mimic other skin diseases, some of which are serious. Once the diagnosis is made, there are some over-the-counter topical treatments that may help:

• Moisturizers. Using a heavy moisturizing cream after bathing can help with mild psoriasis. Moisturizing bath oils can help, too.
• Coal tar. Products containing coal tar can help relieve symptoms. Look for gels, ointments, and shampoos. Drugstores often don't stock them; try looking online. Unfortunately, products with a high concentration of coal tar can be smelly and will discolor clothing.
• Hydrocortisone cream. Hydrocortisone is a type of steroid. It helps calm the immune reaction at the surface of the skin. The over-the-counter creams can be applied once or twice a day over small areas. Be sure to follow the label instructions and check with a doctor before using these creams over large areas or long-term.
• Oatmeal baths. Colloidal oatmeal baths can help soothe itching and remove scales.
• Epsom salts or Dead Sea salts. Soaking for about 15 minutes in an Epsom salt or Dead Sea salt bath can also help remove scales.
• Salicylic acid. Creams and shampoos containing salicylic acid can help remove the scales.
• Anthralin. Anthralin (brand name Drithrocreme) seems to help by slowing down cell reproduction. However, it can be irritating if left on the skin and can stain clothing and bathroom fixtures.

Simply getting out into the sun can help, too. Ultraviolet light, which is part of natural sunlight, actually helps calm the immune reaction. Daily exposure to sunlight (in short doses, not long enough to lead to sunburn) can improve the rash.

Prescription Remedies

A doctor can prescribe more heavy-duty psoriasis treatments. Prescription treatments may be needed for moderate to severe cases or to keep mild cases under control. Possibilities include:

• More potent steroid creams. Strong steroid creams can help when over-the-counter versions fail. However, long-term use can cause thinning of the skin. They also should not be used long-term over large areas of the skin, because the steroids can be absorbed into the body and cause serious problems.
• Artifical light therapy. Artificial sources of ultraviolet light can be used in the doctor's office, sometimes in combination with medicines that make the skin more sensitive to the light rays.
• Medicines to suppress the immune system. Severe cases often improve with medications that reduce the action of the immune system. Methotrexate and cyclosporine are common choices. There are also some newer drugs on the market, which a doctor can help you learn about. These medicines require close supervision, because suppressing the immune system increases the risk of developing potentially serious infections.
• Other medications. Tazarotene is a topical retinoid, similar to the medicine in the acne pill Accutane. It may help with severe cases. The topical preparation Calcipotriene, a special form of Vitamin D, seems to slow down the overgrowth of skin cells. Like all medications, these creams do have side effects, and they're not right for everyone. Your doctor may have other suggestions, as well.

New Forms of Psoriasis Treatment

Researchers are working to find new and better types of psoriasis treatment. Medicines already in use for other skin conditions, such as eczema, may turn out to be helpful for psoriasis. As doctors learn more about how and why psoriasis happens, new treatments may become available. If you have psoriasis and haven't been to the doctor lately, it may be worth a visit to see what's new.

For More Information

• PsoriasisNet. From the American Academy of Dermatology.
• Mayo Clinic. Search for "psoriasis" to read information reviewed by Mayo Clinic doctors.