Psoriasis treatments - an overview
Psoriasis is a chronic condition which affects around 2 - 3% of the global population. Symptoms can often come and go in cycles, with periods of remission. Though there is currently no cure, several treatment options are available to help keep the condition under control.
There are three main factors which typically determine the type of treatment that is recommended or prescribed by healthcare professionals:
- The type of psoriasis
- The severity of the condition
- The area of skin affected
If you have psoriasis, you may need to trial different treatment options over time to see which is most effective. For some people, a combination of treatments may be used to manage symptoms.
We will explore the different types of treatment in more detail below. If you are experiencing the symptoms of psoriasis, speak to a health care professional to discuss the most suitable treatment.
Types of psoriasis treatment
Psoriasis treatments can be categorized as:
- Topical applications - such as Polytar Shampoo
- Phototherapy
- Systemic medicines
We’ll be looking at each of these categories in more detail below, so read on for more information.
Topical applications
Topical treatments are applied directly onto the affected area of skin and come in different forms including creams, ointments and shampoos. Topicals are generally the first option for people who have mild to moderate symptoms of psoriasis. Some can be purchased over-the-counter, while others require a prescription.
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Coal tar preparations have been used to treat psoriasis for many years. In particular, shampoos containing coal tar, such as Polytar Scalp Shampoo, can help to treat and manage scalp psoriasis. Learn more about how Polytar works here.
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Emollients soften and moisturise the skin and can be used alone or in conjunction with other applications. They can also be used for washing and cleansing.
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Topical steroids target inflammation of the skin and are available in a range of strengths, depending on the severity of the condition.
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Vitamin D analogues can help to regulate the immune system and slow down skin cell growth. They are available as ointments and liquids.
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Dithranol is a topical cream that’s available in different strengths. It can be used to treat stubborn plaques of psoriasis on ‘non delicate’ skin, such as the elbows or knees.
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Topical calcineurin inhibitors are anti-inflammatories that are available as a cream or ointment. This treatment was originally developed to treat atopic eczema, but can be effective for psoriasis on thinner areas of skin, for example the face or skin folds.
Phototherapy
Phototherapy, also known as light therapy, uses natural and artificial light to treat psoriasis. It is typically recommended for moderate to severe cases, or where symptoms have not responded well to other treatments. Like some topical treatments, light therapy works by reducing inflammation in the skin and slowing down skin cell production.
There are two different types of light used in phototherapy; Ultraviolet B (UVB) and Ultraviolet A (UVA). The first, UVB, has a shorter wavelength, so it only penetrates the upper levels of the skin.
The second, UVA, has a longer wavelength, which reaches deeper levels of skin. UVA light is used in combination with a compound called psoralen, which makes the skin more sensitive to light. This treatment is sometimes known as PUVA.
Phototherapy is generally given at a hospital or treatment centre and often requires several treatments per week.
Systemic medications
Like phototherapy, systemic treatments may be recommended for moderate to severe cases of psoriasis. The term systemic means that the treatment affects the whole body, rather than a specific area. This type of treatment is generally used when the condition affects more than 5% - 10% of the body, or if other treatments have been ineffective.
There are two types of systemics:
- Non-biological
- Biological
Non-biological medicines usually come in tablet or capsule form. Methotrexate and Acitretin are non-biologics which work by slowing down or reducing skin cell production. Ciclosporin, on the other hand, works by suppressing the immune system and slowing the growth of immune cells.
Biological treatments target overactive cells in the immune system, but are generally taken as a course of injections or intravenous drips. There are four main biological treatments; Adalimumab, Infliximab, Ustekinumab and Etanercept. The duration and frequency of treatment varies between each of them.
All medications have different potential side effects, some of which can be serious. Your GP will be able to provide more information on the benefits and risks of each, and you’ll be monitored throughout the course of treatment.
If you are suffering from psoriasis, speak to a healthcare professional for more information on the treatment options available to you. The treatments listed in this article have specific guidance for use and varying side effects, so it’s important to read the label before administering them.