There is no cure but there is a wide array of treatment options now available for psoriasis. The aim of treatment is to keep the symptoms and condition under control. In most cases this can be achieved by treatment obtained from your GP. In a small minority this will need to be referred to specialist care in a secondary setting which is initiated by a dermatologist.
Identifying the correct treatment for patients remains the biggest challenge for clinicians. Usually a trial and error approach is undertaken and patients are encouraged to report treatment failure to their prescriber as soon as possible so an alternative therapy can be tried.
Treatment usually falls into one of three categories –
• Topical – emollients, creams, etc.
• Phototherapy – ultraviolet (UV) light therapy
• Systemic – oral and injectable medication which works throughout the body, e.g. immunosuppressants.
Initial treatment involves the use of emollients. These work by protecting the skin and by reducing water loss. This works well for mild psoriasis and aims to reduce itching and scaling. If you are using other topical treatments, these should be applied 30 minutes after the emollient.
If moisturising preparations do not have the desired effect on their own, steroid creams and ointments (topical corticosteroids) can be added in. The treatment aim is to reduce inflammation of the skin, which in turns slows down skin cell production and reduces itching. Topical corticosteroid creams can be mild, strong, potent or very potent in strength. The stronger preparations will be prescribed if the weaker ones have not worked. They should only be used on the affected skin sparingly. Overuse can lead to the skin becoming thin.
Other treatments can include –
• Vitamin D analogues
• Calcineurin inhibitors
• Coal tar
• Phototherapy (UVB, PUVA or combined)
• Tablets, capsules or injections (methotrexate, Ciclosporin, Acitretin, Etanercept, Adalimumab, Infliximab, Ustekinumab and some newer drugs)
A full explanation of these treatments can be found by clicking here to access the NHS reference website.