How can psoriasis be treated?

Psoriasis is a chronic skin condition that causes red, scaly patches on the skin. It can affect any part of the body, but it often occurs on the elbows, knees, scalp, and lower back.

Psoriasis is not contagious, but it can be uncomfortable and affect your quality of life. There is no cure for psoriasis, but there are various treatments that can help reduce the symptoms and prevent flare-ups.

The type of treatment you need depends on how severe your psoriasis is, how it affects you, and what works for you. Some of the common treatments for psoriasis are:

Topical treatments: These are creams, ointments, gels, or solutions that you apply directly to the affected skin. They can help reduce inflammation, itching, and scaling. Some of the topical treatments for psoriasis are:

Steroid creams: These are anti-inflammatory drugs that can help calm down the immune system and reduce redness and swelling. They come in different strengths and should be used as prescribed by your doctor. They can cause side effects such as skin thinning, burning, or irritation if used for too long or on sensitive areas.

Vitamin D analogues: These are synthetic forms of vitamin D that can help slow down the growth of skin cells and reduce scaling. They include calcipotriene (Dovonex, Sorilux) and calcitriol (Vectical). They can be used alone or in combination with steroid creams. They can cause side effects such as skin irritation or dryness.

Retinoids: These are synthetic forms of vitamin A that can help regulate the growth and differentiation of skin cells. They include tazarotene (Tazorac, Avage) and roflumilast (Zoryve). They can be used alone or in combination with other topical treatments. They can cause side effects such as skin peeling, burning, or sensitivity to light. They are not recommended for pregnant or breastfeeding women or those who intend to become pregnant.

Calcineurin inhibitors: These are drugs that can help suppress the immune system and reduce inflammation and plaque buildup. They include tacrolimus (Protopic) and pimecrolimus (Elidel). They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are irritating or harmful. They can cause side effects such as skin burning, itching, or infection. They are not recommended for pregnant or breastfeeding women or those who intend to become pregnant.

Coal tar: This is a substance derived from coal that can help ease psoriasis-related inflammation, itching, and scales. It comes in various forms such as ointment, shampoo, or soap. It can be used alone or in combination with other topical treatments. It can cause side effects such as skin redness, dryness, or sensitivity to UV light. It is not recommended for pregnant or breastfeeding women.

Phototherapy: This is a treatment that involves exposing the affected skin to artificial or natural light sources. It can help slow down the growth of skin cells and reduce inflammation and scaling. Some of the phototherapy options for psoriasis are:

Ultraviolet B (UVB) therapy: This involves exposing the skin to UVB rays from a special lamp or sunlight. It can be done at home or in a clinic. It can be used alone or in combination with topical treatments. It can cause side effects such as skin burning, aging, or cancer.

Psoralen plus ultraviolet A (PUVA) therapy: This involves taking a drug called psoralen that makes the skin more sensitive to UVA rays from a special lamp or sunlight. It can be done at home or in a clinic. It can be more effective than UVB therapy but also more risky. It can cause side effects such as nausea, headache, skin burning, aging, or cancer.

Excimer laser therapy: This involves using a laser device that emits a high-intensity beam of UVB light to target specific areas of affected skin. It can be done in a clinic. It can be more precise and less damaging than other forms of phototherapy. It can cause side effects such as skin blistering, redness, or scarring.

Systemic treatments: These are drugs that affect the whole body and are taken by mouth or injection. They can help suppress the immune system and reduce inflammation and scaling. They are usually reserved for moderate to severe psoriasis that does not respond to other treatments or affects large areas of the body. Some of the systemic treatments for psoriasis are:

Methotrexate: This is a drug that can interfere with the growth and function of immune cells and skin cells. It can be taken by mouth or injection. It can be used alone or in combination with other treatments. It can cause side effects such as nausea, vomiting, liver damage, lung problems, or increased risk of infection. It is not recommended for pregnant or breastfeeding women or those who intend to become pregnant.

Cyclosporine: This is a drug that can inhibit the activity of immune cells and reduce inflammation. It can be taken by mouth or injection. It can be used alone or in combination with other treatments. It can cause side effects such as high blood pressure, kidney problems, headache, or increased risk of infection. It is not recommended for pregnant or breastfeeding women or those who intend to become pregnant.

Acitretin: This is a drug that can regulate the growth and differentiation of skin cells. It can be taken by mouth. It can be used alone or in combination with other treatments. It can cause side effects such as dryness, peeling, hair loss, joint pain, or increased cholesterol levels. It is not recommended for pregnant or breastfeeding women or those who intend to become pregnant.

Apremilast: This is a drug that can block an enzyme that causes inflammation. It can be taken by mouth. It can be used alone or in combination with other treatments. It can cause side effects such as diarrhea, nausea, headache, weight loss, or depression.

Biologics: These are drugs that are made from living cells and target specific molecules involved in the immune system and inflammation. They are given by injection or infusion. They can be used alone or in combination with other treatments. They can cause side effects such as injection site reactions, allergic reactions, increased risk of infection, or reactivation of latent infections such as tuberculosis or hepatitis B.