Psoriasis & Psoriatic Arthritis: Many people who have psoriasis will have this medical condition for life. It is possible to see clearer skin by learning about psoriasis and seeing a dermatologist for treatment.
While there is no cure for psoriasis, treatment can help control psoriasis. Because psoriasis can be stubborn, gaining control may require trying different types of treatment and several appointments with a dermatologist. Some patients receive more than one type of treatment. For example, a patient may receive light therapy and medication. When psoriasis requires strong medicine, using more than one treatment often produces the best results and causes fewer side effects
Topical medication may help control mild to moderate psoriasis.
The most frequently prescribed medication for treating mild to moderate psoriasis and it is available as a cream, ointment, gel, foam, spray, and lotion. Some corticosteroids are very strong and are used for short periods of time as their aim is the help clear the skin. Others are mild and can be used for longer periods to keep psoriasis under control. No matter which type is prescribed, it is important to follow the dermatologist’s instructions. Side effects can occur when instructions are not followed. For example, applying the medication every day and suddenly stopping can cause a serious psoriasis flare. If this happens, stronger medication may be needed to control the psoriasis.
Many patients use this medication along with a corticosteroid. Using both medications as prescribed can be very helpful. To avoid side effects such as irritated skin, always use the medications as directed.
Some patients find that applying this medication to their psoriasis is enough to control the psoriasis. For patients who need a bit more help, a dermatologist may prescribe a topical (applied to the skin) corticosteroid. Women should not use a retinoid if they are pregnant.
For more than 100 years, coal tar has been used to safely and effectively treat psoriasis. Many patients disliked this treatment because it was messy and had an awful odor. Newer products are much better.
Systematic medicine works throughout the body. These medications are used to treat moderate to severe psoriasis:
Patients with moderate to severe psoriasis may be able to control their psoriasis by taking retinoid pills and getting light therapy. These retinoid pills are not the same as vitamin A pills available without a prescription.
Patients taking retinoid pills require careful monitoring. Regular blood tests are necessary. Some patients develop high cholesterol from these pills. Retinoid pills can cause other side effects, including dry skin, lips, and eyes.
Pregnant women should not take this medication. Retinoid pills can cause birth defects. If a woman wants to get pregnant she should stop taking retinoid pills for 3 years before trying to get pregnant.
This medication suppresses the immune system, which makes it an effective psoriasis treatment. While effective, cyclosporine is usually only prescribed for severe psoriasis that has not responded to other treatments. Most patients take cyclosporine for a short time, usually 3 to 6 months. Before a dermatologist prescribes cyclosporine, a patient must have blood tests and a blood pressure check. Due to possible side effects, patients taking cyclosporine require regular blood tests and blood pressure checks.
This medication has been used for years to treat moderate to severe psoriasis. It continues to be one of the most effective treatments for patients with erythrodermic psoriasis or pustular psoriasis. Patients taking methotrexate must be carefully monitored with regular blood tests for side effects. Sometime a chest x-ray or liver biopsy may be necessary.
Pregnant women must not take methotrexate. If a woman wants to become pregnant, she should not take methotrexate for at least 12 weeks before becoming pregnant. Men who are trying to get a woman pregnant also should not take methotrexate for at least 12 weeks.
If a patient drinks alcohol, it is important to tell the dermatologist before taking methotrexate. Methotrexate can cause serious side effects in people who drink alcohol regularly.
Under a dermatologist’s care, light therapy may provide safe and effective treatment for many patients with psoriasis. Because too much ultraviolet (UV) light can make psoriasis worse, it is important to see a dermatologist for treatment. Never try to self-treat by using a tanning bed or sunbathing.
Before prescribing light therapy, a dermatologist will meet with a patient. Light therapy is not for everyone as in some cases the skin is too sensitive or some patients cannot spare the time that light therapy requires. Usually, several treatments are required and the patient must go to a dermatologist’s office, psoriasis center, or hospital for the treatments. If light therapy is appropriate for a patient, the dermatologist may prescribe one of the following:
A laser can target the psoriasis and not touch the surrounding skin. Because the light treats only the psoriasis, a strong dose of light can be used. This offers many people an effective way to treat a stubborn patch of psoriasis, such as on the scalp, feet, or hands.
To receive this therapy, a patient stands in a light box or in front of a light panel. If the psoriasis responds, about 24 treatments over a 2-month period should clear the psoriasis. Although UVB is safe and effective, it does have possible side effects. These include burns, freckling, and premature skin aging. A patient’s risk of developing skin cancer appears to be about the same as a lifetime of going out in the sun without sun protection. The dermatologist and the patient will weigh the risks, and dermatologists will closely monitor their patients for skin cancer.
When light therapy is effective, some patients may receive a prescription for a home UV unit. These patients are carefully monitored and must see a dermatologist for skin checkups.