What Is Psoriasis And How Is It Treated?

July 14, 2020     

Skin is the largest organ in our body which is exposed out to the environment. It protects us irrespective of the climate, whether it is hot, cold or toxic. It is vulnerable to various skin conditions; most of them are acute(short) while some are chronic(long term) skin conditions.

What Is Psoriasis?

Psoriasis is also a chronic skin condition that is said to be caused due to autoimmune disorder. In this condition, the production of the skin cells will be rapid – the skin cells production is ten times faster than usual, which results in bumpy, red, and scaly patches on your skin. Psoriasis is not contagious. It can affect any part of the body but commonly seen on the elbows, knees, and scalp. Some rare types of psoriasis are seen around your nails, mouth, and the skin around genitals.

Who Is Affected By Psoriasis?

People of any age and gender can affect psoriasis condition. However, it is commonly observed in adults and is more frequent in Caucasian race. Psoriasis is a chronic skin condition, and over time the condition may improve or might be worsened. The symptoms of psoriasis range from small itchy and dry patches to severe thick, red, scaly skin plaques covering the entire body of a person. 

How Is Psoriasis Diagnosed?

Psoriasis is unique as it appears like a come & goes process in various life cycles. It can be diagnosed in two ways: 

• One is through physical examination by observing the symptoms and doctors might also ask about family history because hereditary is one of the causes. 
• The other way is through a biopsy test; a small sample of skin is taken for a lab test to confirm psoriasis. 

Note: A biopsy is suggested when your symptoms are not apparent or to confirm the condition.

Treatment For Psoriasis

There are dozens of treatments available to test the Psoriasis condition. The procedures intend to reduce the rapid growth of skin cells, relieves itching and removes dead skin. Conservative therapies are more productive, and the treatment plan is based on the size of the rash, the severity of the condition, place the rash appeared on the body, age, overall health, and other things.

A dermatologist suggests a combination of treatments which include creams and topical therapy(ointments), light therapy, and oral medication or injections. 

Topical Therapies

Corticosteroids: These are the drugs prescribed most frequently for treating mild to moderate types of psoriasis. This medication is also available as creams, gels, foams, lotions and sprays. If the rash appears in sensitive areas like the face or skin folds mild corticosteroid ointments like hydrocortisone is recommended. More potent corticosteroid drugs like Acetonide, Trianex, clobetasol are suggested to treat less-sensitive or hard areas.

Vitamin D analogues: Vitamin D supplements like calcipotriene and calcitriol are also suggested in some cases to slow down the skin cell growth. This can be used alone or along with topical corticosteroids as suggested by a skin specialist. 

Retinoids: Retinoids are available as both gel and cream. It is applied once or twice daily at the site of rashes. Usually, retinoids are not recommended for pregnant women or while breast-feeding. If you are planning to become pregnant, you should avoid using retinoids.

Calcineurin inhibitors: Tacrolimus and pimecrolimus are the calcineurin inhibitors that help to reduce the inflammation and plaque buildup. They are primarily used in thin skin areas, such as around the eyes. 

If you’re pregnant or breast-feeding women, it’s better to avoid calcineurin inhibitors. They are also not recommended to use for a long time because of an increased risk of skin cancer and lymphoma.

Salicylic acid: Shampoos made of Salicylic acid and other scalp solutions can reduce the scaling of scalp psoriasis. It can be used alone, or with other medications to enhance the ability to penetrate the skin easily. 

Coal Tar: Coal tar treatment helps to reduce scaling, itching and inflammation. It is available as OTC medication or as a prescription in other forms like shampoo, creams and oil. Coal tar is not recommended for pregnant women and who are breast-feeding.

Anthralin: Anthralin is another product of tar available in the form of a cream which is used to slow down the growth of skin cells. It can also eliminate scales on the skin and makes it smoother. It is not recommended to use on the face or around genitals. 

Light therapy

Light therapy is an effective treatment for moderate to severe form psoriasis. It is done alone or with the combination of other medications. The procedure involves exposing the affected skin area to controlled amounts of natural or artificial light. Light therapy treatment performed in several sessions. 

Sunlight: Exposing your skin to sunlight daily can improve the condition of psoriasis, and it is called heliotherapy. But you should follow this natural remedy only after confirming with your doctor whether the sunlight regimen is safe for the type of psoriasis you are affecting from.

UVB broadband: Focusing UVB light from an artificial light source is controlled doses can treat single patches of psoriasis, widespread psoriasis that doesn’t improve with topical treatments. 

UVB narrowband: This light therapy may be more potent than UVB broadband treatment which is replaced in many other therapies. They are usually administered 2 to 3 times a week until your skin condition improves and like a maintenance therapy less frequently. 

Psoralen plus ultraviolet A (PUVA): In this treatment process, a light-sensitizing medication called psoralen is given to the patient before exposing to UVA light. This is stronger and penetrates deep into the layers of skin where UVB light can’t. Psoralen medicine provided makes your skin more responsive to UVA exposure.

This treatment option is more aggressive and consistently improves your skin condition. It is often used in case of more-severe psoriasis conditions.

Excimer laser: In this light therapy process, an intense UVB light beam targets the affected skin only. Excimer laser therapy is performed in a few sessions than traditional phototherapy. 

Oral Medication & Injections:

In case of moderate to severe psoriasis conditions when other treatments options don’t work, oral or steroid inject are prescribed. Because of side effects, these medications need to use under the guidance of a psoriasis skin specialist for some periods and are alternated with other treatments.

Steroids: Your doctor prescribes an injection of triamcinolone if you have small and few psoriasis patches right into the lesions.

Retinoids: Medicines like Soriatane and other retinoids(pills) are used to reduce the production of skin cells. You may experience side effects like dry skin and muscle soreness. These drugs should be avoided if you’re pregnant or breast-feeding women or if you planned to become pregnant.

Methotrexate: Usually, Methotrexate is administered as a single oral dose once a week, which helps to decrease the skin cells production and suppresses inflammation. However, it might cause side effects like stomach upset, loss of appetite and fatigue. People consuming methotrexate for long term need a regular check of their blood counts and liver functions.

Men and women should avoid taking this medicine at least before three months if you are planning to conceive. 

Cyclosporine: It is taken orally for severe psoriasis as it suppresses the immune system. It is as effective as methotrexate but not recommended to use for more than a year continuously. This drug has some side effects people taking immunosuppressant should monitor their blood pressure and kidney functions.

Biologics: Usually, these drugs are administered through injections. They can alter your immune system to suppress the disease cycles, and shows desired improvement within weeks. Many drugs are approved by the medical councils to treat moderate to severe type of psoriasis in people who didn’t respond to initial therapies.

Biologics should be taken only when advised by experts with caution because they can suppress your immune system causing severe infections. People taking these type of treatments should particularly be screened for tuberculosis.

Other Medications: Thioguanine and hydroxyurea are a kind of medications that are prescribed when other drugs can’t improve your skin condition. Apremilast (Otezla) is an oral drug taken twice a day which is effective at reducing itching.

Treatment considerations

Though doctors suggest treatments based on the type, areas of skin affected, and severity of psoriasis. Starting with the topical creams and phototherapy is the traditional approach, in people experiencing typical skin lesions and progressing to severe ones. But in people suffering from a pustular or erythrodermic type of psoriasis or psoriasis associated with arthritis require systemic therapy from initial stages of treatment. 

Alternative psoriasis medicine

Several alternative therapies are available that can ease the symptoms of psoriasis, which include special diets, dietary supplements, creams, and herbs. However, there is no clinical evidence. But some therapies generally claim that they are safe and might reduce itching and scaling in people. Avoiding triggers like stress is also useful in easing symptoms.

Aloe extract cream, which is taken from the aloe vera plant leaves can ease itching scaling and inflammation and Fish oil supplements used in combination of UVB therapy help to reduce the extent of affected skin. Oregon grape which is also known as Barberry may reduce the severity of psoriasis. Essential oils in aromatherapy show desired results in reducing stress and anxiety.

Home Remedies For Psoriasis

It is not possible to reduce the risk of a flaring up of symptoms with by following strategies of home remedies:

Home Tips include:

• Practising yoga, exercises, meditation can help to reduce stress
• Maintain a healthy weight.
• Eat a balanced diet
• Recognize the triggers stay away and also avoid food triggers
• quit smoking and drinking alcohol if you have psoriasis
• Home remedies to reduce itching due to psoriasis:
• Keep your skin moisturized, and a dermatologist is best who can recommend a proper moisturizer for your skin.
• Avoid hot showers and take cold showers for at least 10 minutes or use a cold pack.

Psoriasis is a long term chronic condition that can be isolating and causes severe discomfort. However, people have various treatment options to manage the symptoms. For more detailed information about this psoriasis condition and available treatment options, consult Dr Swapna Priya, the best psoriasis doctor in Hyderabad. Make a consultation right away and live a healthy life.