Severe Psoriasis – Treatment Options to Consider

Psoriasis is an autoimmune disease associated with abnormal skin patches. These skin patches are typically dry, itchy, and scaly. This condition arises when there is an abnormally rapid growth of the epidermal layer of the skin.

Treatment options for psoriasis
Psoriasis cannot be completely cured. However, it can be treated by various methods. Psoriasis treatment options are broadly classified into the following three types.

Topical treatment

  • Topical cortisol – Mild cortisol can reduce inflammation and relieve itching. These are prescribed for sensitive areas such as the face or skin folds, for treating patches of damaged skin.
  • Vitamin D analogs – Synthetic forms of vitamin D like Calcipotriene treats mild to moderate psoriasis and slows skin cell growth.
  • Moisturizers – Moisturizers and emollients like petroleum jelly and mineral oil, when applied on psoriasis, has shown clearance of plaques.
  • Anthralin – This helps in slow skin growth and removal of scales on the skin. Although it is one of the effective psoriasis treatment options, it can irritate the skin or scalp, if applied for long. Hence, it is recommended that you wash it off after some time.
  • Salicylic acid – It causes sloughing of dead cells, thereby reducing scaling. Available in the form of medicated shampoos and scalp solutions, when combined with other medications, salicylic acid may become more effective.
  • Coal tar – A derivative of coal, it reduces inflammation and scaling. It comes as creams, shampoos, and oils and has a strong odor.
  • Topical retinoids – These are derived from Vitamin A and can decrease inflammation. Avoid using it directly on the skin when exposed to the sun.

Ultraviolet therapy

  • Sunlight – Psoriasis, when exposed to ultraviolet rays from sunlight, slows skin cell production and reduces scaling and inflammation. However, intense exposure may be harmful to the condition.
  • UVB phototherapy – Ultraviolet B phototherapy is one of the psoriasis treatment options which can be used to treat single patches of psoriasis. Special lamps are used for controlled light exposure on the affected area. There are two types of UVB phototherapy – broadband and narrow band.
  • Goeckerman therapy – A combination of UVB and coal tar treatment is known as the Goeckerman treatment. When combined, these therapies prove more effective than either one alone.
  • Psoralen plus ultraviolet A (PUVA) – This is a kind of therapy which involves light-sensitizing medication before UVA phototherapy. The UVA light penetrates deeper into the skin than the UVB light, and psoralen makes the skin more responsive to UVA exposure.

Systemic agents
Oral or injected medicines are psoriasis treatment options prescribed to individuals who are resistant to other forms of treatment. These include the following.

  • Methotrexate – These suppress inflammation and production of skin cells.
  • Cyclosporine – Cyclosporine suppresses the immune system. Hence, its long-term dosages are not recommended.
  • Other medications – Etanercept, Infliximab, Adalimumab, Ustekinumab, Golimumab, Apremilast, Secukinumab, and Ixekizumab are medications that can be considered when other medicines can’t be given.

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