Treatment Options for Psoriasis

Psoriasis is a type of autoimmune ailment that accelerates the growth of skin cells abnormally. Consequently, those diagnosed with psoriasis experience inflammation and build-up of scales on the skin, which are referred to as plaques. These plaques, which may elicit itchiness, a burning feeling, or stinging, can appear anywhere on the body, though typically they are found on the scalp, knees, and elbows.

Psoriasis can be categorized into five types: plaque, guttate, inverse, pustular, and erythrodermic. The symptoms and recommended treatment can differ, rooted in the specific type of psoriasis. Moreover, about one-third of psoriasis patients may also develop psoriatic arthritis (PsA), if they have not already.

While psoriasis doesn't currently have a known cure, a mix of treatments might be suggested by your healthcare provider to alleviate your symptoms.

Your healthcare provider could recommend topical treatments to begin with. These are creams or lotions applied directly to the skin. They may include topical steroids, anti-inflammatory creams, or over-the-counter (OTC) medicated shampoos and lotions.

When considering OTC treatments, the National Psoriasis Foundation urges patients to refer to its Seal of Recognition program for products safe for use by psoriasis patients. The FDA endorses OTC treatments containing salicylic acid (which aids in shedding the dead skin cells and softening the plaques) and coal tar (which reduces inflammation and decelerates cell growth).

Some topical treatments can cause skin irritation. Testing new products on a small patch of skin is advisable to check reaction. Consulting with a dermatologist or your healthcare provider for product recommendations may also be beneficial.

Phototherapy, also known as light therapy, can also be beneficial. The UV rays applied to the skin can slow down cellular growth, reducing pain and inflammation.

An article in the Dermatology and Therapy journal reported that participants who received 20 to 36 light therapy sessions experienced the most remarkable reduction in inflammation and itching. Phototherapy is usually safe for use two to three times per week.

In majority of cases, a healthcare provider should assist you with the therapy treatment in their office or clinic. However, some psoriasis patients might opt to purchase a phototherapy machine for home use. Many insurance plans will cover light therapy in a clinical setting, but not the cost of a home machine.

Phototherapy is generally safe with redness on the skin being a normal initial reaction. It may also result in temporary and more long-term side effects.

If you have a history of skin cancer or have a condition that sensitizes you to UV light such as lupus, your healthcare provider will not recommend light therapy.

A range of prescriptions can be used in the treatment of psoriasis, with systemic medications and biologics being the most popular.

Systemic treatments are prescription oral drugs used to slow skin cell growth rate. They are often used in moderate to severe psoriasis cases. Each systemic option has different potential side effects, and your healthcare provider can help you understand the risks and recommend the best drug for you.

Biologics are drugs administered via injection or intravenous infusion. These medications operate on specific parts of the immune system by blocking T-cells and proteins that accelerate skin cell growth.

If systemic medication and topical treatments aren't effective, your healthcare provider may recommend biologics. Generally used by persons with moderate to severe psoriasis, biologic medications come in various brands with unique risk factors and benefits.

The risks of using biologics are contingent upon your medical history and psoriasis type and severity. These may increase infection risks. Should you develop flu-like symptoms such as a fever, cough, or others, you should inform your healthcare provider. They may lessen the frequency of biologic usage or propose another treatment method.

Some people with psoriasis find that natural remedies help ease symptoms when used in combination with traditional treatments. In fact, more than 40% of people with psoriasis who responded to a National Psoriasis Foundation 2019 survey published in the Journal of the American Academy of Dermatology said they use complementary remedies as part of their treatment plan.

It's important to speak with your healthcare provider before using any complementary medicine. Generally, natural remedies should only be used in conjunction with traditional treatments such as topical creams or medications. 

If you are interested in using natural remedies, some options to consider include:

In general, it’s good practice to test any topical medicines on a small area of the skin, such as the inside of your wrist. This can help protect you from a significant reaction if your body doesn’t respond well to the substance.

It can be frustrating to manage psoriasis symptoms such as dryness, itching, and inflammation. These lifestyle suggestions may supplement your treatment plan:

Receiving a diagnosis for psoriasis can feel like a big change. While there is no cure for the condition at this time, the good news is that a variety of treatments are available to help you manage your symptoms. 

Your treatment plan will vary depending on the type of psoriasis you have. Generally, you can use topical treatments, medication, light therapy, natural remedies, and lifestyle changes to reduce inflammation, pain, and visibility of your patches. Many people with psoriasis prefer to use a combination of treatments that is best fit for their symptoms, diagnosis, and overall lifestyle. Your healthcare provider can help you find the combination that’s the most helpful for you.