Psoriasis Treatment

  • Treatment

    Moisturize your skin often. Keeping your skin moist helps reduce inflammation and itching, and allows the skin to remain flexible. Regular application is the key to optimizing the benefits of moisturizer. Using moisturizer and then covering the skin with an air-tight wrapper can aid penetration, and helps concentrate the moisturizer. This method can be helpful in moisturizing particularly stubborn lesions.

    Soak in a bath to soothe the skin. Adding such products as tar solutions, Epsom salts, Dead Sea salts, and oatmeal to a bath can help remove scales and reduce itching.

    Do not pick at the scales, as doing so may cause psoriasis to spread.

    Your doctor is the best source of information on the drug treatment choices available to you.

    For moderate-to-severe psoriasis, you may be prescribed phototherapy, which involves exposing the skin to ultraviolet B light (UVB). Ultraviolet light therapy is administered in a dermatologist’s office, a psoriasis center, or a hospital. For phototherapy to be effective, most patients need three to five treatments per week for one to two months. After that, a maintenance schedule of one or two treatments per week may prolong remission. Through a prescription, patients can purchase a home UV light unit. However, a physician must monitor the process to avoid the serious side effects that can result from overexposure.

    In cases of moderate-to-severe or disabling psoriasis for which all other treatments have failed, a patient may be prescribed psoralen and ultraviolet light A (PUVA) therapy. Although PUVA therapy is often able to clear psoriasis dramatically, its side effects--premature skin aging and increased risk for skin cancer—are serious. In PUVA therapy, the drug psoralen is taken orally or applied topically to make the skin more sensitive and responsive to UVA light. The risk for side effects of PUVA therapy, which include premature wrinkling and increased potential for skin cancer, is associated with such factors as the patient’s skin type, the number of treatments, and the total dose of UVA light administered to the skin.

    Combination therapy and rotational therapy (which is used for severe psoriasis) help to reduce the risk for side effects. Combination therapy can also achieve results more quickly than therapy with just one treatment agent. For rotational therapy, one therapy is used for 1 to 3 years, and then another is used, and this process is repeated.

    If you are taking methotrexate on a long-term basis, a liver biopsy may be necessary to monitor for liver damage. People who use methotrexate should be monitored for side effects (including liver damage) with blood tests and liver biopsies.

    If you have psoriasis, climatotherapy may be a useful alternative therapy. Climatotherapy involves exposing the diseased skin to sunlight, often combined with bathing in salt water. This method is effective for 80% of people who receive regular doses of sunlight. Climatotherapy sites exist all over the world, including the Dead Sea in Israel where thousands of people with skin conditions such as psoriasis travel for the sun exposure and baths in the unique water.

    If you have psoriasis that is aggravated by stress, meditation may be helpful. Because stress may trigger or worsen psoriasis, stress-reduction strategies that promote relaxation may be beneficial. Some studies show that patients for whom relaxation therapy is combined with drug or phototherapy improve more quickly than others.

    Avoid using methotrexate if you are pregnant or are part of a couple trying to conceive. Methotrexate is an oral medication that is effective in treating many forms of psoriasis. However, significant side effects are associated with its use.

    Avoid using oral retinoids if you are pregnant or are a woman who is trying to conceive. Retinoids are generally safe for long-term use, but they can cause birth defects. Women who use retinoids must wait for a period of time before it is safe to try to become pregnant.

    In most cases, psoriasis may respond to topical or oral treatment and/or phototherapy. Although there is no cure for psoriasis, it can be greatly improved through effective treatment, which provides relief from the pain, itching, and burning, and clears skin lesions.

    The length of time for psoriasis treatment to take effect can vary from patient to patient. In some patients, it may take 2 to 12 weeks for affected areas to return to a normal thickness; the redness may remain for months.

    Psoriasis may interfere with quality of life. Psoriasis can cause impairment of daily functions and psychological distress, and may disrupt social relationships.

    Contact your physician if your psoriasis does not resolve within the specified period of treatment. When psoriasis does not respond to one therapy, a combination of treatments may be the solution. Combination therapy may promote a quicker response and reduce side effects. If psoriasis seems to become resistant to medication, the physician must reassess the regimen.

    Report any drug side effects or complications to your physician promptly. Psoriasis therapies do have side effects that can range from mild skin irritation to liver and kidney damage and high blood pressure. By informing your physician of any side effects, he or she may be able to reverse or minimize them by adjusting medication doses, adding another medication, or rotating to another therapy.

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