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Psoriatic Arthritis
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Treatment - psoriasis

What are the treatments for psoriasis?
There are many topical and systemic (medicines taken internally) ways to treat psoriasis and psoriatic arthritis.* Phototherapy is another treatment option and there are practical ways to care for the skin that may help to remove psoriasis scales, improve the skin's ability to move and bend or to make the skin feel better.

*Some of the medicines mentioned here might not be available in all countries. Ask a medical professional for advice on the names and availability of treatments in your country.

Topical Treatments
A topical treatment is any kind of medicine that can be rubbed into the skin. Topical treatments are usually the first kind of medicine that doctors use to treat psoriasis.

Common topical treatments include the following:
Dithranol/Anthralin is a is a hydroxyanthrone, anthracene derivative, medicine used to treat mild to moderate psoriasis for more than 100 years. It has no long-term side effects, but it can stain the skin and clothing. It cannot be used on the face or genitalia.

Calcipotriol is a manufactured form of vitamin D3 sold by prescription and used to treat mild to moderate psoriasis. Calcipotriol works best at flattening lesions and removing scales, and is also available in a combination with the synthetic glucocorticoid betamethasone.

Topical Steroid Cream, Lotion or Gel refer to cortisone-type drugs, not the body-building "steroids." They slow down the growth of skin cells and decrease the inflammation of skin lesions. They are available in many different strengths and forms, and are most often sold by prescription.

Tar medications help to treat the scaling, inflammation and itching of psoriasis. A doctor can either prescribe more potent tar products or weaker formulas can be bought over the counter and work well on scalp psoriasis.

Tazorotene is a prescription drug that is derived from vitamin A. It comes in a gel or cream and used to treat mild to moderate plaque psoriasis. Tazarotene works by slowing down the rapid growth of skin cells found in psoriasis.

Phototherapy means using different kinds of ultraviolet light to treat psoriasis. It is often used on patients with moderate to severe psoriasis and is often combined with topical treatments. Phototherapy is usually done in a doctor's office or with special home equipment. To achieve best results, frequents treatments (up to three times per week) may be needed.

There are different kinds of ultraviolet light, which are discussed here.

UVB phototherapy uses light called ultraviolet light B. It is a safe and effective treatment for psoriasis and is often combined with other kinds of treatments to clear patients faster.

PUVA stands for "Psoralen plus UltraViolet light A." It combines the light-sensitizing medication psoralen with UVA. PUVA can be very effective at improving psoriasis; however, extensive treatments may increase the risk of skin cancer.

Laser treatment delivers a narrow beam of ultraviolet light to target and treat smaller areas of skin lesions.

Systemic Treatments
A systemic treatment is a prescription drug that is given in the form of a pill or an injection. They can have effects on other parts of the body, not just the skin. Because of their potential risks, systemic treatments are mostly used to treat more severe cases of psoriasis.

The different kinds of systemic treatments are listed below:

Methotrexate is typically used on severe or disabling psoriasis. Methotrexate can improve the skin within four to six weeks. Side effects may include nausea, anemia, tiredness and insomnia. Doctors do regular laboratory tests to check for potential side effects to the liver and blood cells.

Cyclosporine is used in severe, difficult-to-treat cases of psoriasis. Neoral is one brand name for this medicine. Cyclosporine can improve psoriasis quickly, but its potential for kidney side effects prevents most patients from taking it for more than one year in a row. Short-term side effects may include decreased kidney function, headache, high blood pressure, high cholesterol and flu-like symptoms.

Oral Retinoids are manufactured drugs related to vitamin A that can slow down the growth of skin cells. Oral retinoids can cause birth defects, so if you are planning to have children, consult your doctor.

Biologics are a new class of systemic treatments for moderate to severe psoriasis. They are made from proteins produced by living cells, rather than being created in a laboratory through the combining of chemicals, like most pharmaceutical drugs.

Biologics, given by injection, block parts of the immune-system process that drives psoriasis. Other treatments for moderate to severe psoriasis and psoriatic arthritis work by targeting the immune system as well, but in a less specific way. The long-term safety of biologics is still being studied, so talk to your doctor about possible side effects.

Not all biological medicines have been approved in all countries. Consult a doctor to see if biological medicines are available to you.

Practical Solutions
Bath Solutions, such as apple cider vinegar, Dead Sea salt, Epsom salts, special oatmeal products or oils can be added to your bath water to help remove scales and soothe itchy skin.

Salicylic Acid helps loosen scales so other medicines can penetrate the skin. It is usually available in drugstores.

Moisturizers are an important part of caring for psoriasis lesions. Any kind of cream, lotion or ointment made to provide relief from dry, itchy skin could be of benefit for most people. Often people prefer moisturizers that have no scent or perfume added. Even cooking oils could help keep the skin lubricated.

Natural sunlight can be used to help heal lesions. Regular sunbathing is a common approach to treating psoriasis. Also, swimming in salt water can be of help. 

This information was provided as a service of the International Federation of Psoriasis Associations, a nonprofit organization dedicated to bringing psoriasis associations from around the world together to work toward improving the lives of people who have psoriasis and psoriatic arthritis. 

Contact: IFPA Secretariat / Gustavslundsvägen 143 / 167 51 Bromma / SWEDEN ● E-mail: info@ifpa-pso.com
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