There is currently no cure for psoriasis, however, with the correct management, most people will be able to control their flare-ups, meaning they are less frequent and less severe.
Psoriasis treatment varies slightly depending on what type or types that you are suffering from, the whereabouts on your body your skin is affected and the severity of your condition.
The most commonly used treatments for psoriasis are topical creams, ointments and gels that are applied directly to the affected skin. However if you are referred to a specialist you may also be prescribed UV therapy as well as systemic or biologic medications.
Topical treatments fall into four categories but are often used in conjunction with one another:
- Emollients & Moisturisers
- Vitamin D Preparations
- Topical Steroids
- Coal Tar
Moisturisers and emollients
These help to hydrate and protect dry, flaky skin. They can be applied liberally to the skin as part of your daily skincare regime to prevent and reduce symptoms, such as itch and irritation. Some emollients such as Dermol and Cetraben bath additives can be used as a substitute for soap or shower gel to help prevent your skin from drying out further while bathing. For all other emollients, it is advised that they are applied immediately after bathing to ensure maximum hydration is achieved.
Emollient Creams are often preferred for use in the daytime as they are generally designed to be lighter non-greasy formulas, for more natural feeling hydration. Example emollient creams include:
Emollient Ointments are intensely moisturising but tend to be greasier than creams so are generally favoured for overnight use. They do not generally contain any preservative, unlike their cream counterparts, so are less likely to irritate sensitive skin. Examples of ointments include:
Due to the prevalence of scalp psoriasis, new products have been manufactured and become available that have been specifically designed to be easily applied directly to the scalp. Examples of moisturising scalp treatments include:
Emollients and moisturisers are the first line over-the-counter treatment for symptoms of psoriasis. For those people whose emollient creams have not worked or for those suffering from moderate to severe cases of psoriasis prescription creams, ointments, lotions, gels and foams would be the next treatment option.
Vitamin D preparations
Vitamin D gels, ointments and foams are only available on prescriptions and are either used alone or in conjunction with a topical steroid. With correct use, they can reduce inflammation and reduce redness, scaling and dry skin within a matter of weeks. For best results, topical Vitamin D should be applied to the skin half an hour after thoroughly moisturising the affected skin with an emollient. They are not recommended for use in delicate areas such as the face and should not be used long-term as they can cause a build-up of calcium levels in the blood and when combined with steroids can cause thinning of the skin.
Vitamin D (calcipotriol) only formulas:
Vitamin D (calcipotriol) and steroid (betamethasone) combined:
Corticosteroids are a common treatment for psoriasis as well as other skin conditions such as eczema and dermatitis. They are applied directly to the affected areas of the skin to reduce inflammation and thickening. Depending on the severity of your psoriasis, there are varying strengths or potencies of topical steroids that can be prescribed. Mild or low-strength steroids can be bought without a prescription. Steroids are only suitable for short-term use because they can cause certain side effects that can cause the skin to become fragile and irritated.
Stronger preparations for scalp psoriasis:
Coal Tar preparations
The longest-standing treatment for psoriasis, coal tar, has been used for hundreds of years. Today coal tar is most commonly used to treat scalp psoriasis and so often comes as a shampoo, although creams, lotions and ointments are also available. Coal Tar has anti-inflammatory and anti-scaling properties that help to settle and soothe symptoms of psoriasis. Often coal tar treatments are used in conjunction with salicylic acid, a keratolytic agent that helps the body to shed thickened, scaly skin.
Examples of products that contain just coal tar extract:
Coal tar with salicylic acid:
If using topical treatments has proven ineffective at controlling your psoriasis, you may want to consider seeking further treatment through a specialist dermatologist.
If you think that your skin has become infected you may require a prescription of antibiotics or antifungal tablets or creams.
If you have tried treating your skin condition with topical creams and it has not been effective you should discuss with your doctor about seeing a dermatologist who will be able to advise you on specialist treatments, including:
- Ultraviolet light therapy - Phototherapy that helps reduce inflammation of the skin.
- Systemic Treatments - tablets that suppress your immune system.
Biologic Treatments - medicines that block the chemicals that cause an inflammatory response.