Generally, treatments for psoriasis are divided into topical treatments (applied to your skin), systemic treatments (affect the whole body, like tablets or injections), and phototherapy (light treatment).
Please read the information leaflet that comes with your treatment and talk to your doctor if you are unsure how to use your treatment, or for how long you should use it. Topical treatments include:1
Moisturisers (emollients) – these can be used in addition to other treatments to help keep the skin supple and reduce cracking and itching.
Coal tar preparations – these used to be the mainstay of treatment, but tend to be messy, don’t smell nice and can stain clothes. More modern versions may be less messy and smell less strong. Coal-tar based shampoos can be useful for scalp psoriasis.
Dithranol creams – these can work well but irritate normal skin and have to be applied very carefully. They can also stain clothes and need to be used for a very short time before being washed off (the time can be gradually extended from a few minutes).1
Vitamin D analogues – these are widely used. They’re also less messy and smell less than coal tar preparations and don’t stain clothes like dithranol or coal tar. A minority of people get skin irritation and you need to be careful not to exceed the licensed dose.
Steroid creams and ointments – these work by reducing inflammation and are easy to use. They are recommended in courses rather than continuously to reduce the risk of flare-ups when you stop using them.
Combined vitamin D analogue and steroid – these use a combination of ingredients. Each part of the combination works on one of the two parts of psoriasis: inflammation and excess skin production/flakiness.
Phototherapy and systemic treatments are usually only given by specialist hospital departments and tend to be reserved for severe psoriasis that hasn’t responded to topical treatments. Most systemic therapies work by suppressing the immune system. Because psoriasis is an autoimmune condition (where you body’s immune system, which normally protects you against infection, recognises itself as an ‘enemy’) these can be highly effective. However, they can have significant side-effects and need careful monitoring. Light therapy can involve courses of exposure to either ultraviolet B (UVB) or PUVA (psoralen and ultraviolet A) which involves ultraviolet A light along with a tablet called psoralen, to increase the effect.
1. Psoriasis Association UK website. Psoriasis Treatments. https://www.psoriasis-association.org.uk/psoriasis-and-treatments/treatments/from-a-gp Accessed July 2017.