What they are and how they workThere are many different treatment options to help manage and alleviate psoriasis symptoms. You can discuss your options with your doctor and together find the treatment that is best for you. Treatments range from creams and gels to tablets and injectable medication, and even light therapy. The treatment prescribed will depend on many factors, such as the physical severity of the disease and what will best fit with your lifestyle and personal needs. The following information about treatment choices will help you find the most effective one for you.
Topical treatmentsThere are many topical treatment options available to you. Topical medications – typically a cream, gel or an ointment applied directly to the skin – are commonly prescribed by your doctor as first-choice, also known as first-line treatments, to manage mild to moderate cases of psoriasis. You may also want to mention to your doctor if you are finding your medication too time-consuming or greasy to apply, as there may well be another option to try which you may prefer.
Topical treatments available over-the-counter (without a prescription) from your pharmacy
- Moisturisers: moisturising creams and lotions soften and rehydrate the skin and provide a protective barrier, helping to keep the skin comfortable, reducing itching and scaling.
- Coal tar: coal tar has been used for decades to treat psoriasis due to its anti-inflammatory and anti-scaling properties. Available as lotions, creams, solutions and shampoos for scalp psoriasis, as well as oils for use in the bath or shower.
Treatments available on prescriptionOther treatments prescribed for psoriasis include:
- Dithranol: a topical treatment that comes in a cream, gel, ointment or paste form that can slow skin cell growth and the thickness of psoriasis plaques.
- Topical retinoids: these are derived from vitamin A and can reduce the thickness of psoriasis plaques by slowing skin cell growth.
- Topical steroids: Topical steroids often come in a cream, gel or ointment formulation, and are measured in strengths of 'mild,' 'moderate,' 'potent' and 'very potent'. They are used to reduce inflammation, swelling, irritation, redness and itchiness associated with psoriasis.Topical steroids can take a few weeks to work and progress should be reviewed regularly with your doctor.
- Vitamin D3: topical forms of synthetic chemically produced vitamin D analogue to help slow down the growth of skin cells and remove scales.
- Combination fixed-dose products: combine a topical steroid and topical form of vitamin D analogue in one treatment to slow down the development of skin cells as well as to suppress inflammation.
Although natural sunlight can benefit your psoriasis, you should take care to protect yourself from sunburn, which can make your psoriasis worse and increase your risk of skin damage and skin cancer.
Other treatments – systemic treatments:Systemic treatments affect the entire body and therefore are usually prescribed by your doctor for moderate to severe psoriasis and are typically given as pills or injections. Some common systemic treatments are:
- Biologics: a type of medication that targets specific parts of the immune system that play a major role in developing psoriasis and psoriatic arthritis.
- Immunosuppressants: used to treat severe psoriasis and also work to suppress or reduce the body's immune response.
- Cytotoxic drugs: work by binding to and inhibiting an enzyme involved in the rapid growth of cells. They also slow the rate of skin cell growth.
- Oral retinoids: these are synthetic (chemically-produced) forms of vitamin A that work to re-establish a more normal pattern of cell growth. This can help decrease scale and thickness of psoriasis plaques as well as decreasing inflammation. Oral retinoids are often used to treat severe psoriasis – including erythrodermic and pustular types – that covers more than 10% of the body's surface.
- Phototherapy: a treatment involving ultraviolet (UV) light, which is also referred to as "light therapy". It is used to treat moderate to severe psoriasis that has been resistant to topical treatments.
UK/IE 2013b/00072, Date of prep: April 2015