Psoriasis Relief: The Best Topical Treatments

September 9, 2023

Understanding Psoriasis: Causes, Symptoms, and Types

Psoriasis is a chronic autoimmune disease that affects the skin, nails, and joints. It is characterized by thick, red, scaly patches that can be itchy and painful. The exact cause of psoriasis is not fully understood, but it is thought to be a combination of genetic and environmental factors.

Symptoms of Psoriasis

  • Red, raised, scaly patches on the skin, known as plaques. These plaques can appear on any part of the body, but most commonly on the scalp, knees, elbows, and lower back.
  • Itching and burning sensations on the affected skin.
  • Thickened, discolored, or ridged nails.
  • Stiff and swollen joints in severe cases (psoriatic arthritis).

Types of Psoriasis

  • Plaque psoriasis: the most common type, characterized by red, raised, scaly patches.
  • Guttate psoriasis: characterized by small, red, scaly spots, usually found on the trunk and limbs.
  • Inverse psoriasis: characterized by smooth, red patches in skin folds such as the armpits, groin, and under the breasts.
  • Pustular psoriasis: characterized by white, pus-filled blisters surrounded by red skin.
  • Erythrodermic psoriasis: characterized by widespread redness and scaling, affecting most of the body surface.

Causes of Psoriasis

  • Genetics: certain genes have been linked to an increased risk of developing psoriasis.
  • Immune system dysfunction: psoriasis is thought to be caused by an overactive immune system that leads to inflammation and the rapid turnover of skin cells.
  • Environmental factors: certain triggers can cause psoriasis to flare up, such as stress, infection, injury to the skin, and certain medications.

It is important to note that psoriasis can be a lifelong condition and there is currently no cure. However, with the help of a healthcare professional, many people with psoriasis are able to manage their symptoms and improve their quality of life. If you suspect you have psoriasis, it is important to see a dermatologist for an accurate diagnosis and treatment plan.

Topical Treatments for Psoriasis: Ointments, Creams, and Gels

Topical treatments are the most common form of treatment for mild to moderate psoriasis. These treatments are applied directly to the affected skin, and can help to reduce inflammation, itching, and scaling.

Topical Corticosteroids

Topical corticosteroids are the most commonly prescribed topical treatment for psoriasis. They work by reducing inflammation and slowing the growth of skin cells. These medications come in different strengths and formulations, such as ointments, creams, and gels. They are most effective when used for short periods of time and should not be used on the face, genitalia, or skin folds.

Vitamin D Analogues

Vitamin D analogues are topical medications that help to slow the growth of skin cells. They are often used in combination with topical corticosteroids to enhance their effectiveness. Examples of vitamin D analogues include calcipotriene and calcitriol.

Topical Retinoids

Topical retinoids, such as tazarotene, are medications derived from vitamin A. They help to reduce inflammation and slow the growth of skin cells. They are often used in combination with other topical treatments, and should not be used during pregnancy or breastfeeding.

Coal Tar

Coal tar is a by-product of coal processing and has been used for many years to treat psoriasis. It works by slowing the growth of skin cells and reducing inflammation. Coal tar comes in different forms, such as shampoos, creams, and ointments, and is most effective when used in combination with other topical treatments.

It is important to note that these topical treatments can cause skin irritation and dryness, and should be used under the guidance of a healthcare professional. Your dermatologist can help you determine the best treatment plan for your individual needs, and will monitor your progress.

Light Therapy for Psoriasis: UVB, PUVA, and Excimer Laser

Light therapy, also known as phototherapy, is a treatment option for moderate to severe psoriasis that involves exposing the affected skin to ultraviolet (UV) light. There are several types of light therapy, each with their own benefits and potential side effects.

UVB (Ultraviolet B) Therapy

UVB therapy involves exposing the affected skin to UVB light, either through a light box or a handheld device called a UVB lamp. The UVB light helps to slow the growth of skin cells and reduce inflammation. UVB therapy is usually given two to three times per week, and treatment sessions typically last a few minutes to a few hours.

PUVA (Psoralen + UVA) Therapy

PUVA therapy involves taking a medication called psoralen, which makes the skin more sensitive to UVA light. The affected skin is then exposed to UVA light, either through a light box or a handheld device called a UVA lamp. PUVA therapy is usually given two to three times per week, and treatment sessions typically last a few minutes to a few hours.

Excimer Laser Therapy

Excimer laser therapy involves using a special laser to deliver concentrated UVB light to the affected skin. The laser targets only the affected skin, leaving the surrounding skin untouched. Excimer laser therapy is usually given two to three times per week, and treatment sessions typically last a few minutes.

It is important to note that light therapy can cause skin irritation and dryness, and may increase the risk of skin cancer with prolonged use. Before starting light therapy, a healthcare professional will perform a skin examination and discuss the potential risks and benefits with you. Your dermatologist will also monitor your progress and adjust your treatment plan as needed.

Combination Therapies for Psoriasis: Topical and Systemic

Combination therapy is a treatment approach that involves using more than one treatment option to manage psoriasis. This approach can be effective in reducing symptoms and improving the overall outcome of treatment.

Topical and Light Therapy

Combining topical treatments, such as corticosteroids or vitamin D analogues, with light therapy can be an effective way to manage moderate to severe psoriasis. Topical treatments can help to reduce inflammation and slow the growth of skin cells, while light therapy can help to reduce scaling and redness.

Topical and Systemic Therapies

Combining topical treatments with systemic therapies, such as oral medications or injections, can be an effective way to manage moderate to severe psoriasis. Systemic therapies target the underlying cause of the disease, while topical treatments help to manage symptoms on the skin.

Topical, Light, and Systemic Therapies

For people with severe psoriasis, a combination of topical, light, and systemic therapies may be necessary to achieve the best results. This approach can help to reduce inflammation, slow the growth of skin cells, and target the underlying cause of the disease.

It is important to note that combination therapy can have more potential side effects than single treatments and should be administered under the guidance of a healthcare professional. Your dermatologist will work with you to develop a treatment plan that is tailored to your individual needs and will monitor your progress.

Managing the Side-effects of Psoriasis Treatments and Maintaining Remission

Managing the side-effects of psoriasis treatments and maintaining remission are important aspects of managing this chronic disease.

Managing Side-effects of Topical Treatments

Topical treatments for psoriasis, such as corticosteroids, vitamin D analogues, and retinoids, can cause skin irritation and dryness. To manage these side-effects:

  • Use the medication as directed by your healthcare professional
  • Apply a moisturizer immediately after applying the medication
  • Limit exposure to sunlight, as some topical treatments can make the skin more sensitive to UV rays.

Managing Side-effects of Light Therapy

Light therapy can cause skin irritation, dryness, and increase the risk of skin cancer with prolonged use. To manage these side-effects:

  • Wear protective eyewear during treatment
  • Use a moisturizer immediately after treatment
  • Limit sun exposure
  • Avoid tanning beds and sunlamps

Managing Side-effects of Systemic Treatments

Systemic treatments, such as oral medications and injections, can cause a variety of side-effects, such as nausea, headaches, and fatigue. To manage these side-effects:

  • Follow the dosing instructions of your healthcare professional
  • Inform your healthcare professional of any side-effects
  • Eat a well-balanced diet and drink plenty of water

Maintaining Remission

Once psoriasis symptoms have been brought under control, it is important to take steps to maintain remission. This may include:

  • Continuation of topical and/or systemic treatment as prescribed by your healthcare professional
  • Avoiding known triggers such as stress and infection
  • Following a healthy lifestyle, including a healthy diet and regular exercise
  • Regular follow-up visits with your healthcare professional

It is important to work closely with your healthcare professional to find the best treatment plan for your individual needs and to manage side-effects and maintain remission. With the right treatment and management plan, people with psoriasis can lead fulfilling lives and improve their quality of life.

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