Topical and systemic treatments for Psoriasis
In psoriasis, local (topical) treatment is used alone or in combination with the systemic medical treatment. Local treatment is reserved for mild, uncomplicated cases, in association with phototherapy (exposure to A or B type ultraviolet). Occasionally, subcutaneous injection of some medical substances or special patches (transdermal plasters) can be used.
Skin plates have to be removed carefully after softening with hydrating lotions.
This manoeuvre has to be executed carefully by slightly massaging the exfoliated skin plates avoiding lesions at this level (cosmetic peeling).
The exfoliation technique is improved gradually, avoiding mechanical irritation of the interested areas.
Psoriasis that affects scalp or nail areas can be difficult to treat and it is preferably to administer an oral medical treatment.
The treatment of skin plates at the level of the scalp can be cured by applying special shampoos, oils or products containing selenium sulphate or zinc sulphate.
If topical or systemic treatments are used for psoriasis, some specialized medical consultations have to be carried out to identify possible side effects or the occurrence of skin cancer (people with psoriasis are predisposed to cutaneous cancer).
Sometimes, it is recommended to change periodically the treatment, to reduce the risk of unpleasant side effects.
Oral medication includes:
Cyclosporine and Metotrexate are 2 immunosuppressive drugs (inhibiting the immune system), used only in severe forms of psoriasis, due to their severe side effects (infections, occurrence of tumors).
Generally, the treatment for psoriasis begins by using topical products (corticosteroids, Calciferol or Tazaroten). These drugs can be used alone or in different combinations.
In some cases, medication does not have the effect expected; therefore photo-ultraviolet therapy of A type (PUVA) can be used. Also, if the topical or systemic treatment does not ameliorate the symptoms or psoriasis aggravates, Cyclosporine can be administered.
There are many combinations of treatment with good results; these combinations include the following, commonly used in medical practice:
- Psolaren and phototherapy A-type ultraviolet
- resin and phototherapy B-type ultraviolet (UVB- narrow band) (Goeckerman treatment)
- anthralin and phototherapy B-type ultraviolet (UVB – narrow band) (Ingram regime).
Treatments with efficiency proven in psoriasis include the following:
- Calcitriol (vitamin D derivate)
- phototherapy (especially PUVA)
- Ingram regime.