Since Psoriasis cannot be cured, the goal of all treatment modalities is to control symptoms and prevent infections.
1. Topical applications (creams, ointments)
a. which reduce inflammation – these usually contain cortisone, which is a mild steroid and reduces inflammation and redness of skin. However, since it acts by suppressing immunity, it has various side effects too. It is also believed to make people dependent as the psoriatic patches appear to be healing as long as one applies cortisone and relapses as soon as the treatment is withdrawn.
b. which reduce skin cell turnover – creams, ointments, lotions and shampoos containing coal tar or retinoids. These work by slowing down cell growth and turnover. If you are pregnant or planning to get pregnant, you should avoid retinoids as they can cause birth defects in the foetus.
c. Which remove scales associated with Psoriasis – these usually contain salicylic or lactic acid
d. Which moisturize the skin – over-the-counter moisturizers
2. Systemic medications like pills and injections containing Methotrexate, Retinoids, Cyclosporine are prescribed by doctors after a thorough consultation about your general health condition. Since most of these drugs can have severe side effects, be sure to tell your doctor everthing about your health and your plans to get pregnant if any. Your doctor might ask you to get some regular blood tests done to check your immune system.
3. Your doctor might also prescribe antibiotics if your Psoriatic patches get infected.
4. Phototherapy: uses Ultraviolet (UV) light to treat psoriasis. The different types are:
a. UVB light: It is usually given along with other topical or systemic medication. Typical regimen consists of three to five sittings per week for two to three months.
b. PUVA (Psolaren plus ultraviolet A): Beams of ultraviolet A light are used with Psolaren (a topical medicine which increases the skin’s sensitivity to light). For the same reason, it is important that you cover your skin and eyes properly for atleast 12 hrs after you have completed your sitting.
c. Lasers: These are extremely concentrated beams of ultraviolet light which work on only the diseased skin, thus reducing side effects associated with UVB and PUVA treatments.
Apart from the medicines, phototherapy etc, what can I do to take care of my Psoriasis?
a. Treat your skin with a lot of care:
- Use lukewarm (and not hot) water with mild, non-fragrant soaps
- Apply a good, non-fragrant, mild moisturizer/ olive oil after bath to seal in the moisture
- Use a mild, non-fragrant shampoo
- Wear well-fitting, cotton clothes
- Cover your skin well in winter to avoid exposure to the winter cold and dryness
- Take care not to get your skin injured
- Trim your nails regularly to avoid scratching which might lead to a flare-up of symptoms
b. Adopt a healthy lifestyle:
- Quit smoking and alcohol
- Maintain a healthy weight (in case your joints are affected by Psoriasis, consult your doctor before starting any exercise regimen)
- Take up relaxation techniques like meditation and yoga to reduce mental stress
- Avoid red meat as it has been seen to increase inflammation in the affected areas
- One home remedy that seems to have helped many people is the intake of flax seeds (Alsi). The omega 3 fatty acids in flax seeds apparently modify the chain of events that cause Psoriasis. Just before breakfast and dinner every day, roast and grind the seeds. Mix with two spoons of water and eat the paste.
- A 15 minute exposure to the morning sun (before 9 AM) is also known to help.
What are my chances of recovering completely from psoriasis?
While Psoriasis is not curable, it is certainly controllable. One can easily lead a normal, fulfilling life with Psoriasis. The stigma experienced by you (by people thinking they can catch Psoriasis from you) if any, can be taken care of by educating your friends, family and colleagues about your condition.
What are the possible complications of Psoriasis?
- Arthritis – about 10-30% of them may develop Psoriatic Arthritis affecting most of the main joints. Ample stretching with regular walks helps you reduce the symptoms.
- Secondary skin infections – if the area is raw and exposed for a while, you may develop skin infections. Your doctor might prescribe you antibiotics.
- Side effects from medicine used to treat psoriasis
- Skin cancer from phototherapy