The treatments that act directly on the skin can improve the situation. Doctors and patients that some forms of steroid cream or ointment, vitamin D3, retinoids, coal tar and anthralin. Bath solutions and moisturizers may be soothing, but is rarely strong enough to improve skin condition. Therefore, usually combined with more resources.
Corticosteroid's reduce - These drugs inflammation and the turnover of skin cells, and suppress the immune system. It is available in different strengths, topical corticosteroid's (cortisone) are usually applied to the skin twice a day. Psoriasis short-term therapy is often very effective in improving but not completely eliminated. The long-term use or overuse of high power (strong) corticosteroid's can cause thinning of the skin, side effects and internal resistance to treatment benefits. If less than 10 percent of the affected skin, some physicians prescribe an ointment high potency corticosteroid. High-potency corticosteroid's may be prescribed does not improve with other treatments, especially in the hands or feet, even on the plates. In cases where the treatment goal is comfort, environmental efficiency can corticosteroid's for other areas of the skin of the trunk or branches down. The low potency preparations for sensitive skin. Calcipotriene - This drug is a synthetic form of vitamin D3, which can be applied to the skin. Apply the ointment calcipotriol (for example, audits dovonex *) twice daily, the rate of turnover of skin cells. Salicylic Acid because it can irritate the skin, but not recommended for use on the face or genitals. Sometimes it is combined with topical corticosteroid's to reduce irritation. Using more than 100 grams of calcipotriene per week may increase the amount of calcium in the body to unhealthy levels.
* Brand names are provided as examples and their inclusion does not mean they are the National Institute of Health, or flying to another government agency. Even if a particular brand is not listed, that does not mean or imply that the product is unsatisfactory.
Retinoids - topical retinoids are synthetic forms of vitamin A is the retuned tazarotene (Tazorac) jelly or cream applied to the skin. When used alone, this preparation will not work as quickly as topical corticosteroids, but this leads to a thinning of the skin or other side effects associated with steroids. However, it can irritate the skin, especially in the folds of skin and normal skin surrounding a patch of psoriasis. It is less irritating and sometimes more effective when combined with a corticosteroid. Because the risk of birth defects, women of childbearing age must take measures to prevent pregnancy if tazarotene.
) Coal tar - Preparations containing coal tar (gels and ointments can be applied directly to the skin, has () as a liquid in the bath, or scalp, such as using shampoo. Coal tar products are available in different strengths, and many are sold over the counter (not request) on prescription. Step coal is less effective than corticosteroid's and many other treatments, so they are sometimes combined with ultraviolet B (UVB) photo therapy for a better result. The strongest form of coal tar may irritate the skin is dirty, has a strong odor and can stain skin or clothing. It is not popular with many patients. Anthralin - Anthralin reduces the increase in skin cells and inflammation. Doctors can provide 15 to 30 minutes to apply anthralin ointment, cream or paste once daily for treatment of chronic lesions of psoriasis. After anthralin must be washed to prevent irritation of the skin. This treatment is often not sufficient to improve skin and skin spots, bathtub, sink, and clothing brown or purple. On the other hand, takes the risk of skin irritation anthralin unsuitable for acute or actively inflamed eruptions.
Salicylic acid - This peeling agent, which is available in many forms such as ointments, creams, shampoos and gels can be used to reduce the peeling skin or scalp. It is often more effective when combined with topical corticosteroid's, tar, anthralin, or coal.
Clobetasol propionate - This is a foam topical medication (Olux), which has been approved for the treatment of psoriasis in the scalp and body. The foam penetrates the skin very well, easy to use and not as dirty and many other topical medications.
Bathroom Solutions - People with psoriasis may find that adding an oil bath, if so, then apply a moisturizer, softens skin. In addition, individuals can remove scales and reduce itching by soaking for 15 minutes in water containing a coal tar solution, oiled oatmeal, Epsom salts or Dead Sea salts.
Hydration - with normal use over a long period, moisturizers have a soothing effect. Preparations that are thick and greasy usually work best because the water seal in the skin, flaking and itching to do.
Natural ultraviolet radiation from the sun and the controlled delivery of artificial ultraviolet radiation used to treat psoriasis.
Sunlight - Much of the sunlight of areas of different wavelengths of ultraviolet (UV). If the skin and UV light suppresses the process leading to the disease, which causes activation of T cells in the skin to die. This procedure reduces swelling and decreases the turnover of skin cells that causes scaling. Daily, short, sunlight non burning opens or improves psoriasis in many people. Therefore, the affected skin exposure to sunlight is a first treatment for the disease.
UV-B (UVB) photo therapy - UVB is light with a shorter wavelength is absorbed in the epidermis of the skin. An artificial source can be used for mild to moderate psoriasis. Some doctors start treating patients with UVB instead of topical agents. UVB photo therapy, called broadband UVB, can be used for some small lesions, to treat widespread psoriasis, or damage resist topical treatment. This type of photo therapy is usually surgery with a light panel or light box. Some patients use UVB light boxes at home under the guidance of a physician.
A new type called UVB and narrow band UVB is that part of the ultraviolet band is most useful for psoriasis.
The therapy of narrow band UVB is more than broadband UVB, but less effective than PUVA treatment (see below). It is becoming increasingly popular because it helps and is easier than PUVA. Initially, treatment of patients away several narrow-band UVB may have to close to improve your skin. Once the skin improvement, maintenance therapy once a week is all that necessary. However, the therapy of narrow band UVB is not without risks. May cause severe burns and more than broadband treatment.
Psoralen and UV-A photo therapy (PUVA) - This treatment combines oral or topical medication that contains the name and exposure to ultraviolet A (UVA), Psoralen light. UVA has a long wavelength that penetrates deeper into the skin of UVB. Psoralen makes the skin more sensitive to this light. PUVA is normally used when more than 10 percent of skin is affected, or if the disease affects a person's possession (eg if a teacher face or hands of a vendor in question). Compared with UVB therapy broadband PUVA treatment two to three times per week approved for psoriasis treatment more consistent and less. However, this is more short term side effects such as nausea, headache, fatigue, burning and itching.
Be taken to prevent the avoidance of sunlight after psoralen for severe burns and eye must be kept until two days with glasses UV absorption for protection. Long term treatment is associated with increased risk of skin cancer and melanoma cell carcinoma may be related. The concomitant use of drugs that suppress the immune system, such as cyclosporine increased slightly positive and the risk of cancer. Light therapy in combination with other therapies - Studies have shown that combining ultraviolet light treatment and a retinoid such as acitretin, the effectiveness of UV light for psoriasis adds. Therefore, if the patient does not respond to light therapy, retinoids may be added. UVB phototherapy, for example, can be combined with retinoids and other treatments. A combined therapy program, on the situation of Ingram, includes a bathroom, coal tar, UVB phototherapy, and apply anthralin salicylic acid paste that is left on the skin for 6 to 24 hours. A similar scheme Goeckerman therapy combines coal tar ointment with UVB phototherapy. Also, PUVA can be combined with oral medications (eg retinoids) to increase its effectiveness.
For more severe forms of psoriasis, doctors provide drugs, sometimes taken internally by pill or injection. This is called systemic therapy. Recently, attention has been paid) to a group of drugs called biologics (for example, alefacept and etanercept, which is made from proteins produced by living cells instead of chemicals. Could interfere with specific immune system processes .
Methotrexate reduces - including cyclosporine, methotrexate, cell turnover by suppressing the immune system. It can be taken orally or by injection. Patients taking methotrexate must be closely monitored because it can cause liver and / or reduce the production of oxygen transport by red blood cells, infection fighting white blood cells, platelets and clotenhancing. As a precaution, doctors do not prescribe medication for people who have liver disease or anemia (a disease resulting from weakness or fatigue, reducing the number or volume of red blood cells, oxygen in the tissues listed). Sometimes it's with PUVA or UVB therapy. Methotrexate should not pregnant women or women planning to become pregnant may cause birth defects.
Retinoids - a retinoid such as acitretin (Soriatane) is a partnership with the properties of vitamin A, as defined for severe psoriasis unresponsive to other treatments. Because this treatment can also cause birth defects, women must protect themselves from pregnancy beginning 1 month before the 3 years after treatment with acitretin. The majority of patients recruited to the recurrence of psoriasis after these products.
Cyclosporine - orally, cyclosporine acts by suppressing the immune system in the incidence of skin cells to slow down. It can provide rapid relief of symptoms, but the improvement stops when treatment is discontinued. The best candidates for this treatment are those with severe psoriasis who have failed or can not tolerate, other systemic therapies. Rapid onset of action is to prevent hospitalization of patients with psoriasis rapid progress is helpful. Cyclosporine may impair kidney function or lead to high blood pressure (hypertension). Therefore, patients should be monitored carefully by a physician. In addition, cyclosporine is not recommended in patients who have weak immune systems or who had cancer of the skin following PUVA treatment recommended above. Must be used with phototherapy.
6-Thioguanine - This drug is almost as effective as methotrexate and cyclosporine. It has fewer side effects, but there is a greater likelihood of anemia. This medication should be avoided by pregnant women and women planning to become pregnant as it can cause birth defects.
Hydroxyurea (Hydrea) - Compared with methotrexate and cyclosporine, hydroxyurea is somewhat less effective. Sometimes it's with PUVA or UVB therapy. Possible side effects include anemia and decreased white blood cells and platelets. What is methotrexate and retinoids, hydroxyurea be avoided by pregnant women or women planning pregnancy, as it can cause birth defects.
Alefacept (Amevive) - This is the first biological product approved specifically to treat moderate to severe plaque psoriasis severe. Used by a doctor who injected the drug is administered once a week for 12 weeks. The dose was stopped for a while, and observed changes in the skin and a decision on the need for further treatment. Because alefacept suppresses the immune system, skin often improves, but there is also an increased risk of infections or other problems, possibly even cancer. Supervision of a physician is necessary and the patient's blood should be checked weekly to ensure at the time of each injection so that the T cells and other immune cells are not very depressed.
Etanercept (Enbrel) - This medicine is an approved treatment for psoriatic arthritis in the joints become swollen and inflamed. Like alefacept, a biological response modifier, which after the interactions between injection blocks certain immune cells.
Etanercept limits the action of a specific protein, the lubricating fluid in joints and surrounding tissues is overproduction, which leads to inflammation. It depends on the same protein in the skin of people with psoriatic arthritis patients with overproduction of etanercept may also improve your skin. People should not take etanercept if they have an active infection, infection or an underlying disease like diabetes, increases the risk of infection. Those who have psoriasis and certain neurological diseases like multiple sclerosis can be treated with this medication. Added caution is recommended in patients with psoriasis, rheumatoid arthritis, is necessary, these patients should follow the advice of a rheumatologist in this treatment.
Antibiotics - these medications are not indicated in routine treatment of psoriasis. However, antibiotics can be used if an infectious cause, such as that caused by the bacteria Streptococcus, triggers an outbreak of psoriasis, and in some cases, psoriasis guttata.
There are several approaches for the treatment of psoriasis. Combining various topical, systemic light and often allows lower doses of each lead and increased efficiency. Therefore, doctors are paying more attention to combination therapy.