Psoriasis is a chronic skin condition characterized by large, round or oval, red patches with thick white scales. The patches are sometimes itchy, occasionally painful and may bleed. They can also have no symptoms. The most commonly affected areas are the knees, elbows and scalp. Arthritis and nail changes can be associated with psoriasis.
Who Gets Psoriasis?
The cause of psoriasis is multifactorial. It can set in at any age, but the most common age of onset is teens and twenties. There seems to be a genetic link to psoriasis, so people with a family history are at a higher risk.
What Are The Treatments For Psoriasis?
While there is no cure for psoriasis, there are a multitude of treatments. If you suffer from psoriasis, it is important to be evaluated by a doctor to discuss the best course of treatment for you.
Non prescription treatment: For those with milder forms of psoriasis, change in daily routine or diet may be able to help control flares. Sunlight tends to help with psoriasis, but avoid a sunburn which can worsen psoriasis. Alcohol and certain foods seem to be triggers in certain individuals. Keeping track of when your psoriasis flares can be an important part in treating the condition.
Topicals: The first-line defense for psoriasis is topical prescription steroids. These creams, lotions, and ointments range in strength and efficacy, but if used consistently can keep many psoriasis treatments under control. Topical Vitamin D derivatives and retinoids are other options.
Intralesional Injections: For more stubborn, focal areas, intralesional Kenalog injections can be used. This is an injection of a liquid steroid placed right below the skin. Topical treatment is usually recommended to maintain the benefits of this treatment.
XTRAC: For focal or small areas, XTRAC is an effective and safe treatment. During the procedure, a provider will use a handheld machine to administer localized doses of a safe and effective narrow band of ultraviolet light. The treatment is best performed 2-3 times a week during quick office visits with a very minimal risk of side effects.
nbUVB: For more widespread or persistent psoriasis, nbUVB phototherapy treatments may be recommended. This treatment requires the patient to come in for 2-3 quick visits per week. The patient will then stand in a booth that provides a safe and effective band of ultraviolet light. This gives the patient the anti-inflammatory benefits of the sun, without the harmful rays that cause skin damage.
Systemic treatments: If a patient’s psoriasis is resistant to multiple treatments or is extensive, systemic treatments may be recommended. These treatments are usually oral pills that need to be taken once a week or daily. They affect the patient’s immune system (a cause of psoriasis), decrease inflammation and mitigate the proliferation of skin cells. These medications can have serious side effects and require consistent monitoring and follow up visits with your physician. These may also be prescribed as a prerequisite to trying biologic therapy.
Biologics: For severe and persistent psoriasis and psoriatic arthritis, biologics are a great option for healthy individuals. Biologics are medications that are injected, usually at home by the patient, during different intervals (every other week to once every three months). These powerful medications affect the body’s immune system in order to regulate the psoriasis. The most common biologics are Humira®, Stelara®, and Enbrel®. Due to their strength, there are side effects that must be monitored regularly by a physician. Regular blood tests may be necessary. When used safely, biologics can be a very effective way at managing even the most severe cases.