General Advice
Patients should be well-informed about their condition and treatment options. Lifestyle modifications such as smoking cessation, limiting alcohol consumption, and maintaining a healthy weight can help manage psoriasis.
Topical Therapy
Mild psoriasis is often treated with topical agents, which include:
- Corticosteroids: Available in various forms, these are commonly used to reduce inflammation and slow cell turnover.
- Vitamin D Analogues: Calcipotriene and calcitriol slow skin cell growth and are often used in combination with corticosteroids.
- Retinoids: Tazarotene, a gel or cream, helps reduce skin cell production.
- Calcineurin Inhibitors: Tacrolimus and pimecrolimus are used for sensitive areas to reduce inflammation and scaling.
- Salicylic Acid: Helps reduce scaling, especially in scalp psoriasis.
- Coal Tar: Reduces scaling, itching, and inflammation, though it can be messy and has a strong odor.
- Anthralin: Slows skin cell growth and removes scales.
Phototherapy
Light therapy is used for moderate to severe psoriasis:
- UVB Phototherapy: Utilizes UVB light to treat psoriasis, available in broadband and narrowband forms.
- PUVA: Combines UVA light with psoralen, a light-sensitizing medication.
- Excimer Laser: Targets only affected skin with a strong UVB light.
Systemic Therapy
For severe cases, systemic treatments include:
- Methotrexate: Decreases skin cell production and inflammation.
- Ciclosporin: Suppresses the immune system.
- Acitretin: Reduces skin cell production.
- Biologics: Target specific parts of the immune system (e.g., TNF-alpha inhibitors, IL-17 inhibitors, IL-23 inhibitors).
Biologic Therapy
Reserved for severe cases that do not respond to other treatments. These drugs are expensive and may have serious side effects, requiring specialist management. Common biologics include adalimumab, etanercept, and ustekinumab.
Alternative Medicine
Some patients explore alternative therapies, though evidence is limited. Options include:
- Aloe Vera Cream: May reduce scaling and inflammation.
- Fish Oil Supplements: May help when combined with UVB therapy.
- Oregon Grape: Applied to the skin to reduce severity.
Complications
Psoriasis can lead to several complications, including:
Psoriatic Arthritis: An autoimmune disease affecting joints, seen in up to 40% of patients with early-onset chronic plaque psoriasis.
Inflammatory Bowel Disease: Conditions like Crohn’s disease and ulcerative colitis.
- Uveitis: Inflammation of the eye.
- Coeliac Disease: An immune reaction to eating gluten.
- Non-alcoholic Fatty Liver Disease: Linked with severe psoriasis.
- Metabolic Syndrome: A combination of obesity, hypertension, dyslipidemia, and insulin resistance, increasing the risk of cardiovascular disease.
Living with Psoriasis
Psoriasis can significantly impact quality of life, especially when affecting visible areas or causing discomfort. Patients should seek support from healthcare providers to manage both physical and mental health aspects.
Conclusion
While there is no cure for psoriasis, various treatments can manage symptoms and improve the appearance of skin patches. With proper diagnosis and a tailored treatment plan, individuals with psoriasis can lead a better quality of life.
For more detailed information, consult reputable sources such as the Mayo Clinic, NHS, and DermNet.
References:
– Mayo Clinic. (2023). Psoriasis. Retrieved from https://www.mayoclinic.org/diseases-conditions/psoriasis/symptoms-causes/syc-20355840
– National Health Service (NHS). (2023). Psoriasis. Retrieved from https://www.nhs.uk/conditions/psoriasis/
– DermNet New Zealand. (2023). Psoriasis. Retrieved from https://dermnetnz.org/topics/psoriasis
