The first step in psoriasis therapy is to apply treatment directly to the surface of the skin. This may involve the use of prescription or non-prescription topical therapies. The purpose of these treatments is to heal inflammation and reduce other symptoms of psoriasis. Non-prescription topical therapies that work on the skin include, but are not limited to:
Exposure to sunlight can suppress the immune system (activated T cells) in the skin, thus reducing inflammation and slowing the rapid growth of skin cells. People with mild-to-moderate psoriasis may benefit from short, daily doses of sunlight, while people with more extensive psoriasis may require ultraviolet light A (UVA) or ultraviolet light B (UVB) treatment in medically approved centers. (See phototherapy section below.) You should always check with your doctor or dermatologist before self-treating.
A remedy used for centuries, coal tar improves scaling, itching, and inflammation. It is very effective as a shampoo or oil for scalp psoriasis or on the skin. The treatment may be used by itself or in conjunction with ultraviolet light. Although improved, coal tar products may be messy.
Keeping the skin moisturized is an important part of psoriasis treatment and will reduce itching and inflammation and promote flexibility. It is recommended that non-irritating moisturizing creams or ointments be applied on a regular basis. In addition, soaking in water will soothe skin. Healing can be enhanced by adding solutions to bath water, such as Dead Sea salts, oiled oatmeal, and Epsom salts.
In addition to limited natural sunlight, exposure to a certain wavelength of artificial ultraviolet light called ultraviolet light B (UVB) is very effective for people with moderate to severe psoriasis or plaque areas that do not respond to other treatments. More severe psoriasis can be treated with ultraviolet light A (UVA) and a medication called psoralen. Psoralen is an oral or topical medication that makes the body more sensitive to light. This treatment is known as PUVA.
Most phototherapy is given 3-5 times per week for 1-3 months by using a light panel or light box at a clinic or in your doctor’s office. In certain cases, you may be able to use a light box or light panel in your home under your doctor’s guidance.
Traditionally, the wavelength of UVB treatments was “broadband.” Today, newer sources provide narrow-band UVB, which emits the part of the ultraviolet spectrum that is most helpful to treating psoriasis.
This type of laser is designed to produce ultraviolet radiation at a very specific wavelength. The excimer laser is used to treat small, resistant plaque areas of psoriasis.
Phototherapy treatments are sometimes combined with other treatments for a stronger therapy program. Examples of phototherapy treatment combinations include:
Certain treatments may work well initially, but lose their effectiveness as your body develops resistance. Depending on your symptoms, your doctor may prescribe another type of treatment and continue trying new methods as needed to keep your psoriasis under control.
Contact your doctor if:
American Academy of Dermatology website. Available at: http://www.aad.org/default.htm.
Journal Watch. The 308-nm excimer laser is practical therapy for psoriasis. Journal Watch website. Available at: http://dermatology.jwatch.org/cgi/content/full/2003/114/1. Published January 14, 2003. Accessed August 13, 2010.
National Psoriasis Foundation website. Available at: http://www.psoriasis.org/home.
Yones SS, Palmer RA, Garibaldinos TT, Hawk JL. Randomized double-blind trial of the treatment of chronic plaque psoriasis: efficacy of psoralen-UV-A therapy vs narrowband UV-B therapy. Arch Dermatol. 2006;142(7):836-842.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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