Management options for psoriasis

Psoriasis is a long-term skin condition characterised by red, scaly patches that can cause discomfort, itchiness, and emotional distress. It occurs when the immune system overreacts, speeding up the life cycle of skin cells, which then accumulate on the skin's surface. While there is no cure, various management options can help control symptoms and improve quality of life. A renowned dermatologist explores some of these options.

What lifestyle changes can help manage psoriasis?

Making small adjustments to your daily habits can significantly reduce psoriasis flares. For instance, keeping your skin well-moisturised is crucial to prevent dryness and cracking. Choose thick creams or ointments and apply them regularly, especially after bathing.

Stress is a common trigger for psoriasis, and managing it can often lessen symptoms. Techniques such as yoga, meditation, or even taking regular walks may help. Additionally, avoiding skin injuries, such as cuts or scrapes, and limiting alcohol consumption can also minimise flare-ups.

How are topical treatments used?

Topical treatments are directly applied to the skin and are usually the first option for mild to moderate psoriasis. These include corticosteroids, which are anti-inflammatory creams that reduce redness and swelling. They are effective but should be used sparingly, as overuse can thin the skin.

Vitamin D analogues, such as calcipotriol, help slow down the excessive growth of skin cells. Other options include salicylic acid, which helps remove scales, and coal tar, a traditional remedy that reduces itching and inflammation. Many of these are available by prescription, while milder forms can be bought over the counter.

Can light therapy help?

Light therapy, also known as phototherapy, involves exposing the skin to controlled doses of ultraviolet (UV) light. This can slow down the rapid skin cell turnover seen in psoriasis. There are different types of phototherapy, including UVB light and PUVA (a combination of a drug called psoralen with UVA light).

This treatment is usually conducted in a clinical setting and is most suitable for people with moderate to severe psoriasis. It requires consistency, often involving multiple sessions each week, but it can be highly effective in reducing symptoms.

Are oral or injectable treatments an option?

For severe cases of psoriasis that do not respond to topical or light therapy, systemic treatments may be recommended. These include oral medications such as methotrexate, which suppresses the immune system, or acitretin, a vitamin A derivative that helps regulate skin growth.

Biologic drugs, administered via injection or infusion, target specific parts of the immune system responsible for psoriasis. Examples include adalimumab and etanercept. These are generally reserved for individuals with extensive disease or those who have not responded to other treatments.

Each treatment comes with its potential benefits and side effects, and your healthcare provider will work closely with you to determine the most suitable approach. By combining medical treatments with a healthy lifestyle, many people with psoriasis are able to effectively manage their symptoms and lead fulfilling lives.