Large menu of treatments for psoriasis

By Paul G. Donohue, M.D. and Keith Roach, M.D.

October 06, 2012 12:00 AM

DEAR DRS. DONOHUE AND ROACH: Please give me new medicine information for psoriasis. I break out on my scalp very bad, and also on my face, back, chest and arms. It's slowly getting worse. Sometimes my skin is very itchy.

M.T.

Psoriasis is another illness you can blame the immune system for. It sends signals to the skin that prompt the lowest layer of cells to rise to the surface so quickly that they lack the maturity to protect the underlying layers of skin cells. Red patches covered with silvery scales result. Often, psoriatic patches itch. The scalp, elbows, knees and back are targets of psoriasis. The nails can develop pits that look like they're the result of a very slender ice pick.

The choice of medicine rests on where the patches are, how severe the outbreak is and the type of psoriasis a person has. Topical medicines are chosen to treat moderate to mild outbreaks. "Topical" indicates that the medicine is applied directly to the skin. Dovonex (a synthetic version of vitamin D) and Vectical ointment are two widely used topicals.

Stronger medicines belong to the cortisone family. Temovate and Diprolene are two examples.

Methotrexate and cyclosporine are two oral medicines that correct the immune system's excesses.

The newest psoriasis treatments are biological agents designed to rein in the wayward immune system. Their names include Enbrel, Remicade, Humira, Amevive and Stelara. They're administered in the doctor's office.

This information isn't of much use to you. All the above medicines require a prescription. Your best bet for conquering psoriasis is putting yourself in the care of a dermatologist, who can choose for you the medicines that will give you the best chance of controlling this often distressing skin illness.

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Large menu of treatments for psoriasis