There is no substitute for visiting a doctor or dermatologist for help in getting a diagnosis and receiving treatment advice for psoriasis. However, because there are a large number of treatments which are considered effective, some of which are quite simple and inexpensive, many individuals can also find success in treating their psoriasis on their own. How? By informing themselves about the variety of available treatments and then treating themselves through a careful trial-and-error approach. Though there is still no simple cure for all psoriasis, many can find relief and partial or even total clearing of their skin by exploring available treatment options.
In this section describing the treatment of psoriasis, we will briefly review only some of the more popular and effective treatments, some of which involve using prescription or over-the-counter drugs and others which are more natural. However, before describing these treatments lets briefly review what causes psoriasis.
Psoriasis is commonly understood to be a disorder of the immune system, and is called an auto-immune disorder. In psoriasis ones own immune system, and in particular, ones T-helper cells, mistakenly attacks ones own skin cells. Most psoriasis treatments focus on addressing this immune response, either by suppressing the immune system, by removing the source or a link of the immune response, or by treating the symptoms on the skin. Ok, now lets get on to a brief review of some of the more common treatments.
Biologics- Biologics are a new class of drugs for treating more severe cases of psoriasis, and include Amevive, Enbrel, Humira, Remicade, and now Stelara, among others. Amevive works by blocking the T-cell immune response, and Enbrel, Humira, and Remicade work by blocking another key factor in the immune response, which is called TNF-alpha. Stelara, the most recent to be approved, works by blocking the activation of some of the interleukin chains in the immune response. The biologics have given hope to many with moderate to severe psoriasis who were not previously helped by other treatments, however biologics also have a higher risk of sometimes serious side effects, such as infections. Other drawbacks are that the biologics usually have to be administered by injection or infusion, do not work for everybody, are very expensive, and the symptoms of psoriasis usually return after treatment ends.
Coal Tar- An old and common form of treatment used to control mild cases of psoriasis, coal toar is used in shampoos and creams. Though coal tar can reduce itching and inflammation for some people, it is only moderately effective, is messy, can irritate the skin and in high concentrations can be toxic and possibly carcinogenic.
Coconut Oil- Coconut oil has been receiving more attention recently as a treatment for psoriasis sufferers, both as a dietary supplement and as a skin ointment. Coconut oil contains high levels of lauric acid, which is known to help destroy candida in the intestinal tract, thereby healing one of the possible underlying causes of psoriasis. Coconut oil has also been shown to reduce inflammation, both when taken as a nutritional supplement or when applied to the skin.
Cyclosporin- Cyclosporin is an immunosuppressant and is effective at reducing psoriatic symptoms because it reduces and suppresses the immune system For the same reason, however, cyclosporin comes with a higher risk of side-effects and is usually only prescribed for more severe cases of psoriasis.
Diet Modification- Modifying ones diet can often be the most effective form of controlling psoriasis. Why? There is increasing evidence that byproducts from food may be the triggers for the immune response which causes psoriasis. Some researchers have proposed that leaky gut syndrome (also called intestinal hyperpermeability) may be responsible for the leaking of food-based agents from the intestinal tract into the bloodstream. Thus, diet modification may help by not only removing the food triggers from ones system, but also by helping to heal ones intestinal tract, perhaps by combatting an overgrowth of candida, which is one possible cause of leaky gut syndrome. Those that are serious about controlling their psoriasis and that want to do so with minimal cost and risk of side-effects from medications should explore the research available on controlling psoriasis through modifying ones diet. Some common food triggers include dairy products, highly acidic foods, fermented foods, alcohol, sugars, nuts, wheat, gluten, nightshades, and many others; however, it is important to recognize that different people may have different food triggers- one needs to experiment for oneself. Also, in addition to removing certain items, many have benefitted from adding other items to their diet, such as cocounut oil, fish oil and other omega 3s, folic acid, zinc, antioxidants, Vitamin D and probiotics.
Dithralin (Anthralin) Dithralin is a synthetic form of an extract from the bark of the South American araroba tree. It is often quite effective, and works by blocking cell proliferation. It often takes a while to start working and can stain and irritate the skin. Dovonex and other Vitamin D analogues- Dovonex, the brand name for calcipotriene, is the most well known and widely used form of the Vitamin D analogues which are used to treat psoriasis. Others are Vectical and tacalcitol. Dovonex is a synthetic form of Vitamin D3, and works by inhibiting skin cell growth and proliferation. Many people report good results with Dovonex, and the known side effects are minimal, however, it can take a number of weeks before seeing results and some people report minimal clearing. Recently, the Vitamin D analogues have also sometimes been formulated to include hydrocortisone.
Methotrexate- Like cyclosporin, methotrexate is a systemic medication with more potentially serious side effects, but which can also offer relief for more serious cases of psoriasis as well as severe cases of psoriatic arthritis. Methotrexate works by inhibiting cell growth, and was originally approved for use as a chemotherapeutic treatment for cancer. The most serious potential side-effect of taking methotrexate is liver damage, and its use must be monitored by medical professionals.
Moisturizers- There are many forms of moisturizers used to treat psoriasis, which are helpful because they not only can soothe the skin and reduce itching, but because they can also help remove the top layer of scales, allowing other agents to more easily reach and treat the underlying skin cells. Oatmeal baths, salicyclic acid, epsom salt baths, saltwater bathing, and a variety of oils are just a few of many moisturizing treatments. Some moisturizers, such as coconut oil and ocean or salt water, may also work by reducing inflammation as well as merely lifting scales and soothing skin.
Omega 3s (Fish Oil)- Dietary supplements such as fish oil containing Omega 3 fatty acids have been shown to reduce inflammation and some studies and people report good results.
Phototherapy, Sunlight- There are a number of different forms of phototherapy used to control psoriasis, which work by reducing skin cell growth. Though often effective, with phototherapy symptoms get worse before they get better, and the potential for overexposure brings with it a carcinogenic risk, hence the importance of medical oversight when choosing phototherapy.
Retinoids Topical retinoids such as Tazorac come in creams and gels, and are a synthetic form of Vitamin A. Tazorac is the brand name for Tazoratene, and is also used to treat acne. Skin irritation is one side-effect, and it often takes 2-12 weeks to see results.
Topical Corticosteroids- The most common form of treatment. Topical steroids such as hydrocortisone are used in a variety of forms and applied to the skin. They work by reducing the inflammatory reaction. Topical steroids will usually provide temporary relief and reduce inflammation, scaling and itching, however, they do not address the underlying source of the symptoms, and because of side effects are usually only recommended for temporary use.
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