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Drugs and Treatments of Psoriasis

Physicians, after a thorough check up of the patient will determine the type of severity of psoriasis as well as the areas of the skin affected.

Commonly, the treatment starts using the mildest topical creams, oral medicines and light therapy. The doctor then decides later if the patient needs stronger medications depending on the reaction and response of the skin disease to prior mild treatments.

Topical preparations:

  • Anthralin – (Dritho-Scalp or Psoriatec) is a cream preparation which is known to normalize skin cells’ DNA activities therefore reducing skin inflammation. It is also very effective in removing patches, flakes resulting to smoother skin. However, it stains everything it gets in contact with like the skin, clothing and bedding. Due to this fact, physicians advise patients to allow the cream to stay on the skin for a specific amount of time and should be washed off after.
  • Calcineurin inhibitors – This type of preparation is not prescribed for long-term treatment because of possibilities in resulting to skin cancer and lymphoma. It reduces skin inflammation and flake formation.
  • Coal tar – Coal tar is considered to be by far the oldest treatment for psoriasis. It is a by-product when coal is gasified to make coal gas or carbonized to make coke. It lessens itching, inflammation and scaling.
  • Moisturizers – This type of preparation will not promote healing but they do minimize skin itching due to psoriasis. It also hydrates the skin avoiding scaling and flaking.
  • Topical corticosteroids –are considered to be the most frequently prescribed preparation in addressing psoriasis issues. Corticosteroids are anti-inflammatory drugs which slow cell regeneration by suppressing immune system activities. This results to reduced skin inflammation while relieving itching at the same time.
  • Topical retinoids – Although famous for treating acne and sun-damaged skin, retinoids were actually first developed for treating psoriasis. It regulates and keeps in balance the DNA activity of skin cells.
  • Vitamin D analogues – This type of topical treatment is believed to reduce skin inflammation and helps in slowing down the skin cells’ reproduction process.

Oral Medicines:

  • Azathioprine – is an anti-inflammatory drug which helps in treating the severe type of psoriasis especially when other options fail. It is however not allowed to be taken for long since it may result to cancer and certain blood disorders. Intake of the drug may also result to vomiting, nausea, bruises and fatigue.
  • Cyclosporine – functions by decreasing the production of new skin cells therefore reducing the degree of inflammation. The side effects of this drug are infection, cancer, kidney problems, high blood pressure by its long term usage.
  • Hydroxyurea – less effective compared to cyclosporine and methotrexate but can be used in phototherapy treatments. Possible side effects are anemia and decreased white blood cell and platelet count. This drug is not prescribed for pregnant women or those who are planning to be pregnant.
  • Immunomodulator drugs - which are also referred to as biologics are not derived through chemical substances but are obtained from natural resources. Biologics are endorsed in treating cases of psoriasis in mild to moderate cases which act by blocking the reciprocal actions between the cells of the immune system. Biologics are the choice of treatment to people with the disease associated with psoriatic arthritis.

    Examples of immunomodulator drugs or biologics are:

    Amevive - alefacept
    Raptiva - efalizumab
    Enbrel - etanercept
    Remicade - infliximab

    These biologics are introduced to the body by intravenously, intramuscularly or subcutaneously.
  • Methotrexate - According to studies, methrotrexate has the capability to decrease skin cell production. This fact arrests further skin inflammation. People with psoriatic arthritis are also known to benefit from this drug as it decelerates the progress of pain caused by arthritis.

    Like some drugs, methotrexate is not usually prescribed in extended treatments of psoriasis as it results to side effects such as severe liver damange, decrease in the production of white blood cells and decreased platelet counts. However, when taken with 1 milligram of folic acid everyday may possibly minimize some side effects due to methotrexate intake.
  • Retinoids - For psoriasis patients who do not respond to other types of treatments, retinoids is the drug of choice. Retinoids which are associated to vitamin A can reduce skin cell production especially in cases of severe psoriasis. However, once the drug is terminated, the signs and symptoms of the disease continue. Retinoids are not prescribed to pregnant women as it may cause serious birth defects. To women who are planning to get pregnant, it is advised to stop taking in the medication atleast 3 years prior to pregnancy plans.

Light theraphy or phototherapy:

  • Combination light therapy - in this process, UV light is combined with other treatments, usually retinoids to improve the effectiveness of the light therapy. This is usually the choice of treatment when all other phototherapy treatments failed. Doctors mostly use the Goeckerman treatment together with this type of phototherapy by applying the UVB light treatment with coal tar. The combination of these two are said to be more effective since coal tar makes the skin more receptive to UVB light.
  • Excimer laser - is a choice of light therapy for mild to moderate cases of psoriasis as the treatment only involves the affected skin area making sure that the skin around the treated skin reamain unaffected and undamaged.

    In this process, a beam of untraviolet B (UVB) light which is more powerful than those used in other phototherapies is controlled and aimed at the psoriasis plaques to stop the scaling and inflammation of the skin. As a stronger UVB is used, this therapy needs fewer sessions compared to other light therapies.
  • Narrowband UVB therapy - is considered to be one of the latest treatmets of psoriasis. The procedure is usually done to the patient two to three times per week until the skin show signs of improvement. Weekly sessions are required until the skin has healed properly. To some patients, side effects of this phototherapy type are severe and longer-lasting burns.
  • Photochemotherapy - also known as psoralen plus ultraviolet A (PUVA). The process uses psoralen (a light-sensitizing preparation) before exposing the skin to ultraviolet A (UVA) light. Compared to treatments using UVB, UVA lights penetrates the skin deeper and is termed to be a more aggressive approach in treating psoriasis. It consistently improves the skin by undergoing three or more treatments per week. The number of weeks, however depends on how severe the case of psoriasis is.

    Short term side effects after being treated with photochemotheraphy include nausea, headache, itching and burning. Long term and extended treatments may result to cancer, worse, melanoma which is considered to be the most serious type of cancer these days.
  • UVB phototherapy - also called broadband UVB is a type of light therapy which improves mild to moderate psoriasis cases. Controlled amount of UVB light is introduced to the affected area stopping its further development.

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