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Psoriasis Treatment

What is psoriasis? 

Psoriasis is a very common skin condition and is perfectly normal and not life threatening in the majority of cases. Psoriasis is typically characterized by papules and silvery scales across the arms, joints, neck, face, scalp and other spots. Occasionally, other presentations of psoriasis will occur like red splotches or white flakes. Typically, the skin condition varies in severity by breaking out, then subsiding and then repeating this pattern. 

Risk Factors and Symptoms of Psoriasis.  

Psoriasis can often be caused by underlying diseases including the following: 

Symptoms of psoriasis are easy to spot although they may fluctuate in severity. Depending on an individual’s health condition, environment and skin care practices, signs and symptoms may vary greatly. Some of the most common occurrences of psoriasis are as follows: 

  • Raised, red patches on skin
  • Silvery, itchy skin patches on skin
  • Dry skin that cracks and bleeds
  • Painful, swollen joints
  • Itching, burning sensation around skin patches
  • Gray scales on purple or brown patches

Types of Psoriasis. 

This noncontagious, chronic skin condition presents in different forms depending on the individual. Each type of psoriasis is characterized either by location or visual appearance. 

  • Plaque psoriasis. The most common form, plaque psoriasis causes dry, raised red to purple scaly patches that can occur anywhere on the body. The most common areas for plaque psoriasis to occur are the elbows, knees, back and scalp. 
  • Guttate psoriasis. Guttate psoriasis is characterized by small, pink-colored dots that usually appear after an infection. Typically, one may experience guttate psoriasis after a case of strep throat, and it usually subsides on its own. 
  • Pustular psoriasis. Small, pus-filled yellow blisters characterize this type of skin condition. It’s one of the rarer forms of psoriasis and sometimes crops up after reddening of the skin. The pustular bumps look similarly to white heads. 
  • Inverse psoriasis. Found in the folds of the skin, inverse psoriasis does not have scales but appears like red, smooth patches. Typically, inverse psoriasis exists in the folds of the breasts, armpits, buttocks or abdomen.  
  • Erythrodermic psoriasis. A very rare form of psoriasis and the only one that can be life threatening, erythrodermic psoriasis usually covers most of the body and is red, inflamed and causes burning or itching sensations. 

Treatments for Psoriasis and Prevention Tactics. 

Psoriasis is not curable, however, it is very manageable with treatment. Treatment for psoriasis is non-invasive in most cases and usually includes topical, oral medication or alternative therapies. Individuals experiencing psoriasis may try one or many of the following psoriasis treatments: 

Topical treatments. 

  • Topical corticosteroids. A steroid-based cream needs to be prescribed by a doctor but can help quell current breakouts. Topical corticosteroids can come in other forms like shampoos and sprays, depending on where a psoriasis outbreak occurs. With prolonged use, corticosteroids can thin the skin or may become less effective. 
  • Topical retinoids. Similarly, topical retinoids like Tazorac or Avage are applied once or twice daily to minimize the breakout and prevent further rashes. These can cause light sensitivity, skin itching and skin burning. 
  • Anthralin. Made from tar, this paste is applied to trouble areas and left on for short periods of time. It slows skin cell growth and makes skin appear and feel smoother. It is irritating to some skin and shouldn’t be used on the face or genitals.  
  • Vitamin D analogues. Calcipotriene and calcitriol – synthetic forms of vitamin D – also slow skin cell growth. This option may be pricier than topical corticosteroids and used as a backup plan if other methods fail. 
  • Salicylic Acid. Frequently used in skincare routines to quell breakouts because it has a smaller molecular size. When used for psoriasis treatment, it can be utilized in shampoos or face washes to increase the efficacy of other products. 
  • Soothing moisturizers. Oatmeal lotions, calamine and chamomile creams are tremendously helpful at soothing irritation caused by psoriasis. The redness, itching and burning that occur can work to increase the spread and visibility by causing pain and discomfort. While a soothing moisturizer is treating the symptom of psoriasis – the rash – this can be extremely effective at reducing stress, anxiety and pain related to this skin disorder. 

Alternative Therapies for psoriasis

  • Light therapy. Utilizing sunlight in small, safe doses has been proven to effectively lower the chance of psoriasis outbreak. Consult with a dermatologist first before pursuing this route of alternative treatment as the sun can also cause skin damage, burns and cancer. Additionally, UVB broadband and UVB narrowband light therapies use controlled doses of light from a synthetic source to target patches of psoriasis. 
  • Stress management practices, like meditation. Psoriasis outbreaks have a direct link to mental health. Elevated levels of stress and anxiety may cause outbreaks to worsen or become more frequent. Implementing stress management practices including meditation, breathwork or exercise can help mitigate risk of outbreaks. 
  • Talk therapy or counseling to deal with stress, anxiety, or depression. Again, because psoriasis can easily be triggered by one’s mental state, participating in therapy can help tremendously. 
  • Diet modifications. Some food allergies or intolerances can worsen psoriasis. Avoid drinking and smoking as these are irritants to the stomach, throat and skin. Take vitamin supplements like fish oil to provide additional nourishment to the skin. 
  • Aromatherapy. Diffuse calming essential oils throughout the day in your home or office to create a relaxing, calm environment. 

Oral medication. 

  • Methotrexate. This is an intense treatment that must be prescribed and supervised by a doctor. Taken once a week in a single pill dosage, methotrexate can reduce skin cell growth and stop inflammation. However, long term usage of this oral prescription requires blood testing and is not safe for men or women attempting to conceive. 
  • Cyclosporine. This drug suppresses the immune system in an attempt to stop severe forms of psoriasis. It does leave the patient more susceptible to infection and illness. Cyclosporine may only be taken for one year, requires blood tests and can cause harm to the kidney and liver. 
  • Biologics. Administered through injection, biologics refer to a host of drugs that alter the body’s immune system in hopes of disrupting the psoriasis cycle. Some common examples are Humira, Stelara and Taltz. These drugs aren’t always covered by insurance and come with large price tags. 
  • Retinoids. Oral retinoids may be taken in lieu of topical retinoids. They also work to slow skin cell production but are not safe for women who are pregnant or breastfeeding. 

Psoriasis usually needs a variety of treatments to manage the skin condition. One can hope for total elimination of the rash, however, outbreaks throughout life are bound to happen as the disorder is not curable. 

How to prevent psoriasis 

Preventing psoriasis outbreaks is just as important as managing them when they do occur. Depending on the root cause of your psoriasis, prevention tactics can vary. These may include: 

  • Getting plenty of sleep.
  • Staying hydrated and avoiding alcohol, sugary beverages and milk products that can cause subtle allergic reactions in many people. 
  • Exercise as a way to decrease stress and boost mood. 
  • Using gentle skin care products. 
  • Taking mild showers or baths, avoiding hot water. 
  • Wearing natural fabrics that don’t irritate the skin and allow for moisture wicking. 

Living with Psoriasis. 

A lot of adults live with psoriasis and you wouldn’t even know it. Living with psoriasis doesn’t have to be inconvenient or uncomfortable. By establishing a care plan with a trusted dermatologist, patients with psoriasis can manage the disorder and find relief. Additionally, having a team of doctors, including mental health experts, can help you work through root causes of psoriasis, like allergies, autoimmune conditions, and stress. 

UCF Health offers ample resources for you to take control of your psoriasis condition and find relief. Use our patient portal to find an Orlando dermatologist, stay informed with COVID-19 updates for patients and find tips to help you lead an active lifestyle. Don’t wait any longer to treat your chronic skin condition – schedule online today with a trusted dermatologist or primary care doctor.