The treatment of psoriasis depends on the severity of the psoriasis. Think of the treatment of psoriasis as a flight of stairs. Each step represents a treatment of greater potency, but with more potential side effects. The treatment of psoriasis always starts at the bottom step, i.e. the least potent treatment with the least potential side effects. If the treatment at this level does not work, the treatment can progress to the next level. This stepwise approach allows for control of the psoriasis with the least potent and safest medication possible.
The treatment levels for psoriasis are as follows:
- Moisturisers containing Urea or Salicylic Acid. Moisturisers help to remove the white scaling of psoriasis lesions.
- Sun exposure. Sun exposure should not be overdone, because a sun burn can also worsen psoriasis. The time spent in the sun should be just enough to feel you have been in the sun the day before.
- Rest and relaxation
- Diluted corticosteroid creams. Corticosteroid creams suppress the redness and inflammation of psoriasis lesions.
- Undiluted corticosteroid creams, corticosteroid ointments, corticosteroid lotions and corticosteroid shampoos. The most reliably effective ointment is Dovobet™ ointment. Dovobet™ is actually a combination of a topical corticosteroid and a Vitamin D derived ingredient.
- Vitamin D derived creams like Calcipotriol (Dovonex™)
- Vitamin A derived creams like Tazarotene (Zorac™)
- Anthralin or Dithranol containing ointments Level one to four treatments are often used in combination and additively. So, if you progress to a level 4 treatment it is very likely that you will be using all the treatments from level one to four.
- Ultraviolet light therapy. Narrow band Ultraviolet B treatment is the most effective of the ultraviolet treatment options. Ultraviolet treatments can be combined with level 1-4 treatments, but corticosteroid medications should be gradually stopped during Ultraviolet treatment.
- Methotrexate tablets
- Acitretin containing tablets, like Neotigason™. Acitretin is derived from Vitamin A and is especially useful in Pustular Psoriasis
- Cyclosporin tablets (Sandimmun Neoral™)
- Various injections. These medications are also known as the Biologic Response Modifiers