Treatment of Psoriasis
A) a topical therapy where the drug is used on the skin
B) light therapy.
A. Topical therapy
No drug is best for all people and the combinations are to be varied. The components those are used for topical treatment are corticosteroids, vitamin D-3 derivatives, coal tar, anthralin, or retinoids. Keratolytics is another substance used for breaking down scales may be added. Addition of salicylic acid inactivates vitamin D-3 and anthralin (tree bark extract) require addition of salicylic acid to work effectively. Corticosteroids suppress the immune system that causes inflammation with the activation of T cells and is effective for some time. Long-term use causes thinning of the skin. It may suppress the disease but cannot eliminate it, and long term use also make the disease resistant to it. It also leaves the stretch marks on the skin. It should be used with doctor’s advice. Calciportriol/Calcipotriene is used for control of the speed of the turnover of the skin cells and sometimes with corticosteroids to reduce irritation (it should b noted that the two are normally not mixed). It is a cream and solution. Excessive use can cause facial psoriasis. Hands should be washed thoroughly after use and calcium level has to be tested at times in the blood.
Retinoid tazarotene is hazardous to pregnant women. It is a synthetic form of Vitamin A and causes less irritation but the skin folds. Coal tar can be used as a shampoo. Normally less effective so has to be combined with ultra violet B for maximum effect. Daily 15-20 minutes application of Anthralin ointment reduces skin inflammation. Has to be washed off after 20 minutes to escape irritation. Salicylic acid is used to prevent scaling off of skin. The foam of Clobetasol propionate ointment/gel/cream/solution/foam can be used for 14 days for effectiveness. Bath solutions with coal tar, oiled oatmeal, dead sea salts can be produced to moisturize the skin.
B) Light therapy
Ultraviolet light can be used to treat psoriasis. It suppresses the process leading to inflammation. Ultraviolet B (UVB) phototherapy is used to treat Psoriasis that has become resistant to topical treatment. Psoralen and ultrviolet A phototherapy (PUVA) system is used when there is 10% aggravation of skin and it easily penetrates the skin. Eyes must be protected and care must be taken to be protected from sunburns. Light therapy can be combined with retinoids for better results.
To treat subborn Psoriasis X-ray raiation can be given.
