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You know all about psoriasis. Now you need to know which treatment is best for you to reduce the effects of this disease.

Let’s see then which treatments are the most common.

How is psoriasis treated?

Initially, psoriasis is treated with creams, gels or lotions. That is, with topical treatments on the skin. If this is not enough, we use oral, intravenous or subcutaneous treatments, which we call systemic.

1. Topical treatments

They are anti-inflammatory, since the main cause of the disease is inflammation.

The most commonly used are corticosteroids of different potency combined or not with vitamin D derivatives. The different excipients and potency of corticosteroids depend on the thickness of the skin, the location and the thickness of the psoriasis plaque.

• Ointments: these are more greasy and are generally used on thick skin areas such as the palms of the hands, soles of the feet, knees or elbows. They take longer to absorb but are more effective. They are more difficult to spread and may stain clothing.
• Creams have a better texture and are more easily absorbed.
• The solutions or lotions are very convenient to apply on the scalp or hairy areas, mainly on the extremities in males.

2. Phototherapy

Phototherapy is the treatment of various skin diseases using ultraviolet (UV) radiation. The most commonly used phototherapy for psoriasis today is UVB narrow band type because it is the safest due to its narrow spectrum. On many occasions the use of phototherapy allows us to avoid or withdraw other systemic drugs necessary for the control of cutaneous psoriasis. Learn more about phototherapy.

3. Systemic drugs

If the disease does not improve with topical treatments, the dermatologist may prescribe systemic drugs.

Classical systemic drugs have an immunosuppressive effect and slow down the autoimmune response, rapidly improving the disease. Because of their side effects, they are often used on an alternating or rotating basis, i.e., switching between them every six months or every year. Of course, its use is not recommended for pregnant women.

When classical systemic treatments are not effective or produce side effects, the second line of systemic treatment is used: biologic drugs. These are human-like proteins produced by molecular biology techniques. They act by blocking the inflammation that causes the disease. There are two main groups: tumor necrosis factor alpha inhibitors (anti-TNFa) and those that act against interleukins 12 and 23 (inflammation-mediating molecules produced by lymphocytes).

Since these drugs alter the body’s immune response, it is necessary to rule out existing infections in the patient before starting to use them, as well as to periodically check that liver and kidney functions are still preserved during their use. Because biologic treatments act on the whole organism, all comorbidities associated with the cutaneous manifestations of psoriasis improve.

There is no perfect treatment. There are unique patients with different needs. The dermatologist will propose the best individualized solutions for each person and their psoriasis problems at each evolutionary stage of the disease.

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