Psoriasis is a common skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. It usually develops in pre-teens or up to middle age. Patients often suffer with this unnecessarily in the long term. It is not infectious and most people are affected only in small patches on their body.
It is a chronic (long-lasting) disease that affects different people in different ways – from minor irritation to severe impact. Like so many skin diseases, it can come and go. However, with good Dermatology care, psoriasis can usually be effectively controlled, minimizing the embarrassment associated with red patches on your skin or severe dandruff.
Psoriasis has a wide range of treatments from creams and ointments to systemic medication, depending on the severity. Treatments are tailored to patients’ needs, which can alter at different times of life. Mild to moderate psoriasis is frequently treated with creams applied to the affected area. This may not be effective by itself, and if so we will discuss alternatives with you if required.
Phototherapy is often highly effective in improving psoriasis. The range of light therapies includes PUVA, Narrow band UVB and the Eximer laser. These treatments can all be prescribed under the care of Skin Care Network Dermatologists. They provide effective treatment for many people living with psoriasis.
PUVA involves taking a medication (Psoralen) one hour prior to the procedure. This sensitizes you to the Ultra Violet A light. This treatment is done two or three times a week for a period of six to eight weeks. Other treatments include narrowband UVB, which involves a similar schedule of treatment by ultra violet light, two or three times a week for six weeks. With UVB, no additional medication is usually required; the treatment is a bit like a sunbed treatment. All forms of phototherapy will increase the risk of skin cancer in the long term, but this risk is low and roughly equivalent to a two week summer holiday in Spain!
The Eximer laser treatments provide a localised high dose UVB. However, psoriasis cannot always be adequately controlled topically, and it is also associated with other problems such as psoriatic arthritis or nail disease involvement. So medicine taken internally (systemic) is often needed to treat moderate to severe psoriasis. While effective, some of these medications can only be used for a limited time and may be combined and rotated to minimize side effects and toxicity.
A real revolution in the treatment of psoriasis has been biologic medication. These are drugs made from artificial human antibodies or animal proteins, specifically designed to block the disease process in psoriasis. Biologics have been used in other human diseases for many years.
The breakthrough has been in their application to psoriasis and psoriatic arthritis. They are designed to block the pathway of the immune system.
Biologics have produced real benefits in the long term treatment of severe psoriasis leading to prolonged clearance and control of the condition.